| 1. |
- Westin, Britt, et al.
(författare)
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Obstetric brachial plexus injury : expectations before and satisfaction three months after secondary surgery on the shoulder
- 2012
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Ingår i: Hand Therapy. - Stockholm : Karolinska Institutet, Dept of Neurobiology, Care Sciences and Society. - 1758-9983 .- 1758-9991.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Children affected by obstetrical brachial plexus injury frequently have residual external rotation weakness in the shoulder. Secondary surgical procedures are available for improvement. The aim of this study was to describe and compare children's and parents' expectations, the importance of selected arm/hand function, and performance of activities before and satisfaction after surgical correction of rotation deformity in the shoulder. Method: In the Department of Hand Surgery, Södersjukhuset Sweden, all patients ≥4-year-olds (n = 42) affected by obstetrical plexus injury who underwent secondary surgery to release rotation contracture of the shoulder were included in this study between November 2001 and May 2006. A disease-specific questionnaire was developed and used. Results: The expectations before surgery were that the majority of the activities and functions would be improved. There were some differences between the adolescents’ and their parents’ expectations. After surgery, both children and parents were overall satisfied. Conclusion: This study shows that expectations before surgery were high and both children and parents reported positive experiences three months after surgery. A long-term study is warranted if final conclusions are to be drawn.
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| 2. |
- Carlsson, Ingela K., et al.
(författare)
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Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire : a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery
- 2021
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Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 26:1, s. 3-16
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of this study was to evaluate the construct validity, floor and ceiling effects, data completeness and magnitude of change over time for the eight-item patient questionnaire (HQ-8) in the Swedish Healthcare Quality Registry for hand surgery (HAKIR). Methods: Construct validity was investigated through predefined hypotheses and correlation statistics between the single items in HQ-8 (pain on load, pain on motion without load, pain at rest, stiffness, weakness, numbness, cold sensitivity and ability to perform daily activities) and QuickDASH. Floor and ceiling effects and data completeness were analysed at preoperative (n = 13,197), three months (n =10,702) and one year (n = 9,986) responses from hand surgery patients. Effect sizes were calculated for pre- and postoperative change scores in elective conditions and postoperative scores for acute conditions. Results: Correlation coefficients at pre, 3 and 12 months ranged from 0.44 to 0.79 in the total group. No ceiling effect occurred, but a floor effect for the total group was noted for all items at all follow-ups. Missing responses were < 2.6% except for cold sensitivity. The effect sizes varied from small to large for individual items in elective diagnoses. For acute injuries, small effect sizes were found. Discussion: This study provides evidence of construct validity of HQ-8, lack of ceiling effect, expected floor effect, good data completeness and an ability to detect changes over time. The results indicate that HQ-8 measures unique aspects of disability. The HQ-8 could complement the Quick-DASH in describing patient-reported outcomes after hand surgery.
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| 3. |
- Porter, Susann
(författare)
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Occupational performance and grip function following distal radius fracture : A longitudinal study over a six-month period
- 2013
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Ingår i: Journal of Hand Therapy. - : Sage Publications. - 0894-1130 .- 1545-004X. ; 18:4, s. 118-128
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionRecovery following distal radius fracture (DRF) is generally achieved within six months. However, a minority of patients experience functional impairments over a longer period. Traditional outcome measures are grip strength and range of movement. However, this may not reflect all parameters that are important. This study focuses on grip function as well as occupational performance in these patients over a six-month period.MethodA longitudinal study with follow-up at three to four weeks (n = 27) and six months (n = 22) after plaster removal. Patients with a DRF treated with cast or with closed reduction and cast immobilisation were included. Instruments used were the Sollerman Hand Function Test, Visual Analogue Scale, Patient-Rated Wrist Evaluation Outcome Questionnaire and Disabilities of the Arm, Shoulder and Hand. Changes over time and correlation between grip function, pain after grip function test and occupational performance were calculated.ResultsImprovements in grip function, experienced pain after grip test and occupational performance were significant. A significant correlation was found between grip function and feeling of capability, confidence and usefulness. Grip function was close to normal after six months with no differences between the two treatment methods. A wide distribution of the result in occupational performance after six months indicates the possibility of multi-dimensional reasons for remaining problems.DiscussionThe results highlight the importance of a combination of functional assessment and questionnaires addressing complexity in order to acquire a more complete picture of limitations following a DRF.Keywords Distal radius fracture, Sollerman’s Hand Function Test, VAS, PRWE, DASH
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| 4. |
- Rosberg, Hans Eric, et al.
(författare)
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A qualitative study of the long-term consequences and adaptation in daily life after replantation surgery at a young age
- 2022
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Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 27:4, s. 112-122
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Impaired functioning is seen in patients following replantation surgery to the thumb or fingers. Our aim was to explore long-term consequences and adaptation in daily life after a thumb and/or multiple finger amputation followed by replantation surgery during young age. Methods: Semi-structured interviews were conducted with nine recruited individuals and analysed using content analysis. The participants were asked to describe their hand function, pain, appearance, emotional consequences, impact on daily life and strategies for overcoming daily challenges. Results: The interviews revealed five main categories: memories of the injury and concerns for the future; hand function, pain and cold sensitivity; feelings about having a visibly different hand; adaptation to impairments and challenges in daily life; and key messages to healthcare professions and advice to future patients. The circumstances of the injury were well remembered. Pain at rest was rare but occurred when grasping. Cold sensitivity was a major issue. Appearance-related concerns varied from none to a major problem. Despite impaired hand function, solutions were found to challenges in daily life. Compensatory strategies, personal resources and support from others were important in this adaptation process. Conclusions: Patients with replantation surgery after an amputation during young age adapt to challenges in daily life over time. Healthcare professionals should offer adequate support to enable emotional processing of trauma experience. Appearance-related concerns should be addressed to prevent distress. Information about alleviating strategies to overcome long-term problems with cold sensitivity should be emphasized.
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| 5. |
- Saleem, Shifa, et al.
(författare)
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Improvement of hand sensibility resulting from application of anaesthetic cream on the forearm : importance of dose and time
- 2015
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Ingår i: Hand Therapy. - : Sage Publications. - 1758-9983 .- 1758-9991. ; 20:4, s. 109-114
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: A local anaesthetic cream, EMLA (R), applied temporarily to the forearm can improve sensory functions in the hands, both in healthy individuals and in patients with nerve injury. The treatment concept is an example of guided plasticity where the dynamic capacity of the central nervous system is used for therapeutic purposes. However, the optimal dose and duration of the anaesthetic cream is not known and this is addressed here. Methods: Sixty healthy volunteers participated in this experimental study. They were randomised to one of six groups of 10 and received either 10 g or 20 g of EMLA (R) on the volar part of the forearm for either 60, 90 or 120 min, respectively. Outcome measures were touch thresholds and discriminative touch in digits II and V. Results: There was a statistically significant improvement in touch threshold as well as discriminative touch in all six groups. However, there were no statistically significant differences between the six different dose and duration combinations. Conclusions: It is concluded that 10 g of EMLA (R) applied to the volar part of the forearm for 60 min may be adequate to induce improved hand sensibility.
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| 6. |
- Svingen, Jonas, et al.
(författare)
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Mental and behavioural disorders increase the risk of tendon rupture after flexor tendon repair in zone I and II
- 2023
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Ingår i: Hand Therapy. - : SAGE PUBLICATIONS LTD. - 1758-9983 .- 1758-9991.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The effect of mental and behavioural disorders (MBD) on the risk of tendon ruptures after flexor tendon repair is not well understood. This study aimed to analyse the association between MBD and tendon rupture after flexor tendon repair in zones I and II.Methods Data from the Swedish National Registry for Hand Surgery (HAKIR) on patients with a complete flexor tendon repair at our department between 2012 and 2019 were followed for a minimum of 2 years to assess the rate of rupture. Independent variables were collected from HAKIR and clinical records: prevalence MBD based on ICD-10 codes F0-F99, age, sex, injured tendon, number of injured fingers, day to surgery, core suture, digital nerve injury, smoking, injury mechanism, and rehabilitation method. Multiple logistic regression was used to assess the association between variables.Results A cohort of 593 patients with 49 ruptures (8.2%) was identified. Potential causes of rupture were non-adherence behaviour in 16 (33%), accidents in seven (14%), infections in six (12%), and no clear cause in 20 (41%) patients. Patients with MBD had an association to rupture (OR 3.6), 17.7% ruptures compared to 7.2% in patients with no diagnosed disorders. Patients >50 years of age had a higher risk compared to patients <25 years (OR 4.3), 15% compared to 3.9%' respectively. Men had a higher risk compared to women (OR 2.9), 10% compared to 4.3%' respectively.Conclusion We identified an association between the prevalence of mental and behavioural disorders and rupture after flexor tendon repair.
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