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Wanklyn T, Webster KE, Mak-Yuen Y, Rens Z, Boey D, Bhopti A, Dalliston C, Carey LM. A scoping review of observation-based tools for assessing use of the upper limb in activities. Disabil Rehabil 2024:1-11. [PMID: 39373275 DOI: 10.1080/09638288.2024.2405572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 08/22/2024] [Accepted: 09/13/2024] [Indexed: 10/08/2024]
Abstract
PURPOSE To summarise information about tools available to rate observed performance in activities, tested with populations with upper limb impairment. METHODS AND MATERIALS A scoping review was conducted. Articles were included if they reported psychometric properties of tools that could be used with populations with upper limb impairment, had at least one activity item, and item/s involved use of the upper limbs. Information about the tools was extracted, summarised and key findings are presented. RESULTS Twenty-seven tools met the inclusion criteria. The results indicated that few tools used client-selected (19%) items or clinician-selected (11%) items. Most tools (70%) used pre-defined items. Fourteen tools (52%) included activity-only items. Eleven tools (41%) had less than half activity items. An in-depth summary of the tools with activity-only items is reported. CONCLUSION Many tools exist for assessing observed performance in activities to examine use of the upper limb. However, there were few tools (N = 6) available that assess observed performance in client-selected activities.
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Affiliation(s)
- Tamara Wanklyn
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Kate E Webster
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Yvonne Mak-Yuen
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Occupational Therapy, St Vincent's Hospital, Melbourne, Australia
| | - Zona Rens
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Occupational Therapy, School of Allied Health, Curtin University, Perth, Australia
| | - Debbie Boey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Department of Occupational Therapy, Tan Tock Seng Hospital, Singapore
| | - Anoo Bhopti
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Claire Dalliston
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Leeanne M Carey
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Birinci T, Altun S, Ziroğlu N, Kaya Mutlu E. The Shanghai Elbow Dysfunction Score: Psychometric Properties, Reliability and Validity Study of the Turkish Version. Eval Health Prof 2024; 47:111-118. [PMID: 37312232 DOI: 10.1177/01632787231183089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Shanghai Elbow Dysfunction Score (SHEDS) is a self-reported assessment of post-traumatic elbow stiffness that measures elbow-related symptoms and elbow motion capacities. This study aimed to (1) translate and cross-culturally adapt the SHEDS into Turkish and (2) investigate the psychometric properties of the Turkish version in patients with post-traumatic elbow stiffness. The psychometric properties of the Turkish version of the SHEDS (SHEDS-T) were tested in 108 patients (72 male; mean age, 43.2 ± 11.2 years) with post-traumatic elbow stiffness. Cronbach's alpha was used to assess internal consistency. The intraclass correlation coefficients were used to estimate test-retest. Construct validity was analyzed with the Turkish version of the Disabilities Arm, Shoulder and Hand (DASH), the Mayo Elbow Performance Score (MEPS), and the Short Form-12 (PCS-12 and MCS-12). The SHEDS-T showed sufficient internal consistency (Cronbach's α coefficient = 0.83) and test-retest reliability (ICC = .96). The correlation coefficients between the SHEDS-T, the DASH, and the MEPS were .75 and .54, respectively (p < .001). There was a moderate correlation between the SHEDS-T and PCS-12 (r = .65, p = .01) and a weak positive correlation between the SHEDS and the MCS-12 (r = .40, p = .03). The SHEDS-T has sufficient reliability and validity to measure elbow-related symptoms and elbow motion capacities for Turkish-speaking individuals with post-traumatic elbow stiffness.
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Affiliation(s)
- Tansu Birinci
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Suleyman Altun
- Clinic of Orthopaedics and Traumatology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nezih Ziroğlu
- Clinic of Orthopaedics, Traumatology and Sports Surgery, Acıbadem Atakent Hospital, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Bandırma Onyedi Eylul University, Balikesir, Turkey
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Chanthana P, Atthakomol P, Manosroi W, Wongpakaran T, Kraisarin J, Sananpanich K. Comparison of patient preferences and responsiveness among common patient-reported outcome measures for hand/wrist injuries or disorders. J Orthop Traumatol 2023; 24:2. [PMID: 36622514 PMCID: PMC9829933 DOI: 10.1186/s10195-022-00681-4] [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: 09/12/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) were developed to examine patients' perceptions of functional health. Most studies compare the responsiveness of each type of questionnaire. However, reports of patient preferences among PROMs commonly used with patients with hand/wrist injuries or disorders are limited. This study aimed to compare patient preferences, factors associated with those preferences and responsiveness among the Disability of the Arm, Shoulder, and Hand (DASH), Michigan Hand Outcomes Questionnaire (MHQ), Patient-Rated Wrist/Hand Evaluation (PRWHE) and EQ-5D in patients with hand/wrist injuries or disorders. MATERIAL AND METHODS This retrospective cohort study collected data on 183 patients with hand/wrist injuries or diseases who had visited a hand/wrist outpatient clinic or were hospitalized for surgery between 2017 and 2020. Patients had to be at least 18 years old and able to complete the four questionnaires included in the study. The four PROMs (DASH, MHQ, PRWHE and EQ-5D) were administered to the patients prior to treatment. After completing the questionnaires, patients were asked to answer two open-ended questions regarding their preferences. Multinomial logistic regression was used to identify factors related to patient preferences. Results are presented as the relative risk ratio (RRR). The standardized response mean (SRM) was used to evaluate questionnaire responsiveness. RESULTS Of the 183 patients, most preferred the PRWHE questionnaire (n = 74, 41%), with the main reasons cited being "specific to injuries/diseases and reflects hand/wrist function (n = 23, 31%)" and "easy to complete (n = 22, 30%)." Sex was found to be associated with patient preference after adjusting for demographic data and reasons for choosing a PROM as confounders (RRR = 0.46, P value = 0.049). The PRWHE had the highest SRM, followed by DASH (0.92 and 0.88, respectively). CONCLUSIONS The PRWHE is the most preferred by patients and is the most responsive questionnaire. It is recommended for use in clinical practice in situations where a clinician would like to use only one PROM for evaluating patients with various types of hand/wrist problems. LEVEL OF EVIDENCE Prognostic III.
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Affiliation(s)
- Phongniwath Chanthana
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pichitchai Atthakomol
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worapaka Manosroi
- grid.7132.70000 0000 9039 7662Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- grid.7132.70000 0000 9039 7662Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jirachart Kraisarin
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanit Sananpanich
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Venturin D, Giannotta G, Pellicciari L, Rossi A, Pennella D, Goffredo M, Poser A. Reliability and validity of the Shoulder Pain and Disability Index in a sample of patients with frozen shoulder. BMC Musculoskelet Disord 2023; 24:212. [PMID: 36949437 PMCID: PMC10032005 DOI: 10.1186/s12891-023-06268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/23/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The Shoulder and Pain Disability Index (SPADI) is a widely used outcome measure. The aim of this study is to explore the reliability and validity of SPADI in a sample of patients with idiopathic frozen shoulder. METHODS The SPADI was administered to 124 patients with idiopathic frozen shoulder. A sub-group of 29 patients were retested after 7 days. SPADI scores were correlated with other outcome measures (i.e., Disabilities of the Arm, Shoulder and Hand Questionnaire - DASH; Numerical Pain Rating Scale-NPRS; and 36-item Short Form Health Survey-SF-36) to examine construct validity. Structural validity was assessed by a Two-Factors Confirmatory Factor Analysis (CFA). Internal consistency, test-retest reliability, and measurement error were also analyzed. RESULTS The construct validity was satisfactory as seven out of eight of the expected correlations formulated (≥ 75%) for the subscales were satisfied. The CFA showed good values of all indicators for both Pain and Disability subscales (Comparative Fit Index = 0.999; Tucker-Lewis Index = 0.997; Root Mean Square Error of Approximation = 0.030). Internal consistency was good for pain (α = 0.859) and disability (α = 0.895) subscales. High test-retest reliability (Intraclass correlation coefficient [ICC]) was found for pain (ICC = 0.989 [95% Confidence Interval (CI = 0.975-0.995]) and disability (ICC = 0.990 [95% CI = 0.988-0.998]). Standard Error of Measurement values of 2.27 and 2.32 and Minimal Detectable Change values of 6.27 and 6.25 were calculated for pain and disability subscales, respectively. CONCLUSION The SPADI demonstrated satisfactory reliability and validity properties in a sample of patients with idiopathic frozen shoulder.
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Affiliation(s)
- Davide Venturin
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Gabriele Giannotta
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- In Corpore Sano, Physiotherapic Clinic, Lecce, Italy
| | | | - Alex Rossi
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Rome "Tor Vergata", Rome, Italy
| | - Denis Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- "Manual Therapy Lab" Clinic, Bari, Italy
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.
| | - Antonio Poser
- Kinè Physiotherapic and Orthopedic Center, San Vendemiano, Treviso, Italy
- University of Padua, Padua, Italy
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Papen A, Schöttker-Königer T, Schäfer A, Morrison F, Hollinger B, Burkhart KJ, Nietschke R, Zimmerer A, Maffulli N, Migliorini F, Schneider MM. Reliability, validity and critical appraisal of the cross-cultural adapted German version of the Mayo Elbow Performance Score (MEPS-G). J Orthop Surg Res 2022; 17:328. [PMID: 35752835 PMCID: PMC9233775 DOI: 10.1186/s13018-022-03210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
Background The Mayo Elbow Performance Score (MEPS) is a rating system consisting of four dimensions to evaluate elbow performance. It is a common tool for assessment of elbow impairments worldwide. We determined the validity and reliability of its German version (MEPS-G) after cross-cultural adaptation.
Methods Six investigators examined 57 patients with elbow pathologies. The MEPS-G was compared to validated elbow scores such as the German versions of DASH, the Oxford Elbow Score, pain level and subjective elbow performance on a VAS. Inter-rater reliability (IRR) and validity of the score and its dimensions were also reviewed. Verification was performed using the intraclass correlation coefficient (ICC), the prevalence and bias with adjusted Kappa (PABAK) and the Spearman correlation.
Results The IRR of the MEPS-G score was moderate (ICC (2.1) = 0.65). The IRR of the four individual dimensions was moderate to high (KPABAK = 0.55 -0.81). Validity for the sum score (r = 0.52–0.65) and the dimensions pain (r = 0.53–0.62), range of motion (r = 0.7) and stability (r = − 0.61) was verified. The function subscale reached insufficient validity (r = 0.15–0.39). Conclusion The MEPS-G is not sufficiently valid, which is consistent with its English version. The patient-based dimensions were a weakness, demonstrating high risk of bias. There is no general recommendation for the utilization of the MEPS-G as outcome measurement for patients with elbow pathologies.
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Affiliation(s)
- A Papen
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Hildesheim, Germany
| | - T Schöttker-Königer
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Hildesheim, Germany
| | - A Schäfer
- Faculty of Social Work and Health, University of Applied Science and Art (HAWK), Hildesheim, Germany
| | - F Morrison
- German Association for Manual Therapy (DVMT e.V.), Dresden, Germany
| | - B Hollinger
- Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Markgroeningen, Germany
| | - K J Burkhart
- Arcus Sportklinik, Pforzheim, Germany.,University of Cologne, Cologne, Germany
| | | | | | - N Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, UK.,Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - F Migliorini
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Marco M Schneider
- Arcus Sportklinik, Pforzheim, Germany. .,University of Witten/Herdecke, Witten, Germany.
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Harada R, Nishida K, Matsuyama Y, Hashizume K, Wada T, Nasu Y, Nakahara R, Horita M, Senda M, Ozaki T. The Japanese Version of the Patient-Rated Elbow Evaluation is a Useful Outcome Measure that Potentially Reflects Hand Function in Patients with Rheumatoid Arthritis who Underwent Total Elbow Arthroplasty. Mod Rheumatol 2021; 32:1041-1046. [PMID: 34791352 DOI: 10.1093/mr/roab100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We examined the relationship between The Japanese version of Patient-Related Elbow Evaluation (PREE-J) and other established subjective and objective outcome measures in Japanese patients with rheumatoid arthritis (RA) who underwent total elbow arthroplasty (TEA). PATIENTS AND METHODS This study involved 46 elbows of 40 RA patients. We collected clinical data one year after surgery, including the PREE-J, the Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder, and Hand (DASH), and Hand20. The correlation and responsiveness to PREE-J were evaluated compared with other outcome measures pre-and postoperatively. RESULTS Almost all outcome measures were improved significantly after surgery. Preoperative PREE-J was significantly correlated with preoperative DASH, Hand20, and MEPS. Interestingly, postoperative PREE-J did not correlate with postoperative MEPS. Multiple regression analyses revealed that preoperative grip strength (B = -0.09; 95% CI -0.17 to -0.01, p = 0.03) and preoperative Hand20 (B = 0.31, 95% CI 0.03 - 0.58, p = 0.03) were significant factors those might influenced the postoperative PREE-J. CONCLUSIONS The PREE-J was shown to correlate well with other preoperative outcome measures among the RA patients included in the current study. The postoperative PREE-J after TEA was influenced by the preoperative grip strength and function of the hand.
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Affiliation(s)
- Ryozo Harada
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Orthopaedic Surgery, Kurashiki Sweet Hospital, Okayama, Japan
| | - Keiichiro Nishida
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshiyuki Matsuyama
- Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Kenzo Hashizume
- Department of Rehabilitation, Japan Labour Health and Welfare Organization, Okayama Rosai Hospital, Okayama, Japan
| | - Takuro Wada
- Department of Orthopaedic Surgery, Saiseikai Otaru Hospital, Sapporo, Japan
| | - Yoshihisa Nasu
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryuichi Nakahara
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Horita
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masuo Senda
- Division of Physical Medicine and Rehabilitation, Okayama University Hospital, Okayama, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Wright T, Donato D, Veith J, Magno-Padron D, Agarwal J. Thirty-Day Outcomes following Upper Extremity Flap Reconstruction. J Hand Microsurg 2021; 13:101-108. [PMID: 33867769 PMCID: PMC8041497 DOI: 10.1055/s-0040-1715557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Flap reconstructions of upper extremity defects are challenging procedures. It is important to understand the surgical outcomes of upper extremity flap reconstruction, as well as associations between preoperative/perioperative variables and complications. Materials and Methods The National Surgical Quality Improvement Program (NSQIP) database was queried for patients from 2005 to 2016 who underwent flap reconstruction of an upper extremity defect. Patient and perioperative variables were collected for identified patients and assessed for associations with rates of any complication and major complications. Results On multivariate analysis, American Society of Anesthesiologists (ASA) classification >2, bleeding disorder, preoperative steroid use, free flap reconstruction, wound classification other than clean, and nonplastic surgeon specialty were independently associated with any complications. Bleeding disorder, ASA classification >2, male gender, wound classification other than clean, and preoperative anemia were independently associated with major complications. Free flap reconstruction was associated with increased length of stay, operative time, any complications, transfusions, and unplanned reoperations. Conclusion There is an association between complications in patients undergoing upper extremity free flap reconstruction and ASA classification >2, preoperative anemia, preoperative steroid use, bleeding disorders, and contaminated wounds. Male patients may require more thorough counseling in activity restriction following reconstruction. Free flaps for upper extremity reconstruction will require increased planning to reduce the chance of complications.
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Affiliation(s)
- Thomas Wright
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Daniel Donato
- Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Texas, United States
| | - Jacob Veith
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - David Magno-Padron
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Jayant Agarwal
- Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
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Carlsson IK, Ekstrand E, Åström M, Stihl K, Arner M. Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire: a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery. HAND THERAPY 2021; 26:3-16. [PMID: 37905195 PMCID: PMC10584055 DOI: 10.1177/1758998320966018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/22/2020] [Indexed: 11/02/2023]
Abstract
Introduction The aim of this study was to evaluate the construct validity, floor and ceiling effects, data completeness and magnitude of change over time for the eight-item patient questionnaire (HQ-8) in the Swedish Healthcare Quality Registry for hand surgery (HAKIR). Methods Construct validity was investigated through predefined hypotheses and correlation statistics between the single items in HQ-8 (pain on load, pain on motion without load, pain at rest, stiffness, weakness, numbness, cold sensitivity and ability to perform daily activities) and QuickDASH. Floor and ceiling effects and data completeness were analysed at preoperative (n = 13,197), three months (n =10,702) and one year (n = 9,986) responses from hand surgery patients. Effect sizes were calculated for pre- and postoperative change scores in elective conditions and postoperative scores for acute conditions. Results Correlation coefficients at pre, 3 and 12 months ranged from 0.44 to 0.79 in the total group. No ceiling effect occurred, but a floor effect for the total group was noted for all items at all follow-ups. Missing responses were < 2.6% except for cold sensitivity. The effect sizes varied from small to large for individual items in elective diagnoses. For acute injuries, small effect sizes were found. Discussion This study provides evidence of construct validity of HQ-8, lack of ceiling effect, expected floor effect, good data completeness and an ability to detect changes over time. The results indicate that HQ-8 measures unique aspects of disability. The HQ-8 could complement the Quick-DASH in describing patient-reported outcomes after hand surgery.
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Affiliation(s)
- Ingela K Carlsson
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine – Hand Surgery, Lund University, Malmö, Sweden
| | - Elisabeth Ekstrand
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Mikael Åström
- Data Analytics and Register Centrum, Region Skåne, Sweden
| | - Kerstin Stihl
- Department of Hand Surgery, Södersjukhuset, Stockholm, Sweden
| | - Marianne Arner
- Department of Hand Surgery, Södersjukhuset, Stockholm, Sweden
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
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Reproducibility: reliability and agreement parameters of the Revised Short McGill Pain Questionnaire Version-2 for use in patients with musculoskeletal shoulder pain. Health Qual Life Outcomes 2020; 18:365. [PMID: 33176784 PMCID: PMC7661222 DOI: 10.1186/s12955-020-01617-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 11/03/2020] [Indexed: 12/03/2022] Open
Abstract
Background The Revised Short McGill Pain Questionnaire Version-2 (SF-MPQ-2) is a multidimensional outcome measure designed to capture, evaluate and discriminate pain from neuropathic and non-neuropathic sources. A recent systematic review found insufficient psychometric data with respect to musculoskeletal (MSK) health conditions. This study aimed to describe the reproducibility (test–retest reliability and agreement) and internal consistency of the SF-MPQ-2 for use among patients with musculoskeletal shoulder pain. Methods Eligible patients with shoulder pain from MSK sources completed the SF-MPQ-2: at baseline (n = 195), and a subset did so again after 3–7 days (n = 48), if their response to the Global Rating of Change (GROC) scale remained unchanged. Cronbach alpha (α) and intraclass correlation coefficient (ICC2,1), and their related 95% CI were calculated. Standard error of measurement (SEM), group and individual minimal detectable change (MDC90), and Bland–Altman (BA) plots were used to assess agreement. Results Cronbach α ranged from 0.83 to 0.95 suggesting very satisfactory internal consistency across the SF-MPQ-2 domains. Excellent ICC2,1 scores were found in support of the total scale (0.95) and continuous subscale (0.92) scores; the remaining subscales displayed good ICC2,1 scores (0.78–0.88). Bland–Altman analysis revealed no systematic bias between the test and retest scores (mean difference = 0.13–0.19). While the best agreement coefficients were seen on the total scale (SEM = 0.5; MDC90individual = 1.2 and MDC90group = 0.3), they were acceptable for the SF-MPQ-2 subscales (SEM: range 0.7–1; MDC90individual: range 1.7–2.3; MDC90group: range 0.4–0.5). Conclusion Good reproducibility supports the SF-MPQ-2 domains for augmented or independent use in MSK-related shoulder pain assessment, with the total scale displaying the best reproducibility coefficients. Additional research on the validity and responsiveness of the SF-MPQ-2 is still required in this population.
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da Silva NC, Chaves TC, Dos Santos JB, Sugano RMM, Barbosa RI, Marcolino AM, Mazzer N, Fonseca MCR. Reliability, validity and responsiveness of Brazilian version of QuickDASH. Musculoskelet Sci Pract 2020; 48:102163. [PMID: 32560867 DOI: 10.1016/j.msksp.2020.102163] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To analyse the construct validity, test-retest reliability and responsiveness of the Brazilian version of Quick-DASH (QD-Br) in patients with upper limb disorders. METHOD Participants completed the full Brazilian DASH, the QD-Br and the SF-12 Brazil questionnaires at the beginning of treatment, after 48-72h and the after 2-12 months. Construct validity was analysed by Pearson's correlation coefficient (r). To evaluate the test-retest reliability we used the Intraclass Correlation Coefficient (ICC) and the Cronbach's alpha coefficient to test the internal consistency. Responsiveness was analysed by Standardized Response Mean (SRM) and Effect Size (ES). The Minimal detectable change (MDC) score was based upon calculations of the standard error of measurement (SEM), confidence interval of 95%. RESULTS The construct validity presented strong direct correlation with the total QD-Br score and the Brazilian DASH (r = 0.91), a moderate inverse correlation between the total QD-Br score and the physical component of the SF- 12 Brazil (r = -0.55) and weak inverse correlation between the QD-Br and the mental component of SF-12 Brazil (r = -0.49). The ICC test-retest showed good reliability of 0.81 (0.72-0.87). QD-BR presented high responsiveness, with ES of 1.06 and SRM of 0.94. The MDC was 17.27 points. CONCLUSION These results provide evidence that the QD-Br was a valid, reliable and responsive instrument when utilized in patients with upper limb traumatic and no-traumatic disorders in the Brazilian population.
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Affiliation(s)
| | - Thais Cristina Chaves
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | - Raquel Metzker Mendes Sugano
- Rehabilitation Centre, Ribeirao Preto Clinical Hospital, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | | | - Nilton Mazzer
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.
| | - Marisa C Registro Fonseca
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Konzelmann M, Burrus C, Gable C, Luthi F, Paysant J. Prospective multicentre validation study of a new standardised version of the 400-point hand assessment. BMC Musculoskelet Disord 2020; 21:313. [PMID: 32434509 PMCID: PMC7240941 DOI: 10.1186/s12891-020-03303-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand rehabilitation needs valid evaluation tools; the 400-point Hand Assessment (HA) is an exhaustive but not standardised tool. The aim of this study was to validate a standardised version of this test. METHODS A modified version and a standardised prototype was made for this prospective validation study (four centres, three countries). Psychometric properties studied: reliability (intra-rater and inter-rater, standard error of measurement [SEM], minimum detectable change [MDC],internal consistency); content validity, construct validity with Jebsen Taylor hand function test, QuickDASH, MOS-SF 36 and pain; responsiveness, using an anchor-based approach (ROC curve with area under curve, mean response change) with calculation of MCID. For SEM, MDC and responsiveness, QuickDASH was used for comparison. RESULTS One hundred and seventy-six patients with hand/wrist injuries were included between May 2013 and February 2015. One hundred and seventy were available for final analysis: 67% men; mean age 43.4 ± 13.2 years; both manual and office workers (46, 5% of each); 37% had a hand or wrist fracture. Reliability: ICC intra-rater = 0.967 [0.938-0.982]; inter-rater = 0.868 [0.754-0.932]. Distribution-based approach: for 400-point HA/QuickDASH: SEM = 3.48/4.52, MDC = 9.065/12.53, internal consistency of 400-point HA: Cronbach α = 0.886. VALIDITY Content validity was good according to COSMIN guidelines. Construct validity: correlation coefficient: Jebsen-Taylor hand function test = - 0.573 [- 0.666-0.464], QuickDASH = - 0.432 at T0 [- 0.545-0.303], - 0.551 at T3 [- 0.648-0.436]; MOS-SF 36 physical component = 0.395 [0.263-0.513]; no correlation with MOS-SF 36 mental component = 0.142 [- 0.009 + 0.286] and pain = - 0.166 [- 0.306 + 0.018]. Responsiveness: Anchor-based approach: AUC Δ400-point HA = 0.666 [0.583-0.749], AUC ΔQuickDASH = 0.556 [0.466-0.646]. MCID (optimal ROC curve cut-off): 6.07 for 400-point HA, - 2.27 for QuickDASH. MCID with mean response change + 12.034 ± 9.067 for 400-point HA and - 8.03 ± -9.7 for QuickDASH. The patient's global impression of change was only correlated with the Δ400-point HA. CONCLUSIONS The 400-point HA standardised version has good psychometric properties. For responsiveness, we propose an MCID of at least 12.3/100. However, these results must be confirmed in other populations and pathologies. TRIAL REGISTRATION This study was retrospectively registered into ISCTRN registry (Number ISRCTN25874481) the 07/02/2019.
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Affiliation(s)
- Michel Konzelmann
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland. .,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.
| | - Cyrille Burrus
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland
| | - Colette Gable
- Regional institute of physical medecine and rehabilitation, 75 boulevard Lobeau, CS 34209, 54042, Nancycedex, France
| | - François Luthi
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Department of Physical Medicine and Rehabilitation,Orthopaedic Hospital, Lausanne University Hospital, Avenue Pierre Decker, 1011, Lausanne, Switzerland
| | - Jean Paysant
- Regional institute of physical medecine and rehabilitation, 75 boulevard Lobeau, CS 34209, 54042, Nancycedex, France
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Webber CM, Shin AY, Kaufman KR. Assessment of Upper Extremity Function. J Hand Surg Am 2019; 44:600-605. [PMID: 30420194 DOI: 10.1016/j.jhsa.2018.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/02/2018] [Indexed: 02/02/2023]
Abstract
Assessment of upper extremity function either before or after surgical treatment has been a rapidly evolving field. A reproducible, accurate, and valid assessment tool provides the ability to compare surgical interventions, evaluate physical therapy regimens, and assess novel assistive and restorative technologies. The purpose of this article is to detail the various upper extremity assessment tools and introduce the concept of real-world data acquisition of upper extremity function.
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Affiliation(s)
- Christina M Webber
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN
| | | | - Kenton R Kaufman
- Departments of Orthopedic Surgery and Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN
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13
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Construct validity of the Patient-Rated Wrist and Hand Evaluation questionnaire (PRWHE) for nerve repair in the hand. Musculoskelet Sci Pract 2019; 40:40-44. [PMID: 30690338 DOI: 10.1016/j.msksp.2019.01.007] [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: 10/04/2018] [Revised: 01/02/2019] [Accepted: 01/15/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Many tools have been described for outcome assessment after nerve repair. The Patient-Rated Wrist and Hand Evaluation (PRWHE) have been shown to be valid for several hand conditions. OBJECTIVES To explore the construct validity of the PRWHE in comparison to cold intolerance, pain and dysfunction questionnaires; the Rosén score and its subcomponents; and threshold sensibility, dynamometry and dexterity tests for nerve repair of the hand. STUDY DESIGN Clinical measurement. METHODS Construct validity was analysed through Pearson's correlation coefficient in a convenience sample of 32 adult patients after long-term median and ulnar nerve repair. RESULTS The PRWHE total score was highly to moderately associated with the Disability of Arm, Shoulder and Hand (r = 0.83), Cold Intolerance Symptom Severity (r = -0.60) and McGill's Pain (r = 0.58) questionnaires. In addition, it was correlated to motor (r = -0.55) and sensor subdomains (r = -0.56) of the Rosén score. Substantial to high associations were found for the motor, sensory impairment and dexterity test. CONCLUSIONS The PRWHE was shown to be valid, based on construct validity, for patients with nerve repair of the hand.
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Evans JP, Porter I, Gangannagaripalli JB, Bramwell C, Davey A, Smith CD, Fine N, Goodwin VA, Valderas JM. Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: A Systematic Review and Standardised Comparison of English Language Clinical Rating Systems. SPORTS MEDICINE-OPEN 2019; 5:10. [PMID: 30895407 PMCID: PMC6426924 DOI: 10.1186/s40798-019-0183-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/06/2019] [Indexed: 11/10/2022]
Abstract
Background Lateral elbow tendinopathy (LET) is a common condition affecting adults. Although a lack of treatment consensus continues to prompt numerous effectiveness studies, there is a paucity of clear guidance on the choice of outcome measure. Our aim was to undertake a standardised evaluation of the available clinical rating systems that report patient-centred outcomes in LET. Methods A systematic review of studies reporting the development, assessment of metric properties and/or use of instruments aiming to quantify LET-specific patient-centred outcome measures was conducted in MEDLINE, Embase and CINAHL (inception-2017) adhering to PRISMA guidance. The evidence for each instrument was independently assessed by two reviewers using the standardised evaluating measures of patient-reported outcomes (EMPRO) method evaluating overall and attribute-specific instrument performance (metric properties and usability). EMPRO scores > 50/100 were considered indicative of high performance. Results Out of 7261 references, we identified 105 articles reporting on 15 instruments for EMPRO analysis. Median performance score was 41.6 (range 21.6–72.5), with four instruments meeting high-performance criteria: quick Disabilities of the Arm Shoulder and Hand score (qDASH) (72.5), DASH (66.9), Oxford Elbow Score (OES) (66.6) and Patient-Rated Tennis Elbow Evaluation (PRTEE) (57.0). One hundred seventy-nine articles reported instrument use internationally with DASH as the most frequent (29.7% articles) followed by PRTEE (25.6%), MEPS (15.1%) and qDASH (8.1%). The correlation between frequency of use and performance was r = 0.35 (95%CI − 0.11; 0.83). Conclusions This is the first study to provide standardised guidance on the choice of measures for LET. A large number of clinical rating systems are both available and being used for patients with LETs. Robust evidence is available for four measures, the DASH, QDASH, PRTEE and OES. The use of instruments in the literature is only in part explained by instrument performance. Electronic supplementary material The online version of this article (10.1186/s40798-019-0183-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jonathan Peter Evans
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK. .,Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
| | - Ian Porter
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
| | | | - Charlotte Bramwell
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
| | - Antoinette Davey
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
| | - Chris D Smith
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Nicola Fine
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Victoria A Goodwin
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK
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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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Abstract
Despite more than a hundred years of publications on Dupuytren disease, there has been a lack of consensus on definitions and outcomes until recently. Staging and classifications systems have an important historical context; however, more recently, outcomes rely on patient-reported outcomes, angular correction, and definitions of recurrence. This article reviews commonly used assessments, classifications, and staging systems for Dupuytren disease.
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Gómez-Valero S, García-Pérez F, Flórez-García MT, Miangolarra-Page JC. Assessment of cross-cultural adaptations of patient-reported shoulder outcome measures in Spanish: a systematic review. Shoulder Elbow 2017; 9:233-246. [PMID: 28932280 PMCID: PMC5598822 DOI: 10.1177/1758573217694340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/28/2016] [Accepted: 01/13/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND The present study aimed to conduct a systematic review of self-administered shoulder-disability functional assessment questionnaires adapted to Spanish, analyzing the quality of the transcultural adaptation and the clinimetric properties of the new version. METHODS A search of the main biomedical databases was conducted to locate Spanish shoulder function assessment scales. The authors reviewed the papers and considered whether the process of adaptation of the questionnaire had followed international recommendations, and whether its psychometric properties had been appropriately assessed. RESULTS The search identified nine shoulder function assessment scales adapted to Spanish: Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Upper Limb Functional Index (ULFI), Simple Shoulder Test (SST), Shoulder Pain and Disability Index (SPADI), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), Western Ontario Rotator Cuff index (WORC), Western Ontario Shoulder Instability index (WOSI) and Wheelchair Users Shoulder Pain Index (WUSPI). The DASH was adapted on three occasions and the SPADI on two. The transcultural adaptation procedure was generally satisfactory, albeit somewhat less rigorous for the SDQ and WUSPI. Reliability was analyzed in all cases. Validity was not measured for one of the adaptations of the DASH, nor was it measured for the SDQ. CONCLUSIONS The transcultural adaptation was satisfactory and the psychometric properties analyzed were similar to both the original version and other versions adapted to other languages.
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Affiliation(s)
- Sara Gómez-Valero
- Department of Physical Medicine and Rehabilitation, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain,Sara Gómez-Valero, Hospital Universitario Fundacion Alcorcon, c/ Budapest, Alcorcon, 28922 Spain.
| | - Fernando García-Pérez
- Department of Physical Medicine and Rehabilitation, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain,Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Mariano Tomás Flórez-García
- Department of Physical Medicine and Rehabilitation, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain,Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Juan Carlos Miangolarra-Page
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
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Zhou C, Hovius SER, Pieters AJ, Slijper HP, Feitz R, Selles RW. Comparative Effectiveness of Needle Aponeurotomy and Collagenase Injection for Dupuytren's Contracture: A Multicenter Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1425. [PMID: 29062633 PMCID: PMC5640330 DOI: 10.1097/gox.0000000000001425] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although the efficacy of collagenase clostridium histolyticum (CCH) injections has been demonstrated by randomized clinical trials, the relative effectiveness of CCH remains uncertain. Our aim was to compare the outcomes of CCH with those of percutaneous needle aponeurotomy (PNA) in daily clinical practice. METHODS We analyzed data from patients undergoing PNA or CCH between 2011 and 2014 at 7 practice sites in the Netherlands. We examined the degree of improvement in contracture and adverse effects at 6-12 weeks after surgery or the last injection. Additionally, we invited patients to complete the Michigan Hand Questionnaire before and at 6-12 months follow-up. To minimize the risk of bias, we used propensity score matching. RESULTS Among 130 matched patients (93% Tubiana I or II) undergoing PNA (n = 46) and CCH (n = 84), improvement in contracture was similar: 26 degrees (65% improvement from baseline) for PNA versus 31 degrees (71%) for CCH for affected metacarpophalangeal joints (P = 0.163). This was 16 degrees (50% improvement) versus 17 degrees (42%) for affected proximal interphalangeal joints (P = 0.395), respectively. No serious adverse effects occurred in either of the 2 treatment groups. Of the mild adverse effects, only skin fissures and sensory disturbances were seen in both groups. Through 1-year follow-up, patients reported similar improvements in the overall Michigan Hand Questionnaire score (PNA 5.3 points versus CCH 4.9 points; P = 0.912). CONCLUSIONS In patients with mild contractures (Tubiana I or II), CCH was as effective as PNA in reducing contractures. Both treatments were safe and improved hand function to a similar extent in daily practice.
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Affiliation(s)
- Chao Zhou
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Steven E. R. Hovius
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Adriana J. Pieters
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Harm P. Slijper
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Reinier Feitz
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Ruud W. Selles
- From the Department of Plastic, Reconstructive and Hand surgery, Erasmus MC, Rotterdam, The Netherlands; Hand and Wrist Center, Xpert Clinic, Hilversum, The Netherlands; and Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
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Pet MA, Morrison SD, Mack JS, Sears ED, Wright T, Lussiez AD, Means KR, Higgins JP, Ko JH, Cederna PS, Kung TA. Comparison of patient-reported outcomes after traumatic upper extremity amputation: Replantation versus prosthetic rehabilitation. Injury 2016; 47:2783-2788. [PMID: 28029356 DOI: 10.1016/j.injury.2016.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/03/2016] [Accepted: 10/08/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND After major upper extremity traumatic amputation, replantation is attempted based upon the assumption that outcomes for a replanted limb exceed those for revision amputation with prosthetic rehabilitation. While some reports have examined functional differences between these patients, it is increasingly apparent that patient perceptions are also critical determinants of success. Currently, little patient-reported outcomes data exists to support surgical decision-making in the setting of major upper extremity traumatic amputation. Therefore, the purpose of this study is to directly compare patient-reported outcomes after replantation versus prosthetic rehabilitation. METHODS At three tertiary care centers, patients with a history of traumatic unilateral upper extremity amputation at or between the radiocarpal and elbow joints were identified. Patients who underwent either successful replantation or revision amputation with prosthetic rehabilitation were contacted. Patient-reported health status was evaluated with both DASH and MHQ instruments. Intergroup comparisons were performed for aggregate DASH score, aggregate MHQ score on the injured side, and each MHQ domain. RESULTS Nine patients with successful replantation and 22 amputees who underwent prosthetic rehabilitation were enrolled. Aggregate MHQ score for the affected extremity was significantly higher for the Replantation group compared to the Prosthetic Rehabilitation group (47.2 vs. 35.1, p<0.05). Among the MHQ domains, significant advantages to replantation were demonstrated with respect to overall function (41.1 vs. 19.7, p=0.03), ADLs (28.3 vs. 6.0, p=0.03), and patient satisfaction (46.0 vs. 24.4, p=0.03). Additionally, Replantation patients had a lower mean DASH score (24.6 vs. 39.8, p=0.08). CONCLUSIONS Patients in this study who experienced major upper extremity traumatic amputation reported more favorable patient-reported outcomes after successful replantation compared to revision amputation with prosthetic rehabilitation.
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Affiliation(s)
- Mitchell A Pet
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, United States
| | - Shane D Morrison
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, United States
| | - Jacob S Mack
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States
| | - Erika D Sears
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States
| | - Thomas Wright
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, United States
| | - Alisha D Lussiez
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States
| | - Kenneth R Means
- Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD, United States
| | - James P Higgins
- Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD, United States
| | - Jason H Ko
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, United States
| | - Paul S Cederna
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States
| | - Theodore A Kung
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States.
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Predictors of Patient Satisfaction with Hand Function after Fasciectomy for Dupuytren’s Contracture. Plast Reconstr Surg 2016; 138:649-655. [DOI: 10.1097/prs.0000000000002472] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wehrli M, Hensler S, Schindele S, Herren DB, Marks M. Measurement Properties of the Brief Michigan Hand Outcomes Questionnaire in Patients With Dupuytren Contracture. J Hand Surg Am 2016; 41:896-902. [PMID: 27469936 DOI: 10.1016/j.jhsa.2016.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 06/06/2016] [Accepted: 06/24/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ. METHODS Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline. Two to 14 days after baseline and 1 year after collagenase injection or surgery, patients again filled out the briefMHQ. Reliability was determined using the intraclass correlation coefficient and by calculating internal consistency (Cronbach alpha). Validity was tested by quantifying correlations with the full-length MHQ and QuickDASH. Responsiveness, based on the standardized response mean and the minimally clinically important change, was also determined. RESULTS The briefMHQ had an intraclass correlation coefficient of 0.87, Cronbach alpha of 0.88, and correlations of r = 0.88 and -0.82 with the original MHQ and QuickDASH, respectively. The standardized response mean was 0.9 and the minimally clinically important change was 7 points. CONCLUSIONS Overall, the briefMHQ demonstrates excellent reliability, good validity, and high responsiveness in patients with Dupuytren contracture. CLINICAL RELEVANCE The briefMHQ is an accurate and time-saving tool to evaluate patients with Dupuytren contracture and the effect of a corresponding treatment.
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Affiliation(s)
- Martina Wehrli
- Department of Teaching, Research and Development, Schulthess Clinic, Zurich, Switzerland; Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland.
| | - Stefanie Hensler
- Department of Teaching, Research and Development, Schulthess Clinic, Zurich, Switzerland
| | | | - Daniel B Herren
- Department of Hand Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Miriam Marks
- Department of Teaching, Research and Development, Schulthess Clinic, Zurich, Switzerland
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Strömberg J, Ibsen-Sörensen A, Fridén J. Comparison of Treatment Outcome After Collagenase and Needle Fasciotomy for Dupuytren Contracture: A Randomized, Single-Blinded, Clinical Trial With a 1-Year Follow-Up. J Hand Surg Am 2016; 41:873-80. [PMID: 27473921 DOI: 10.1016/j.jhsa.2016.06.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/27/2016] [Accepted: 06/26/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE This study compared the efficacy of collagenase treatment and needle fasciotomy for contracture of the metacarpophalangeal (MCP) joint in Dupuytren disease. METHODS This is a prospective, single-blinded, randomized study with follow-up 1 week and 1 year after treatment. One hundred and forty patients with an MCP contracture of 20° or more in a single finger were enrolled, of whom 69 patients were randomized to collagenase treatment and 71 patients to needle fasciotomy. The patients were followed at 1 week and were examined by a physiotherapist after 1 year. Measurements of joint movement and grip strength were recorded as well as patient-perceived outcomes measured by the Unité Rhumatologique des Affections de la Main (URAM) questionnaire and a visual analog scale (VAS) for the estimation of procedural pain and subjective treatment efficacy. RESULTS Eighty-eight percent of the patients in the collagenase group and 90% of the patients in the needle fasciotomy group had a reduction in their MCP contracture to less than 5° 1 week after treatment, and the median gains in passive MCP movement were 48° and 46°, respectively. The median VAS score for procedural pain was 4.9 of 10 in the collagenase group and 2.7 of 10 in the needle fasciotomy group. After 1 year, 90% of the patients in both groups had full extension of the treated MCP joint. One patient in each group had a recurrence of the contracture. The median improvement in URAM score was 8 units in both groups and the VAS estimation of treatment efficacy by the patients was 8.7 of 10 in both groups. CONCLUSIONS There was no significant difference between the treatment outcomes after collagenase and needle fasciotomy treatment after 1 year. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic I.
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Affiliation(s)
- Joakim Strömberg
- Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | | | - Jan Fridén
- Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden
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Tonga E, Durutürk N, Gabel PC, Tekindal A. Cross-cultural adaptation, reliability and validity of the Turkish version of the Upper Limb Functional Index (ULFI). J Hand Ther 2016; 28:279-84; quiz 285. [PMID: 25998545 DOI: 10.1016/j.jht.2014.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 11/02/2014] [Accepted: 11/02/2014] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement. BACKGROUND The Upper Limb Functional Index (ULFI) is a patient reported outcome (PRO) measure with sound clinimetric properties and clinical viability for determination of upper limb function. PURPOSE-METHODS The aims of this study were to cross-culturally adapt the ULFI for Turkish-speaking patients (ULFI-Tk) and investigate the reliability and validity in patients with upper limb problems. Patients (n=l02, age 49.1±16.6) with upper limb disorders were consecutively recruited. All participants completed the ULFI-Tk and the Disability of Arm, Shoulder and Hand Turkish-version (DASH-Tk) criterion at baseline and day-three. RESULTS The ULFI-Tk demonstrated good internal consistency (α=0.87), moderate criterion validity (DASH-Tk:r=0.68;p<0.05), moderate reliability (ICC2:1=0.72,CI=0.58-0.80) and strong error measurement (SEM=2.94;MDC90=5.35). Exploratory factor analysis demonstrated a dual factor structure that explained 31.2% of total variance. CONCLUSIONS The ULFI-Tk is a reliable and valid PRO that could be used to assess upper limb musculoskeletal disorders in Turkish speaking patients LEVEL OF EVIDENCE Class 2.
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Affiliation(s)
- Eda Tonga
- Baskent University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Neslihan Durutürk
- Baskent University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Philip C Gabel
- Centre for Healthy Activities, Sport and Exercise, Faculty of Science, University of the Sunshine Coast Queensland, Sippy Downs, Australia
| | - Agah Tekindal
- Baskent University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
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Griffin M, Roushdi I, Osagie L, Cerovac S, Umarji S. Patient-Reported Outcomes Following Surgically Managed Perilunate Dislocation: Outcomes After Perilunate Dislocation. Hand (N Y) 2016; 11:22-8. [PMID: 27418885 PMCID: PMC4920520 DOI: 10.1177/1558944715617222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perilunate dislocations (PLDs) are uncommon high-energy injuries that may result in significant morbidity if inadequately treated. We report the midterm outcomes following surgical intervention and the validity of the Patient-Rated Wrist Evaluation (PRWE) score as an assessment tool post injury. METHODS We prospectively present outcomes in 16 patients with perilunate injuries. Definitive surgical management comprised fixation of all fractures and anatomical reconstruction of ruptured ligaments where possible. All patients completed the Disabilities of the Arm, Shoulder and Hand (DASH), 12-Item Short-Form Health Survey, and PRWE, for which internal consistency and construct validity were assessed. RESULTS At 24 months, the mean grip strength was 59% of the uninjured side (range 33%-85%) and the mean range of flexion was 71% and extension was 58%. Eighty-eight percent of patients returned to work within 6 months and 63% to sport within 1 year. The PRWE score was 36.2 (range 14.5-77.3) and DASH 25.2 (range 7.5-91.7). The mean visual analog scale (VAS) satisfaction score was 7.9 (range 0-10), VAS pain at rest 1.9 (range 0-6) and on activity 3.3 (range 1-6). DASH and PRWE demonstrated similar internal consistencies with Cronbach alphas of .98 and .91, respectively, and a strongly positive correlation coefficient of r = +.7 (P < .05). CONCLUSIONS Surgical treatment of PLDs can provide good clinical outcomes allowing patients to return to normal activities in a reasonable timescale when delays to surgery are kept to a minimum. The PRWE demonstrated high internal consistency and was found to be a valid questionnaire with advantages over the DASH for use following severe carpal injures.
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Affiliation(s)
| | | | | | | | - Shamim Umarji
- St Georges Healthcare, London, UK,Shamim Umarji, Department of Orthopaedic Surgery, St Georges Healthcare Trust, Tooting London, 0208 6721255, UK.
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The Importance of Hand Appearance as a Patient-Reported Outcome in Hand Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e552. [PMID: 26893977 PMCID: PMC4727704 DOI: 10.1097/gox.0000000000000550] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/23/2015] [Indexed: 11/27/2022]
Abstract
Hand appearance is meaningful to patients because hands are an essential part of human interactions, communication, and social integration. Recent literature indicates that hand aesthetics is an important, measurable patient-reported outcome. In hand surgery, several outcome instruments exist that accurately measure functional outcomes, but aesthetics is often overlooked or imprecisely measured. This makes comparison of disease burden and effectiveness of therapies, as they pertain to aesthetics, difficult. This special topic article outlines the aesthetic features of the hand, how literature is evaluating the appearance of the hand in outcomes research, and proposes a novel approach to assessing hand aesthetics.
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Bahadori M, Raadabadi M, Heidari Jamebozorgi M, Salesi M, Ravangard R. Measuring the quality of provided services for patients with chronic kidney disease. Nephrourol Mon 2015; 6:e21810. [PMID: 25695038 PMCID: PMC4318013 DOI: 10.5812/numonthly.21810] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 07/15/2014] [Accepted: 07/19/2014] [Indexed: 12/02/2022] Open
Abstract
Background: The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. Objectives: This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. Patients and Methods: This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. Results: The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Conclusions: Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and comments and use their feedback to solve the workplace problems and improve the quality of provided services. In addition, training the health staff to meet the patients' emotional needs and expectations is suggested.
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Affiliation(s)
- Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Raadabadi
- Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Majid Heidari Jamebozorgi
- School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Mahmood Salesi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ramin Ravangard
- Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Ramin Ravangard, Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7112340774, Fax: +98-7112340039, E-mail:
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Meireles SM, Natour J, Batista DA, Lopes M, Skare TL. Cross-cultural adaptation and validation of the Michigan Hand Outcomes Questionnaire (MHQ) for Brazil: validation study. SAO PAULO MED J 2014; 132:339-47. [PMID: 25351754 PMCID: PMC10496781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 10/30/2013] [Accepted: 11/06/2013] [Indexed: 04/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE Rheumatoid arthritis is a chronic systemic disease that causes joint damage. A variety of methods have been used to evaluate the general health status of these patients but few have specifically evaluated the hands. The objective of this study was to translate, perform cultural adaptation and assess the validity of the Michigan Hand Outcomes Questionnaire for Brazil. DESIGN AND SETTING Validation study conducted at a university hospital in Curitiba, Brazil. METHODS Firstly, the questionnaire was translated into Brazilian Portuguese and back-translated into English. The Portuguese version was tested on 30 patients with rheumatoid arthritis and proved to be understandable and culturally adapted. After that, 30 patients with rheumatoid arthritis were evaluated three times. On the first occasion, two evaluators applied the questionnaire to check inter-rater reproducibility. After 15 days, one of the evaluators reassessed the patients to verify intra rater reproducibility. To check the construct validity at the first assessment, one of the evaluators also applied other similar instruments. RESULTS There were strong inter and intra rater correlations in all the domains of the Michigan Hand Outcomes Questionnaire. Cronbach's alpha was higher than 0.90 for all the domains of the questionnaire, thus indicating excellent internal validity. Almost all domains of the questionnaire presented moderate or strong correlation with other instruments, thereby showing good construct validity. CONCLUSION The Brazilian Portuguese version of the Michigan Hand Outcomes Questionnaire was translated and culturally adapted successfully, and it showed excellent internal consistency, reproducibility and construct validity.
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Affiliation(s)
- Sandra Mara Meireles
- PT, PhD. Physiotherapist, Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, Brazil
| | - Jamil Natour
- MD, PhD. Associate Professor, Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, Brazil
| | - Daniel Alberton Batista
- PT, BSc. Physiotherapist, Rheumatology Unit, Hospital Universitário Evangélico de Curitiba (HUEC), Curitiba, Brazil
| | - Mayara Lopes
- PT, BSc. Physiotherapist, Rheumatology Unit, Hospital Universitário Evangélico de Curitiba (HUEC), Curitiba, Brazil
| | - Thelma Larocca Skare
- MD, PhD. Head of Rheumatology Unit, Hospital Universitário Evangélico de Curitiba (HUEC), and Associate Professor, Discipline of Rheumatology, Faculdade Evangélica do Paraná, Curitiba, Brazil
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London DA, Stepan JG, Boyer MI, Calfee RP. The impact of depression and pain catastrophization on initial presentation and treatment outcomes for atraumatic hand conditions. J Bone Joint Surg Am 2014; 96:806-14. [PMID: 24875021 PMCID: PMC4018773 DOI: 10.2106/jbjs.m.00755] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prior studies have suggested that patient-rated hand function is impacted by depression and pain catastrophization. We studied the impact that these comorbidities have on treatment outcomes. METHODS Two hundred and fifty-six patients presenting to an orthopaedic hand clinic were followed in this prospective cohort investigation. Patients who were prescribed treatment for atraumatic hand/wrist conditions were eligible for inclusion. At enrollment, all patients completed the Center for Epidemiologic Studies Depression (CES-D) scale, the Pain Catastrophizing Scale (PCS), and the Michigan Hand Outcomes Questionnaire (MHQ; scale of 0 to 100, with 100 indicating the best hand performance). One month and three months after treatment, patients again completed the MHQ. Participants' psychological comorbidity status was categorized as either affected (a CES-D score of ≥16, indicating depression, or a PCS score of ≥30, indicating catastrophization) or unaffected (a CES-D score of <16 and a PCS score of <30). Diagnoses and treatments for both the affected and unaffected groups were examined. The effect of time and patient status, and their interaction, on MHQ scores was evaluated by mixed modeling. RESULTS Fifty patients were categorized as affected and 206 as unaffected. Diagnoses and treatments differed minimally between the two groups. At the time of enrollment, the mean MHQ score of the unaffected group (64.9; 95% confidence interval [CI], 62.5 to 67.3) was significantly higher than that of the affected group (48.1; 95% CI, 43.3 to 53.0). Both groups demonstrated similar significant absolute improvement over baseline at three months after treatment (an increase of 12.5 points [95% CI, 7.5 to 17.4] in the affected group and 12.8 points [95% CI, 10.4 to 15.3] in the unaffected group). Thus, at the time of final follow-up, the rating of hand function by the affected patients (60.6 [95% CI, 55.0 to 66.2]) was still significantly poorer than the rating by the unaffected patients (77.7 [95% CI, 75.0 to 80.5]). CONCLUSIONS Although patients affected by depression and/or pain catastrophization reported worse self-rated hand function at baseline and at the time of follow-up, these patients showed similar absolute improvement in self-rated hand function following treatment compared with patients with unaffected status. LEVEL OF EVIDENCE Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Daniel A. London
- Washington University, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.P. Calfee:
| | - Jeffrey G. Stepan
- Washington University, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.P. Calfee:
| | - Martin I. Boyer
- Washington University, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.P. Calfee:
| | - Ryan P. Calfee
- Washington University, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.P. Calfee:
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Gabel CP, Osborne JW, Melloh M. Clinimetric re: Badalamente et al. Parts 1 and 2. J hand surg Am. 2013;38(2):401-406 and 407-412. J Hand Surg Am 2013; 38:1661-2. [PMID: 23890507 DOI: 10.1016/j.jhsa.2013.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 05/29/2013] [Indexed: 02/02/2023]
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