gms | German Medical Science

Clinical issue/s: Many of the hand and upper extremity injuries lead to permanent impairment. Severe impairments can lead to functional disability and even effect on returning to work. These restrictions are considered as disability.

The relation between impairment (such as restricted in range of motion, loss of sensation) and disability remains both complex and difficult. Only a few studies support low to moderate correlation between impairment and disability.

This reported relation might be due to the way of measuring disability and its definition mostly

Clinical reasoning: The aim of this paper is to analyze the relation between components of disability with distinguished score of impairment, activity and participation questionnaire based on clinical data of persons with hand injuries.

Innovative, analytical or new approach: Impairment was evaluated by use of AMA guide 6th edition and disability by DASH questionnaire on Convenience sample of patients (N= 117), with chronic hand injuries. Linking and allocating items of the DASH were done based on the ICF Core Set for Hand Conditions and the opinions of a group of experts from different related fields. Data was analyses by using Kappa index, Chi square test and a set of Pearson, Part and Partial correlations coefficient. Most of the DASH items were allocated to the activity; one to four of the items could not be classified and 0 to 22 were classified as having overlap. Participation and activity scores correlated positively with each other (r>0.80). Impairment had high correlation with activity and participation scores (>73). With controlling the effect of each or both construct, this relation between them with impairment diminished but still significant between activity and impairment.

Contribution to advancing HT practice: There is a huge overlap in definition of activity and participation. The most effecting item in relation of disability and impairment is activity restriction. Participation had no relation with impairment.