Pain, Range of Motion, Edema, Sensibility, Strength (PRESS) & Self-reported Function Create a Comprehensive Score
Study Details
Study Description
Brief Summary
The aim of this study is to examine the development of a conceptual framework and provide evidence for reliability of a comprehensive hand therapy evaluation score. This approach provides a new standardized tool for upper extremity (UE) evaluation. Components of Pain, Range of Motion (ROM), Edema, Sensibility, Strength (PRESS), and self-reported Function were combined to create a baseline. Each assessment tool used for the PRESS to Function Approach assists in determining appropriate interventions.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
In this study, investigators used the innovative PRESS to Function Approach and Composite Score to describe the development and piloting of a systematic standard for upper extremity evaluation. Using existing instruments with substantial evidence of validity and reliability is more cost-effective than starting from scratch to develop and validate an instrument. This Approach and Score will provide occupational therapists an accurate measure to track the progression of a patient. The hypothesis for this study is Press to Function components will demonstrate utility for measuring clinical and patient-reported function when used as a comprehensive assessment tool.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Single Arm Clinical Trial Participants with various upper extremity disorders are provided treatment/interventions and evaluated at baseline, 3-6 weeks, and at discharge using the PRESS to Function Approach |
Other: Upper Extremity Rehabilitation
Pain management, ROM, Edema Management, Desensitization, Strengthening, Functional Tasks
|
Outcome Measures
Primary Outcome Measures
- Development and Reliability of PRESS to Function Approach: A Systematic Method for Upper Extremity Assessment [4 weeks - 16 weeks depending on diagnosis and protocol]
The Development of the PRESS (pain, range of motion (ROM), edema, sensibility, strength) to Function Approach created a composite score. The PRESS to Function Composite Score combines subjective and objective measures to provide a single value to evaluate treatment prognosis. The six outcome measures (pain, ROM, edema, sensibility, strength, and function) were summed for 900 points to create a single score. The higher the score the less the overall disability.
Secondary Outcome Measures
- Pain Scale [4 weeks - 16 weeks depending on diagnosis and protocol]
Pain was measured using the Numerical Pain Rating Scale (NPRS) and descriptors. The NPRS is indicative of a rating 0 through 10. The zero represents no pain and the 10 represents the worst imaginable pain
- Range of Motion (ROM) [4 weeks - 16 weeks depending on diagnosis and protocol]
For ROM, joints were measured with a goniometer. The unit of measurement is in degrees. Measurements range from 0 to 180 degrees. Each joint is compared to normative data. Zero represents the neutral and the least amount of motion.
- Edema [4 weeks - 16 weeks depending on diagnosis and protocol]
Edema considered both upper extremities (right and left) using a standard tape measure. The measurements were recorded according to units in centimeters (cm). Anatomical landmarks were chosen strategically for a ratio comparison as well as to establish baseline. Smaller numbers represent less edema or swelling.
- Sensibility [4 weeks - 16 weeks depending on diagnosis and protocol]
Sensibility was measured with Semmes Weinstein Monofilaments to determine sensory loss and touch pressure. The filaments are classified from grade 1 to 5 according to their thickness, where 5 represents the thinnest filament and 1 represents the largest filament: 1.65-2.83 = grade 5, 3.22-3.61 = grade 4, 3.84-4.31 = grade 3, 4.56-6.45 = grade 2, and 6.65 = grade 1
- Strength (Grip and Pinch) [4 weeks - 16 weeks depending on diagnosis and protocol]
Measured with the dynamometer and the pinch gauge in pounds. The higher the the number the stronger the patient. Strength may range from 0 pounds (weak) to 200 pounds (strong).There will be a comparison in some cases with normative data based on age and gender
- Function with Quick Disability of the Arm, Shoulder, and Hand (DASH) [4 weeks - 16 weeks depending on diagnosis and protocol]
The Quick DASH questionnaire is a Likert scale that uses 11 questions to measure the degree of difficulty in performing various physical activities. Due to a shoulder, arm, or hand problem questions address the severity of pain and tingling, the limitation on social activities, work, and sleep. All 11 self-report items must be completed to receive a score on a scale between 0-to-100 with the higher scores reflecting greater disability.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Clinical diagnosis of upper extremity disorder as the primary diagnosis
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Surgical and nonsurgical Diagnoses
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Age 21 years or older
Exclusion Criteria:
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Concomitant Diseases (i.e cerebralvascular accident, cerebral palsy, spinal cord injury)
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Full Body Lymphedema
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Individuals who did not complete at least one reassessment
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Pinnacle Hand Therapy | Newport News | Virginia | United States | 23606 |
Sponsors and Collaborators
- Howard University
Investigators
- Principal Investigator: Phyllis Ross, OTD, Howard University
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
- IRB-20-PNAH-08