Journal of hand therapy : official journal of the American Society of Hand Therapists
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The purpose of this study was to translate, adapt, and validate a Greek version of the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire. The English version of DASH was translated into Greek (DASH-GR) and cultural adaptation was performed. Subsequently, psychometric properties and validity were assessed in 106 consecutive eligible patients presenting with a variety of unilateral upper limb disorders. ⋯ The correlation coefficient between total scores of the initial assessment and reassessment was high (Pearson's r=0.918, p<0.0005) (Kentall tau-b=0.72, p<0.001). The correlation coefficient between the DASH-GR and SF-36 total scores was 0.625 (p<0.001), showing a strong correlation between the two questionnaires. The Greek version of the DASH retains the characteristics of the English original and is a reliable and valid instrument that can provide a standardized measure of patient-centered outcomes in Greek-speaking patients with unilateral disorders of the upper limb.
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In October 2002, two bombs exploded in Bali injuring hundreds, and killing 202 people. The purpose of this paper is to report the organization of the first response, rehabilitation strategies, and outcome of a series of patients evacuated to the Royal Perth Hospital (RPH), a civilian hospital in Australia. The initial medical response in Bali was primarily conducted by holidaying health professionals supporting the hospital on the island. ⋯ Self-rated physical recovery exceeded major burn population norms at 6 months postdischarge. Physical therapy outcome measures demonstrated upper limb recovery as usual in the Bali group, despite a mass casualty situation. To achieve this required support from the multidisciplinary team, in combination with community, government, and hospital administrative assistance.
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Current perception threshold (CPT) testing was used to quantitatively measure the sensory response to upper limb tension testing (ULTT). The study addressed the ability of ULTT to tension the intended nerve, and the influence of age on CPT. Normal subjects (n=59) performed a randomized series of CPT tests at 5 and 2,000 Hz in a resting position and in a median-nerve bias position using the Neurometer. ⋯ Age had a differential impact on CPT frequencies, suggesting differential impacts on nerve fibers, with a trend towards hypoesthesia at 2,000 Hz (r=0.10 to 0.30) and toward hyperesthesia at 5 Hz (r=-0.16 to -0.28). ULTT causes measurable effects in the sensory threshold of peripheral nerve, which are more pronounced with age; increased touch threshold and decreased pain thresholds can be expected. The specificity of nerve bias elicited by specific ULTT needs further exploration.
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With increasing economic globalization, including health care, it is important to use standardized outcome measures applicable to a broad spectrum of patients in a wide array of countries. The purpose of this study was to verify construct and content validity and reliability of the Chinese version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong version). The PRWE was translated into Chinese, and face validity was established by inviting experts and patients to participate in the panel review of the questionnaire. ⋯ Internal consistency testing results suggested that item consistency within subset items was good and persisted over time. In conclusion, the Chinese version of the PRWE is a reliable and valid self-rated tool in measuring treatment outcome. It supplements traditional objective clinical measures and is potentially applicable in Hong Kong clinical settings.
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Review
Diagnosis and management of complex regional pain syndrome complicating upper extremity recovery.
Complex regional pain syndrome (CRPS) is a clinical syndrome of pain, autonomic dysfunction, trophic changes, and functional impairment. CRPS is common after hand trauma or surgery. Early diagnosis and intervention is critical for adequate recovery. ⋯ A large spectrum of pharmacologic interventions is efficacious in treating CRPS. Surgery may be used to relieve nociceptive foci. Patient-specific hand therapy is very important in reducing swelling, decreasing pain, and improving range of motion.