TY - JOUR
T1 - Predictors of functional outcome after peripheral nerve injury and compression
AU - Stonner, Macyn M.
AU - Mackinnon, Susan E.
AU - Kaskutas, Vicki
N1 - Funding Information:
Statement of funding: This research was internally funded by The Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
Publisher Copyright:
© 2020
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Study Design: Retrospective cohort study. Introduction: Upper-extremity peripheral nerve injuries can impact long-term pain, work performance, and disability, yet there are few studies evaluating treatment outcomes for a large sample of patients with varying peripheral nerve pathology. Purpose of the Study: The purpose of this study was to identify outcomes of care and predictors of disability and health status in adults with peripheral nerve injuries. Methods: We explored medical records from 364 patients treated by a plastic surgeon over a three-year period. Descriptive and inferential statistics compared the Disabilities of the Arm, Shoulder, and Hand, Short-Form 8, and routine intake data between baseline and discharge, diagnosis, and intervention group. Multivariate linear regression models predicted disability, work disability, and physical and mental health at discharge. Results: We found significant improvements in disability, work disability, pain, depression, and stress. Health status changed minimally. Disability decreased most in patients who were working and who had symptoms fewer than six months. Outcomes were not statistically different between surgical and nonsurgical patients. Disability was the highest in patients with brachial plexus injuries. Multivariate models predicted 35 to 55% of the variance in the outcome measures. Factors that were highly predictive of functional outcomes included work status, household management, pain, depression, stress, and difficulty sleeping. Conclusions: Patients with peripheral nerve injuries experience improved pain and disability whether treated surgically or nonsurgically. Maintaining engagement in meaningful home and work roles may improve outcomes. Helping patients manage pain remains important, along with combatting stress, depression, and sleep deprivation.
AB - Study Design: Retrospective cohort study. Introduction: Upper-extremity peripheral nerve injuries can impact long-term pain, work performance, and disability, yet there are few studies evaluating treatment outcomes for a large sample of patients with varying peripheral nerve pathology. Purpose of the Study: The purpose of this study was to identify outcomes of care and predictors of disability and health status in adults with peripheral nerve injuries. Methods: We explored medical records from 364 patients treated by a plastic surgeon over a three-year period. Descriptive and inferential statistics compared the Disabilities of the Arm, Shoulder, and Hand, Short-Form 8, and routine intake data between baseline and discharge, diagnosis, and intervention group. Multivariate linear regression models predicted disability, work disability, and physical and mental health at discharge. Results: We found significant improvements in disability, work disability, pain, depression, and stress. Health status changed minimally. Disability decreased most in patients who were working and who had symptoms fewer than six months. Outcomes were not statistically different between surgical and nonsurgical patients. Disability was the highest in patients with brachial plexus injuries. Multivariate models predicted 35 to 55% of the variance in the outcome measures. Factors that were highly predictive of functional outcomes included work status, household management, pain, depression, stress, and difficulty sleeping. Conclusions: Patients with peripheral nerve injuries experience improved pain and disability whether treated surgically or nonsurgically. Maintaining engagement in meaningful home and work roles may improve outcomes. Helping patients manage pain remains important, along with combatting stress, depression, and sleep deprivation.
KW - Activities of daily living
KW - Peripheral nerve injuries
KW - Treatment outcomes
KW - Work
UR - http://www.scopus.com/inward/record.url?scp=85083580805&partnerID=8YFLogxK
U2 - 10.1016/j.jht.2020.03.008
DO - 10.1016/j.jht.2020.03.008
M3 - Article
C2 - 32334939
AN - SCOPUS:85083580805
SN - 0894-1130
VL - 34
SP - 369
EP - 375
JO - Journal of Hand Therapy
JF - Journal of Hand Therapy
IS - 3
ER -