Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients.

Kazuhiro Izawa,Yusuke Kasahara,Satoshi Watanabe,Koji Hiraki,Yasuyuki Hirano

doi:10.3390/diseases5040031

Abstract

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01) and with knee extensor muscle strength (r = −0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

Highlights

With regard to muscle proteolysis in cardiac surgery patients, a recent study suggested that muscle proteolysis due to postoperative hypercatabolism is responsible for the functional decline that is observed in patients undergoing cardiac surgery [8]
In regard to patient-reported outcomes of cardiac rehabilitation (CR), we previously reported that upper- and lower-body self-efficacy for physical activity and physical component summary and mental component summary scores, as assessed by Short Form-36 in cardiac surgery patients were lower than those of patients undergoing percutaneous coronary intervention (PCI) performed for acute myocardial infarction one month after the onset of infarction or after cardiac surgery [7]
This study attempted to examine the relation between the DASH score and physiological outcomes of muscle strength after cardiac surgery

Summary

Introduction

CR [3,7] Both handgrip strength and knee extensor muscle strength in such patients were lower than those in patients who underwent percutaneous coronary intervention (PCI) performed one month after the onset of acute myocardial infarction or after cardiac surgery [7]. In regard to patient-reported outcomes of CR, we previously reported that upper- and lower-body self-efficacy for physical activity and physical component summary and mental component summary scores, as assessed by Short Form-36 in cardiac surgery patients were lower than those of patients undergoing PCI performed for acute myocardial infarction one month after the onset of infarction or after cardiac surgery [7]. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Respective handgrip strength, knee extensor muscle strength, and DASH score were

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