The Cognitive-Functional Relationship in Geriatric Hand-Forearm Injuries

Primary outcomes

1. Modified Hand Injury Severity Score

   Time frame: At baseline

   A scoring system that evaluates the severity of hand and forearm injuries based on integumentary, skeletal, motor, and neurovascular components. The total score is obtained by summing the scores of all components and is divided into four categories: minor (<20), moderate (21-50), severe (51-100), and major (>101) injury.

2. Standardized Mini-Mental Test

   Time frame: At 12th week after injury or surgery

   This test will be used to assess the cognitive levels of the participants. The test consists of five subdomains: orientation, registration, attention and calculation, recall, and language, and is scored out of a total of 30 points. The results are evaluated as follows; 27-30 points: within normal limits, 24-27 points: mild cognitive impairment, and below 24 points: severe cognitive impairment.

3. Upper Extremity Functional Index

   Time frame: At 12th week after the injury or surgery

   A 20-item scale used to assess upper extremity function and is scored using a 0-5 Likert-type rating, with a total score ranging from 0 to 80. Lower scores indicate that the individual has difficulty performing activities as a result of an upper extremity problem.

4. Grip-pinch strength

   Time frame: At 12th week after injury or surgery

   Grip strength will be measured using a Jamar hand dynamometer according to the procedure recommended by the American Society of Hand Therapists. Pinch strength will be measured using a Jamar pinch gauge in four positions: tip pinch, pulp pinch, lateral pinch, and tripod pinch. Results will be recorded in kilograms.

5. Perceived pain intensity

   Time frame: At 12th week after injury or surgery

   Perceived pain intensity will be assessed using the Visual Analog Scale. The evaluation will be performed on a 10-cm line ranging from "no pain" to "worst possible pain.