Pain, Range of Motion, Edema, Sensibility, Strength (PRESS) & Self-reported Function Create a Comprehensive Score

Upper Extremity Problem Clinical Trial

— PRESS  

Official title:

Development and Reliability of the PRESS to Function Approach: A Systematic Method for Upper Extremity Assessment

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT06155617
• Other study ID #: IRB-20-PNAH-08
• Status: Completed
• Phase: N/A
• Start date: November 13, 2017
• Est. completion date: May 24, 2023

Study information

• Verified date: October 2023
• Source: Howard University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to examine the development of a conceptual framework and provide evidence for reliability of a comprehensive hand therapy evaluation score. This approach provides a new standardized tool for upper extremity (UE) evaluation. Components of Pain, Range of Motion (ROM), Edema, Sensibility, Strength (PRESS), and self-reported Function were combined to create a baseline. Each assessment tool used for the PRESS to Function Approach assists in determining appropriate interventions.

Description:

In this study, investigators used the innovative PRESS to Function Approach and Composite Score to describe the development and piloting of a systematic standard for upper extremity evaluation. Using existing instruments with substantial evidence of validity and reliability is more cost-effective than starting from scratch to develop and validate an instrument. This Approach and Score will provide occupational therapists an accurate measure to track the progression of a patient. The hypothesis for this study is Press to Function components will demonstrate utility for measuring clinical and patient-reported function when used as a comprehensive assessment tool.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 30
• Est. completion date: May 24, 2023
• Est. primary completion date: May 5, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 21 Years to 85 Years

Eligibility

Inclusion Criteria:

• Clinical diagnosis of upper extremity disorder as the primary diagnosis

• Surgical and nonsurgical Diagnoses

• Age 21 years or older

Exclusion Criteria:

• Concomitant Diseases (i.e cerebralvascular accident, cerebral palsy, spinal cord injury)

• Full Body Lymphedema

• Individuals who did not complete at least one reassessment

Related Conditions & MeSH terms

• Hand Injuries
• Hand Injuries and Disorders
• Upper Extremity Problem

Intervention

Other:
• Upper Extremity Rehabilitation
Pain management, ROM, Edema Management, Desensitization, Strengthening, Functional Tasks

Locations

Country	Name	City	State
United States	Pinnacle Hand Therapy	Newport News	Virginia

Sponsors (1)

Lead Sponsor	Collaborator
Howard University

Country where clinical trial is conducted

United States, 

References & Publications (3)

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed,) American Journal of Occupational Therapy, 74 ( Suppl. 2).

Bohannon RW. Test-Retest Reliability of Measurements of Hand-Grip Strength Obtained by Dynamometry from Older Adults: A Systematic Review of Research in the PubMed Database. J Frailty Aging. 2017;6(2):83-87. doi: 10.14283/jfa.2017.8. — View Citation

Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018 Oct 23;10(10):CD008570. doi: 10.1002/1465185 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Development and Reliability of PRESS to Function Approach: A Systematic Method for Upper Extremity Assessment	The Development of the PRESS (pain, range of motion (ROM), edema, sensibility, strength) to Function Approach created a composite score. The PRESS to Function Composite Score combines subjective and objective measures to provide a single value to evaluate treatment prognosis. The six outcome measures (pain, ROM, edema, sensibility, strength, and function) were summed for 900 points to create a single score. The higher the score the less the overall disability.	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Pain Scale	Pain was measured using the Numerical Pain Rating Scale (NPRS) and descriptors. The NPRS is indicative of a rating 0 through 10. The zero represents no pain and the 10 represents the worst imaginable pain	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Range of Motion (ROM)	For ROM, joints were measured with a goniometer. The unit of measurement is in degrees. Measurements range from 0 to 180 degrees. Each joint is compared to normative data. Zero represents the neutral and the least amount of motion.	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Edema	Edema considered both upper extremities (right and left) using a standard tape measure. The measurements were recorded according to units in centimeters (cm). Anatomical landmarks were chosen strategically for a ratio comparison as well as to establish baseline. Smaller numbers represent less edema or swelling.	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Sensibility	Sensibility was measured with Semmes Weinstein Monofilaments to determine sensory loss and touch pressure. The filaments are classified from grade 1 to 5 according to their thickness, where 5 represents the thinnest filament and 1 represents the largest filament: 1.65-2.83 = grade 5, 3.22-3.61 = grade 4, 3.84-4.31 = grade 3, 4.56-6.45 = grade 2, and 6.65 = grade 1	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Strength (Grip and Pinch)	Measured with the dynamometer and the pinch gauge in pounds. The higher the the number the stronger the patient. Strength may range from 0 pounds (weak) to 200 pounds (strong).There will be a comparison in some cases with normative data based on age and gender	4 weeks - 16 weeks depending on diagnosis and protocol
Secondary	Function with Quick Disability of the Arm, Shoulder, and Hand (DASH)	The Quick DASH questionnaire is a Likert scale that uses 11 questions to measure the degree of difficulty in performing various physical activities. Due to a shoulder, arm, or hand problem questions address the severity of pain and tingling, the limitation on social activities, work, and sleep. All 11 self-report items must be completed to receive a score on a scale between 0-to-100 with the higher scores reflecting greater disability.	4 weeks - 16 weeks depending on diagnosis and protocol

External Links

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