Predictors of functional outcome after peripheral nerve injury and compression |
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| Affiliation: | 1. Occupational Therapist, Milliken Hand Rehabilitation Center, Washington University School of Medicine, Program in Occupational Therapy;2. Minot Packer Fryer Chair of Plastic Surgery, Washington University School of Medicine, Division of Plastic and Reconstructive Surgery;3. Associate Professor of Occupational Therapy and Medicine, Washington University School of Medicine, Program in Occupational Therapy;1. Orthoklinik Hand Center, Santa Cruz do Sul, Rio Grande do Sul, Brazil;2. Titular Member and Board Member of The Brazilian Society of Hand Therapy and Upper Limb, SBTM, Brazil;3. Hand and Microsurgery Department, Santa Cruz Hospital, Santa Cruz do Sul, Rio Grande do Sul, Brazil;4. Pazin Clinic, Brazil;1. School of Physical Therapy, Western University, London, ON, Canada;2. Roth-McFarlane Hand and Upper Limb Centre, St. Joseph''s Hospital, London, ON, Canada;3. Department of Surgery, University of Western Ontario, London, ON, Canada;4. Department of Surgery, Western University, London, ON, Canada;1. Physiotherapy Department, Perth Children''s Hospital, Perth, Western Australia, Australia;2. Department of Clinical Research and Education, Child Adolescent Health Service, Perth, Western Australia, Australia;3. Department of Plastics and Reconstructive Surgery, Child and Adolescent Health Service, Perth, Western Australia, Australia;1. Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia;2. Faculty of Economics, University of Novi Sad, Subotica, Serbia;3. Department of Physical and Sports Education, PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Faculty of Sport Sciences, University of Granada, Granada, Spain |
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| Abstract: | Study DesignRetrospective cohort study.IntroductionUpper-extremity peripheral nerve injuries can impact long-term pain, work performance, and disability, yet there are few studies evaluating treatment outcomes for a large sample of patients with varying peripheral nerve pathology.Purpose of the StudyThe purpose of this study was to identify outcomes of care and predictors of disability and health status in adults with peripheral nerve injuries.MethodsWe explored medical records from 364 patients treated by a plastic surgeon over a three-year period. Descriptive and inferential statistics compared the Disabilities of the Arm, Shoulder, and Hand, Short-Form 8, and routine intake data between baseline and discharge, diagnosis, and intervention group. Multivariate linear regression models predicted disability, work disability, and physical and mental health at discharge.ResultsWe found significant improvements in disability, work disability, pain, depression, and stress. Health status changed minimally. Disability decreased most in patients who were working and who had symptoms fewer than six months. Outcomes were not statistically different between surgical and nonsurgical patients. Disability was the highest in patients with brachial plexus injuries. Multivariate models predicted 35 to 55% of the variance in the outcome measures. Factors that were highly predictive of functional outcomes included work status, household management, pain, depression, stress, and difficulty sleeping.ConclusionsPatients with peripheral nerve injuries experience improved pain and disability whether treated surgically or nonsurgically. Maintaining engagement in meaningful home and work roles may improve outcomes. Helping patients manage pain remains important, along with combatting stress, depression, and sleep deprivation. |
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| Keywords: | Activities of daily living Peripheral nerve injuries Treatment outcomes Work |
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