Abstract
BackgroundDistal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health.MethodsThis is a prospective cohort study of 790 individuals who were assessed at 1 week, 3 months, and 1 year post injury. The Patient Rated Wrist Evaluation (PRWE), The Wrist Outcome Measure (WOM), and the Medical Outcome Survey Short-Form (SF-36) were used to measure impairment, activity, participation, and health. Multiple regression was used to develop explanatory models of health outcome.ResultsRegression analysis showed that the PRWE explained between 13% (one week) and 33% (three months) of the SF-36 Physical Component Summary Scores with pain, activities and participation subscales showing dominant effects at different stages of recovery. PRWE scores were less related to Mental Component Summary Scores, 10% (three months) and 8% (one year). Wrist impairment scores were less powerful predictors of health status than the PRWE.ConclusionThe ICF is an informative model for examining distal radius fracture. Difficulty in the domains of activity and participation were able to explain a significant portion of physical health. Post-fracture rehabilitation and outcome assessments should extend beyond physical impairment to insure comprehensive treatment to individuals with distal radius fracture.
Highlights
Distal radius fractures are common injuries that have an increasing impact on health across the lifespan
The Patient Rated Wrist Evaluation (PRWE) specific activity subscale showed the most change over time, from 51.3 to 6.3
This study determined that the IFnitgeurnreati1onal Classification of Functioning (ICF) framework is supported when evaluating the impact of distal radius fracture on health because impairment, activity limitations and participation restrictions, individually and in combinations, were related to self-reported physical health status as measured on the SF-36
Summary
Distal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/ function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health. In 1980 the WHO [1] published a framework for classifying the consequences of disease This classification system included the domains of impairment, disability, and handicap where a linear relationship was thought to exist between domains. This framework emphasized the multifaceted nature of health and led to changes in the measurement of health outcomes, the evaluation of disability, and handicap [2]. With increased application of the model it became apparent that the relationship between the domains was not linear and other relevant contributions to health (e.g., environmental, socio-demographic, and psychological has been ignored).
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