This study determined the inter-instrument reliability of pinch strength scores obtained using three commercially available pinch gauges (B&L, JTech and NK pinch gauges). The consistency of pinch scores obtained with new devices compared with that of scores obtained by traditional devices underlies the ability of therapists to use new devices when communicating about patient status or using normative data published for these traditional devices. Validation of appropriate scales and inclusion of both impairment and disability measures in future clinical studies is required to fully understand health outcomes after tendon and nerve injury. Recent literature on treatment outcomes has focused on impairment measures with minimal attention to activity limitations and participation restrictions. Use of this validated instrument will facilitate more meaningful comparisons across centers and studies. A comprehensive impairment rating scale for nerve injury with subscales addressing sensory, motor, and pain/discomfort domains has been developed.
Cold sensitivity is common and can be measured through rewarming responses or by self-report. Two-point discrimination was once a mainstay of assessment, but current evidence suggests it is less valid and responsive than other quantitative sensory testing. Development of quantitative measures of sensibility continues to evolve, although all current methods have some limitations. Nerve injuries result in an impairment of motion, strength, sensibility, and sympathetic nerve function. Subjective ratings have not been validated, vary across scales, and inhibit meaningful comparisons by diluting information. These scales also tend to classify outcomes on a subjective four-point scale ranging from poor to excellent. Published impairment rating scales have expressed outcome based on regained total active motion of relevant joints. Recently developed devices can be used to measure strength impairments associated with individual digits after tendon injury, although the importance of either grip or digital strength measures as indicators of post-tendon recovery has not been fully delineated.
Literature on outcome of tendon surgery has focused on active motion. A tendon injury results in impairment of motion and strength of affected digits. The World Health Organization's model of health suggests that tendon and nerve injury outcomes can be assessed in terms of impairment, activity limitations, and participation restrictions.
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