Impact of impaired wrist motion on hand and upper-extremity performance(1).
OBJECTIVE
To quantify and compare the disabilities caused by reduced and absent wrist motion using objective measurements of task performance and perceived disability, and to assess the compensatory motions of the shoulder, elbow, forearm, and trunk caused by impaired wrist motion.


METHODS
A clinical study of 21 normal subjects was done to measure physical performance and to assess wrist function under conditions of reduced (30 degrees flexion and 30 degrees extension) and nearly absent wrist motion using established physical tests and questionnaires (Disabilities of the Arm, Shoulder, and Hand [DASH], Patient Rated Wrist Evaluation [PRWE], and a study-specific survey). The clinical study also measured compensatory motions of the shoulder, elbow, forearm, and trunk.


RESULTS
Average times to perform the Jebsen test and activities of daily living (ADLs) test increased for both motion-restricted conditions of the wrist but did not differ significantly between the conditions. Questionnaire scores regarding function were significantly worse for both motion-restricted conditions and poorest for nearly absent motion. Average compensatory motions in the extremity and trunk statistically increased for both motion-restricted conditions but were not marked and did not differ between the conditions. High variability among subjects occurred in all physical tests and questionnaires for both motion-restricted conditions.


CONCLUSIONS
Perceived disability from reduced wrist motion appeared greater than measured functional loss using common physical tests and outcome surveys.
Adams
Brian D
BD
Departments of Orthopedic Surgery and Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
Grosland
Nicole M
NM
Murphy
David M
DM
McCullough
Matthew
M
D000203:Activities of Daily Living; D000328:Adult; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000503:physiopathology; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology; D013647:Task Performance and Analysis; D014955:Wrist Joint / Q000503:physiopathology*