Quick Disabilities Of Arm, Shoulder And Hand Research Articles

Cross-cultural adaptation of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for Hebrew-speaking subjects with and without hand injury

Purpose: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire is used internationally to assess function and disability. The instrument has been translated into several languages, but no Hebrew version exists. The objective of this study was to evaluate the use of the 12-item WHODAS 2.0 questionnaire among Hebrew speakers with and without hand injuries (HI).Methods: The translated questionnaire was conducted among 155 uninjured subjects (UI) and 77 male workers with HI. Internal consistency was assessed using Cronbach’s alpha. Test–retest reliability was assessed in UI subjects and calculated using the intraclass correlation coefficient (ICCagreement). Validity was evaluated by correlating the 12-item WHODAS 2.0 to the short-form of health survey (SF-12) in UI subjects and comparing the 12-item WHODAS 2.0 scores and the Quick Disability of Arm, Shoulder, and Hand (QDASH) Outcome Measure in the HI group.Results: The Cronbach’s alpha of the WHODAS 2.0 for the entire sample was α = 0.83. The ICCagreement for test–retest reliability was 0.88. A positive significant correlation was found between the 12-item WHODAS 2.0 and the QDASH (rs = 0.53, p < .005).Conclusions: The results support the reliability and validity of this Hebrew translation of the 12-item WHODAS 2.0. IMPLICATIONS FOR REHABILITATIONMeasurement tools that assess activities and participation after HI are an essential part of the rehabilitation process. The 12-item WHODAS 2.0 is a useful tool, since it addresses a broader range of activity and participation domains compared to the DASH and enables better implementation of the ICF model.Since the WHODAS 2.0 does not target a specific disease (as oppose to the DASH), it can be used to compare disabilities caused by different diseases or traumas.The WHODAS 2.0 measures both the function and disability in general populations as well as clinical situations; therefore, the instrument is useful for assessing both health and disability.

Association of real-time sonoelastography findings with clinical parameters in lateral epicondylitis.

The objective of this study was to investigate the role of real-time sonoelastography (RTSE) in patients with lateral epicondylitis (LE) and whether it is associated with clinical parameters. Seventeen patients with unilateral LE were enrolled in the study. The healthy elbows of the participants constituted the control group. Using B-mode ultrasound, color Doppler ultrasound, and RTSE, we prospectively examined 34 common extensor tendon elbows of 17 patients. Both color scales and strain ratio were used for evaluating RTSE images. Two radiologists evaluated the RTSE images separately. Elbow pain was scored on a 100-mm visual analog scale (VAS). Symptom duration and the presence of nocturnal pain were questioned. Quick disabilities of arm shoulder and hand (DASH) Questionnaire was applied to assess the pain, function, and disability. Nottingham health profile (NHP) was used to determine and quantify perceived health problems. Both color scales and strain ratios of the affected tendon portions were significantly different from that of healthy tendons (p < 0.001). There was no significant association between NHP, VAS, Quick DASH scores, and color scales and strain ratio. Strain ratio of the medial portion of the affected tendon was significantly correlated with symptom duration (rho = -0.61 p = 0.010) and nocturnal pain (rho = 0.522 p = 0.031). Interobserver agreement was substantial for color scales (κ = 0.74, p = 0.001) and strain ratio (ICC = 0.61, p = 0.031). RTSE may facilitate differentiation between healthy and affected elbows as a feasible and practical supplementary method with substantial interobserver agreement. RTSE was superior to B-mode ultrasound and color Doppler ultrasound in discriminating tendons with LE. Strain ratio of the medial portion of the tendon is associated moderately with nocturnal pain and symptom duration. No other associations were present between RTSE findings and clinical or functional parameters.

Study protocol: non-displaced distal radial fractures in adult patients: three weeks vs. five weeks of cast immobilization: a randomized trial

BackgroundUp to 30% of patients suffer from long-term functional restrictions following conservative treatment of distal radius fractures. Whether duration of cast immobilisation influences functional outcome remains unclear.Methods/DesignThe aim of the study is to evaluate whether the duration of immobilization of non or minimally displaced distal radial fractures can be safely reduced. We will compare three weeks of plaster cast immobilization with five weeks of plaster cast immobilization in adult patient with non or minimally displaced distal radial fractures.Study design: a prospective randomized clinical trial.Study population: adult (>18 years) (independent in activities of daily living) patients with a non/minimal displaced distal radius fracture (dorsal angulation <15°, volar tilt <20°, radial inclination >15°, ulnar positive variance <5 mm and an articular step off <2 mm).Intervention: three weeks of plaster cast immobilization versus five weeks of plaster cast immobilization.Main study parameters: primary outcome parameters: Patient related wrist evaluation (PRWE) Quick Disability of Arm, Shoulder and Hand (QUICKDASH) score after a one year follow-up, and secondary parameters: range of motion, pain level (VAS) and complications.DiscussionThe expectation of this study is that shorter duration of plaster cast immobilisation is beneficial for the patient with a distal radius fracture. This risk of specific complications is low and generally similar in both treatment options. Moreover, the burden of the study is not much higher compared to standard treatment. Follow-up is standardized according to current trauma guidelines. Literature indicates that both treatment options from the study are accepted for displaced distal radius fractures. No clear advantage for one treatment options is found at present in the literature, although there is no level I evidence present. This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two treatment options for non-displaced distal radial fractures. The gathered data may support the development of a clinical guideline for conservative treatment of distal radial fractures.Trial registrationNetherlands National Trial Register NTR3552.

Excellent Results After Bone Grafting and K-Wire Fixation for Scaphoid Nonunion Surgery in Skeletally Immature Patients

Scaphoid nonunion is relatively rare in children and adolescents, and no long-term follow-up has been reported. Retrospective follow-up study. Eleven patients (10 boys and 1 girl), mean 15.2 (13.9-15.9) years of age, with scaphoid nonunion and open growth plates were operated with bone grafting, Kirschner-wire fixation and 12 weeks of cast immobilization. Bony union, degenerative wrist changes, and restoration of the carpal architecture were assessed with CT and radiographs. Clinical parameters included active range of motion, grip strength, key pinch strength, and subjective outcome scores (quick disabilities of arm, shoulder and hand (DASH), visual analog scale). The patients were followed up after mean 6.9 (3.1-15.1) years; all patients attended. Radiographs and CT confirmed healing of all nonunions, the carpal anatomy was restored, and the wrists were rated as 0 according to the scaphoid nonunion advanced collapse, without degenerative changes. The clinical result was excellent with visual analog scale at rest = 1, at activity = 6, and quick DASH score = 3.3. Active range of motion and grip strength were insignificantly reduced (14 degrees and 2 kg); the key pinch strength remained similar. Healing of a scaphoid nonunion can be expected in adolescents after open reduction, Kirschner-wire fixation, bone grafting, and plaster immobilization, resulting in pain relief and excellent wrist function without degenerative changes after longer term follow-up. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The results of non-surgical treatment for unstable distal radius fractures in elderly patients

This study was designed to evaluate anatomical and functional results of non-surgical treatment for unstable distal radius fractures in the elderly. Twenty-nine patients (7 males, 22 females; mean age 72+/-2 years) aged = or > 65 years were treated with closed reduction and short-arm circular casting for unstable distal radius fractures. According to the AO classification, all patients had type C fractures. Anatomical and functional results were assessed using the Stewart criteria and Q-DASH (Quick-Disability of Arm, Shoulder and Hand) questionnaire, respectively. Bone mineral density measurements were performed. Grip strength and wrist range of motion were measured in comparison to the unaffected side. The mean follow-up was eight months (range 6 to 12 months). Union was achieved in all fractures within a mean of 4+/-1 weeks. Bone mineral density measurements showed osteoporosis in 22 patients (75.9%), and 26 patients (89.7%) had regional osteoporosis in cortical width measurements. After treatment, radiographic measurements showed the following: radius tilt angle +5.6+/-5.4 degrees , inclination angle 17+/-4.6 degrees , radial height 9+/-2.3 mm, and positive ulnar variance 2.8+/-2 mm. Five patients (17.2%) exhibited an articular step-off of less than 1 mm on the radial surface. According to the Stewart criteria, the results were good in 15 patients (51.7%), moderate in 12 patients (41.4%), and poor in two patients (6.9%). The mean Q-DASH score was 38+/-19.2 at three months, and 23+/-2.4 at final follow-up. Grip strength, extension/flexion, and pronation/supination were measured as 57.3+/-12.5%, 52+/-14%, and 75+/-16% of the unaffected side, respectively. Complications were seen in 11 patients (37.9%). Three patients (10.3%) developed malunion which required corrective osteotomy. Unstable distal radius fractures can be treated with closed reduction and cast application in low-demand elderly patients to avoid risks and complications of surgery.