Determinants of Grip Strength in Healthy Subjects Compared to That in Patients Recovering From a Distal Radius Fracture

Bot, Arjan G.J.; Mulders, Marjolein A. M.; Fostvedt, Sigrid; Ring, David

doi:10.1016/j.jhsa.2012.04.032

Cited by 38 publications

(26 citation statements)

References 32 publications

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“…Although psychological factors are known to affect patient-reported disability more than an objective measure of function [27], considerable variances in grip strength (18% at 3-month followup) were explained by pain-coping strategies in our multivariate analysis model. The results are consistent with the findings presented by Bot et al [4] who noted that pain anxiety affects grip strength and disability only in patients recovering from injury, and not in healthy individuals. Grip strength appears to be a reflection of both physical impairment as well as psychological factors [27], and our results demonstrate an important role for pain coping in grip strength during early recovery from hand fractures.…”

Section: Discussionsupporting

confidence: 93%

“…Although there were no special intensified treatments between 3 and 6 months postoperatively, the influence of pain coping on disability was diminished at 6 months followup. The results are consistent with previous findings that psychical makeup is important in the healthy state but less important than anxiety or negative thoughts in response to pain in the context of recovery in patients with hand fractures [4]. It may be intuitive to assume that something must have gone wrong during surgery if patients do not recover well, but more severe symptoms or disability than are expected for a given physical state during early recovery may signal a patient's maladaptive nociception or ineffective coping strategy.…”

Section: Discussionsupporting

confidence: 92%

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To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Roh

Noh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Patients with hand fractures often have pain, swelling, and stiffness in the joints of the hand, which may lead them to protect their hands, resulting in more stiffness and in delayed recovery. However, the effects of paincoping strategies and catastrophization (the tendency to expect the worst to occur when pain is present, an approach that can be thought of as the opposite of ''coping'') on functional recovery after hand fractures have not been investigated in depth. Questions/purposes Are preoperative catastrophization and anxiety in patients with hand fractures associated with (1) decreased grip strength; (2) decreased range of motion; and (3) increased disability at 3 and 6 months after surgical treatment for a hand fracture? Secondarily, we asked if there are other patient and injury factors that are associated with these outcomes at 3 and 6 months. Methods A total of 93 patients with surgically treated hand fractures were enrolled in this prospective study. Preoperative assessments measured coping strategies evaluated by measuring catastrophic thinking with the Pain Catastrophizing Scale and pain anxiety with the Pain Anxiety Symptom Scale. At 3 and 6 months postoperatively, grip strength, total active range of motion, and disability (Quick Disabilities of the Arm, Shoulder, and Hand score) were assessed. Bivariate and multivariate analyses were performed to identify patient demographic, injury, and coping skills factors that accounted for outcomes of strength, motion, and disability. Results Decreased grip strength was associated with catastrophic thinking (beta = À1.29 [95% confidence interval, À1.67 to À0.89], partial R 2 = 11%, p \ 0.001) and anxiety (beta = À0.83 [À1.16 to À0.50], partial R 2 = 7%, p = 0.007) at 3 months, but by 6 months, only anxiety (beta = À0.74 [À1.04 to À0.44], partial R 2 = 7%, p = 0.010) remained an important factor. Decreased total active range of motion was associated with pain catastrophizing (beta = À0.63 [À0.90 to À0.36], partial R 2 = 6 %, p = 0.024) and anxiety (beta = À0.28 [À0.42 to À0.14], partial R 2 = 3%, p = 0.035) at 3 months but not at 6 months. Similarly, increased disability was associated with pain catastrophizing (beta = 1.09 [1.39-0.79], partial R 2 = 12%, p \ 0.001) and anxiety (beta = 0.93 [1.21-

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Roh

Noh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Although they were able to account for the lesser part of variability, Doornberg et al 5 and Lindenhovius et al 8 noted that pain was the strongest predictor of patient-rated measures of upper-extremity disability, explaining 36% and 41% of the variability, respectively. Numerous other studies have also elucidated the pivotal role that pain and illness behavior play in upper-extremity disability 6,7,9,11,[36][37][38] . The importance of this study lies in the innovative paradigm used for patient-reported outcomes assessment in upperextremity conditions.…”

Section: Computerized Adapti V E T E S T I N G O F P S Yc H O Lo G I mentioning

confidence: 99%

“…Some patients asked more about these aspects of their recovery and others accepted it without comment and we proceeded to the next step. For many patients with musculoskeletal conditions, improved mood and mindset are their best option to increase health and well-being 8,[10][11][12]18,36 . There is growing evidence that depression and ineffective coping strategies affect recovery from treatment as well, but as long as we only look at the percentage of ''successful'' results in uncontrolled studies, we may only be looking at the percentage of patients for whom our treatment gave permission to be healthy at least for a while (the placebo effect).…”

Section: Computerized Adapti V E T E S T I N G O F P S Yc H O Lo G I mentioning

confidence: 99%

Computerized Adaptive Testing of Psychological Factors

Menendez

Bot

Hageman

et al. 2013

The Journal of Bone & Joint Surgery

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BACKGROUND: Psychological factors are important mediators of the differences between impairment and disability. The most commonly used measures of disability and psychological factors are lengthy and are usually administered as paper questionnaires. The aim of this study was to assess the correlation between perceived disability and psychological factors with use of the user-friendly, web-based Patient Reported Outcomes Measurement Information System initiative, and to compare its correlation with a frequently used, paper-based, pain self-efficacy questionnaire. METHODS: A cohort of 213 patients completed a web-based version of the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), the pain self-efficacy questionnaire, the Patient Reported Outcomes Measurement Information System-based computerized adaptive testing Pain Interference questionnaire, and the Patient Reported Outcomes Measurement Information System-based computerized adaptive testing Depression questionnaire. Bivariate and multivariable analyses measured the correlation of these psychological measures with QuickDASH. RESULTS: There was large correlation between QuickDASH and the Pain Interference computerized adaptive testing (r = 0.74; p lt; 0.001), between the Pain Interference computerized adaptive testing and the pain self-efficacy questionnaire (r = -0.72; p lt; 0.001), and between QuickDASH and the pain self-efficacy questionnaire (r = -0.76; p lt; 0.001). The Depression computerized adaptive testing showed a medium correlation both with QuickDASH (r = 0.37; p lt; 0.001) and with the Pain Interference computerized adaptive testing (r = 0.40; p lt; 0.001). The best multivariable model for QuickDASH included the Pain Interference computerized adaptive testing, prior treatment received, and smoking, and accounted for 57% of the variability. Fifty-one percent of the variability in the QuickDASH was explained by pain interference alone. CONCLUSIONS: Maladaptive responses to upper-extremity pain are accurately measured by the relatively user-friendly Patient Reported Outcomes Measurement Information System-based computerized adaptive testing questionnaire. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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“…6 Hand dominance, as an independent factor, is known to have an influence on upper extremity function, and strength. [7][8][9][10][11][12] The DOM-side extremity is typically more used, has greater strength, and has greater demands placed on it. Thus, injuries leading to physical limitations on the DOM upper extremity may result in greater patient-rated impairment and disability than injures of the non-DOM extremity.…”

Section: Introductionmentioning

confidence: 99%

Outcomes After Hemiarthroplasty for Proximal Humerus Fracture Are Significantly Affected by Hand Dominance

LeBlanc

MacDermid

Faber

et al. 2015

Journal of Orthopaedic Trauma

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Determinants of Grip Strength in Healthy Subjects Compared to That in Patients Recovering From a Distal Radius Fracture

Cited by 38 publications

References 32 publications

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

To What Degree Do Pain-coping Strategies Affect Joint Stiffness and Functional Outcomes in Patients with Hand Fractures?

Computerized Adaptive Testing of Psychological Factors

Outcomes After Hemiarthroplasty for Proximal Humerus Fracture Are Significantly Affected by Hand Dominance

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