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Macedo FPF, McKee P, Semedo ACG, Parisi M, Scarpa I, Santiago PRP, Fonseca MDCR. Exploration of outcome measures for assessing orthotic intervention in upper extremity peripheral nerve injuries: 2 case reports. Prosthet Orthot Int 2024; 48:76-82. [PMID: 38334503 DOI: 10.1097/pxr.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 08/17/2023] [Indexed: 02/10/2024]
Abstract
In upper extremity peripheral nerve injuries, orthotic intervention has been used as a valuable device to restore function. However, there is lacking evidence to support it. The purpose of this study was to explore the application of body function's outcome measures for orthotic intervention evaluation in patients with peripheral nerve injury. Two participants sustaining a peripheral nerve injury who underwent orthotic intervention were assessed: subject 1 was a 25-year-old man with ulnar and median nerve injury presenting with a composite claw; subject 2, a 28-year-old man with radial nerve injury presenting with a dropped wrist. Strength, range of motion, and electromyography were measured in 2 conditions: wearing the orthosis and without it. The Jamar, Pinch Gauge, a 3D motion capture system (Optitrack-NaturalPoint), and surface electromyography (Trigno Wireless System, Delsys) were the chosen instruments. Both subjects presented differences in grip and pinch strength. In both tasks, subject 1 reached higher wrist extension while wearing the orthosis. Subject 2 reached higher wrist extension and radial deviation while wearing the orthosis. There were marked differences in both tasks for subject 2, especially the maintenance of wrist extension when wearing the orthosis. Electromyographic assessment showed higher root-mean-square values for all muscles, in both tasks for subject 1. For subject 2, a higher root-mean-square value was found for flexor carpi ulnaris during the execution of task 1 wearing the orthosis. Outcome measures of body function can quantify the impact of orthotic intervention in patients sustaining peripheral nerve injury, and therefore, they are feasible for evaluating it.
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Affiliation(s)
- Flávia Pessoni F Macedo
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Pat McKee
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ana Carolina Grillo Semedo
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Maitê Parisi
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Isadora Scarpa
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Paulo Roberto Pereira Santiago
- Laboratory of Biomechanics and Motor Control, School of Physical Education and Sport of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
| | - Marisa de Cássia Registro Fonseca
- Department of Health Sciences, Rehabilitation and Functional Performance Postgraduate Program, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Boake BR, Childs TK, Soules TD, Zervos DL, Vincent JI, MacDermid JC. Rasch analysis of The Shoulder Pain and Disability Index (SPADI) in a postrepair rotator cuff sample. J Hand Ther 2021; 34:612-618. [PMID: 33250397 DOI: 10.1016/j.jht.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/20/2020] [Accepted: 09/07/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement study: Level of evidence (N/A) INTRODUCTION: The Shoulder Pain and Disability Index (SPADI) is a self-reported outcome measure of pain and disability related to shoulder pathology. In comparison to Classical Test Theory (CTT), Rasch analysis offers a more rigorous examination of the measurement properties of a scale. PURPOSE OF THE STUDY This study utilizes Rasch analysis to evaluate the psychometric properties of the SPADI to propose potential modifications and avenues for future investigation. METHODS SPADI scores (n = 212) from participants one-year post rotator cuff repair were collected from an outpatient specialty clinic. Fit to the Rasch model, unidimensionality of the subscales, and areas of bias were evaluated. RESULTS Both the pain and disability subscales satisfied the requirements of the Rasch model with very minimal modifications and demonstrated unidimensionality. The person separation index was found to be high (P > .80), indicating reliability and internal consistency. Sex and the affected dominant side influenced how people scored on the SPADI (Differential item functioning (DIF)). CONCLUSIONS The findings suggest some patients in our sample have difficulty discriminating between item responses, particularly within the middle of the scale. Rasch analysis supports the clinical measurement properties of consistency and reliability, previously determined by CTT methods.
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Affiliation(s)
- Bradley R Boake
- Physiotherapist, APEX Performance Training and Rehabilitation, Hamilton, ON, Canada
| | - Timothy K Childs
- Physiotherapist, Palermo Physiotherapy and Wellness Centre, Oakville, ON, Canada
| | | | | | - Joshua I Vincent
- Post-Doctoral Fellow, School of Physical Therapy, Western University, London, ON, Canada; Roth, McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
| | - Joy C MacDermid
- Professor, School of Physical Therapy, Western University, London, ON, Canada; Co-Director of Clinical Research, Roth, McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
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Normand M, Tang TS, Brismée JM, Sobczak S. Clinical evaluation of thumb base osteoarthritis: A scoping review. HAND THERAPY 2021; 26:63-78. [PMID: 37969172 PMCID: PMC10634380 DOI: 10.1177/17589983211002560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/16/2021] [Indexed: 11/17/2023]
Abstract
Introduction Thumb base osteoarthritis (OA) is a prevalent hand OA phenotype, associated with specific risk factors, treatment strategies, and requiring a distinct subset of evaluative approaches. This paper aimed at surveying our clinical evaluative methods and identifying gaps in our ability to capture the thumb's unique attributes and how they could impact our treatment recommendations. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodology to gather relevant published and non-published articles regarding clinical tests currently available to assess the physical presentation of thumb base OA with special consideration of its specific multifactorial parameters namely architecture, ligaments, biomechanics, neuromuscular control, and proprioception. A full search strategy of MEDLINE, CINAHL, EMBASE, Scopus, Google Scholar, and Clinical Trials.gov from their inception through May 2020 was performed. Results Of 1936 citation identified, 54 met the inclusion criteria. Fifty-two clinical physical tests for the evaluation of thumb base OA were extracted, most of which well suited to address research questions regarding efficacy of clinical intervention, however providing limited information regarding the underlying impairments of ligaments, biomechanics, neuromuscular or proprioceptive components. Conclusions The tests and measures specific to the basal thumb OA phenotype, and capable of isolating its multifactorial contributors are scarce. Our limited physical assessment repertoire impedes our ability to describe and answer explicative research questions. Without these we cannot evaluate the effect of conservative management and provide specific treatment recommendations. Further research is needed to develop and validate distinct clinical tools for this debilitating pathology.
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Affiliation(s)
- Mirka Normand
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Chaire de recherche en anatomie fonctionnelle, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Rehabilitation Department, Pequot Health Center, Yale New Haven Health System, Groton, CT, USA
| | - Tiffany S Tang
- Physical Medicine and Rehabilitation, California Pacific Medical Center, San Francisco, CA, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences and Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Stéphane Sobczak
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Chaire de recherche en anatomie fonctionnelle, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Temmesfeld MJ, Hauksson IT, Mørch T. Intra-Articular Osteotomy of the Distal Radius with the Use of Inexpensive In-House 3D Printed Surgical Guides and Arthroscopy: A Case Report. JBJS Case Connect 2020; 10:e0424. [PMID: 31899717 DOI: 10.2106/jbjs.cc.18.00424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE An 18-year-old man complained about persistent wrist pain and functional impairment due to intra-articular malunion, 1 year after volar plating of a distal radius fracture. We designed and produced patient-specific surgical guides (PSSGs) in-house with a benchtop three-dimensional printer to perform an arthroscopy-assisted intra-articular osteotomy of the radial column without dorsal arthrotomy. The procedure was performed without complications. After 1 year, there was no osteoarthritis and the patient's wrist function was practically normalized. CONCLUSIONS Virtual surgical planning, design, and production of PSSGs were feasible without consultation of an external medical engineering company and without dorsal arthrotomy.
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Affiliation(s)
- Max Joachim Temmesfeld
- Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Division of Surgery Campus AHUS, University of Oslo, Oslo, Norway
| | - Ingi Thor Hauksson
- Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Division of Surgery Campus AHUS, University of Oslo, Oslo, Norway
| | - Thale Mørch
- Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway
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McGee C. Measuring intrinsic hand strength in healthy adults: The accuracy intrarater and inter-rater reliability of the Rotterdam Intrinsic Hand Myometer. J Hand Ther 2019; 31:530-537. [PMID: 28457691 DOI: 10.1016/j.jht.2017.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 01/11/2017] [Accepted: 03/20/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement study. INTRODUCTION Measuring the isometric strength generated during isolated hand joint motions is a challenging feat. The Rotterdam Intrinsic Hand Myometer (RIHM; med.engineers, Rotterdam, Netherlands) permits measurement of isolated movements of the hand. To date, there is limited evidence on the inter-rater reliability and limited adult normative data of RIHM. Given that multiple raters, often with varying degrees of experience, are needed to collect normative data, inter-rater reliability testing and a comparison of novice and experienced raters are needed. PURPOSES OF THE STUDY The purposes of this study were to test the accuracy, intrarater reliability, and inter-rater reliability of the RIHM in healthy-handed adults. METHODS RIHM accuracy was tested through use of precision class F weights. Adults 18 years or older without upper limb dysfunction were recruited. Each participant was tested by 4 raters, 3 occupational therapy graduate students, and an experienced certified hand therapist, through use of a calibrated RIHM. Five strength measures were tested bilaterally (ie, thumb carpometacarpal palmar abduction, index finger metacarpophalangeal [MP] abduction, index finger MP flexion, thumb MP flexion, and small finger MP abduction) 3 times per a standardized protocol. Statistical methods were used to test accuracy, inter-rater reliability, and intrarater/response stability. RESULTS The accuracy of RIHM device error was 5% or less. Reliability testing included the participation of 19 women and 10 men (n = 29). All raters were in excellent agreement across all muscles (intraclass correlation coefficient, ≥0.81). Low standard error of measurement values of ≤8.3 N (1.9 lb) across raters were found. The response stability and/or intrarater reliability of the novice and certified hand therapist raters were not statistically different. DISCUSSION The RIHM has an acceptable instrument error; the RIHM and its standardized procedure have excellent inter-rater reliability and response stability when testing those without hand limitations; and the response stability and/or intrarater reliability of expert and novice raters were consistent. CONCLUSIONS The use of the RIHM is justified when multiple raters of varying expertise collect normative data or conduct cohort studies on persons with healthy hands. Future research is warranted. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Corey McGee
- Program in Occupational Therapy, University of Minnesota, Minneapolis, MN, USA.
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Top M, Sönmez S, Aslan H. An Evidence-Based Approach to Outcome Measurement in Oral and Dental Health Services: Oral Health-Related Quality of Life and Oral Health Impact. Worldviews Evid Based Nurs 2019; 16:408-415. [PMID: 31544360 DOI: 10.1111/wvn.12398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP. METHODS This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses. RESULTS Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP. LINKING EVIDENCE TO ACTION These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.
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Affiliation(s)
- Mehmet Top
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
| | - Seda Sönmez
- Department of Health Care Management, Faculty of Health Sciences, Kւrւkkale University, Kւrւkkale, Turkey
| | - Hüseyin Aslan
- Türkiye Cumhuriyeti Sağlık Bakanlığı İzmir İl Sağlık Müdürlüğü, İzmir, Turkey
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Kask G, Barner-Rasmussen I, Repo JP, Kjäldman M, Kilk K, Blomqvist C, Tukiainen EJ. Functional Outcome Measurement in Patients with Lower-Extremity Soft Tissue Sarcoma: A Systematic Literature Review. Ann Surg Oncol 2019; 26:4707-4722. [PMID: 31407171 PMCID: PMC6863783 DOI: 10.1245/s10434-019-07698-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Indexed: 12/16/2022]
Abstract
Background The importance of functional outcome (FO) in the treatment of patients with extremity soft tissue sarcoma (STS) has been increasingly recognized in the last three decades. This systematic review aimed to investigate how FO is measured in surgically treated lower-extremity STS patients. Methods A systematic search of PubMed, Web of Science, and Scopus was performed based on the PRISMA guidelines. The methodologic quality of the publications was measured using the MINORS tool. The results from the included studies examining measurement types, measures, and time of FO measurement were compiled. The FO pooled mean and standard deviation were calculated as a weighted average for the groups. The validity of the applied measures is reported. Results The literature search found 3461 publications, 37 of which met the inclusion criteria. The measurement types used were clinician-reported outcomes (n = 27), patient-reported outcomes (n = 20), and observer-reported outcomes (n = 2). The most frequently used measures were the Toronto Extremity Salvage Score (TESS) (n = 16) and the Musculoskeletal Tumor Society (MSTS) score 1993 (n = 12). The postoperative FO was relatively good. The pooled mean TESS and MSTS 1993 scores were respectively 83.3 and 86.2 (out of 100). Of the 10 previously reported measures, 3 provide validated FO scores. The methodologic quality of publications was generally low. Conclusions Based on this systematic review, several different methods exist for assessing FO in patients with lower-extremity sarcoma. The most frequently used measure is a validated TESS. The postoperative FO of patients with lower-extremity STS seems to increase to the preoperative baseline level during long-term follow-up evaluation.
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Affiliation(s)
- Gilber Kask
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland. .,Department of Orthopaedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland.
| | - Ian Barner-Rasmussen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Jussi Petteri Repo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Magnus Kjäldman
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Kaarel Kilk
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Carl Blomqvist
- Helsinki University Hospital Comprehensive Cancer Center, HUS, Helsinki, Finland
| | - Erkki Juhani Tukiainen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland
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McQuillan TJ, Vora MM, Kenney DE, Crisco JJ, Weiss APC, Ebert KA, Snelgrove KE, Sarnowski A, Ladd AL. The AUSCAN and PRWHE Demonstrate Comparable Internal Consistency and Validity in Patients With Early Thumb Carpometacarpal Osteoarthritis. Hand (N Y) 2018; 13:652-658. [PMID: 28934868 PMCID: PMC6300181 DOI: 10.1177/1558944717729217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Australian/Canadian Osteoarthritis Hand Index (AUSCAN) and Patient-Rated Wrist-Hand Evaluation (PRWHE) are 2 patient-related outcome measures to assess pain and disability in patients with osteoarthritis (OA). The purpose of this study was to evaluate the AUSCAN and PRWHE in a large-scale, longitudinal cohort of patients with early thumb carpometacarpal (CMC) OA. METHODS We obtained baseline data on 135 individuals (92 with early CMC OA participants and 43 asymptomatic controls) and at follow-up (year 1.5) on 83 individuals. We assessed the internal consistency using Cronbach alpha, and construct and criterion validity using other pain scales and objective measures of strength, respectively. We also examined the correlation between the AUSCAN and PRWHE and correlation coefficients at baseline and follow-up, as well as the correlation between changes in these instruments over the follow-up period. RESULTS Internal consistency was high for both AUSCAN and PRWHE totals and subscales (Cronbach α > 0.70). Both instruments demonstrated construct validity compared with the Verbal Rating Scale ( r = 0.52-0.60, P < .01), an assessment of pain, and moderate criterion validity compared with key pinch and grip strength ( r = -.24 to -.33, P < .05). These instruments were highly correlated with each other at baseline and follow-up time points ( r = 0.76-.94, P < .01), and changes in a patient's total scores over time were also correlated ( r = 0.83, P < .01). CONCLUSIONS The AUSCAN and PRWHE are both valid assessments for pain and/or disability in patients with early thumb CMC OA.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Amy L. Ladd
- Stanford University, CA, USA,Amy L. Ladd, Department of Orthopaedic Surgery, Robert A. Chase Hand & Upper Limb Center, Stanford University, Stanford, CA 94393, USA.
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Fonseca MDCR, Elui VMC, Lalone E, da Silva NC, Barbosa RI, Marcolino AM, Ricci FPFM, MacDermid JC. Functional, motor, and sensory assessment instruments upon nerve repair in adult hands: systematic review of psychometric properties. Syst Rev 2018; 7:175. [PMID: 30368253 PMCID: PMC6204279 DOI: 10.1186/s13643-018-0836-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 10/05/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Outcome after nerve repair of the hand needs standardized psychometrically robust measures. We aimed to systematically review the psychometric properties of available functional, motor, and sensory assessment instruments after nerve repair. METHODS This systematic review of health measurement instruments searched databases from 1966 to 2017. Pairs of raters conducted data extraction and quality assessment using a structured tool for clinical measurement studies. Kappa correlation was used to define the agreement prior to consensus for individual items, and intraclass correlation coefficient (ICC) was used to assess reliability between raters. A narrative synthesis described quality and content of the evidence. RESULTS Sixteen studies were included for final critical appraisal scores. Kappa ranged from 0.31 to 0.82 and ICC was 0.81. Motor domain had manual muscle testing with Kappa from 0.72 to 0.93 and a dynamometer ICC reliability between 0.92 and 0.98. Sensory domain had touch threshold Semmes-Weinstein monofilaments (SWM) as the most responsive measure while two-point discrimination (2PD) was the least responsive (effect size 1.2 and 0.1). A stereognosis test, Shape and Texture Identification (STI), had Kappa test-retest reliability of 0.79 and inter-rater reliability of 0.61, with excellent sensibility and specificity. Manual tactile test had moderate to mild correlation with 2PD and SWM. Function domain presented Rosén-Lundborg score with Spearman correlations of 0.83 for total score. Patient-reported outcomes measurements had ICC of 0.85 and internal consistency from 0.88 to 0.96 with Patient-Rated Wrist and Hand Evaluation with higher score for reliability and Spearman correlation between 0.38 and 0.89 for validity. CONCLUSIONS Few studies included nerve repair in their sample for the psychometric analysis of outcome measures, so moderate evidence could be confirmed. Manual muscle test and Rotterdam Intrinsic Hand Myometer dynamometer had excellent reliability but insufficient data on validity or responsiveness. Touch threshold testing was more responsive than 2PD test. The locognosia test and STI had limited but positive supporting data related to validity. Rosén-Lundborg score had emerging evidence of reliability and validity as a comprehensive outcome following nerve repair. Few questionnaires were considered reliable and valid to assess cold intolerance. There is no patient-reported outcome measurement following nerve repair that provides comprehensive assessment of symptoms and function by patient perspective.
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Affiliation(s)
- Marisa de Cássia Registro Fonseca
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP Brazil
- Clinical Research, Hand and Upper Limb Centre, St Joseph’s Health Centre, Western University, London, ON Canada
| | - Valéria Meireles Carril Elui
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP Brazil
| | - Emily Lalone
- Clinical Research, Hand and Upper Limb Centre, St Joseph’s Health Centre, Western University, London, ON Canada
| | | | - Rafael Inácio Barbosa
- Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Araranguá, SC Brazil
| | - Alexandre Márcio Marcolino
- Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Araranguá, SC Brazil
| | | | - Joy C. MacDermid
- Clinical Research, Hand and Upper Limb Centre, St Joseph’s Health Centre, Western University, London, ON Canada
- Rehabilitation Science, School of Rehabilitation, McMaster University, Hamilton, ON Canada
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Furtado S, Errington L, Godfrey A, Rochester L, Gerrand C. Objective clinical measurement of physical functioning after treatment for lower extremity sarcoma – A systematic review. Eur J Surg Oncol 2017; 43:968-993. [DOI: 10.1016/j.ejso.2016.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 09/27/2016] [Accepted: 10/03/2016] [Indexed: 12/24/2022] Open
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Outcome Evaluation in Tendinopathy: Foundations of Assessment and a Summary of Selected Measures. J Orthop Sports Phys Ther 2015; 45:950-64. [PMID: 26471855 DOI: 10.2519/jospt.2015.6054] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Synopsis Clinical measurement studies that address outcome evaluation for patients with tendinopathy should consider conceptual, clinical, practical, and measurement issues to guide the selection of valid measures. Clinical outcomes reported in research studies can provide benchmarks that assist with interpretation of scores during clinical decision making. Given the pathophysiology and functional impacts of tendinopathy, there is a need for outcome measures that assess physical impairments, activity performance, and patient-reported symptoms and function. Tendinopathy-specific patient-reported outcome measures have been shown to be superior to more generic tools for some conditions, such as lateral epicondyle tendinopathy (Patient-Rated Tennis Elbow Evaluation) and Achilles tendinopathy (Victorian Institute of Sport Assessment-Achilles), whereas both generic shoulder outcome measures and disease-specific measures perform similarly in individuals with rotator cuff tendinopathy. A patient-reported outcome measure that captures pain and limitation in function should be fundamental to outcome evaluation in patients with tendinopathy. The current measurement literature does not yet provide comprehensive empirical data to define optimal outcome measures for all types of tendinopathy. This article reviews concepts, instruments, and measurement properties that should provide clinicians with a foundation for assessment of condition severity and treatment outcomes in patients with tendinopathy. J Orthop Sports Phys Ther 2015;45(11):950-964. Epub 15 Oct 2015. doi:10.2519/jospt.2015.6054.
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Bilateral hand transplantation: Functional benefits assessment in five patients with a mean follow-up of 7.6 years (range 4–13 years). J Plast Reconstr Aesthet Surg 2015; 68:1171-83. [DOI: 10.1016/j.bjps.2015.07.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/09/2015] [Accepted: 07/12/2015] [Indexed: 01/10/2023]
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Abstract
Patient-reported outcome measures (PRO) can provide reliable and valid estimates of patient status and response to interventions to complete the final step in an evidence-based patient interaction. A variety of PRO are relevant to upper extremity surgery and rehabilitation outcomes. PRO provide feasible tools for clinical research or practice, although use in clinical decision making lags behind research applications. Recent trends in clinical measurement include better integration of International Classification of Functioning, Disability and Health in content validation, more modern methods of evaluating scaling properties (Rasch analysis), consensus exercise on establishing core measures, electronic data collection, and computer-adaptive testing.
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Bain M, Ward HJT. Non-clinical health services – what do they contribute to patient care and how can we measure their contribution? Scott Med J 2014; 59:16-21. [DOI: 10.1177/0036933013518145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and aims Assessing the contribution of ‘support services’ to improving healthcare is challenging. Despite involving a significant part of the NHS budget, there is very little published literature on methods and approaches. This article describes the development of an integrated approach to assessing and measuring the health impact of these services. Methods and results An empirical approach was developed by the main provider of national support services to NHS Scotland. This involved identifying meaningful ways to describe health impact of services several steps removed from patient care, applying this to the full range of national support services provided by NHS National Services Scotland and developing relevant measurement methodologies. Through this approach it was possible to assess the relative health impact of all 63 NSS services and to use this for planning and prioritisation. Conclusion Assessing the contribution of support services to improving patient outcomes is a neglected area, despite the significant dependency of direct patient care services upon these services and the resource involved. The methods described in this article have potential to be used across the range of support services within the NHS to improve quality and efficiency of healthcare services.
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Affiliation(s)
- M Bain
- Executive Medical Director, NHS National Services Scotland, UK
| | - HJT Ward
- Divisional Medical Director, NHS National Services Scotland, UK
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de Moraes VY, Godin K, Dos Santos JBG, Faloppa F, Bhandari M, Belloti JC. Influence of compensation status on time off work after carpal tunnel release and rotator cuff surgery: a meta-analysis. Patient Saf Surg 2013; 7:1. [PMID: 23281638 PMCID: PMC3548717 DOI: 10.1186/1754-9493-7-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 12/27/2012] [Indexed: 12/31/2022] Open
Abstract
Background The assessment of post-surgical outcomes among patients with Workers’ Compensation is challenging as their results are typically worse compared to those who do not receive this compensation. These patients’ time to return to work is a relevant outcome measure as it illustrates the economic and social implications of this phenomenon. In this meta-analysis we aimed to assess the influence of this factor, comparing compensated and non-compensated patients. Findings Two authors independently searched MEDLINE (Ovid), Embase (Ovid), CINAHL, Google Scholar, LILACS and the Cochrane Library and also searched for references from the retrieved studies. We aimed to find prospective studies that compared carpal tunnel release and elective rotator cuff surgery outcomes for Workers’ Compensation patients versus their non-compensated counterparts. We assessed the studies’ quality using the Guyatt & Busse Risk of Bias Tool. Data collection was performed to depict included studies characteristics and meta-analysis. Three studies were included in the review. Two of these studies assessed the outcomes following carpal tunnel release while the other focused on rotator cuff repair. The results demonstrated that time to return to work was longer for patients that were compensated and that there was a strong association between this outcome and compensation status - Standard Mean Difference, 1.35 (IC 95%; 0.91-1.80, p < 0.001). Conclusions This study demonstrated that compensated patients have a longer return to work time following carpal tunnel release and elective rotator cuff surgery, compared to patients who did not receive compensation. Surgeons and health providers should be mindful of this phenomenon when evaluating the prognosis of a surgery for a patient receiving compensation for their condition. Type of study/level of evidence Meta-analysis of prospective Studies/ Level III
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Affiliation(s)
- Vinícius Ynoe de Moraes
- Division of Hand and Upper Limb Surgery, Department of Orthopaedics and Trauma, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Borges Lagoa, 778, São Paulo, Brazil.
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The Hamilton Inventory for Complex Regional Pain Syndrome: a cognitive debriefing study of the clinician-based component. J Hand Ther 2012; 25:97-111; quiz 112. [PMID: 22265445 DOI: 10.1016/j.jht.2011.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 09/27/2011] [Accepted: 09/28/2011] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Descriptive. INTRODUCTION The Hamilton Inventory for Complex Regional Pain Syndrome (HI-CRPS) is a multidisciplinary assessment tool under development. PURPOSE OF THE STUDY This study examined the assessment practices, beliefs and preferences of health care professionals working with CRPS to inform the content and structure of the clinician-based portion of the HI-CRPS (CB-HI-CRPS), as well as refine the user manual. METHODS Semi-structured cognitive interviews were conducted with health care professionals from a spectrum of disciplines working with CRPS. Assessment practices and scaling preferences for 15 assessment concepts were collected, relating directly to items on the CB-HI-CRPS. Interviews were transcribed and coded with emergent themes. RESULTS Participants reported using the concepts from the CB-HI-CRPS 85.2% of the time. Physicians and nurses preferred present/absent judgements, while therapists used none/mild/moderate/severe scaling. Emerging themes highlighted assessment values, beliefs about CRPS, professional roles, and knowledge translation. CONCLUSIONS Lack of uniformity in terminology and assessment behaviours underscores the need for clear scoring frameworks and standardized assessment instructions to improve reliability across the proposed users of the HI-CRPS. LEVEL OF EVIDENCE Level 4.
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Vogel AP, Barker SJ, Young AE, Ruseckaite R, Collie A. What is return to work? An investigation into the quantification of return to work. Int Arch Occup Environ Health 2011; 84:675-82. [PMID: 21573769 DOI: 10.1007/s00420-011-0644-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To describe and demonstrate issues with return to work (RTW) outcome metrics in common use among clinical researchers and injury compensation organisations. We also aim to describe a framework on which to capture relevant RTW information including current employment status and data on participation and maintenance. METHODS Structured telephone interviews discussing participant health and vocational status were conducted following compensable transport-related injury. Participants who were working at the time of injury and took time off work because of their injuries (N = 414) were asked questions relating to their work participation and maintenance, including length of continuous employment, hours worked and duties performed before and after injury. A series of RTW metrics was developed and applied to survey data. Rates of RTW according to each metric were calculated. RESULTS Eighty-four per cent of participants had achieved some employment since their injury, and 74% were working at the time of the survey. In contrast, only 58% of participants were working the same hours as prior to their injury and had been doing so for at least 3 months. These data show that different impressions of rehabilitative success can be obtained depending on the criterion used to define RTW suggesting that reliance on a single RTW index (e.g. 'are you currently working?') will not represent important characteristics of employment. CONCLUSION A multi-layered approach to measuring RTW that includes data on reasons for not working, length of continuous employment, hours and duties performed after injury provides greater insight into the vocational status of injured individuals compared to single metrics or outcomes that fail to capture key detail on motives and participation. This information can assist clinicians to more accurately monitor the progress of rehabilitation following injury and compensation schemes to more effectively monitor their performance.
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Affiliation(s)
- Adam P Vogel
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
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Forhan M, Vrkljan B, MacDermid J. A systematic review of the quality of psychometric evidence supporting the use of an obesity-specific quality of life measure for use with persons who have class III obesity. Obes Rev 2010; 11:222-8. [PMID: 19493301 DOI: 10.1111/j.1467-789x.2009.00612.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With global obesity rates at 42%, there is a need for high-quality outcome measures that capture important aspects of quality of life for persons with obesity. The aim of this paper was to systematically review and critique the psychometric properties and utility of the impact of weight on quality of life-lite (IWQOL-Lite) for use with persons who have class III obesity. Databases were searched for articles that addressed obesity-specific quality of life. A critical appraisal of the psychometric properties of the IWQOL-Lite and connection to a quality of life conceptual framework was completed. Raters used a standardized data extraction and quality appraisal form to guide evidence extraction. Two articles that reviewed obesity-specific quality of life measures were found; none were based on a systematic review. Six articles on the IWQOL-Lite met the criteria for critical appraisal using guidelines. The mean quality score for these articles was 59.2%. Concepts measured were consistent with the biopsychosocial concept of health defined by the World Health Organization. There is limited but consistent evidence that the IWQOL-Lite is a reliable, valid and responsive outcome measure that can be used to assess disease-specific quality of life in persons with class III obesity.
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Affiliation(s)
- M Forhan
- McMaster University, School of Rehabilitation Science, Hamilton, ON L8S 1C7, Canada.
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