Patient Outcomes After Peripheral Nerve Injury Depend on Bimanual Dexterity and Preserved Use of the Affected Hand.
Taewon Kim, Keith R Lohse, Susan E Mackinnon and 1 others
PMID 38268466WHAT IT FOUND
Better patient outcomes after hand nerve injury depend on dexterity in the non-dominant hand and continued use of the affected hand.
Standard tests miss hand dominance, so clinicians should assess both hands separately and encourage using the injured hand.
Key findings
01Good patient outcomes were strongly associated with performance in the non-dominant hand, even when the dominant hand was injured.
02Outcomes were also linked to preserved function and use of the affected hand, but some patients had good outcomes despite impaired performance in that hand.
03Standard assessments like the QuickDASH do not account for hand dominance, potentially missing the functional impact of dominant-hand injury.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Cross-sectional design prevents establishing causality; we do not know if interventions that improve non-dominant hand performance will actually improve outcomes. Small sample size (48) limited the ability to detect subgroups or cluster patients by injury type. Tactile sensation measures were unreliable and excluded, so the study does not address how sensory loss impacts outcomes. The study excluded patients with complex bilateral conditions (e.g., diabetic neuropathy), so findings may not apply to those populations. Standard assessments used were insensitive to hand dominance, potentially masking the true impact of dominant-hand injury.
Declared interests
Dr. Philip and Washington University in St. Louis have a licensing agreement with PlatformSTL to commercialize the precision drawing task used in the study.
The easy way to misread this
Do not interpret the lack of association between dominant-hand injury and patient outcomes as evidence that dominant-hand function does not matter. This finding is likely a measurement artifact, as the standard assessments used (like QuickDASH) are insensitive to hand dominance.