Limited upper limb functioning has impact on restrictions in participation and a

[Guest guest]

J Rehabil Med. 2009 Sep;41(9):746-50.

Limited upper limb functioning has impact on restrictions in participation and

autonomy of patients with hereditary motor and sensory neuropathy 1a.

Videler AJ, Beelen A, van Schaik IN, de Visser M, Nollet F.

Department of Rehabilitation, University of Amsterdam, Amsterdam, The

Netherlands. a.j.videler@...

OBJECTIVE: To evaluate upper limb functioning, restrictions on participation and

the independent contribution of upper and lower limb disability to participation

in hereditary motor and sensory neuropathy 1a.

DESIGN: Descriptive cross-sectional study.

SUBJECTS: Forty-nine patients with hereditary motor and sensory neuropathy 1a.

METHODS: Perceived upper limb functioning was evaluated using the Michigan Hand

Outcomes Questionnaire and participation restrictions with the Impact on

Participation and Autonomy Questionnaire. Upper and lower limb domains of Guy's

Neurological Disability Scale were used to determine their impact on

participation restrictions.

RESULTS: Limitations in upper limb functioning were perceived by 98% of the

patients. Median scores ranged between 70 points for overall hand function and

100 points for aesthetics (scale 0-100). Patients were least satisfied with

dominant hand performance. Most patients (46-78%) reported their participation

to be sufficient. Restrictions were reported in the domains work, family roles,

and autonomy outdoors. Minor problems with restricted participation were

indicated by 22-55%, severe problems by 2-12%. Upper limb functioning correlated

significantly with all participation subscales. Upper limb disability was

independently associated with participation restrictions, whereas lower limb

disability was not. CONCLUSION: Limitations in upper limb functioning were

perceived by the majority of patients with hereditary motor and sensory

neuropathy 1a and strongly related to restricted participation.