Distal Humeral Fractures of the Adult
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The aim of this study was to assess the utility of the Coonrad-Morrey elbow prosthesis in patients with severe elbow dysfunction secondary to rheumatoid arthritis (RA) or post-traumatic elbow dysfunction.The study involved 35 patients followed up for a mean of 36 months. The patients were divided into those with RA (Group I) and those with post-traumatic elbow dysfunction (Group II). Treatment outcomes were evaluated according to the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand Score (Quick DASH).According to the MEPS, there were 20 (57.15%) excellent, 12 (34.3%) good, 1 (2.85%) fair, and 2 (5.7%) poor outcomes. The mean post-operative Quick-DASH score for the entire study group was 37.73 points. In subgroup analysis, the MEPS-based evaluation revealed: 14 (70%) excellent, 5 (25%) good, and 1 (5%) satisfactory outcome in Group I, versus 6 (40%) excellent, 7 (46.7%) good, and 2 (13.3%) poor outcomes in Group II. The mean Quick Dash scores were 78.64 points in Group I and 76.36 points in Group II. The final MEPS scores in Group I (p=0.000018) and Group II (p=0.00065) were most markedly influenced by reduction in elbow pain and improvement in the ability to perform activities of daily living (ADL): p=0.000018 in Group I and p=0.000713 in Group II.The treatment outcomes confirm the utility of arthroplasty for severe elbow dysfunctions; they were most strongly influenced by pain reduction and improved ability to perform activities of daily living.
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dash is a program to calculate the DASH score using Stata. The DASH Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in people with any of several musculoskeletal disorders of the upper limb. The tool gives clinicians and researchers the advantage of having a single, reliable instrument that can be used to assess any or all joints in the upper extremity. The DASH questionnaire is distributed by the Institute for Work & Health in Toronto, Canada.
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Through analysis of the characters of modern dash skills,the thesis expounds shortcomings of specialized dash skills practice that people frequently use nowadays. The writer chooses and designs some techniques that are fit for specialized practice in modern dash skills.
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DASH diet
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dash is a program to calculate the DASH score using Stata. The DASH Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in people with any of several musculoskeletal disorders of the upper limb. The tool gives clinicians and researchers the advantage of having a single, reliable instrument that can be used to assess any or all joints in the upper extremity. The DASH questionnaire is distributed by the Institute for Work & Health in Toronto, Canada.
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The DASH (Dietary Approaches To Stop Hypertension) diet is one way to reduce hypertension. Dietary factors are important things to consider in patients with hypertension. Patients with hypertension should adhere to the DASH diet in order to prevent further complications. Therefore, counseling for the elderly is needed to understand the DASH diet. This activity aims to increase the knowledge and attitudes of the elderly about the hypertension DASH diet and how to process food for the hypertension DASH diet. The method used is counseling for the elderly who have hypertension who are selected by the Puskesmas staff as the person in charge of the posyandu for the elderly. The elderly understand the DASH diet for hypertension, which is characterized by being able to answer questions about how to process food. The elderly can also mention the type of food for the DASH hypertension diet and want to apply it in their daily diet. During the activity process, the participants/elderly listened, had discussions and were able to discuss or ask questions with the presenters.
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Patient-reported outcome meaures (PROMs) not only provide valuable insights into subjective indices of joint health, but also may provide limited objective information about range of motion (ROM). We sought to evaluate the accuracy of patient-reported range of elbow motion compared to measured ROM.Sixty clinic patients were recruited, of whom 26 had elbow pathologies and 34 had pathologies other than at the elbow joint. Each patient independently estimated ROM for extension, flexion, pronation and supination before this was measured by a clinician using a universal goniometer, with the mean being the gold standard.We found that patients' ROM estimates were significantly different from measured ROM (p < 0.00001 at 95% confidence interval). There was no statistically significant difference between elbow pathology and non-elbow pathology patients' estimated ROM.There was great disparity between patient-estimated and measured ROM, although estimates of patients with known elbow pathology did not demonstrate any significant difference from their healthy counterparts. These differences may be too great for patient-estimated range of motion to be used as a reliable tool for assessing outcomes.
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Die bisherig uneinheitlich verwendeten Tests zur Evaluation funktioneller Einschränkungen und Beschwerden nach Verletzungen oder Erkrankungen an der oberen Extremität kombinierten häufig scheinbar „objektive“ Parameter, wie Bewegungsausmaß und Kraft mit subjektiven Parametern, wie Schmerzen. Nach zunehmender Etablierung des Disability of Arm, Shoulder and Hand Questionnaire (DASH) in der prä- und postoperativen Erfassung funktioneller Einschränkungen sollte nun überprüft werden, inwieweit der DASH mit scheinbar „objektiven“ Parametern, wie Bewegungsausmaß und Kraft, sowie mit so genannten „Misch-Scores“, wie dem Krimmer- oder Cooney-Score korreliert. Hierzu wurden anhand von sechs verschiedenen Diagnosegruppen die Korrelationen zwischen den einzelnen Parametern berechnet. Während sich keine Korrelation des DASH zum Bewegungsausmaß zeigte, konnte lediglich bei wenigen Diagnosegruppen eine moderate Korrelation zur Kraft festgestellt werden. Sowohl der Krimmer- als auch der Cooney-Score zeigen eine gute Korrelation zum DASH, sind damit als „Misch-Score“ durch diesen ersetzbar. Die zukünftige Verwendung von Parametern, wie Bewegungsausmaß und Kraft, muss darüber hinaus diskutiert werden, da davon auszugehen ist, dass beide Messmethoden die Einschränkungen des Patienten nicht ausreichend wiedergeben.
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