Abstract
Reconstructive arm/hand surgery for tetraplegia is performed to improve arm/hand function
and therefore personal well-being for individuals who accept such elective surgeries.
However, changes at an impairment level do not always translate into functional or
quality of life changes. Therefore, multiple outcome tools should be used that incorporate
sufficient responsiveness to detect changes in arm/hand function, activity and participation,
and quality of life of the individuals involved. This narrative review aims to assist
clinicians to choose the most appropriate tools to assess the need for reconstructive
surgery and to evaluate its outcomes. Our specific objectives are (1) to describe
aspects to consider when choosing a measure and (2) to describe the measures advised
by an international therapist consensus group established in 2007. All advised measures
are appraised in terms of the underlying construct, administration, and clinical relevance
to arm/hand reconstructions. Essentially there are currently no criterion standard
measures to evaluate the consequences of reconstructive arm/hand surgery. However,
with judicious use of available measures it is possible to ensure the questions asked
or tasks completed are relevant to the surgical reconstruction(s) undertaken. Further
work in this field is required. This would be best met by immediate collaboration
between 2 outcome's tool developers and by analysis of pre- and postoperative data
already held in various international sites, which would allow further evaluation
of the measures already in use, or components thereof.
Keywords
List of abbreviations:
COPM (Canadian Occupational Performance Measure), GRASSP (Graded Redefined Assessment of Strength, Sensibility and Prehension), GRT (Grasp and Release test), ICF (International Classification of Functioning, Disability and Health), PWI (Personal Wellbeing Index), ROM (range of motion)To read this article in full you will need to make a payment
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Article info
Footnotes
The consensus project and development of the upper limb surgery registry were supported by the New Zealand Spinal Trust for the purpose of international collaboration. Each contributing center funded individual therapist time.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
