title: The associations among hand dexterity, functional performance, and quality of life in diabetic patients with neuropathic hand from objective- and patient-perceived measurements.
abstract: OBJECTIVE
  To comprehend the associations among the dexterity and functional performance of the hands and quality of life in diabetic patients with neuropathic hands, via objective- and patient-perceived measurements.
  
  
  METHODS
  The study participants were 144 diabetes patients who received objective evaluations, including the Purdue pegboard test, electrophysiological testing in sensory amplitude of the median nerve, and self-administrated measurements, including the Michigan Hand Outcomes Questionnaire (MHQ) and Diabetes-39 (D-39). Pearson's and Spearman's correlation tests were conducted to assess the relationships among hand neuropathy, hand dexterity and functions, and quality of life.
  
  
  RESULTS
  The results show that the amplitude of the sensory nerve action potential of the median nerve was positively correlated with hand dexterity (r = 0.28-0.43; p < 0.01) and the total score of MHQ (r = 0.24-0.33; p < 0.01). Objective hand dexterity had mild to moderate relationships with most of the MHQ results, but only weak associations with some dimensions of the D-39 results. The MHQ results were negatively correlated with the D-39 scores, with mild to moderate relationships in the domains of energy/mobility and anxiety.
  
  
  CONCLUSIONS
  In comparison with diabetic feet, neuropathic diabetic hands are an easily neglected problem, with insufficient empirical evidence in the literature to indicate its impact on functional performance and quality of life. This study showed that lesions related to neural functioning in the diabetic hand may negatively influence dexterity and functional hand performance and thus also affect the quality of life.
authors.affiliation: Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chien-Ju
authors.initials: CJ
authors.lastname: Yang
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Hsu
authors.forename: Chieh-Hsiang
authors.initials: CH
authors.lastname: Lu
authors.forename: Yen-Li
authors.initials: YL
authors.lastname: Chao
authors.forename: Haw-Yen
authors.initials: HY
authors.lastname: Chiu
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Kuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D057566:Self Report; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human