Outcome measures for hand function naturally reveal three latent domains in older adults: strength, coordinated upper extremity function, and sensorimotor processing
Autor: | Emily L Lawrence, Sudarshan eDayanidhi, Isabella eFassola, Philip Santos Requejo, Caroline eLeclercq, Carolee J Winstein, Francisco J Valero-Cuevas |
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Rok vydání: | 2015 |
Předmět: |
030506 rehabilitation
medicine.medical_specialty Cognitive Neuroscience medicine.medical_treatment Thumb lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Hand strength medicine lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry latent functional domains Original Research Communication Rehabilitation Hand function business.industry aging Outcome measures Function (mathematics) sensorimotor processing medicine.anatomical_structure dexterity Treatment modality hand 0305 other medical science business Psychology strength 030217 neurology & neurosurgery Neuroscience |
Zdroj: | Frontiers in Aging Neuroscience Frontiers in Aging Neuroscience, Vol 7 (2015) |
ISSN: | 1663-4365 |
Popis: | Understanding the mapping between individual outcome measures and the latent functional domains of interest is critical to a quantitative evaluation and rehabilitation of hand function. We examined whether and how the associations among six hand-specific outcome measures reveal latent functional domains in elderly individuals. We asked 66 healthy older adult participants (38F, 28M, 66.1 ± 11.6 years, range: 45–88 years) and 33 older adults (65.8 ± 9.7 years, 44–81 years, 51 hands) diagnosed with osteoarthritis (OA) of the carpometacarpal (CMC) joint, to complete six functional assessments: hand strength (Grip, Key and Precision Pinch), Box and Block, Nine Hole Pegboard, and Strength-Dexterity tests. The first three principal components suffice to explain 86% of variance among the six outcome measures in healthy older adults, and 84% of variance in older adults with CMC OA. The composition of these dominant associations revealed three distinct latent functional domains: strength, coordinated upper extremity function, and sensorimotor processing. Furthermore, in participants with thumb CMC OA we found a blurring of the associations between the latent functional domains of strength and coordinated upper extremity function. This motivates future work to understand how the physiological effects of thumb CMC OA lead upper extremity coordination to become strongly associated with strength, while dynamic sensorimotor ability remains an independent functional domain. Thus, when assessing the level of hand function in our growing older adult populations, it is particularly important to acknowledge its multidimensional nature—and explicitly consider how each outcome measure maps to these three latent and fundamental domains of function. Moreover, this ability to distinguish among latent functional domains may facilitate the design of treatment modalities to target the rehabilitation of each of them. |
Databáze: | OpenAIRE |
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