A simulation of hand impairments: effects on upper extremity function and implications toward medical impairment rating and disability determination

Archives of Physical Medicine and Rehabilitation
Robert D RondinelliN J Lawrence

Abstract

To determine whether simulation of significant impairment of the hand will have a predictable impact on degree of functional loss at the wrist and hand. Single subject repeat measures using before-after trial comparisons and healthy volunteer subjects. Occupational therapy section of a large academic medical center. Twenty adult volunteer student subjects from an occupational therapy education (OTE) department were included. All were between ages 18 and 43 years, right hand dominant, and in excellent general health. There were 19 women and 1 man, reflecting gender distribution of the OTE student body. A simulated fusion of the carpometacarpal (CMC) joint of the thumb was achieved by immobilization in an individually fabricated splint designed to maximally restrict motion at the first CMC joint. Impairment ratings (baseline vs splinted) according to the AMA Guides were obtained by Greenleaf testing, and upper extremity function was quantitatively assessed before and after splinting. Measures of upper extremity function included grip and pinch strength, wrist torque, and speed of performance on the Valpar Small Tools test, Jebsen Hand Function test, and an exploratory measure, the Functional Life Activity Test (FLAT). Significant...Continue Reading

References

Aug 1, 1992·American Journal of Physical Medicine & Rehabilitation·R RondinelliC Cholmakjian
Jan 1, 1991·The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association·E B Stern
Jan 1, 1983·Spine·R A Brand, T R Lehmann
Nov 12, 1982·JAMA : the Journal of the American Medical Association·D S Gloss, M G Wardle
Nov 1, 1993·The American Journal of Emergency Medicine·K T JordanC A Butzin

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Citations

Jul 9, 2010·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Elizabeth R Andersen HammondBarbara L Shay
Jul 25, 2009·PM & R : the Journal of Injury, Function, and Rehabilitation·Robert D Rondinelli
Dec 17, 2014·Journal of Burn Care & Research : Official Publication of the American Burn Association·Lt Stephanie Niedzielski, Maj Ted Chapman
Nov 26, 1999·American Journal of Physical Medicine & Rehabilitation·H M OerlemansR A Oostendorp
Feb 9, 2013·Journal of Occupational and Environmental Medicine·Seth A SeaburyTeryl Nuckols
Dec 13, 2001·The Journal of Bone and Joint Surgery. American Volume·J M Melhorn
Aug 11, 2004·The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics·James P RobinsonJohn D Loeser

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