Joint Protection

findings show a single factor for the DASH and dual factors for the QuickDASH. However, CFA for the DASH has only been published in 2 studies and both showed a 3-factor structure. No study has investigated the QuickDASH with CFA making this a necessity. Conclusion: The internal consistency of the DASH in this study was <0.95 indicating no item redundancy and was lower than that found in other studies with smaller samples. Both DASH and QuickDASH factor structure under CFA showed dual or multi factors. These findings raise further concerns on use of the DASH and QuickDASH in research and clinical settings as their psychometric characteristics indicate they may be unsuitable for single summated scores. Further research is needed in larger samples to verify both the internal consistency and the factor structure. Results: The internal consistency showed the DASH at a ¼ 0.93 and the QuickDASH at 0.87. The EFA provided a single factor solution for the DASH and a dual factor for the QuickDASH. The CFA however demonstrated a three-factor model for the DASH and a two-factor model for the QuickDASH. Methods: Participants with upper limb conditions referred to and included in registered studies were de-identified and pooled to two separate data bases with baseline measures for the DASH (n ¼ 459) and QuickDASH (n ¼ 566). Internal consistency was determined on both samples. Factor structure was determined in two stages, initial EFA and subsequent CFA for the full sample with models compared empirically for the best fit. The CFA calculated factor loadings of the variables included in the models and against the EFA findings. The maximum likelihood extraction (MLE) method was used.

BODY: Results: The sample had a symmetrical distribution of hand OA (ns) (Table 1). Participants used less hand force when twisting with their left hand (p<.0001). The smallest hand force across time was produced by the left nonskid supinated approach (p<.05). Conversely, the highest average torque was used during the left nonskid supinated approach (p<.05) (Figure 2a). The left hand had significantly lower pain ratings than the right hand (p=.05) after turning. For both hands, participants rated significantly less pain when using a supinated grasp pattern (p<.0001). Participants rated PE significantly lower when using the left hand to turn (p<.0001), the supinated grasp pattern (p<.0001), and nonskid material (p<.0001) (Figure 2b). A left supinated grasp with a nonskid material was a significantly more successful strategy to open jars than was any other (χ 2 =9.4, p<.001). Conclusion: The data supports that women with hand OA will know more success, report less pain and effort, use less hand force, and will more effectively produce torques when twisting lids with the left hand, grasping the base of the jar with a supinated right hand, and using nonskid material. Nonskid material, when used by the right hand during opening, does not have the same hand force and pain reducing effects. This data challenges the belief that nonskid materials alone reduce hand forces. Hand therapists should consider how the stabilizing hand supports the jar and which hand grasps the lid when recommending use of nonskid materials for opening sealed jars. The use of nonskid material without additional reasoning will likely increase loads on arthritic joints, pain and, dysfunction. Given the composition of the sample, these findings are most generalizable to a symptomatic population of women with bilateral thumb CMC OA. Purpose: To investigate if hand force profiles, pain, and perceived effort of women with hand osteoarthritis differ by a) the hand twisting the lid, b) grasp pattern of the stabilizing hand, and c) the use of a nonskid material when attempting to open a sealed jar. Methods: Women (n=31), aged18 years+, were recruited through orthopedic, women's health, and hand therapy clinics, as well as community-based centers serving older adults. Participants were eligible if they were female, aged 18 years+, and had radiographicially confirmed and symptomatic hand osteoarthritis (OA). A 2x2x2 experimental cross-sectional design was used to study within-subject differences in pain, perceived effort (PE), hand force profiles, hand forces across time, and hand generated torques during a jar-opening task across three factors: 1) orientation of hand used to stabilize the jar's base (supinated vs. oblique), 2) hand used to twist the lid (right vs. left), and 3) use of nonskid material when twisting the lid (yes vs. no). (Figure 1a) An ecologically valid jar device