The relationship between the Patient-rated Ulnar Nerve Evaluation and the common impairment measures of grip strength, pinch strength, and sensation.
METHODS
Prospective cohort study.


BACKGROUND
Grip strength, pinch strength, and sensory threshold are common evaluations used on a daily basis. Identifying how these variables relate to function for patients allows these assessments to be used for screening to identify who may benefit from surgical intervention, and provides valuable information about what impairments patients think are important with respect to functional use of their upper extremity. Therapists can use this information to focus rehabilitation programs on the most important impairments.


OBJECTIVE
To evaluate the relationship between the Patient-rated Ulnar Nerve Evaluation (PRUNE) and impairment measures of grip strength, pinch strength, and one-point sensory threshold.


METHODS
Data was prospectively collected from 77 patients before surgery and during regular time points for 2 years following surgery. Patients completed the PRUNE, grip and pinch strength measures, and a one-point sensory threshold evaluation. Correlations between these variables were calculated at baseline, 2 years after surgery, and for change scores during the 2-year follow up. A multiple regression analysis was used to determine the contribution of the impairment variables for determining functional change.


RESULTS
Grip strength showed moderate, statistically significant correlation with PRUNE scores at both baseline (r = -0.38) and at two years (r = -0.29). There was also a statistically significant correlation between one point sensory threshold for the small finger at two years (r = 0.36), but not at baseline. Change in grip strength (r = -0.28) and pinch strength (r = -0.30) both demonstrated significant correlations with PRUNE change scores. Overall, changes in grip strength, pinch strength, and sensation accounted for 20% of the variance in PRUNE changes.


CONCLUSIONS
Since grip strength was most highly correlated with PRUNE scores at baseline and at two years, rehabilitation programs that target grip strengthening is supported. While neither grip nor pinch strength were significant contributors to the regression when used together, each showed significant contributions to PRUNE variability when used in the model independently. Therefore, a combination of grip and pinch strengthening may be important during rehabilitation for improving functional results in patients that undergo surgical intervention for cubital tunnel syndrome.


METHODS
2b.
Health and Rehabilitation Sciences, Western University, London, Ontario, Canada. Electronic address: mike.szekeres@gmail.com.
Mike
M
Szekeres
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada.
Joy C
JC
MacDermid
The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada.
Graham J W
GJ
King
The Roth McFarlane Hand and Upper Limb Centre, London, Ontario, Canada; Department of Surgery, Western University, London, Ontario, Canada.
Ruby
R
Grewal
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020430:Cubital Tunnel Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012684:Sensory Thresholds / Q000502:physiology*; D055815:Young Adult
Nerve compression; Outcome measures; PRUNE; Ulnar nerve