Abstracts / Journal of Hand Therapy 27 (2014) e1ee4e2

able to predict 12.4% variability in musculoskeletal disability(MSKD) at 1 year following DRF.Conclusions: This study concluded that the baseline pain intensityis an independent predictor of chronic pain following DRF and canserve as an extremely important clinical tool for this purpose.Rehabilitation practitioners can use the score of >35 points on painsubscale of the PRWE at baseline to screen at risk patients. How-ever, it is acknowledged that further research is required in form ofprospective studies to validate this cut-off level.Clinical Relevance: Distal radius fracture is the most common fall-related fracture inmiddle-aged and older adults. Physical therapistsare routinely involved in rehabilitating patients with DRF.Approximately 16% patients continue to experience chronic painfollowing DRF.Whilemost of the care is focused towards improvingwrist/hand functions and reducing pain, there is a critical need toaddress the prevention aspect when it comes to chronic ongoingpain following DRF. At the outset, however, patients who havegreater risk of chronic pain need to be screened. This study hasprovided useful information for screening the risk of chronic painwhich can be readily translated into clinical practice.Keywords: Chronic pain, Distal radius fracture, Outcome measure.

3

Scapular Muscle Performance in Patients with LateralEpicondylalgiaJOSEPH M. DAY 1, ARTHUR NITZ 2, TIM L. UHL 3

1 Rehabilitation Sciences, University of Kentucky, Lexington, KY,United States2 Physical Therapy, University of Kentucky, Lexington, KY, UnitedStates3 Athletic Training, University of Kentucky, Lexington, KY, UnitedStates

Purpose/Hypothesis: Empirical evidence suggests that addressingscapular muscle deficits may be an important component of reha-bilitation in patients with Lateral Epicondylalgia (LE). However,there is limited descriptive data directly assessing scapular muscleperformance in patients with LE. The primary purpose of this studywas to describe scapular strength, endurance, andmuscle thickness(measured by rehabilitative ultrasound imaging (RUSI)) in patientswith LE compared to a control group. Our secondary purposewas toexamine the same measures of muscle performance in a compari-son of the patients involved and uninvolved limbs.Number of Subjects: Twenty- eight patients (mean age 47 SD 9)and 28 controls (mean age 46 SD 9), satisfied the eligibility criteriaand agreed to participate.Materials/Methods: Consecutive patients referred to 4 outpatientclinics were considered for participation in this cross sectionalstudy. For the control group, healthy subjects were recruited andmatched to patients by age and gender. To be included in the study,patients had to test positive on 2/5 clinical tests for LE and scoredgreater than 10% on a self-report disability scale (QDASH). Healthysubjects had to be between the ages of 30 and 65 and score lessthan 10% on the QDASH. Strength of the lower trapezius (LT),middle trapezius (MT), and serratus anterior (SA) was assessedwith a hand held dynamometer. Static posterior scapular muscleendurance was assessed at 135 degrees horizontal abduction withthe subject in prone. Percent change in muscle thickness of the LTand SAwas assessed in sitting using RUSI. The differences betweengroups for all dependent variables were evaluated with separaterepeated measures analysis of covariance (ANCOVA). Alpha was setat p�.05 a priori.Results: When comparing the experimental group to the controlgroup, there was significantly less LT strength (p ¼ .002), SA

strength (p <.001), scapular muscle endurance (p ¼.002), andpercent change in SA thickness (p ¼ .016). When comparing theinvolved limb to the uninvolved limb in LE patients, only the SAwasfound to be weaker by 2 kg compared to the non-involved side(p¼.02).Conclusions: Scapular muscle performance is diminished in onlythe serratus when comparing side to side differences in patientswith LE. However, when compared to matched control multiplemuscular parameters are found to be deficient. Interpretation ofthese differences should be cautioned as only 2 measures exceededMDC.Clinical Relevance: Assessment of scapular strength and endur-ance in patients with LE should be screened and the results shouldbe compared to normative data, yet to be established. Futurestudies should develop normative databases and investigate theefficacy of treating scapularmuscle performance deficits as part of acomprehensive treatment program.Keywords: Serratus anterior, Trapezius, Strength.

4

In Patients With Hand Osteoarthritis There is no Evidence Thata Booster Session after Multidisciplinary Treatment is Effective;Results of a Randomised Controlled TrialM.J. STUKSTETTE 1,2, C.H.M. VAN DEN ENDE 2, T.J. HOOGEBOOM3,W. NOORT-VAN DER LAAN 4, J.W. BIJLSMA 5, J. DEKKER 1,6

1 Physical Therapy Science, Program in Clinical Health Sciences,University Medical Center Utrecht, Utrecht, Netherlands2 Department of Rheumatology, Sint Maartenskliniek, Nijmegen,Netherlands3 Department of Epidemiology, CAPHRI School for Public Health andPrimary Care, Maastricht University Medical Centre+, Maastricht,Netherlands4 Department of Rheumatology, Sint Maartenskliniek, Woerden,Netherlands5 Rheumatology and Clinical Immunology, University Medical CenterUtrecht, Utrecht, Netherlands6 Department of Rehabilitation Medicine, VU Medical Center,Amsterdam, Netherlands

Purpose/Hypothesis: In a systematic review on the long-termeffectiveness of exercise therapy in patients with osteoarthritis(OA) of the knee and/or hip it was suggested that additional boostersessions positively influence the long-term effectiveness on painand limitations in activities. The effectiveness of a booster sessionafter non-pharmacological treatment in patients with hand OAutilizing a randomized design has never been investigated. Thepurpose of the current study was to investigate the effect of a singlebooster session after non-pharmacological multidisciplinarytreatment, on pain and limitations in activities in patients withhand OA on the long term.Number of Subjects: 147 patients with a mean (SD) age of 59 (8)years, 84% female, with hand OA according to the clinical ACRclassification criteria of whom complaints due to OA of hands werethe most or second most important problem were included in thestudy.Materials/Methods: Design: randomized controlled trial, nestedwithin cohort study. All patients received 4 group-based treatmentsessions supervised by a specialized nurse and a hand therapist. Sixmonths after the start of the multidisciplinary treatment programpatients were randomly assigned to the experimental (booster-session) or control group (wait and see). Primary outcome mea-sures were the AUSCAN subscale limitations in activities and theOARSI responder criteria one year after the start of