Single-handed, double loaded: The effect of an increase in biomechanical loads and central sensitization on the presence of musculoskeletal complaints in upper limb absence and brachial plexus injury.

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 80

Inclusion Criteria

- Aged 18 and older
- Able to give written informed consent
- Able to read/understand Dutch or English
- All questions of the Physical Activity Readiness Questionnaire (PAR-Q)
answered with *no*, and therefore assuming that executing physical activities
is reasonably safe. Or, when one of the questions is answered with *yes, if the
subject can clarify that their clinician approved participation in the study or
physical activity in general. If needed, and approved by the participant, the
responsible clinician will be asked to approve participation in the study.

Specific criteria per subgroup:
- Upper limb absence (ULA): defect at transhumeral, transradial, elbow
disarticulation or wrist disarticulation level, so the maximum voluntary
contraction (MVC) protocol as part of the movement protocol can be executed.
- Brachial plexus injury (BPI): a score between 0 and 8 on the questionnaire
about functional movements of the hand, meaning almost no function in the hand.
If a higher score is noted, an interview with the participant is held about
sensation and function of the whole arm and not only of the hand. The expertise
of the researchers will determine if the participant can be included.
- In case of acquired ULA or BPI: >= 1 year after amputation or injury
- Able bodied controls: matching based on gender and age group (+ or - 5 years)
- Muskuloskeletal complaints (MSC): answered with *yes* on the first two
questions (Controls: Q24-Q25, ULA Q32-Q33, BPI Q36-Q37) about MSC in the
questionnaires for the participants. Having complaints like pain, stiffness and
tingling of the muscles, bones, nerves and/or joints that are NOT the result of
an accident, an infection, a sport injury or a joint disease, occurring for at
least four weeks in the past year.

Exclusion Criteria

- Incapacity to follow instructions
- Manifest co-morbidity, other than MSC, leading to restrictions in physical or
mental functioning that interfere with the measurement results. Examples:
fractures of the upper extremity bones, muscle dystrophies or stroke.
- Lower extremity complaints, as the legs are used as a site reference in the
Quantitative Sensory Testing (QST)

Specific criteria per test:
- QST: signs or suspicion of neurological dysfunction at tested sites
- Capacity tests: history of medical disorder that influence heart rate or use
of medication that influences heart rate (for example beta-blockers). If a
participant uses medication to stabilize heart rate, they are asked to clarify
if their clinician approves physical activity.

Study & Design

Study Type: Observational non invasive

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>For the central sensitization protocol the main outcome measures are the<br /><br>Central Sensitization Inventory (CSI) questionnaire and the Quantitative<br /><br>Sensory Testing (QST) outcome measures. The primary outcome measures for the<br /><br>movement protocol are muscle fatigue, upper extremity angles, muscle activity<br /><br>and force. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>Secondary study parameters are heart rate, the Borg CR10 scale and the<br /><br>functionality asssesed with the outcome parameters of the Jebsen Taylor Hand<br /><br>Function Test (JTHFT) and the Functional Capacity Evaluation for One-Handed<br /><br>individuals (FCE-OH).</p><br>