Bilateral sensory and motor as well as cognitive differences between persons with and without musculoskeletal disorders of the wrist and hand (original) (raw)
Related papers
Impact of impaired wrist motion on hand and upper-extremity performance1
Journal of Hand Surgery-american Volume, 2003
Purpose: To quantify and compare the disabilities caused by reduced and absent wrist motion using objective measurements of task performance and perceived disability, and to assess the compensatory motions of the shoulder, elbow, forearm, and trunk caused by impaired wrist motion. Methods: A clinical study of 21 normal subjects was done to measure physical performance and to assess wrist function under conditions of reduced (30°flexion and 30°extension) and nearly absent wrist motion using established physical tests and questionnaires (Disabilities of the Arm, Shoulder, and Hand [DASH], Patient Rated Wrist Evaluation [PRWE], and a study-specific survey). The clinical study also measured compensatory motions of the shoulder, elbow, forearm, and trunk. Results: Average times to perform the Jebsen test and activities of daily living (ADLs) test increased for both motion-restricted conditions of the wrist but did not differ significantly between the conditions. Questionnaire scores regarding function were significantly worse for both motionrestricted conditions and poorest for nearly absent motion. Average compensatory motions in the extremity and trunk statistically increased for both motion-restricted conditions but were not marked and did not differ between the conditions. High variability among subjects occurred in all physical tests and questionnaires for both motion-restricted conditions. Conclusions: Perceived disability from reduced wrist motion appeared greater than measured functional loss using common physical tests and outcome surveys. (J Hand Surg 2003;28A: 898 -903.
Impact of Impaired Wrist Motion on Hand and Upper-Extremity Performance
Purpose: To quantify and compare the disabilities caused by reduced and absent wrist motion using objective measurements of task performance and perceived disability, and to assess the compensatory motions of the shoulder, elbow, forearm, and trunk caused by impaired wrist motion. Methods: A clinical study of 21 normal subjects was done to measure physical performance and to assess wrist function under conditions of reduced (30° flexion and 30° extension) and nearly absent wrist motion using established physical tests and questionnaires (Disabilities of the Arm, Shoulder, and Hand [DASH], Patient Rated Wrist Evaluation [PRWE], and a study-specific survey). The clinical study also measured compensatory motions of the shoulder, elbow, forearm, and trunk. Results: Average times to perform the Jebsen test and activities of daily living (ADLs) test increased for both motion-restricted conditions of the wrist but did not differ significantly between the conditions. Questionnaire scores regarding function were significantly worse for both motion-restricted conditions and poorest for nearly absent motion. Average compensatory motions in the extremity and trunk statistically increased for both motion-restricted conditions but were not marked and did not differ between the conditions. High variability among subjects occurred in all physical tests and questionnaires for both motion-restricted conditions. Conclusions: Perceived disability from reduced wrist motion appeared greater than measured functional loss using common physical tests and outcome surveys. (J Hand Surg 2003;28A: 898 –903.
Journal of Hand Therapy, 2007
The objective of this study was to explore whether the items from a specific outcome measure, that is, Disabilities of the Arm, Shoulder, and Hand (DASH), for quantifying limb symptoms and functions in musculoskeletal disorders fit into the framework of the International Classification of Functioning, Disability and Health (ICF). All DASH items were compared to the ICF according to eight linking rules. Two groups of researchers performed the linking independently, and the results were compared by correlation. The 30 DASH items and four items from the optional modules were linked to 63 ICF categories and 11 chapters: 15 categories belong to the ICF body functions component and 48 to the activities and participation component. There were no items coded under the components body structure or environmental factors. Kappa index showed an agreement of 0.73 (p , 0.001). The results showed that the content of the DASH does link well with the ICF framework. Clinicians and researchers must attend to the fact that certain domains and categories from the ICF are not covered by the DASH. Limitations of the instrument may be overcome by simultaneously using other instruments that address the intended content.
Psychometric Differences in Motor Functioning
2013
Clinical experience has shown that patients performing the Grooved Pegboard Test have difficulty maintaining the manualized right-to-left placement strategy with their left hand. This study sought to investigate possible differences in placement time on the Grooved Pegboard task between participants using the standardized left hand approach and a reversed manualized left hand placement strategy (i.e., left-to-right). The participants included 63 male and female undergraduate volunteers between the ages of 18 and 25 years. All participants had no history of neurologic disease/trauma, or conditions that would affect motor functioning of the right and left upper extremities. Data were analyzed using a 3-way mixed-design ANOVA. Results revealed a significant main effects for gender (F(1, 59) = 5.215, p = .026) and handedness (F(1, 59) = 6.362, p = .014). Of primary interest was the main effect for placement direction, which was not significant, F(1, 59) = .120, p = .731. No significant interaction was observed (all p > .40). Recommendations for the use of this test in applied neuropsychological settings are offered.
Generic ABILHAND questionnaire can measure manual ability across a variety of motor impairments
International Journal of Rehabilitation Research, 2011
ABILHAND is, in its original version, a 46-item, 4-level questionnaire. It measures the difficulty perceived by patients with rheumatoid arthritis as they do various daily manual tasks. ABILHAND was originally built through Rasch analysis. In a later study, it was simplified to a generic 23-item, three-level questionnaire, showing both cross-cultural (Belgium vs. Italy) and cross-impairment (rheumatoid arthritis vs. stroke) validity. Later research returned to the development of impairment-specific versions, with modified item sets and levels. Each version has its own Rasch-derived item difficulty calibrations, which are required to extract the patient's measure from the individual string of responses, through computerized algorithms. All of these hamper the practical application of the scale in rehabilitation units, where patients with diverse conditions may share similar impairments and treatment approaches. In this study through Rasch analysis the 'generic' scale was applied to 126 chronic patients with different upper limb impairments, and to 24 healthy controls. It was supported that the generic questionnaire remains valid across a variety of motor impairments. To further facilitate clinical application, a normative cut-off ( > 79 of 100) is suggested. Rasch-based item calibrations are provided together with a software routine designed to calculate, on individual patients, linear 0-100 measures and error estimates from the raw scores.
Psychometric Features of the Patient Evaluation Measure in Iranian Individuals With Wrist Disorders
Iranian Rehabilitation Journal, 2023
Objectives: The patient evaluation measure (PEM) evaluates the hand health profile. Having an appropriate measurement tool for the assessment of hand outcomes in Iranian individuals with wrist disorders is essential for clinical and research settings. The objective of the present study was to examine the psychometric features of the PEM in Iranian individuals with wrist disorders. Methods: Ninety individuals with wrist disorders were recruited. Hand outcome was evaluated with the PEM, quick-disabilities of the arm, shoulder, and hand (Q-DASH), visual analogue scale-pain (VAS-P), and JAMAR hand-grip dynamometer. The PEM was translated into Persian. Face, content, and convergent validity was examined. Also, acceptability, internal consistency, test-retest reliability, and absolute reliability were calculated. Results: All questions had an item impact score and CVR score of >1.5 and >0.42, respectively. All questions except for question 1 (CVI=0.76) and 10 (CVI=0.73) of section B had a CVI score of <0.79. After changes were applied, the CVI score for these questions (question 1=0.83; question 10=0.87) reached acceptable criteria. The total score of the PEM showed a significant moderate correlation with Q-DASH (ρ=0.51; P<0.001) and VAS-P (ρ=0.55; P<0.001) and an insignificant weak correlation with grip strength (ρ=-0.11; P>0.05). Floor and ceiling effects were 0% for the total PEM score. The Cronbach’s α and intra-class correlation values were 0.72-0.87 and 0.96-0.98, respectively. Discussion: The present study suggests that the PEM has acceptable validity and reliability for measuring performance and satisfaction in individuals with wrist disorders. This measure might contribute as an outcome measure in research and routine assessments in clinical practice.
Rehabilitation Research and Practice, 2018
The Left Right Judgement Task (LRJT) involves determining if an image of the body part is of the left or right side. The LRJT has been utilized as part of rehabilitation treatment programs for persons with pain associated with musculoskeletal injuries and conditions. Although studies often attribute changes and improvement in LRJT performance to an altered body schema, imaging studies suggest that the LRJT implicates other cortical regions. We hypothesized that cognitive factors would be related to LRJT performance of hands and feet and that sensory, motor, and pain related factors would be related to LRJT in the affected hand of participants with wrist/hand pain. In an observational cross-sectional study, sixty-one participants with wrist/hand pain participated in a study assessing motor imagery ability, cognitive (Stroop test), sensory (Two-Point Orientation Discrimination, pressure pain thresholds), motor (grip strength, Purdue Pegboard Test), and pain related measures (West Haven Yale Multidimensional Pain Inventory) as well as disability (Disability of the Arm, Shoulder and Hand). Multiple linear regression found Stroop test time and motor imagery ability to be related to LRJT performance. Tactile acuity, motor performance, participation in general activities, and the taking of pain medications were predictors of LRJT accuracy in the affected hand. Participants who took pain medications performed poorly in both LRJT accuracy (p=0.001) and reaction time of the affected hand (p=0.009). These participants had poorer cognitive (p=0.013) and motor function (p=0.002), and higher pain severity scores (p=0.010). The results suggest that the LRJT is a complex mental task that involves cognitive, sensory, motor, and behavioural processes. Differences between persons with and without pain and improvement in LRJT performance may be attributed to any of these factors and should be considered in rehabilitation research and practice utilizing this task.