Serenza Felipe de Souza, Rizzato Marília Manuella Simões Augusto, Vieira Fernando, McQuade Kevin James, de Oliveira Anamaria Siriani
Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Engineer in the Human Movement Analysis laboratory at the Hospital das Clínicas of the Faculty of Medicine of Ribeirao Preto, Ribeirão Preto, São Paulo, Brazil.
Shoulder Elbow. 2025 Jan 21:17585732241313363. doi: 10.1177/17585732241313363.
This study aimed to assess reachable workspace (RWS) in patients post-osteosynthesis of shoulder, elbow, or wrist fractures and explore correlations with self-reported function and kinesiophobia.
An observational case-control study compared patients with fractures to a control group, utilizing questionnaires and 3D kinematic data.
The sample included 66 individuals who had undergone osteosynthesis: 21 with shoulder fractures, 10 with elbow fractures, and 22 with wrist fractures. A control group of 23 participants without upper limb pathologies was also established. Inclusion criteria were ages 18-80 and recent surgery; exclusions were previous upper limb surgeries, cervical pathologies, systemic diseases or nerve injuries.
RWS, the three-dimensional volume the hand can reach, was measured with participants standing. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TKS), and physical disability and pain were measured using the DASH questionnaire and the Numeric Pain Rating Scale (NPRS).
Fracture groups exhibited significant RWS reductions (62-85%) compared to the control group, with no significant differences among the fracture types. RWS showed a high correlation with TKS (R = 0.77) and a moderate correlation with DASH (R = 0.52).
RWS is a promising biomechanical parameter for assessing upper limb function post-fracture, aiding in refining rehabilitation protocols.
本研究旨在评估肩部、肘部或腕部骨折骨固定术后患者的可达工作空间（RWS），并探讨其与自我报告功能及运动恐惧之间的相关性。
一项观察性病例对照研究，将骨折患者与对照组进行比较，采用问卷调查和三维运动学数据。
样本包括66例接受骨固定术的个体：21例肩部骨折患者、10例肘部骨折患者和22例腕部骨折患者。还设立了一个由23名无上肢病变的参与者组成的对照组。纳入标准为年龄18 - 80岁且近期接受手术；排除标准为既往有上肢手术史、颈椎病变、全身性疾病或神经损伤。
RWS，即站立位参与者手可触及的三维空间体积，通过测量获得。采用坦帕运动恐惧量表（TKS）评估运动恐惧，使用上肢功能障碍和伤残问卷（DASH）及数字疼痛评分量表（NPRS）测量身体残疾和疼痛情况。
与对照组相比，骨折组的RWS显著降低（62 - 85%），各骨折类型之间无显著差异。RWS与TKS呈高度相关（R = 0.77），与DASH呈中度相关（R = 0.52）。
RWS是评估骨折后上肢功能的一个有前景的生物力学参数，有助于完善康复方案。
