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Akbari H, Saraee A, Mirzaei L, Abolfazli M, Bagheri H, Akbari P. Comparison of Functionality Level, Disability and Quality of Life in Subjects with Peripheral Nerve Repair in the Upper Extremity. World J Plast Surg 2024; 13:68-73. [PMID: 39193248 PMCID: PMC11346686 DOI: 10.61186/wjps.13.2.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/24/2024] [Indexed: 08/29/2024] Open
Abstract
Background Peripheral nerve damage is a very important factor in patients' quality of life and functionality for various reasons. We aimed to compare the functionality level, disability and quality of life in subjects with peripheral nerve repair in the upper extremity. Methods This cross-sectional study was conducted on patients with nerve injuries in 2019. Among those patients, Eighty-five were selected as the sample. The instruments used in this study included the health-related quality of life standard questionnaire (SF-36), and the disability of the arm, shoulder and hand questionnaire (DASH-38). Data were analyzed by SPSS software version 22 and one-way ANOVA and Kruskal-Wallis statistical tests. Results Results of the Kruskal-Wallis test showed that the disability score in the groups of patients was not significant. In addition, according to the results of the one-way ANOVA test, the quality of life score was not significant among the patient groups. Conclusion Considering that peripheral nerve damage has a significant impact on patients' quality of life and functionality, apart from more research on the subject, it is necessary to provide support for patients to improve their quality of life.
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Affiliation(s)
- Hossein Akbari
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Amir Saraee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Leila Mirzaei
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mahsa Abolfazli
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hossein Bagheri
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Peyman Akbari
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Heinzel JC, Dadun LF, Prahm C, Winter N, Bressler M, Lauer H, Ritter J, Daigeler A, Kolbenschlag J. Beyond the Knife-Reviewing the Interplay of Psychosocial Factors and Peripheral Nerve Lesions. J Pers Med 2021; 11:jpm11111200. [PMID: 34834552 PMCID: PMC8624495 DOI: 10.3390/jpm11111200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 01/12/2023] Open
Abstract
Peripheral nerve injuries are a common clinical problem. They not only affect the physical capabilities of the injured person due to loss of motor or sensory function but also have a significant impact on psychosocial aspects of life. The aim of this work is to review the interplay of psychosocial factors and peripheral nerve lesions. By reviewing the published literature, we identified several factors to be heavily influenced by peripheral nerve lesions. In addition to psychological factors like pain, depression, catastrophizing and stress, social factors like employment status and worker's compensation status could be identified to be influenced by peripheral nerve lesions as well as serving as predictors of functional outcome themselves, respectively. This work sheds a light not only on the impact of peripheral nerve lesions on psychosocial aspects of life, but also on the prognostic values of these factors of functional outcome. Interdisciplinary, individualized treatment of patients is required to identify patient at risk for adverse outcomes and provide them with emotional support when adapting to their new life situation.
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Affiliation(s)
- Johannes C. Heinzel
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
- Correspondence: ; Tel.: +49-7071-6061038
| | - Lucy F. Dadun
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Cosima Prahm
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Natalie Winter
- Department of Neurology, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany;
| | - Michael Bressler
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Henrik Lauer
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Jana Ritter
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Adrien Daigeler
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
| | - Jonas Kolbenschlag
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstraße 95, 72076 Tuebingen, Germany; (L.F.D.); (C.P.); (M.B.); (H.L.); (J.R.); (A.D.); (J.K.)
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Dimova V, Oertel BG, Kabakci G, Zimmermann M, Hermens H, Lautenbacher S, Ultsch A, Lötsch J. A more pessimistic life orientation is associated with experimental inducibility of a neuropathy-like pain pattern in healthy individuals. THE JOURNAL OF PAIN 2015; 16:791-800. [PMID: 26056011 DOI: 10.1016/j.jpain.2015.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/27/2015] [Accepted: 05/19/2015] [Indexed: 01/31/2023]
Abstract
UNLABELLED The clinical pattern of neuropathic pain, diagnosed using the quantitative sensory testing (QST) battery (German Research Network on Neuropathic Pain), could be partly mimicked in healthy volunteers after topical capsaicin application. However, similar to clinical neuropathic pain that develops in only a subgroup of patients who have a neurologic lesion, this attempt to mimick a neuropathic pain pattern succeeded only in a small fraction (18%) of healthy individuals. In the present assessment, we pursued the hypothesis that the inducible subgroup differed from the other healthy participants with respect to their psychological phenotype. Therefore, in an observational study, participants were assessed using a comprehensive set of psychological variables comprising general psychological and pain-related cognitive-emotional mechanisms. The sum scores of the questionnaires were significantly linearly correlated with each other. Principal component analysis indicated that a major source of variance (46%) could be attributed to dispositional optimism examined via the Life Orientation Test (LOT). The LOT score significantly differed between the groups of participants, either those in whom a neuropathy-like pattern of pain assessed via QST could be partly (50-60% of the 11 QST parameters) induced (n = 20) or not (n = 90; P = .0375). It emerged again as the main selection criterion in a classification and regression tree predicting a participant's group assignment (inducible neuropathy-like QST pattern versus noninducible neuropathy-like QST pattern) at a cross-validated accuracy of 95.5 ± 2.1%. Thus, the few participants in a random sample of healthy volunteers who, after topical capsaicin application, partly resemble (to a degree of about 60%) the clinical pattern of neuropathic pain in the QST test battery, are preselectable on the basis of psychological factors, with a particular emphasis on pessimistic life attitudes. PERSPECTIVE In a small fraction of 18% of healthy volunteers, topical capsaicin application resulted in a neuropathy-like pattern in 50 to 60% of the components of a clinical test battery. These individuals displayed a more pessimistic life attitude as assessed by means of the LOT.
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Affiliation(s)
- Violeta Dimova
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Bruno G Oertel
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Frankfurt am Main, Germany
| | - Gülden Kabakci
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany
| | - Michael Zimmermann
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Hanneke Hermens
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany
| | - Stefan Lautenbacher
- Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany
| | - Alfred Ultsch
- DataBionics Research Group, University of Marburg, Marburg, Germany
| | - Jörn Lötsch
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany; Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Frankfurt am Main, Germany.
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Wojtkiewicz DM, Saunders J, Domeshek L, Novak CB, Kaskutas V, Mackinnon SE. Social impact of peripheral nerve injuries. Hand (N Y) 2015; 10:161-7. [PMID: 26034424 PMCID: PMC4447662 DOI: 10.1007/s11552-014-9692-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Disorders involving the peripheral nervous system can have devastating impacts on patients' daily functions and routines. There is a lack of consideration of the impact of injury on social/emotional well-being and function. METHODS We performed a retrospective database and chart review of adult patients presenting between 2010 and 2012 with peripheral nerve compression, brachial plexus injury, thoracic outlet syndrome (TOS), or neuromas. At the initial assessment, patients completed a questionnaire used to obtain demographic and psychosocial variable data including the (1) average level of pain over the last month, (2) self-perceived depression, (3) how much pain impacts quality of life (QoL), (4) current level of stress, and (5) ability to cope with stress. Statistical analyses were used to assess the differences between the dependent variables and diagnostic and demographic groups. RESULTS This study included 490 patients (mean age 50 ± 15 years); the most common diagnosis was single nerve compression (n = 171). Impact on QoL was significantly greater in patients with TOS, cutaneous peroneal compressions, and neuroma versus single site nerve compressions. Average pain, impact on QoL, and stress at home were significantly higher in females versus males. Impact on QoL was correlated with average pain, depression, stress at home, and ability to cope with stress at home. CONCLUSIONS Our study demonstrates that patients with single site nerve compression neuropathies experience fewer negative psychosocial effects compared to patients with more proximal upper extremity peripheral nerve disorders and neuromas. The impact on QoL was strongly correlated with pain and depression, where patients with neuromas and painful peroneal nerve entrapments reported greater detriments to QoL.
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Affiliation(s)
- Danielle M. Wojtkiewicz
- />Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO USA
| | - James Saunders
- />Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Suite 1150, Northwest Tower, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110 USA
| | - Leahthan Domeshek
- />Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Suite 1150, Northwest Tower, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110 USA
| | - Christine B. Novak
- />Hand and Upper Extremity Program, Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON Canada
| | - Vicki Kaskutas
- />Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO USA
| | - Susan E. Mackinnon
- />Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, Suite 1150, Northwest Tower, 660 South Euclid Avenue, Campus Box 8238, St. Louis, MO 63110 USA
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Brandow AM, Farley RA, Dasgupta M, Hoffmann RG, Panepinto JA. The use of neuropathic pain drugs in children with sickle cell disease is associated with older age, female sex, and longer length of hospital stay. J Pediatr Hematol Oncol 2015; 37:10-5. [PMID: 25222053 PMCID: PMC4270887 DOI: 10.1097/mph.0000000000000265] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although neuropathic pain is increasingly recognized in sickle cell disease (SCD), it is unknown how neuropathic pain drugs are used in children with SCD. Thus, we investigated use of these drugs and hypothesized older age and female sex are associated with increased neuropathic drug use and the use of these drugs is associated with longer length of stay. We analyzed the Pediatric Health Information System (2004 to 2009) including all inpatient visits aged 0 to 18 years with any SCD-related (all genotypes) discharge diagnosis. To limit confounding we excluded psychiatric and seizure visits. Antiepileptics, tricyclic antidepressants, and selective serotonin reuptake inhibitors were drugs of interest. Generalized Estimating Equations determined the impact of age and sex on neuropathic drug use and the impact of neuropathic drug use on length of stay. We analyzed 53,557 visits; 2.9% received≥1 neuropathic drugs. The odds of receiving a neuropathic drug increased significantly with age (reference group, 0 to 4 y: 5 to 10, odds ratio [OR], 5.7; 11 to 14: OR, 12.5; 15 to 18: OR, 22.8; all P<0.0001] and female sex (OR, 1.5; P=0.001). Neuropathic drug use was associated with longer length of stay (risk ratio, 8.3; P<0.0001). Neuropathic drug use in children with SCD was associated with older age, female sex, and longer length of stay.
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Affiliation(s)
- Amanda M. Brandow
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
- Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Rebecca A. Farley
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mahua Dasgupta
- Section of Quantitative Health Sciences, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Raymond G. Hoffmann
- Section of Quantitative Health Sciences, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
- Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, WI, United States
| | - Julie A. Panepinto
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
- Children's Research Institute of the Children's Hospital of Wisconsin, Milwaukee, WI, United States
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Brandow AM, Farley RA, Panepinto JA. Neuropathic pain in patients with sickle cell disease. Pediatr Blood Cancer 2014; 61:512-7. [PMID: 24167104 PMCID: PMC4357477 DOI: 10.1002/pbc.24838] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/12/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Despite the suggestion of a neuropathic component to sickle cell disease (SCD) pain, there are minimal data on the systematic assessment of neuropathic pain in patients with SCD. Neuropathic pain is defined as pain primarily initiated by dysfunction of the peripheral or central nervous system. PROCEDURE In a cross-sectional study, we used the painDETECT questionnaire, a one-page validated neuropathic pain screening tool, to determine the presence of neuropathic pain in patients with SCD and to evaluate the relationship between neuropathic pain, age, and gender. We hypothesized that 20% of patients with SCD will experience neuropathic pain and that neuropathic pain will be associated with older age and female gender. The completed painDETECT questionnaire yields a total score between 0 and 38 (≥ 19 = definite neuropathic pain, 13-18 = probable neuropathic pain, ≤ 12 = no neuropathic pain). Scores ≥ 13 were designated as having evidence of neuropathic pain. RESULTS A total of 56 patients participated. Median age was 20.3 years and 77% were female. We found 37% of patients had evidence of neuropathic pain. Age was positively correlated with total score (r = 0.43; P = 0.001) suggesting older patients experience more neuropathic pain. Females had higher mean total scores (13 vs. 8.4; P = 0.04). Significantly more patients with neuropathic pain were taking hydroxyurea (90% vs. 59%; P = 0.015). Despite 37% of patients experiencing neuropathic pain, only 5% were taking a neuropathic pain drug. CONCLUSIONS Neuropathic pain exists in SCD. Valid screening tools can identify patients that would benefit from existing and future neuropathic pain therapies and could determine the impact of these therapies.
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Affiliation(s)
- Amanda M. Brandow
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
- Children’s Research Institute of the Children’s Hospital of Wisconsin, Milwaukee, WI, United States
| | - Rebecca A. Farley
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Julie A. Panepinto
- Section of Pediatric Hematology/Oncology, Milwaukee, WI, United States
- Medical College of Wisconsin, Milwaukee, WI, United States
- Children’s Research Institute of the Children’s Hospital of Wisconsin, Milwaukee, WI, United States
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