title: Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome.
abstract: BACKGROUND
  Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS) and in normal subjects.
  
  
  METHODS
  Responses to the Cold Intolerance Symptom Severity (CISS) questionnaire, Potential Work Exposure Scale (PWES), Disability of the Arm, Shoulder and Hand (DASH) and Short-Form 36 questionnaire (SF-36) were investigated in normal subjects (n = 94), hand injured patients (amputation and nerve injuries, n = 88) and patients with HAVS (n = 30). The results are presented as median (range), percent and mean deviation from norms. The Kruskal Wallis Test or Mann-Whitney U-Test were used to identify significant differences between multiple groups or subgroups. The Spearman rank correlation was used to study the relationship between cold sensitivity and disability.
  
  
  RESULTS
  Abnormal cold sensitivity (CISS score > 50) was seen in 75% and 45% of patients with HAVS and a traumatic hand injury, respectively. Patients were significantly more exposed to cold in their work environment than the normal population, with a consequently negative effect on work ability due to cold sensitivity. Patients with abnormal cold sensitivity were more seriously disabled and had a poorer health-related quality of life than patients with normal cold sensitivity [higher DASH scores and e.g. significantly larger mean deviation from norms in the subscales Role Physical and Bodily Pain (SF-36)].
  
  
  CONCLUSIONS
  Severe and abnormal cold sensitivity may have a profound impact on work capacity, leisure, disability and health-related quality of life. It is frequently seen in patients with traumatic hand injuries and particularly apparent in patients with HAVS.
authors.affiliation: Department of Hand Surgery, Skåne University Hospital, Lund University, SE-205 02 Malmö, Sweden. Ingela.k.carlsson@hotmail.com
authors.forename: Ingela K
authors.initials: IK
authors.lastname: Carlsson
authors.forename: Birgitta
authors.initials: B
authors.lastname: Rosén
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D003080:Cold Temperature / Q000009:adverse effects*; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006230:Hand Injuries / Q000453:epidemiology* / Q000503:physiopathology; D053421:Hand-Arm Vibration Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000502:physiology; D015995:Prevalence; D011788:Quality of Life; D012016:Reference Values; D012647:Self-Assessment; D020886:Somatosensory Disorders / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014940:Work Schedule Tolerance; D055815:Young Adult
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