THE IMPACT OF HAND DOMINANCE ON FUNCTIONAL RECOVERY FOLLOWING UPPER EXTREMITY INJURIES
Notice bibliographique
Résumé
Hand dominance is an important component of the history for patients with upper extremity injuries; however, the impact that this actually has on patient functional recovery and outcomes is unclear. The few studies that have examined the relationship between hand dominance and outcomes following upper extremity injury have reported mixed results. Furthermore, the effect of hand dominance appears to be mediated by factors such as age, sex, and operative versus nonoperative management. The primary aim of this study was to determine the role that hand dominance plays in patient recovery following operative and nonoperative management of upper extremity injuries. This study is a retrospective subgroup analysis of three previous multi-centre prospective randomized clinical trials (RCT; Humeral Diaphyseal RCT, PERK 1 RCT, Ulnar Diaphyseal RCT). Patient and injury characteristics including age, sex, injury classification, and management (operative vs. non-operative) were collected. Common clinical outcomes across all three RCTs included range of motion and grip strength), patient reported outcomes included the Disability Shoulder, Arm, Hand (DASH) score, Pain Visual Analogue Scale (VAS), and return to work. Wilcoxon rank sum tests and Person's Chi-squared tests were used, as appropriate. A multiple variable repeated measures regression analysis will be performed to determine what variables are predictive of patient-reported outcome scores with the variable of interest being if the dominant arm was injured. Survival analysis will be used to evaluate the effect of hand dominance on return to work. A total of 421 patients across the three RCTs met inclusion criteria, with 72% of participants being male in the Ulnar Diaphyseal RCT, 61% being male in the Humeral Diaphyseal RCT, and 51% being male in the PERK 1 RCT. The dominant upper extremity was injured in 55% of those in the Humeral Diaphyseal RCT and in 45% of the PERK 1 RCT. The DASH scores were statistically significantly lower if the dominant extremity was injured at the 2-week follow-up [59 (± 20) for dominant side injured compared with 53 (± 21); p = 0.029]. However, at subsequent follow-ups at 6 weeks, 6 months, and 12 months, there was no difference in DASH score between the side of the extremity injury. Interestingly, DASH scores were significantly improved for those in the PERK 1 RCT (elbow fractures and dislocations) compared with the Humeral Diaphyseal RCT (isolated humeral diaphyseal injuries) at the 2- (p the rate of DASH improvement over time will also be completed. Although hand dominance is routinely collected during patient assessment, the influence of injury to the dominant upper extremity on outcomes is poorly understood following upper extremity trauma. This study found more significant early impairment if the dominant arm was injured, but this did not persist at the 6-week follow-up assessment. This novel data from three large multi-centre RCTs will help inform post-injury patient counselling regarding expectations for functional recovery after upper extremity injuries.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».