Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients

Abstract

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01) and with knee extensor muscle strength (r = −0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection

“…Upper limb exercise capacity plays an important role in many basic and instrumental activities of daily living and may provide unique information about upper extremity endurance not reflected in the field-based walking tests. Previous studies in similar populations have found an upper limb impairment in patients after breast cancer or cardiac surgery[ 29 ], showing decreased functionality and exercise capacity after surgery, similar to our results. However, and despite its importance, we have not found studies about UL exercise capacity after lung resection.…”

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

“…13 A low but significant correlation (r= −0.32) between grip strength and DASH scores has also been reported for patients examined one month after cardiac surgery. 14 Sunderland et al demonstrated high correlations between grip strength and performance on the Frenchay Arm Test (r= 0.91), Motor Club Assessment (r= 0.86), and Peg Test (r= 0.79) by patients with stroke. 15 Although grip strength is not directly required for the performance of functional activities such as gait, it does distinguish between older adults on the basis of their mobility.…”

Longitudinal Changes of Handgrip, Knee Extensor Muscle Strength, and the Disability of the Arm, Shoulder and Hand Score in Cardiac Patients During Phase II Cardiac Rehabilitation

“…We previously reported on our cross-sectional investigation on the relationship between handgrip and knee extensor muscle strength and the DASH score of cardiac surgery patients at one month following surgery (74.4% men, age: 62.1 years) [7] and found that both strength factors correlated negatively with the DASH score [7]. In that study, we proposed that the DASH score could be valuable in assessing post-cardiac surgery patients’ handgrip and knee extensor muscle strength as a representative measure of upper and lower extremity function [7].…”