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Linking Impairments with Limitations

Impairments and limitations. These are words used in the medical world to describe what's wrong and how it affects us. In this study, physical therapists report on the link between impairments and limitations in patients with a condition called type I complex regional pain syndrome (CRPS).

CRPS was formerly known as reflex sympathetic dystrophy. It's a poorly understood problem. It occurs after trauma or surgery and affects the arms or legs. Patients have mild to severe pain, dry or flaking skin, hair loss or hair growth, and hot or cold skin temperature.

Patients with CRPS vary in how severe the problem (impairment) is as measured by range of motion and grip strength. But does this impairment always lead to limitations in what patients can actually do in normal daily life? That's what these researchers tried to find out.

They used a special tool called the upper-limb activity monitor (ULAM) to measure arm activity. This device gives data on what patients can actually do, not just what they say they can do. Thirty patients wore the ULAM for 24 hours. The results showed activity patterns (whether or not the arms were active) and what activities were performed.

The authors report that everyone had a loss of motion (impairment). The involved limb was less active than the "normal" arm. This was especially true when the patient was sitting. However, this impairment didn't appear to limit the patients' general mobility. The ULAM did show that the patients with CRPS of the dominant arm had more activity limitations than patients with CRPS of the nondominant side.

Does impairment lead to activity limitation? According to this study, yes. The more impairment, the more limits there were on activity.

References: Fabiënne C. Schasfoort, PhD, PT, et al. Impairments and Activity Limitations in Subjects with Chronic Upper-Limb Complex Regional Pain Syndrome Type I. In Archives of Physical Medicine and Rehabilitation. April 2004. Vol. 85. No. 4. Pp. 557-566.

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