Evaluation of impairment in the upper extremity

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Medical Engineering

Background:

• The evaluation of physical impairment in the hand and upper extremity is crucial for patient care and compensation.
• Existing methods may lack a standardized approach for combining various types of impairments.
• International consensus is needed for consistent impairment assessment.

Purpose of the Study:

• To present a comprehensive system for evaluating physical impairment of the hand and upper extremity.
• To establish a method for quantifying amputation, sensory, and motion impairments.
• To provide a framework for relating specific impairments to the whole person.

Main Methods:

• Developed a system for evaluating amputation, sensory, and motion impairments.
• Determined amputation impairment percentages for digits and major joints.
• Utilized a principle of progressive multiplication for combining impairment values.
• Incorporated American Medical Association guidelines for flexion and ankylosis.
• Derived extension impairment values using a specific formula.
• Applied a method where each subsequent impairment acts on the remaining functional portion.

Main Results:

• Established percentage values for amputation impairment at various anatomical levels.
• Quantified sensory impairment as 50% of amputation impairment.
• Developed methods to evaluate flexion, extension, and ankylosis impairments.
• Created a formula for combining multiple impairments on a single part.
• Related segmental impairments to the hand, upper extremity, and whole person.

Conclusions:

• The developed system provides a standardized method for assessing hand and upper extremity physical impairment.
• The progressive multiplication principle allows for accurate calculation of combined impairments.
• The system is approved for international application, facilitating global consistency in evaluation.