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Does Disability Correlate With Impairment After Hand Injury?
Maryam Farzad1, Ali Asgari2, Fatemeh Dashab1
1Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Clinical Orthopaedics and Related Research
|March 6, 2015
Summary
Hand injury disability is not solely determined by impairment. Psychosocial factors like depression and pain significantly influence outcomes, suggesting personalized treatment approaches are crucial for better results.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Psychology
Background:
- Impairment (loss of body function/structure) and disability (activity limitation) are distinct concepts.
- Psychosocial factors may significantly influence disability more than objective impairments.
- The relationship between impairment and disability requires further exploration.
Purpose of the Study:
- To determine the correlation between hand impairment and disability using the Disabilities of the Arm, Shoulder and Hand (DASH) and Michigan Hand Questionnaire (MHQ).
- To assess the correlation between pain intensity and hand impairment.
- To investigate the predictive effect of pain intensity and depression symptoms on disability.
Main Methods:
- Evaluated 107 hand-injured patients approximately 11 months post-injury.
- Collected data on impairment ratings (American Medical Association guide), disability (DASH, MHQ), pain intensity (visual analog scale), and psychological factors (Beck Depression Inventory).
- Utilized bivariate and multivariate analyses to examine correlations.
Main Results:
- Disability scores (DASH, MHQ) showed only intermediate correlation with impairment ratings.
- Pain intensity did not correlate with impairment but was associated with time since surgery and depression symptoms.
- Gender, age, and injured hand accounted for limited variability in disability scores.
Conclusions:
- The weak correlation between impairment and disability highlights the importance of non-pathophysiological factors.
- Physical factors (pain, dominant hand), conditional factors (time since surgery), and psychological factors (depression) significantly impact disability.
- Personalized interventions considering factors beyond impairment are essential for effective disability management.
