Pinch Strength Measurements Research Articles

Function in unaffected arms of children with obstetric brachial plexus palsy.

The objective is to compare the fine and gross motor function of unaffected arms of children with obstetric brachial plexus palsy (OBBP) with typically developing children's dominant upper extremities. Fifty-three patients with OBBP and fifty-one typically developing children between the age of 4 and 13 were included in the study. For gross motor function evaluation in the upper extremity box-block test (BBT), for fine motor skill nine-hole peg (9HP) test was used. For grasp and pinch strength measurements, a Jamar dynamometer is used. The patient group performed significantly worse in 9HP and BBT tests. When further divided into age groups, 4-8 age patient group performed significantly worse in 9HP and BBT tests, while there were no differences in children in the 9-13 age group. The fine and gross motor functions of the unaffected arms of children with OBPP are significantly worse in children between the ages of four and eight but this deficit improves with age, and possibly with ongoing therapy.

The impact of finger position on pinch strength

Introduction Pinch strength is a widely used measurement of hand function, but digit position on the pinch gauge has not been described in the literature. The aim of this study was to assess for differences in tip, lateral, and three-jaw-chuck pinch force when the digits are placed on the groove or bridge of a Bernadette and Linda pinch gauge. Methods Thirty-six healthy volunteers each pinched six times in random order: one for each type of pinch force with the digits placed in each position. Results There were no significant differences in pinch strength measurements based on digit position, except for three-jaw-chuck pinch which was slightly higher on the groove. Equivalence was found within one pound for tip and lateral pinch but not for three-jaw-chuck. Conclusion Variations in finger position may result in similar pinch strength measurements for tip and lateral pinch. Clinicians may reliably assess lateral and tip pinch using either position; however, standardized positioning is still recommended.

Does electrodiagnostic evidence correlate with mood and function in patients with a pre-diagnosis of carpal tunnel syndrome?

This study aims to investigate if function and mood involvement correlate in female patients who have a pre-diagnosis of carpal tunnel syndrome (CTS) and its correlation with physical examination and electrodiagnostic findings. A total of 170 patients between the ages of 18-65 who applied to Physical Medicine and Rehabilitation outpatient clinics with CTS symptoms between May 2014 and December 2015 were enrolled. The mean age of patients was 44.6±11 years. Before electrophysiological testing (electromyography; EMG), Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), Beck Depression Inventory, Tinnel, Phalen and Durkan tests, grip and pinch strength measurement by JAMAR hand dynamometer were performed. The patients also used a Visual Analog Scale (VAS) to determine the severity of their symptoms during the day and at night. In 98 patients (57.6%) the diagnosis of CTS was confirmed by EMG, while 72 patients (42.4%) had normal electrodiagnostic findings. In patients who had normal EMG, Beck Depression Inventory and QuickDASH scores were not significantly different from the patients who had an electrodiagnosis of CTS. Pain experienced in the night was significantly higher in patients who had an electrodiagnosis of CTS, and these patients had significantly higher Beck Depression Inventory and QuickDASH scores. The lack of electrodiagnostic evidence in patients who have CTS symptoms does not show that function and mood are not affected in these patients. However, mood is significantly affected in patients with severe CTS.

Comparison of two medial epicondylectomy techniques in cubital tunnel syndrome

This study aims to compare partial medial epicondylectomy (PMe) and distal medial epicondylectomy (DMe) techniques in terms of sensory and motor improvements, functional results and complications. The study included a total of 59 cubital tunnel syndrome patients (37 males, 22 females; mean age 42.3 years; range 23 to 80 years). Of the patients, DMe was applied on 30 and PMe was applied on 29. Patients were evaluated with Wilson Krout scores, Semmes-Weinstein Monofilament (SWM) test, and grip and pinch strength measurements preoperatively and at postoperative third, sixth, and 12th months. Both groups' pre- and postoperative intragroup and intergroup results were compared. Wilson Krout scores in postoperative checks were better with DMe compared to PMe. The improvement in SWM test scores was statistically significant for only DMe. The improvement in grip strength, lateral pinch and terminal pinch measurements in DMe group was significant at postoperative third month. In PMe group, significant improvement for these measurements was obtained at postoperative sixth month. The only complication observed with DMe was tenderness developing over the medial epicondyle. Painful subluxation of the nerve associated with paresthesia was detected in four patients in PMe group. Compared to PMe, DMe offers more satisfactory subjective results. Motor functional recovery occurs earlier with DMe. DMe appears to have lower complication rates.

Development and Evaluation of Tip Pinch Strength Measurement on a Paretic hand Rehabilitation Device

In this study, we described the development of a methodology to measure tip-pinch strength on the paretic hand rehabilitation device and aimed to investigate reliability of the device. FSR sensors were embedded on the device, and tip pinch strength was estimated with data collected from the sensors using a developed equation while participants were demonstrating tip pinch. Reliability tests included inter-rater, test-retest, and inter-instrument reliability. B&L Engineering pinch gauge was utilized for the comparison. Thirty-seven healthy students participated in the experiment. Both inter-rater and test-retest reliability were excellent as Intraclass Correlation Coefficients (ICCs) were greater than 0.9 (p<0.01). There were no statistically significant differences in tip-pinch strengths. Inter-instrument reliability analysis confirmed good correlation between the two instruments (r = 0.88, p < 0.01). The findings of this study suggest that the two instruments are not interchangeable. However, the tip-pinch mechanism used in the paretic hand rehabilitation device is reliable that can be used to evaluate tip pinch strength in clinical environment and can provides a parameter that monitors changes in the hand functions.

Moberg Picking-Up Test in patients with hand osteoarthritis

Study DesignClinical measurement. IntroductionThe Moberg Pick-up Test (MPUT) was previously used to evaluate functional performance in patients with hand inflammatory disease. This is the first study using the MPUT in hand osteoarthritis (OA). Purpose of the StudyCompare the functional performance (MPUT) in hand OA patients and healthy controls. MethodsFifty hand OA patients and 50 controls were assessed using the MPUT, AUSCAN and Cochin questionnaires, grip and pinch strength, pain using a visual analog scale and a Likert scale regarding difficulty to perform MPUT. ResultsIn the MPUT evaluation, the OA group presented a statistically significant difference from the control group. The OA group spent more time executing test. The grip and pinch strength measurements showed higher values for the control group. The OA group reported a greater difficulty than the control group in performing the test. ConclusionThe MPUT is a short and easy to apply test, which can be safely used to assess the functional performance of the hand OA. Level of EvidenceII.

Residual Grip and Pinch Strength Deficits After Completion of Hand Rehabilitation

Introduction: Grip and pinch strength are commonly used to document progress in the hand rehabilitation process and in return to work clinics. Grip strength measurement is widely studied; however, pinch strength measurements are not well documented. The majority of the studies on grip and pinch strength were conducted on healthy participants, and there is a dearth of studies on people with hand injuries. Patients who undergo hand rehabilitation have various diagnoses, and the type of diagnosis may affect the residual hand force deficits. Objectives: To examine whether there are residual hand force deficits after the completion of the rehabilitation process by comparing grip and pinch strength between the injured and uninjured hand, to explore whether the type of diagnosis affected these deficits, and to investigate whether there are gender, age, and dominancy differences in these deficits. Materials and Methods: Data were collected retrospectively from 234 participants (174 males and 60 females) with hand injury who were referred to the hand clinic for functional evaluation after completion of the rehabilitation process using the EVAL computerized system. Mean number of years after injury was 3.05 (standard deviation [SD], 2.78). Mean age was 39.2 (SD, 14.7) years. Outcome measures include the average grip strength (in kilograms) of 8 trials measured at the second handle position during the rapid exchange grip force test, and the average of 3 trials of lateral pinch, tripod pinch, and tip pinch (in kilograms). Both injured and uninjured hands were evaluated. The deficits in hand force were calculated using the formula: (Injured hand / Uninjured hand) × 100. The participants were divided into 5 groups according to the type of injury as follows: elbow and shoulder fractures, musculoskeletal disorders in the upper extremity, finger injury (limited active range of motion in the fingers due to fractures of the phalanges or tendon injury), wrist fractures, and nerve injuries (postrelease or repair surgery). The data were analyzed using the general linear model for repeated measures (SPSS). Results: There were significant differences in hand force between the injured and uninjured hands after completion of hand rehabilitation for all injury groups ( P &lt; .05). There were no significant differences in grip and pinch force deficit whether the dominant or nondominant hand was injured. Grip strength deficits ranged from 20% to 30%, whereas pinch strength deficits ranged from 40% to 50%. There were no significant differences in both grip and pinch strength between the 5 injury groups or between men and women. Conclusion: The significant differences in grip and pinch strength between the injured and uninjured hands indicated that there were residual deficits in hand force after completion of the rehabilitation process. Yet, mean grip strength in the injured hand was greater than 9 kg and mean pinch strength was greater than 2 kg, indicating that despite those deficits, hand force in these participants was considered functional. Furthermore, hand force deficits after completion of the rehabilitation process were not affected by gender or by the location and type of injury.

Arthrodesis for Primary Osteoarthritis of the Trapeziometacarpal Joint in Elderly Patients

To investigate the outcomes of trapeziometacarpal (TMC) joint arthrodesis for primary osteoarthritis in elderly patients in comparison with a younger cohort. We performed a retrospective study of outcomes following TMC joint arthrodesis between patients older than 65 years (elderly group) and patients younger than 55 years (younger group). Thirty-eight hands in 29 patients were included in this study. There were 19 hands in 16 elderly patients and 19 hands in 13 younger patients with average ages of 68 and 52 years, respectively. Postoperative follow-ups were 36 and 35 months, respectively. Patient-reported upper extremity disability was assessed using the Japanese Society for Surgery of theHand version of Disabilities of the Arm, Shoulder, and Hand (DASH). Clinical evaluation of impairment measures included measurement of key pinch strength, grip power, range of motion, and Kapandji score. In both groups, surgery was effective in relieving pain. The DASH score improved at the final follow-up in both groups. Improvements in the DASH score showed similar results in both groups. Preoperative key pinch strength was similar between the 2 groups. Although this improved for both groups, the younger group did have greater improvement. Grip strength also improved in both groups. The younger group had better pre- and postoperative grip strength; however, the extent of improvement was similar between the 2 groups. Postoperative range of motion and Kapandji scores were similar between the 2 groups. Outcomes of patients older than 65 years following TMC joint arthrodesis and those of patients younger than 55 years were similar except for improvement of key pinch strength. This procedure has a role in the surgical treatment of primary TMC joint osteoarthritis in the elderly as well as in younger patients. Therapeutic IV.

Investigation of grip and pinch strengths in Iranian adults and their correlated anthropometric and demographic factors.

Grip and pinch strength measurement is important for objective evaluation of the function of the upper extremities in upper limbs injuries treatment and also for ergonomists as a way of optimizing the requirements of hand tool design. The present study was conducted to investigate the correlation of anthropometric and demographic factors with hand strength as well as to develop regression models for grip and three types of pinch strengths including Tip, Key and Palmar in Iranian adult population. The study population consisted of 1008 Iranian adults aged 20 to 107 years. Participants were selected using a stratified random sampling method from crowded places of the cities with the highest number of Persian ethnic group. Strength measurements were undertaken according to recommendations by the American Society of Hand Therapists (ASHT). This study found a positive and significant correlation between all measured strengths and anthropometric factors. The regression equations of grip and pinch strengths were developed for dominant and non-dominant hands. The results of this study provided more information about correlated factors of grip and pinch strengths. The regression equations developed in this research are applicable to clinical treatment and ergonomics programs.

A Matched Comparative Study of the Bilhaut Procedure Versus Resection and Reconstruction for Treatment of Radial Polydactyly Types II and IV

To compare outcomes of the Bilhaut procedure with outcomes of conventional resection and reconstruction in radial polydactyly types II and IV. Patients treated with the Bilhaut procedure were radiologically matched with patients treated with reconstruction. Evaluated outcomes included the Rotterdam assessment system, pinch strength, and thumb size measurements. To determine objectively which aesthetic outcome scores truly depended on surgical technique rather than observer opinion, we analyzed evaluations by a panel of 22 individuals with varying clinical experience who were blinded to the study protocol, using a linear mixed regression model. The Bilhaut procedure reduced the risk of suboptimal outcome for metacarpophalangeal joint instability in type IV radial polydactyly. Conversely, the Bilhaut procedure increased the risk of suboptimal scar appearance, residual prominence at amputation site, thumb size, and nail appearance. Tip pinch strength was more significantly reduced after the Bilhaut compared with reconstruction, whereas pulp circumference and nail width exceeded 100% of the unaffected contralateral hand after the Bilhaut reconstruction. There was no significant difference in active range of motion between procedures. Nail appearance proved the only aesthetic drawback of the Bilhaut procedure after adjustment for clinical experience. There was superior metacarpophalangeal joint stability after the Bilhaut procedure for radial polydactyly type IV, but this did not result in the presumed benefit to thumb strength. For experienced surgeons, both procedures resulted in comparable thumb active range of motion. However, aesthetic results were more likely perceived as pleasing after conventional reconstruction, even after adjusting for observer experience with regard to nail appearance. Despite possible benefits of modified Bilhaut procedures that preserve the nail, conventional reconstruction is the preferred procedure until otherwise proven. Therapeutic III.

Dynamometry for the measurement of grip, pinch, and trunk muscles strength in subjects with subacute stroke: reliability and different number of trials.

ABSTRACTBackgroundMuscle strength is usually measured in individuals with stroke with Portable dynamometers (gold standard). However, no studies have investigated the reliability, the standard error of measurement (SEM) and the minimal detectable difference (MDD95%) of the dynamometry for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke.Objective1) To investigate the intra and inter-rater reliability, the SEM and the MDD95% of the portable dynamometers for the measurement of grip, pinch and trunk strength in subjects with subacute stroke, and 2) to verify whether the use of different number of trials (first trial and the average of the first two and three trials) affected the results.Method32 subjects with subacute stroke (time since stroke onset: 3.6 months, SD=0.66 months) were evaluated. Hand grip, 3 pinch grips (i.e. pulp-to-pulp/palmar/lateral) and 4 trunk muscles (i.e. flexors, extensors, lateral flexors and rotators) strength were bilaterally assessed (except trunk flexors/extensors) with portable dynamometry by two independent examiners over two sessions (1-2 weeks apart). One-way ANOVAs and intraclass correlation coefficients (ICC2,k) were used for analysis (α=0.05). SEM and MDD95% were also calculated.ResultsFor all muscular groups and sources of outcome values, including one trial, after familiarization, similar results were found (0.01≤F≤0.08; 0.92≤p≤0.99) with significant and adequate values of intra-rater (0.64≤ICC≤0.99; 0.23≤95%CI≤0.99) and inter-rater (0.66≤ICC≤0.99; 0.25≤95%CI≤0.99) reliability. SEM and MDD95% were considered low (0.39≤EPM≤2.21 Kg; 0.96≤MMD95%≤6.12 Kg) for all outcome scores.ConclusionOnly one trial, following familiarization, demonstrated adequate intra-rater and inter-rater reliability of the portable dynamometers for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke.

Treatment of Proximal Scaphoid Non-union by Resection of the Proximal Pole and Palmaris Longus Interposition Arthroplasty.

The purpose of this study was to determine the long-term clinical and radiographic outcome in a group of patients treated with resection of the proximal pole and tendon ball arthroplasty because of a scaphoid non-union. 15 patients affected by scaphoid non-union and treated with resection arthroplasty were studied at a mean follow-up of 9.1 years. The assessment included a visual analogue scale (VAS) to evaluate pain, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the measurement of grip and pinch strength. We also evaluated pre-operative and follow-up radiographs to determine the stage of SNAC wrist. We obtained a good subjective clinical result in 11 patients and a poor result in 4. Mean VAS and DASH score at follow-up was 1.2±1.2 and 12±12,1, respectively. Grip and key pinch strength in the surgically treated hand were 89% of the contralateral hand. There was significant increase in the SNAC stage at follow-up with respect to the preoperative evaluation in the operated wrist. Resection of the proximal pole and tendon ball arthroplasty provided long-term relief of pain and good functional results in most patients affected by scaphoid non-union. This technique did not affect the natural history of SNAC wrist with its clinical and functional consequences.

Proximal row carpectomy for Lichtman stage III Kienböck's disease.

The purpose of this study was to investigate the objective and subjective outcomes of proximal row carpectomy (PRC) for stage III Kienböck's disease and determine if the physician's objective measurements correlate with the patients' subjective outcomes. Twenty-four patients who underwent PRC for stage III Kienböck's disease with a follow-up period of more than 18 months were enrolled in the study. Clinical evaluation included preoperative and postoperative Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) questionnaire, postoperative Mayo wrist score, postoperative total joint range of motion (ROM), as well as grip and pinch strength measurements of the operated and normal side. Radiographic criteria such as carpal height ratio, subchondral cyst, and osteophyte formation were assessed during the follow-up period. Mean follow-up period was 41.7 months (range: 18-106 months). No wrists underwent total arthrodesis. Reflex sympathetic dystrophy was observed in 2 patients (8.3%). Postoperative ROM measurements, power grip, and pinch strength values significantly decreased in both stages (IIIA and IIIB) on the operated side compared to the normal side. In contrast, Q-DASH scores significantly increased in both stages compared to preoperative values. Average Mayo wrist score was 67.3 (range: 10-90). PRC is a well-tolerated procedure for stage III Kienböck's disease with certain complications. While subjective values improved significantly, there was no correlation between this improvement in subjective values and objective measurements. PRC was not able to restore motion postoperatively to that of the normal side, even though this feature did not affect postoperative subjective patient satisfaction.

AB1174-HPR Effects of Disease Activity on Hand Functions in Rheumatoid Arthritis

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease with exacerbation and remission periods. Patients tend to limit their physical activity levels further during the exacerbations in addition to already existing...

Factors affecting surgical results of Wassel type IV thumb duplications

The aim of this study is to review the outcomes of Wassel type IV thumb duplications with a minimum of one year follow-up, and to identify any factors that may compromise the quality of results. Forty one patients (42 thumbs) returned for assessment of thumb alignment, metacarpophalangeal joint and interphalangeal joint stability and motion; carpometacarpal joint motion; pinch and grip strengths; and thumb size. The subjective assessment considered thumb shape and contour, scarring, nail deformity and examiner and patient/parent satisfaction. The mean age at surgery was 16 months and the mean follow-up time was 79 months. Metacarpophalangeal joint and interphalangeal joint mal-alignment was present in 56% and 38% of cases, respectively. Interphalangeal ulnar collateral ligament laxity was significant. Metacarpophalangeal joint and interphalangeal joint motion was significantly decreased. Pinch and grip strength measurements were normal. A novel and comprehensive assessment scale is introduced, which revealed results of one (2.5%) excellent, 23 (59%) good, 14 (36%) fair and one (2.5%) poor. We consider that greater attention should be directed to the avoidance of mal-alignment and instability to improve these results.

Clinical Evaluation of the Articulinx Intercarpometacarpal Cushion for the First CMC Joint: A Feasibility Study

Background The Intercarpometacarpal Cushion (ICMC; Articulinx, Cupertino, CA, USA) is an implantable spacer designed as a less invasive surgical treatment for osteoarthritis (OA) of the first carpometacarpal joint (CMC-1). Description of Technique Following local anesthesia and exposure of the joint capsule the ICMC, attached to a needle and suture tethers, is guided into the joint space under fluoroscopic visualization through a dorsal approach. The needle is pulled through the thenar eminence to the opposite side of the hand and, once proper device placement is confirmed, cut free and the joint capsule closed. Patients and Methods Eight female patients (median age 56 years; range, 42-83) were treated and followed for 6 to 24 months. Safety of the implant procedure was evaluated intraoperatively. Pain, joint function, and strength were evaluated at 6 weeks, 3, 6, 12 and 24 months with a Visual Analog Scale (VAS) for pain, the QuickDASH inventory, Canadian Occupational Performance Measure (COPM), and pinch and grip strength measurements. Results At 2 years (n = 6), mean VAS pain scores decreased from 6.3 (± 1.5) to 2.2 (± 1.1) (p < 0.001), mean QuickDASH scores improved from 47 (± 15) to 31 (± 11) (p < 0.10), mean COPM performance scores improved from 5.0 (± 1.2) to 5.5 ( ± 1.3) (p = NS). Mean pinch and grip strength measurements also improved compared with baseline. No serious adverse events occurred. Two device removals occurred, associated with a traumatic event and Stage IV OA with device displacement, at 6 and 9 months respectively. Conclusion The ICMC can be implanted safely. Effectiveness needs to be confirmed in future studies.

Thumb Carpometacarpal Arthroplasty with Ligament Reconstruction and Interposition Costochondral Arthroplasty

Background Thumb arthritis at the carpometacarpal (CMC) joint is one of the most common sites of arthritis, especially in women. Thumb arthroplasty is an effective method of relieving pain and improving function. Materials and Methods Qualitative and quantitative outcomes were assessed clinically and radiographically in 58 patients (66 thumbs) with thumb basal joint arthritis limited to the trapeziometacarpal joint, treated with hemiresection arthroplasty of the trapezium, flexor carpi radialis (FCR) ligament reconstruction, and allograft costochondral interposition graft. Description of Technique The thumb CMC joint arthroplasty is performed using an FCR tendon for ligament reconstruction combined with removal of the distal half of the trapezium, which is replaced with a life preserver-shaped spacer that is carved out of allograft cartilage. Results Results of the validated Disability of Arm, Shoulder, and Hand (DASH) questionnaire at a mean follow-up time of 56 months (range, 24-103 months) revealed that 90% of the patients had a high level of function with minimal symptoms. Important improvements in web space with increased palmar and radial abduction and grip and pinch strength measurements were observed. The trapeziometacarpal space had decreased 21% after surgery, while trapeziometacarpal subluxation was 14% compared with 21% before surgery. There was an inverse correlation between the loss of trapezial height and subluxation and clinical outcome. Conclusions The results of this study demonstrate that, although the preoperative trapezial height was not maintained, the reconstructed thumbs remained stable, with little subluxation and improved clinical outcomes. Level of Evidence IV, retrospective case series.

Interinstrument Reliability of the Jamar Electronic Dynamometer and Pinch Gauge Compared With the Jamar Hydraulic Dynamometer and B&amp;L Engineering Mechanical Pinch Gauge

OBJECTIVE. This study sought to determine interinstrument reliability of the Jamar electronic dynamometer and pinch gauge compared with the commonly used Jamar hydraulic dynamometer and B&L Engineering mechanical pinch gauge. METHOD. Twenty men and 20 women were tested for grip strength with the two different dynamometers, and 17 men and 25 women were tested for lateral pinch strength with the two different pinch gauges. RESULTS. Grip strength measurements were approximately 10% higher with the hydraulic dynamometer, and lateral pinch strength measurements were approximately 18% higher with the mechanical pinch gauge. Paired t tests and intraclass correlation coefficients (ICCs) were used for statistical analyses. The two-tailed p value was <.0001, and the ICC indicated poor to moderate reliability. CONCLUSION. When retesting patients, it is recommended that occupational therapists use the same instrument to measure hand strength because interinstrument reliability may be lacking.

Role of Mechanical Forces in Hand Nail Configuration Asymmetry in Hemiplegia: An Analysis of Four Hundred Thumb Nails

Objective: To assess the relationship between nail configuration and mechanical force, the nail morphology and pinch strengths of the paralyzed and non-paralyzed sides of patients with hemiplegia were measured. Methods: Study 1: Analysis of nail configuration. Both thumb nails of 100 subjects with hemiplegia and 100 healthy volunteers (400 thumb nails) were enrolled. The left and right thumb nails were compared in terms of configuration, namely the curve index (defined as nail height/width). Study 2: Measurement of pinch strength. In 10 subjects with hemiplegia and 10 healthy volunteers, the pinch strengths of both sides were compared. Results: Study 1: In the subjects with hemiplegia, the palsy side had a significantly higher curve index than the non-palsy side (32.7 ± 8.3 vs. 24.4 ± 6.5%). The two sides of the healthy volunteers did not differ significantly in terms of the curve index. Study 2: In all hemiplegia cases, the non-palsy side had a higher pinch strength. The differences were statistically significant (4.40 ± 1.90 vs. 0.05 ± 0.16 kg). In the healthy volunteers, the dominant and non-dominant sides did not differ significantly. Conclusion: Mechanical forces may affect the nail configuration and could participate in the pathophysiology of nail deformities.

Disability and Pain after Cortisone versus Placebo Injection for Trapeziometacarpal Arthrosis and De Quervain Syndrome

This study tested the null hypothesis that type of injection (corticosteroid vs. placebo) is not a predictor of arm-specific disability as measured with the Disabilities of Arm, Shoulder and Hand questionnaire 1 to 3months after injection of dexamethasone or placebo for treatment of trapeziometacarpal (TMC) arthrosis or de Quervain syndrome. Secondly, we tested if type of injection was a predictor of pain intensity. Thirty-six English-speaking adults with TMC arthrosis or de Quervain syndrome were randomized for a dexamethasone or a placebo injection. At time of the injection, patients completed a demographic data sheet and validated questionnaires assessing arm-specific disability, pain intensity, depressive symptoms, pain catastrophizing, and patient's health-related beliefs. At an average of 1.4 ± 0.42months (range, 0.79-2.5months) after the injection, patients completed questionnaires regarding arm-specific disability, pain, and treatment satisfaction. Grip and pinch strength measurements were measured at both time points. Bivariable and multivariable analyses assessed predictors of arm-specific disability and pain intensity at follow-up. Type of injection was not a predictor of arm-specific disability or pain intensity 1 to 3months after injection. The best model both for arm-specific disability and pain intensity at follow-up included pain catastrophizing and explained 18% and 33% of the variability, respectively. Catastrophic thinking was a better predictor of both of arm-specific disability and pain intensity than diagnosis or type of injection (steroid vs. placebo) 1to 3 months after an injection.