评估单侧手损伤的幼儿手掌挛缩的新技术的可靠性。

Reliability of a novel technique to assess palmar contracture in young children with unilateral hand injuries.

机构信息

Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, New South Wales, Australia; Burns Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.

出版信息

J Hand Ther. 2022 Apr-Jun;35(2):254-260. doi: 10.1016/j.jht.2022.03.004. Epub 2022 Apr 28.

DOI:10.1016/j.jht.2022.03.004

PMID:35491302

Abstract

BACKGROUND

Palmar contracture in young children can have significant developmental consequences. Despite this, objective techniques to measure palmar range of movement and quantify contracture in young children are limited.

PURPOSE

The purpose of this study was to determine the reliability of hand span and hand length measures in young children and to establish whether there is any association with age, sex and presence of a palmar burn injury in the reliability of these measures. The study also sought to determine the normative difference and establish a cut off value for the between-hand difference to identify loss of movement in 1 hand.

STUDY DESIGN

Cross sectional METHODS: Forty-four children aged 0 to <5 years were recruited. Twenty-two children had a unilateral palmar burn injury and 22 did not have a palmar burn injury. Each child's hand span and hand length were measured 3 times. This was performed twice by the first assessor and once by the second assessor. Intraclass correlation coefficients were calculated to determine the intra-rater and inter-rater reliability. The largest of the 3 values for both hand span and hand length from the first assessor's first assessment were used to determine the normative between-hand difference. Outliers were removed prior to determining the normative difference. Children were considered outliers if their between-hand difference in hand span and/or hand length was in the top 5% of values.

RESULTS

Excellent reliability was established for hand span and hand length measures for the whole group (intra-rater ICC ≥0.95, inter-rater ICC ≥0.94). The mean normative between-hand difference for both measures was 2 mm. The cut-off for the normative difference in hand span was <9 mm and hand length was <6 mm.

CONCLUSION

This measurement technique has excellent reliability and could be a useful method to quantify palmar range of movement and identify contracture in young children with unilateral hand injuries.

摘要

背景

儿童手掌挛缩会对其发育造成严重影响。尽管如此，用于测量儿童手掌活动度并量化挛缩程度的客观技术仍十分有限。

目的

本研究旨在确定手跨度和手长度测量在幼儿中的可靠性，并确定年龄、性别和手掌烧伤损伤对这些测量可靠性的影响。本研究还试图确定正常差异并建立一个手间差值的截断值，以识别单手运动损失。

研究设计

横断面研究

方法

招募了 44 名 0 至<5 岁的儿童。22 名儿童患有单侧手掌烧伤，22 名儿童没有手掌烧伤。每位儿童的手跨度和手长度均测量 3 次。由 1 位评估员进行了 2 次测量，由另 1 位评估员进行了 1 次测量。计算组内相关系数以确定评估者内和评估者间的可靠性。将第一位评估员第一次评估的手跨度和手长度的 3 个值中的最大值用于确定正常手间差值。在确定正常差值之前，先剔除异常值。如果手跨度和/或手长度的手间差值在值的前 5%，则认为儿童为异常值。