title: Measurement of Outcomes of Upper Limb Reconstructive Surgery for Tetraplegia.
abstract: Reconstructive arm/hand surgery for tetraplegia is performed to improve arm/hand function and therefore personal well-being for individuals who accept such elective surgeries. However, changes at an impairment level do not always translate into functional or quality of life changes. Therefore, multiple outcome tools should be used that incorporate sufficient responsiveness to detect changes in arm/hand function, activity and participation, and quality of life of the individuals involved. This narrative review aims to assist clinicians to choose the most appropriate tools to assess the need for reconstructive surgery and to evaluate its outcomes. Our specific objectives are (1) to describe aspects to consider when choosing a measure and (2) to describe the measures advised by an international therapist consensus group established in 2007. All advised measures are appraised in terms of the underlying construct, administration, and clinical relevance to arm/hand reconstructions. Essentially there are currently no criterion standard measures to evaluate the consequences of reconstructive arm/hand surgery. However, with judicious use of available measures it is possible to ensure the questions asked or tasks completed are relevant to the surgical reconstruction(s) undertaken. Further work in this field is required. This would be best met by immediate collaboration between 2 outcome's tool developers and by analysis of pre- and postoperative data already held in various international sites, which would allow further evaluation of the measures already in use, or components thereof.
authors.affiliation: Burwood Academy of Independent Living, Burwood Hospital, Christchurch, New Zealand; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand. Electronic address: annes@burwood.org.nz.
authors.forename: K Anne
authors.initials: KA
authors.lastname: Sinnott
authors.affiliation: Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand; Burwood Spinal Unit, Burwood Hospital, Christchurch, New Zealand.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dunn
authors.affiliation: Center of Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Wangdell
authors.affiliation: Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Graduate Program in Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA.
authors.forename: M Elise
authors.initials: ME
authors.lastname: Johanson
authors.affiliation: NZ Spinal Trust, Christchurch, New Zealand.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Hall
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands; Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: Marcel W
authors.initials: MW
authors.lastname: Post
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D011782:Quadriplegia / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications
keywords: Consensus; Quadriplegia, tetraplegia; Reconstructive surgical procedures; Rehabilitation; Tendon transfer; Upper extremity