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A descriptive study on wrist and hand sensori-motor impairment and function following distal radius fracture intervention

Published:April 29, 2013DOI:https://doi.org/10.1016/j.jht.2013.03.004

      Abstract

      Study design

      Descriptive cross-sectional design.

      Introduction

      Wrist and hand sensori-motor impairment have been observed after distal radius fracture (DRF) treatment. This impairment and its relationship to function lack research.

      Purpose of the study

      The primary aim of this exploratory study was to determine the magnitude of wrist and hand sensori-motor impairment following surgical and non-surgical treatment among older patients following DRF. Secondary aims were to determine the relationship between wrist and hand sensori-motor impairment with function and pain as well as the relationships among wrist and hand sensori-motor impairment and function and age following DRF.

      Methods

      Ten Test (TT), active joint position sense (JPS), electromyography (EMG), computerized hand-grip dynamometer (CHD), and the Patient-Rated Wrist Evaluation (PRWE) were used to assess twenty-four female participants 8 weeks following DRF treatment and their 24 matched-control healthy counterparts on wrist and hand sensibility, proprioception, muscle recruitment, grip force, muscle fatigue, and functional status.

      Results

      Participants following DRF demonstrated significantly (p < .05) greater sensory (i.e., JPS, TT), and motor (i.e., EMG, CHD) deficits than their control counterparts. A significantly higher functional deficit (i.e., PRWE) also existed among participants following DRF than the control group. Participants following surgical and non-surgical DRF treatment were found to be statistically different only on total grip force. Group differences on JPS and total grip force revealed the strongest effect size with the highest correlations to PRWE. EMG and muscle fatigue ratio group differences revealed a weaker effect size with a fair degree of correlation to PRWE. Pain significantly correlated with sensori-motor function. Age did not correlate with any measured variable.

      Conclusions

      Significant wrist and hand sensori-motor impairment and functional deficits among older females 8 weeks following DRF surgical and non-surgical interventions were revealed. JPS and total grip force were the most clinically meaningful tests for assessing the sensori-motor status as well as explaining functional disability and pain levels for these patients.

      Level of evidence

      2c.

      Keywords

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      JHT Read for Credit

      Quiz: #279

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
      • #1.
        The primary aim of the study was to determine the
        • a.
          magnitude of wrist and hand sensori-motor impairment following surgical treatment among young male patients 4 weeks following DRF
        • b.
          magnitude of wrist and hand sensori-motor impairment following surgical and non-surgical treatment among older male and female patients 8 weeks following DRF
        • c.
          relationship between wrist and hand sensori-motor impairment with function
        • d.
          magnitude of wrist and hand sensori-motor impairment following surgical and non-surgical treatment among older female patients 8 weeks following DRF
      • #2.
        The secondary aims of the study consisted of all of the following except to determine the relationship between
        • a.
          between wrist and hand sensori-motor impairment with function
        • b.
          wrist and hand sensori-motor impairment with fracture severity
        • c.
          wrist and hand sensori-motor impairment with pain
        • d.
          wrist and hand sensori-motor impairment with age
      • #3.
        The active wrist JPS test was utilized in the study to assess
        • a.
          conscious wrist proprioception
        • b.
          unconscious wrist proprioception
        • c.
          both conscious and unconscious wrist proprioception
        • d.
          wrist and hand motor impairment
      • #4.
        The outcomes of this study revealed
        • a.
          not-significant wrist and hand sensori-motor impairment and functional deficits among older females 8 weeks following DRF interventions
        • b.
          significant wrist and hand sensori-motor impairment and functional deficits among older females 8 weeks following DRF interventions
        • c.
          pain was not an influential factor on wrist and hand sensori-motor function
        • d.
          age was a clinically meaningful variable for wrist and hand sensori-motor function
      • #5.
        The most clinically useful tests for assessing the sensori-motor status for older female patients following DRF are:
        • a.
          EMG and fatigue ratios
        • b.
          JPS test and total grip force
        • c.
          Ten-test and JPS test
        • d.
          PRWE and EMG
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.