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Bredy TM, Glasgow C, Liddle J, Colwell S, Holding J, Swan S, Patterson F. Considering occupational performance during recovery of distal radius fracture: A scoping review. Aust Occup Ther J 2024. [PMID: 38803065 DOI: 10.1111/1440-1630.12965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Distal radius fracture (DRF) is one of the most common upper extremity fractures treated by hand therapists and can lead to chronic physical impairment and reduced occupational performance. This scoping review aimed to reveal what is currently known about occupational performance following DRF and to explore if and how occupational performance is defined and considered in the research. METHODS This review was guided by the PRISMA-Scoping review and the Joanna Briggs Institute (JBI) guidelines. Relevant databases were searched, and studies that addressed occupation performance in adult participants following DRF were included. The findings were summarised according to the components of occupational performance (person, occupation, and environment), and quality was measured using the Mixed Methods Appraisal Tool. RESULTS Forty-three articles met the eligibility criteria for inclusion. All of the studies discussed at least two components of occupational performance, while 25 recognised all three. The consideration of occupational performance was dominated by biomechanical issues associated with the person component (i.e. range of motion, strength). There was some acknowledgement of the psychosocial aspects of the person and, to a lesser extent, the environment, as well as the impact of both on return to occupational performance. CONCLUSION Despite occupational performance being at the core of occupational therapy theory, its consideration within the context of research on DRF appears to be focussed on the person component of occupational performance and on biomechanical issues. Further research is recommended to determine how much this reflects current clinical practice and if a more comprehensive consideration of occupational performance will improve rates of recovery following DRF. CONSUMER AND COMMUNITY INVOLVEMENT As part of the protocol development for this review, consumers and stakeholders were consulted. They provided feedback on clarity and importance of the research questions. PLAIN LANGUAGE SUMMARY A distal radius fracture happens when you break the bone on the thumb side of your wrist. This type of injury often occurs when you fall and land on an outstretched hand. It is one of the more common injuries that hand therapists see in their practice. For some people, recovering from this fracture can take a long time and come with a lot of pain, difficulty moving, and emotional stress. These problems can make it hard to do everyday things like driving, cooking, or getting dressed. It can also affect both paid and unpaid work as well as leisure and social activities, making life more difficult for everyone involved. The findings from this review suggest that the current research usually focuses on how the body physically heals from this type of injury, but it does not pay as much attention to the emotional and social impact on healing. Also, it does not always discuss the activities that are important to the person, or the environment where they live, work, and socialise. This may show a gap in the research regarding our full comprehension of recovery from distal radius fractures. Taking a broader view and approach to recovery, considering a person's emotions, social life, environment, and daily activities, could help people recover fully and get back to their previous life routines and roles after this type of injury.
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Affiliation(s)
- Terra M Bredy
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Celeste Glasgow
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
- Department of Occupational Therapy, Ipswich Hospital, Ipswich, Queensland, Australia
- Department of Occupational Therapy, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Jacki Liddle
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
- Department of Occupational Therapy, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | | | - Jessica Holding
- Department of Occupational Therapy, Griffith University, Nathan, Queensland, Australia
| | - Sarah Swan
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
| | - Freyr Patterson
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia
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Valdes K, Naughton N, Rider JV. Hand therapist use of patient-reported outcomes. J Hand Ther 2024; 37:110-117. [PMID: 37586992 DOI: 10.1016/j.jht.2023.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The use of standardized outcome measures is essential for best clinical practice by hand therapists to determine patient status, progress, and the outcome of interventions. A better understanding of current patient-reported outcome (PRO) use in hand and upper extremity practice is warranted. PURPOSE This study sought to understand what outcome measures are being used in clinical practice, how they are being used, and the perceived usefulness of PROs by active members of the American Society of Hand Therapists (ASHT). STUDY DESIGN This study employed a cross-sectional design. METHODS The web-based survey was distributed through Qualtrics (Qualtrics, Salt Lake City, Utah) to active members of ASHT with an email address on file. The survey consisted of multiple choice and open-ended questions. RESULTS A total of 348 members responded to the survey. Seven hundred thirty-two different outcome measures were reported to be used by the hand therapist respondents. The most used outcome measure was QuickDASH by 38% of the respondents. Two hundred seventy-five (88%) indicated that their workplace advocated the use of PROs. Most respondents indicated that there were not constraints preventing the use of a PRO. Few therapists respondents use a psychosocial PRO in clinical practice. CONCLUSIONS Most of the hand therapist respondents to our survey use a PRO and discuss the results with their clients. The QuickDASH was the PRO used most often by hand therapists. Only a few hand therapists use a psychosocial tool to measure patient status in clinical practice.
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Affiliation(s)
- Kristin Valdes
- Touro University, School of Occupational Therapy, Henderson, NV, USA.
| | | | - John V Rider
- Touro University, School of Occupational Therapy, Henderson, NV, USA
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Patient satisfaction with the CMC controller: A cohort study. J Hand Ther 2021; 34:53-57. [PMID: 32151498 DOI: 10.1016/j.jht.2019.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/23/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cohort study. INTRODUCTION The evidence specific to understanding patient satisfaction, preference and the effects on occupational performance using a CMC orthosis is sparse. PURPOSE OF THE STUDY The main purpose of this study was to determine patient satisfaction, aspects of the orthotic preference, and the effect on pain and function of the CMC Controller Plus neoprene orthotic device. METHODS This research was conducted at two outpatient clinics located in Pennsylvania and Florida during 2019. The subjects of this study included any individuals referred to one of two participating hand therapy facilities with either a primary or secondary diagnosis of thumb CMC joint arthritis or present with this diagnosis as a comorbidity. The CMC Controller Plus orthosis (Hely & Weber) was provided to each patient by the treating therapist at no cost to the patient after the patient agreed to take part in the study. None of the patients received hand therapy treatment for the CMC pain; the only intervention provided was the CMC Controller Plus. RESULTS The CMC Controller Plus orthosis improved the patients' functional status and reduced their pain. The effect size for the change in function was large (1.29) compared to the effect size for the reduction in pain which approached moderate at 0.49. DISCUSSION The CMC Controller Plus orthosis improved the patient's functional status by 52% and reduced their pain by 29%. CONCLUSION The results were both statistically and clinically significant.
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Ziebart C, Mehta SP, MacDermid J. Measurement Properties of Outcome Measures Used to Assess Physical Impairments in Patients After Distal Radius Fracture: A Systematic Review. Phys Ther 2021; 101:6149605. [PMID: 33647944 DOI: 10.1093/ptj/pzab080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/03/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Individuals with distal radius fractures (DRF) may experience difficulty with gripping an object, painful wrist movements, sensorimotor difficulties, and swelling around the wrist and hand. A comprehensive review of the existing evidence concerning the measurement properties of common physical impairment measures can provide a valuable resource to guide hand therapy practice while managing DRF. The primary objective was to locate and assess the quality of literature on the measurement properties for the measures of physical impairment used in individuals with DRF. METHODS Two reviewers searched PubMed, CINAHL, and EMBASE. A combination of DRF, measurement properties, and physical impairments were used as keywords, and articles were independently assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments critical appraisal tool. Primary studies were included if they examined at least 1 of the following: reliability, validity, responsiveness, or indices of true and meaningful changes for measures of physical impairment in the DRF sample. A total of 19 articles were included in this review. The quality of the studies ranged from 46% to 92%. This review suggests that measures such as assessment of grip strength and supination and pronation range of motion (ROM), using various goniometric devices, showed good intrarater and interrater reliability, construct validity, and responsiveness in individuals with DRF. CONCLUSION Acceptable reliability and responsiveness were reported in grip and wrist ROM assessments for measuring changes in wrist and hand function after DRF; however, wrist ROM assessed using traditional goniometric techniques were less reliable in individuals with DRF. IMPACT This study provides insight into which objective tools might be better suited for measuring outcomes related to DRF.
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Affiliation(s)
- Christina Ziebart
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada
| | - Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, West Virginia, USA.,Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Joy MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada
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Naughton N, Algar L. Linking commonly used hand therapy outcome measures to individual areas of the International Classification of Functioning: A systematic review. J Hand Ther 2020; 32:243-261. [PMID: 29433763 DOI: 10.1016/j.jht.2017.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 11/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION Identifying outcome measures that correspond to the International Classification of Functioning (ICF) provides insight into selecting appropriate outcome tools in hand therapy practice. PURPOSE OF THE STUDY The objective of this study is to systematically review patient-reported outcome measures commonly used in hand therapy to determine the extent to which the content represents the biopsychosocial view of the ICF. METHODS A comprehensive literature search was conducted. Studies that met inclusion criteria were identified, and outcome measures were extracted. The meaningful concept was determined for each item on the measure and linked to the most specific ICF category. Summary linkage calculations were completed. RESULTS Eleven patient-reported outcomes were identified from 43 included studies. Activity and participation had the highest content coverage followed by body functions. There was linking to personal factors and not defined-disability and mental health. Environmental factors were not represented in any of the included outcome measures. The core set representation of unique codes ranged from 8.55% to 18.80% (mean: 11.97%) for the Comprehensive ICF Core Set for Hand Conditions and from 30.43% to 47.83% (mean: 31.40%) for the Brief ICF Core Set for Hand Conditions. The percent representation of the Comprehensive ICF Core Set for Hand Conditions for unique disability ranged from 21.62% to 43.24% (mean: 20.33%) and from 62.50% to 87.50% (mean: 72.22%) for the Brief ICF Core Set for Hand Conditions. DISCUSSION None of the included measures represent all categories of the ICF Core Sets for Hand Conditions. CONCLUSION Utilizing the most recent refinement rules for the linking process, this study provides comparisons of measures along with clarity of content coverage for the most commonly used tools in the practice of hand therapy.
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Affiliation(s)
| | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
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Abdelmegeed M, Lohman E, Daher N, Syed HM. Linking physical therapy outcome measures to the Brief International Classification of Functioning Core Set for Hand Conditions in subjects with ulnar wrist pain. J Back Musculoskelet Rehabil 2020; 32:707-715. [PMID: 30636727 DOI: 10.3233/bmr-181181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The purpose of this study was to apply the Brief International Classification of Functioning (ICF) Core Set for Hand Conditions to the physical therapy outcome measures, and to evaluate the contribution of these measures to overall health in subjects with ulnar wrist pain. METHODS Thirty-five subjects with ulnar wrist pain received a 4-week home-based treatment program including orthotics and strengthening exercises. Investigators measured pain, function, grip strength, and overall health four weeks post-intervention. Regression analysis was used to investigate the effect of these variables on overall health represented by the Short Form (SF-36) questionnaire. RESULTS Fifty-three percent of the variability in SF-36 physical health summary scores was explained by the studied variables with grip strength predicting 31% of the variability. CONCLUSIONS The Brief ICF Core Set for Hand Conditions can be a useful abridged list of categories relevant to functioning and health in subjects with ulnar wrist pain.
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Affiliation(s)
- Mohamed Abdelmegeed
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA.,Department of Orthopedic Physical Therapy, Cairo University, Cairo, Egypt
| | - Everett Lohman
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Noha Daher
- Epidemiology, Biostatistics, and Population Medicine, School of Public Health, Loma Linda University, Loma Linda, CA, USA.,School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Hasan M Syed
- Department of Orthopedic Surgery, Loma Linda University, Loma Linda, CA, USA
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ICF components of outcome measures for mallet finger: A systematic review. J Hand Ther 2017; 29:388-395. [PMID: 27780628 DOI: 10.1016/j.jht.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/18/2016] [Accepted: 06/17/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for the assessment of the conservative management of mallet finger to determine if they characterize the International Classification of Functioning, Disability, and Health components of activity, participation, environmental factors, or quality of life. METHODS/RESULTS Five studies published within the last 10 years were included in the systematic review. A majority, 19 of the outcomes used by the authors, fell within the body functions and structures category. Six were related to activity, and 1 was related to participation. One was linked to environmental factors. Five were found to be not definable and related to quality of life. DISCUSSION/CONCLUSION This systematic review suggests that many outcome measures focus on body structures and functions in the current research on the conservative treatment of mallet finger injuries. LEVEL OF EVIDENCE 2a.
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Valdes K, Naughton N, Algar L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: A systematic review. J Hand Ther 2017; 29:396-404. [PMID: 27662802 DOI: 10.1016/j.jht.2016.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/24/2016] [Accepted: 06/06/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for assessment of orthotic intervention in the conservative management of thumb carpometacarpal osteoarthritis to determine if they characterize International Classification of Functioning, Disability, and Health (ICF) components. The determinants of patient satisfaction regarding the orthotic intervention were also extracted from the studies. METHODS A comprehensive literature search was conducted. Outcome measures in the included studies were linked to the ICF. Determinants of patient satisfaction regarding the orthotic intervention were also extracted. RESULTS Nine studies met inclusion criteria. Eight (47.1%) outcomes were linked to body structures and functions, 8 (47.1%) to activity limitations and participation restrictions, and 1 (5.9%) outcome fell into the nondefinable quality of life category. Four studies assessed patient satisfaction. DISCUSSION/CONCLUSIONS This systematic review on orthotic intervention for thumb carpometacarpal osteoarthritis found opportunities related to assessment and outcome measures when present studies are linked to the ICF. LEVEL OF EVIDENCE 2a.
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Affiliation(s)
- K Valdes
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA; Hand Works Therapy, Venice, FL, USA.
| | | | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
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9
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Belghali S, Ben Abderrahim K, Mahmoud I, Baccouche K, El Amri N, Zeglaoui H, Maaref K, Bouajina E. Brief Michigan Hand Outcomes Questionnaire in rheumatoid arthritis: A cross-sectional study of 100 patients. HAND SURGERY & REHABILITATION 2017; 36:24-29. [DOI: 10.1016/j.hansur.2016.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 09/02/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
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Esakki S, MacDermid J, Vajravelu S. Linking of the American Academy of Orthopaedic Surgeons Distal Radius Fracture Clinical Practice Guidelines to the International Classification of Functioning, Disability, and Health; International Classification of Diseases; and ICF Core Sets for Hand Conditions. Hand (N Y) 2016; 11:314-321. [PMID: 27698634 PMCID: PMC5030861 DOI: 10.1177/1558944715627305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: American Academy of Orthopaedic Surgeons (AAOS) distal radius fracture (DRF) clinical practice guidelines (CPG) are readily available to clinicians, patients, and policymakers. International Classification of Functioning, Disability, and Health (ICF) provides a framework for describing the impact of health conditions. The International Classification of Diseases-10th Revision (ICD-10) is a classification system to classify health conditions as specific disease or disorders. The aim of this study is to analyze and describe the scope and focus of the AAOS DRF CPG using the ICF and ICD-10 as a basis for content analysis, and to compare the content of the CPG with the ICF hand core sets as the reference standard. Methods: Established linking rules were used by 2 independent raters to analyze the 29 recommendations of the AAOS DRF CPG. ICD-10 codes were assigned in the same process. Summary linkage statistics were used to describe the results for ICF and the hand core sets. Results: Among the 29 recommendations of the AAOS DRF CPG, 5 meaningful concepts were linked to the ICF codes. Of these, 5 codes appeared on the comprehensive ICF core set and only 3 codes appeared in the brief ICF core set, and 7 conditions were covered in ICD-10 codes. Conclusions: The AAOS DRF CPG focuses on surgical interventions and has minimal linkage to the constructs of the ICD-10 and ICF. It does not address activity or participation (disability), and is not well linked to key concepts relevant to hand conditions.
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Affiliation(s)
- Saravanan Esakki
- McMaster University, Hamilton, ON, Canada,Saravanan Esakki, School Of Rehabilitation Sciences, McMaster University, 1280, Main St West, Hamilton, ON L8S 4L8, Canada.
| | - Joy MacDermid
- McMaster University, Hamilton, ON, Canada,St. Joseph’s Hospital, London, ON, Canada
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Waljee JF, Ladd A, MacDermid JC, Rozental TD, Wolfe SW, Calfee RP, Dennison DG, Hanel DP, Herzberg G, Hotchkiss R, Jupiter JB, Kaufmann RA, Lee SK, Ozer K, Ring DC, Ross M, Stern PJ. A Unified Approach to Outcomes Assessment for Distal Radius Fractures. J Hand Surg Am 2016; 41:565-73. [PMID: 26952734 DOI: 10.1016/j.jhsa.2016.02.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 02/02/2023]
Abstract
Distal radius fractures are one of the most common upper extremity injuries. Currently, outcome assessment after treatment of these injuries varies widely with respect to the measures that are used, timing of assessment, and the end points that are considered. A more consistent approach to outcomes assessment would provide a standard by which to assess treatment options and best practices. In this summary, we review the consensus regarding outcomes assessment after distal radius fractures and propose a systematic approach that integrates performance, patient-reported outcomes, pain, complications, and radiographs.
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Affiliation(s)
- Jennifer F Waljee
- Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
| | - Amy Ladd
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA
| | - Joy C MacDermid
- School of Rehabilitation Sciences, University of Western Ontario, Ontario, Canada
| | - Tamara D Rozental
- Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
| | - Scott W Wolfe
- Department of Orthopedic Surgery, Hospital for Special Surgery and Weill Medical College of Cornell University, New York, NY.
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Do Patient- and Parent-reported Outcomes Measures for Children With Congenital Hand Differences Capture WHO-ICF Domains? Clin Orthop Relat Res 2015; 473:3549-63. [PMID: 26286444 PMCID: PMC4586230 DOI: 10.1007/s11999-015-4505-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patient- and parent-reported outcome measures (PROMs) are increasingly used to evaluate the effectiveness of surgery for congenital hand differences (CHDs). Knowledge of an existing outcome measure's ability to assess self-reported health, including psychosocial aspects, can inform the future development and application of PROMs for CHD. However, the extent to which measures used among children with CHD align with common, accepted metrics of self-reported disability remains unexplored. QUESTIONS/PURPOSES We reviewed studies that used PROMs to evaluate surgery for CHD to determine (1) the number of World Health Organization-International Classification of Functioning, Disability and Health (WHO-ICF) domains covered by existing PROMs; (2) the proportion of studies that used PROMs specifically validated among children with CHD; and (3) the proportion of PROMs that targets patients and/or parents. METHODS We performed a comprehensive review of the literature through a bibliographic search of MEDLINE®, PubMed, and EMBASE from January 1966 to December 2014 to identify articles related to patient outcomes and surgery for CHD. We evaluated the 42 studies that used PROMs to identify the number and type of WHO-ICF domains captured by existing PROMs for CHD and the proportion of studies that use PROMs validated for use among children with CHD. The most common instruments used to measure patient- and parent-reported outcomes after reconstruction for CHD included the Prosthetic Upper Extremity Functional Index (PUFI), Disabilities of the Arm, Shoulder, and Hand questionnaire, Childhood Experience Questionnaire, and Pediatric Quality of Life Inventory. RESULTS Current PROMs that have been used for CHD covered a mean of 1.3 WHO-ICF domains (SD ± 1.3). Only the Child Behavior Checklist and the Piers-Harris Children's Self-Concept Scale captured all ICF domains (body functions and structures, activity, participation, and environmental factors). The PUFI, the only PROM validated specifically for children with congenital longitudinal and transverse deficiency, was used in only four of 42 studies. Only 13 of the 42 studies assessed patient-reported outcomes, whereas five assessed both patient- and parent-reported outcomes. CONCLUSIONS The PROMs used to assess patients after CHD surgery do not evaluate all WHO-ICF domains (ie, body structure, body function, environmental factors, and activity and participation) and generally are not validated for children with CHD. Given the psychological and sociological aspects of CHD illness, a PROM that encompasses all components of the biopsychosocial model of illness and validated in children with CHD is desirable. LEVEL OF EVIDENCE Level III, therapeutic study.
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van de Ven-Stevens LAW, Kus S, Graff M, Geurts ACH. Which assessment tools address the categories of the Brief ICF Core Set for Hand Conditions? HAND THERAPY 2015. [DOI: 10.1177/1758998315586276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The purpose of this study was to explore whether assessment tools address aspects that are relevant according to the Brief ICF Core Set for Hand Conditions (BICF-CS). Methods Assessment tools meant to assess functioning and/or environmental factors in adults with hand conditions were reviewed. MEDLINE and CINAHL databases, previously published reviews, the book Clinical Assessment Recommendations of the ASHT, and websites of assessment tools were used for the content comparison and linking to the 23 categories of the BICF-CS. The updated version of the linking rules was applied by two reviewers. Results Forty-six assessment tools, known within the areas of hand therapy and hand surgery, were linked to the 23 categories of the BICF-CS. Regarding Body functions and body structures, the categories that were most frequently addressed were b730 “Muscle power functions,” b280 “Sensation of pain,” b710 “Mobility of joint functions, ” and s730 “Structure of upper extremity. ” Regarding Activities and Participation, d440 “Fine hand use” was addressed mostly and 25 assessment tools (with a total of 146 items) were linked to this category. Regarding Environmental Factors, only one assessment tool was identified that could be linked to two categories. Fifteen points of discussion were encountered in the linking process. Conclusions Content comparison of 46 assessment tools revealed that 19 of the 23 categories of the BICF-CS were addressed. The environmental factors were hardly addressed.
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Affiliation(s)
| | - Sandra Kus
- Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Maud Graff
- Department of Rehabilitation, Radboud University Medical Centre, Donders Institute for Cognition, Brain and Behaviour, Nijmegen, The Netherlands
| | - Alexander CH Geurts
- Department of Rehabilitation, Radboud University Medical Centre, Donders Institute for Cognition, Brain and Behaviour, Nijmegen, The Netherlands
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In reply. J Hand Surg Am 2014; 39:1231-2. [PMID: 24862122 DOI: 10.1016/j.jhsa.2014.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 03/17/2014] [Indexed: 02/02/2023]
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Shauver MJ, Chang KWC, Chung KC. Contribution of functional parameters to patient-rated outcomes after surgical treatment of distal radius fractures. J Hand Surg Am 2014; 39:436-42. [PMID: 24447846 PMCID: PMC4155537 DOI: 10.1016/j.jhsa.2013.11.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/07/2013] [Accepted: 11/08/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE Outcomes of distal radius fractures can be measured radiographically, functionally, or via patient-rated questionnaires, but previous studies report conflicting results regarding the relationship between these outcomes. Our specific aim was to explore the role that functional outcomes have in the score of the Michigan Hand Outcomes Questionnaire (MHQ), a patient-rated hand instrument. METHODS We obtained data for 207 patients. Demographic information was collected as part of the MHQ. Function (wrist motion and grip and pinch strength) was assessed 3 and 6 months after fracture fixation. We applied linear regression analysis to determine each item's contribution to the total MHQ score. RESULTS After we applied linear regression analysis, we determined that 3 months after fixation, all included factors contributed 37% of the MHQ score. Only the grip strength difference between the injured and uninjured hands was significantly associated, contributing 22% of the MHQ score. Six weeks and 6 months after fixation, all included factors contributed 43% and 34%, respectively, of the MHQ score. No individual factors were significant contributors. CONCLUSIONS Measured functional outcomes variables account for less than 40% of the total MHQ score. Identifying the unmeasured factors that make up the additional 60% of the total MHQ score would be beneficial in the continued examination of patient-rated outcomes. Furthermore, the use of multiple outcomes assessment modalities should be considered in any study measuring patient-rated outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Melissa J. Shauver
- Clinical Research Coordinator, Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Kate Wan-Chu Chang
- Research Associate, Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
| | - Kevin C. Chung
- Professor of Surgery, Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School
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Kus S, van de Ven-Stevens LA, Coenen M, Berno S, Kollerits B, Cieza A. What is Our Knowledge of Functioning and Disability in Hand Conditions Based on? Arch Phys Med Rehabil 2011; 92:1326-32. [DOI: 10.1016/j.apmr.2011.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 01/28/2011] [Accepted: 02/14/2011] [Indexed: 10/18/2022]
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