| 1. |
- Carlsson, Ingela K., et al.
(författare)
-
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
-
Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 26:1, s. 3-16
-
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.
|
|
| 2. |
- Kristjansdottir, Freyja, et al.
(författare)
-
Social participation in persons with upper limb amputation receiving an esthetic prosthesis
- 2020
-
Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 0894-1130. ; 33:4, s. 520-527
-
Tidskriftsartikel (refereegranskat)abstract
- Study Design: Qualitative study. Introduction: An amputation injury to the hand may lead to not only impaired hand function but also psychosocial consequences. Purpose of the Study: The purpose of the study was to explore personal experiences of social participation for persons provided with an esthetic prosthesis after acquired upper limb amputation. Methods: Thirteen persons with acquired upper limb amputation, who were in need of and had received an esthetic prosthesis, were interviewed. The transcribed text was subjected to content analysis. Results: The emotional reactions to a visibly different hand were linked to a changed appearance and a feeling of being exposed. Recollecting the accident could result in nightmares and sleeping disorders. A change of personality, due to sadness after the amputation was expressed, as well as social insecurity and impact on relations and life roles. Adapting to social challenges comprised hiding or exposing the hand, using personal internal resources and receiving support from others. The esthetic prosthesis contributed to an intact appearance and could serve as a facilitator for initial or long-term social participation. The time that had passed since the injury made it easier to deal with the consequences or in achieving acceptance. Discussion: Coping with emotions and social relations after an acquired amputation can be difficult and complex. Conclusions: Individual needs must be considered and questions about appearance and how it may affect social participation must be asked. An esthetic prosthesis can normalize the appearance and offer the confidence needed to facilitate social participation in those struggling with appearance-related concerns.
|
|
| 3. |
- Larsson, Sara, et al.
(författare)
-
Patients' experiences before and after total wrist fusion or total wrist arthroplasty:A qualitative study of patients with wrist osteoarthritis
- 2022
-
Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 0894-1130. ; 35:1, s. 41-50
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative. Purpose: To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life. Study Design: Qualitative descriptive. Methods: A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using qualitative content analysis. Results: Four categories are described: the problematic wrist, the breakpoint, appraisal of the results, and adaptation to challenges in everyday life. Pain relief was the primary expectation of surgery, and involvement in the discussion regarding different surgical options had a positive effect on the appraisal of results. The participants' ability to perform tasks in everyday life appeared to be more related to their level of pain than the range of wrist motion. Successful coping strategies were developed, enabling the participants to become more independent and adapt to challenges in daily life. Conclusions: Previous surgical experiences, occupation, and amount of wrist motion influenced the participants' expectations, surgical choice with either a TWF or a TWA, and the appraisal of results. The findings contribute valuable insights to both surgeons and hand therapists about the importance of having the patient's individual expectations and needs in focus.
|
|
| 4. |
- Mortazavi, Katarina, et al.
(författare)
-
Hand function 6 weeks following non-surgically treated proximal phalangeal fractures and factors associated to upper extremity disability
- 2023
-
Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 25:4, s. 213-222
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe hand function, and investigate adherence to a rehabilitation protocol and factors associated with upper extremity disability in non-surgically treated proximal phalangeal fractures. Material and methods: In a prospective cohort study, 86 patients (58 women, mean age of 49 years) were assessed at cast removal and 6 weeks follow-up. Adherence was registered in a diary. Factors potentially associated with disability were assessed in a logistic regression model. Results: At 6 weeks, the mean total active range of motion in the injured finger was 84% of the uninjured finger and median pain intensity levels were low (VAS <20). Mean grip strength was 66% of the uninjured hand and 28% perceived high upper extremity disability (QuickDASH score ≥30). Most patients adhered to exercise and night splint regime. The strongest associated factors with high upper extremity disability were more days in cast (Odds ratio 1.429, 95% CI 1.110–1.840) and fear of movement (Odds ratio 1.119, 95% CI 0.990–1.256) in the final regression model (Nagelkerke R Square 0.46). Conclusion: Most patients regain early satisfactory hand function, but a quarter still perceives high upper extremity disability. Longer immobilisation time in particular and fear of movement are important factors that may negatively affect the early outcome.
|
|
| 5. |
- Rosberg, Hans Eric, et al.
(författare)
-
A qualitative study of the long-term consequences and adaptation in daily life after replantation surgery at a young age
- 2022
-
Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 27:4, s. 112-122
-
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.
|
|
| 6. |
- Vikström, Pernilla, et al.
(författare)
-
Atypical sensory processing pattern following median or ulnar nerve injury - A case-control study
- 2018
-
Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 18:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Due to brain plasticity a transection of a median or ulnar nerve results in profound changes in the somatosensory areas in the brain. The permanent sensory deprivation after a peripheral nerve injury might influence the interaction between all senses. The aim of the study was to investigate if a median and/or ulnar nerve injury gives rise to a changed sensory processing pattern. In addition we examined if age at injury, injured nerve or time since injury influence the sensory processing pattern. Methods: Fifty patients (40 men and 10 women, median age 43) operated due to a median and/or ulnar nerve injury were included. The patients completed the Adolescent/Adult Sensory Profile questionnaire, which includes a comprehensive characterization on how sensory information is processed and how an individual responds to multiple sensory modalities. AASP categorizes the results into four possible Quadrants of behavioral profiles (Q1-low registration, Q2-sensory seeking, Q3-sensory sensitivity and Q4-sensory avoiding). The results were compared to 209 healthy age and gender matched controls. Anova Matched Design was used for evaluation of differences between the patient group and the control group. Atypical sensory processing behavior was determined in relation to the normative distribution of the control group. Results: Significant difference was seen in Q1, low registration. 40% in the patient group scored atypically in this Quadrant compared to 16% of the controls. No correlation between atypical sensory processing pattern and age or time since injury was seen. Conclusion: A peripheral nerve injury entails altered sensory processing pattern with increased proportion of patients with low registration to sensory stimulus overall. Our results can guide us into more client centered rehabilitation strategies.
|
|
| 7. |
- Vikström, Pernilla, et al.
(författare)
-
The effect of early relearning on sensory recovery 4 to 9 years after nerve repair : a report of a randomized controlled study
- 2018
-
Ingår i: Journal of Hand Surgery: European Volume. - : SAGE Publications. - 1753-1934 .- 2043-6289. ; 43:6, s. 626-630
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty patients randomized to early sensory relearning (nine patients) or traditional relearning (11 patients) were assessed regarding sensory recovery 4 to 9 years after median or ulnar nerve repair. Outcomes were assessed with the Rosen score, questionnaires, and self-reported single-item questions regarding function and activity. The patients with early sensory relearning had significantly better sensory recovery in the sensory domain of the Rosen score, specifically, discriminative touch or tactile gnosis and dexterity. They had significantly less self-reported problems in gripping, clumsiness, and fine motor skills. No differences were found in questionnaires between the two groups. We conclude that early sensory relearning improves long-term sensory recovery following nerve repair. Level of evidence: I
|
|
| 8. |
- Wijk, Ulrika, et al.
(författare)
-
Sensory Feedback in Hand Prostheses : A Prospective Study of Everyday Use
- 2020
-
Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 14
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Sensory feedback in hand prostheses is lacking but wished for. Many amputees experience a phantom hand map on their residual forearm. When the phantom hand map is touched, it is experienced as touch on the amputated hand. A non-invasive sensory feedback system, applicable to existing hand prostheses, can transfer somatotopical sensory information via phantom hand map. The aim was to evaluate how forearm amputees experienced a non-invasive sensory feedback system used in daily life over a 4-week period. Methods: This longitudinal cohort study included seven forearm amputees. A non-invasive sensory feedback system was used over 4 weeks. For analysis, a mixed method was used, including quantitative tests (ACMC, proprioceptive pointing task, questionnaire) and interviews. A directed content analysis with predefined categories sensory feedback from the prosthesis, agency, body ownership, performance in activity, and suggestions for improvements was applied. Results: The results from interviews showed that sensory feedback was experienced as a feeling of touch which contributed to an experience of completeness. However, the results from the questionnaire showed that the sense of agency and performance remained unchanged or deteriorated. The ability to feel and manipulate small objects was difficult and a stronger feedback was wished for. Phantom pain was alleviated in four out of five patients. Conclusion: This is the first time a non-invasive sensory feedback system for hand prostheses was implemented in the home environment. The qualitative and quantitative results diverged. The sensory feedback was experienced as a feeling of touch which contributed to a feeling of completeness, linked to body ownership. The qualitative result was not verified in the quantitative measurements. Clinical Trial Registration: Name: Evaluation of a Non-invasive Sensory Feedback System in Hand Prostheses. Date of registration: March 15, 2019. Date the first participant was enrolled: April 1, 2015. ClinicalTrials.gov Identifier: NCT03876405 ORCID ID: https://orcid.org/0000-0002-4140-7478.
|
|
| 9. |
- Wijk, Ulrika, et al.
(författare)
-
Touch on predefined areas on the forearm can be associated with specific fingers : Towards a new principle for sensory feedback in hand prostheses
- 2019
-
Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 51:3, s. 209-216
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Currently available hand prostheses lack sensory feedback. A "phantom hand map", a referred sensation, on the skin of the residual arm is a possible target to provide amputees with non-invasive somatotopically matched sensory feedback. How-ever, not all amputees experience a phantom hand map. The aim of this study was to explore whether touch on predefined areas on the forearm can be associated with specific fingers.DESIGN: A longitudinal cohort study.SUBJECTS: A total of 31 able-bodied individuals.METHODS: A "tactile display" was developed consisting of 5 servo motors, which provided the user with mechanotactile stimulus. Predefined pressure points on the volar aspect of the forearm were stimulated during a 2-week structured training period.RESULTS: Agreement between the stimulated areas and the subjects' ability to discriminate the stimulation was high, with a distinct improvement up to the third training occasion, after which the kappa score stabilized for the rest of the period.CONCLUSION: It is possible to associate touch on intact skin on the forearm with specific fingers after a structured training period, and the effect persisted after 2 weeks. These results may be of importance for the development of non-invasive sensory feedback systems in hand prostheses.
|
|
