03138nas a2200409   4500000000100000008004100001260001300042653001500055653002800070653001000098653000800108653002600116653001300142653001100155653001100166653000800177653001200185653000900197653001600206653003900222653002600261653003200287653003000319100001800349700001200367700001800379700001800397700001300415700001900428245016500447856005900612300001100671490000700682050001800689520200700707022001402714       2000                            d  c2000 Sep10aAdolescent10aAdrenal Cortex Hormones10aAdult10aArm10aDisability Evaluation10aEthiopia10aFemale10aHumans10aLeg10aleprosy10aMale10aMiddle Aged10aPeripheral Nervous System Diseases10aRetrospective Studies10aSensitivity and Specificity10aSeverity of Illness Index1 aBroekhuis S M1 aMeima A1 aKoelewijn L F1 aRichardus J H1 aBenbow C1 aSaunderson P R00aThe hand-foot impairment score as a tool for evaluating prevention of disability activities in leprosy: an exploration in patients treated with corticosteroids.  uhttp://leprev.ilsl.br/pdfs/2000/v71n3/pdf/v71n3a15.pdf  a344-540 v71  aBROEKHUIS20003 a<p>The hand-foot (HF) impairment score in leprosy patients is the sum of the WHO disability grades for hands and feet. This retrospective study explored the possibility of using the HF score for evaluation of the effectiveness of corticosteroid treatment programmes for nerve function impairment (NFI). Changes in the score were compared with changes in sensory testing (ST) and voluntary muscle testing (VMT) for 42 leprosy patients who received corticosteroid treatment. The WHO grade did not change in 30/60 (50%) of extremities gaining, and in 4/10 (40%) extremities losing sensation and/or muscle strength. However, 18/24 (75%) patients with a definite gain in function improved in HF score, while the HF score remained unchanged in 10/11 (91%) patients with no change in nerve function. Five patients with impairment in multiple extremities showed both gain and loss of sensation and/or muscle strength in the same or different extremities. Overall, improvement, deterioration and absence of change in NFI, as indicated by changes in ST and VMT were reflected correctly by the HF score in 28 (76%) of the remaining 37 patients. It was also shown that the HF score does not give appropriate information on the extent of the effect of corticosteroid treatment. This study illustrates that the HF score can not be used to support management of corticosteroid treatment of individual patients, but indicates this score to be a promising device for the evaluation of the effectiveness of corticosteroid treatment programmes. This study used the HF score because information on (changes in) eye impairment was not considered reliable. However, in principle, we consider the EHF score, which is the sum of the WHO disability grades for hands, feet and eyes, preferable for evaluation purposes. We strongly recommend further validation of the EHF score as a tool for evaluation of corticosteroid treatment programmes for patient groups with different distributions of NFI through prospective studies.</p>  a0305-7518