Poole Kerry, Mason Howard
Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire, UK.
Disabil Rehabil. 2007 Mar 15;29(5):359-66. doi: 10.1080/09638280600787138.
To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS).
A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire.
PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%.
Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.
通过手臂、肩膀和手部功能障碍(DASH)问卷来确定手部-手臂振动综合征(HAVS)中手部功能定量测试与上肢功能障碍之间的关系。
本研究共纳入228例HAVS患者。每位患者均由经验丰富的医生进行了全面的HAVS评估,包括振动触觉和热觉阈值的定量测试、最大握力(HG)测试以及普渡钉板(PP)测试。研究对象还被要求完成一份DASH问卷。
定量测试中的PP和HG与DASH功能障碍评分的个体相关性最佳且具有统计学意义(r2 = 0.168和0.096)。逐步线性回归分析显示,只有PP和HG测量值是上肢功能障碍的统计学显著预测指标(r2 = 0.178)。总体而言,PP和HG测量值相结合,而非单独使用其中任何一项,在区分正常和异常DASH评分方面的辨别能力略好,尽管无统计学意义,灵敏度为73.1%,特异度为64.3%。
使用PP和HG对手部灵活性和握力进行测量,可能有助于确认HAVS患者是否存在上肢功能缺失和“感知到的”功能障碍。