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Ziebart C, Bobos P, Furtado R, Dabbagh A, MacDermid J. Patient-reported outcome measures used for hand and wrist disorders: An overview of systematic reviews. J Hand Ther 2023; 36:719-729. [PMID: 36914499 DOI: 10.1016/j.jht.2022.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/19/2022] [Accepted: 10/14/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Multiple options for patient reported outcome measures are available to assess patients with hand, wrist and elbow impairments. This review of systematic reviews (overview) evaluated the evidence on these outcome measures. METHODS An electronic search of six databases (MEDLINE, Embase, CINAHL, ILC, the Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS) was performed in September 2019, and updated in August 2022. The search strategy was designed to locate systematic reviews that addressed at least one clinical measurement property of PROMs used for patients with hand and wrist impairment. Two independent reviewers screened the articles and extracted the data. The AMSTAR tool was used to assess the risk of bias in the included articles. RESULTS Eleven systematic reviews were included in this overview. A total of 27 outcome assessments were assessed, with DASH, PRWE and MHQ assessed by five, four, and three reviews, respectively. We found high-quality evidence of good to excellent internal consistency (ICC = 0.88-0.97), poor content validity but high construct validity (r > 0.70), moderate- to high-quality evidence for the DASH. The reliability of the PRWE was excellent (ICC >0.80), the convergent validity was excellent (r > 0.75), but poor criterion validity compared to the SF-12. The MHQ also reported excellent reliability (ICC = 0.88-0.96), and good criterion validity (r > 0.70), but poor construct validity (r > 0.38). CONCLUSION Clinical decisions around which tool will depend on which psychometric property is most important for the assessment and whether global or specific condition assessment is needed. All of the tools demonstrated at least good reliability; therefore, the clinical decisions will rely on the type of validity for clinical application. The DASH has good construct validity, while the PRWE has good convergent validity, and the MHQ has good criterion validity.
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Affiliation(s)
- Christina Ziebart
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada.
| | - Pavlos Bobos
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada; Dalla Lana School of Public Health, Department of Clinical Epidemiology and Health Care Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Rochelle Furtado
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada
| | - Armaghan Dabbagh
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada
| | - Joy MacDermid
- Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Vincent JI, MacDermid JC, King GJW, Grewal R. The Patient-Rated Elbow Evaluation and the American Shoulder and Elbow Surgeons-Elbow form capture aspects of functioning that are important to patients with elbow injuries. J Hand Ther 2021; 34:415-422. [PMID: 32327289 DOI: 10.1016/j.jht.2020.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/20/2020] [Accepted: 02/04/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This is a cross-sectional study. INTRODUCTION The Patient-Rated Elbow Evaluation (PREE) and the self-report section of the American Shoulder Elbow Surgeons-elbow form (pASES-e) are two important elbow-specific self-report measures used in routine clinical practice. PURPOSE OF THE STUDY To use the International Classification of Functioning Disability and Health (ICF) to link aspects of functioning that are reported using the Patient-Specific Functional Scale by a cohort of patients with elbow disorders and compare it to the content of the PREE and the pASES-e. METHODS One hundred patients with a variety of elbow disorders (mean age and SD 53.88 (14.51); M: F 48: 52) were recruited from the Roth-McFarlane Hand and Upper Limb Centre. They self-reported important aspects of functioning using the Patient-Specific Functional Scale. These concerns were linked to the ICF using formal linking procedures. These ICF categories were compared to the categories related to the PREE and the pASES-e. Linking was carried out by two independent raters, and agreement was calculated using percentage agreement. RESULTS A total of 423 self-reported functional activities were linked to 25 second-level ICF categories from the activity and participation domain. Commonly reported activities were D640 doing housework (52%); D540 dressing (47%); and D475 driving (35%). PREE had better coverage of the patient concerns (71%) than pASES-e (50%). D475-driving (35%) and D440-fine hand use (24%) were the 2 major categories that were not captured by the questionnaires. Agreement between the raters was 90.5%. DISCUSSION This study established that the PREE and the pASES-e were able to capture aspects of functioning important to patients and that align with the ICF, with this happening to a greater extent on the PREE than the pASES-e. Because all patients reported concerns from the activity and participation section ('d' categories) of the ICF, this validated that these PROMs measure this conceptual domain. CONCLUSION The PREE provided more comprehensive coverage of patients' functional concerns than the pASES-e.
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Affiliation(s)
- Joshua I Vincent
- School of Physical Therapy, Western University, London, ON, Canada; Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
| | - Joy C MacDermid
- School of Physical Therapy, Western University, London, ON, Canada; Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada; Department of Surgery, University of Western Ontario, London, ON, Canada
| | - Graham J W King
- Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada
| | - Ruby Grewal
- Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada
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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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Patel MS, Kirsch JM, Gutman MJ, McEntee RM, Alberta F, Ramsey ML, Abboud JA, Namdari S. Single Assessment Numeric Evaluation Correlates with American Shoulder and Elbow Surgeons Score for Common Elbow Pathology: A Retrospective Cohort Study. Am J Sports Med 2021; 49:2771-2777. [PMID: 34170754 DOI: 10.1177/03635465211024253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There are currently a variety of patient-reported outcomes (PROs) for elbow pathology, without any established gold standard. The Single Assessment Numeric Evaluation (SANE) is a single question assessment of the patient's perceived overall function compared with normal. The SANE score has been correlated with PROs from the shoulder and knee literature. PURPOSE To correlate the SANE score for a variety of elbow pathologies with a traditionally reported elbow outcome measure, the American Shoulder and Elbow Surgeons-Elbow score (ASES-E). STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS A retrospective review was performed of all patients identified at a single center between April 2016 and January 2019 who presented as a new patient with elbow pathology. All patients prospectively completed the ASES-E along with the SANE score for elbow (SANE-E) at the time of initial consultation. Spearman correlations (r) were performed to evaluate the correlation between the ASES-E and the SANE-E score for specific elbow pathology, along with descriptive data such as age, sex, and chronicity of the problem. RESULTS A total of 555 patients (166 women, 29.9%) with a mean ± SD age of 51.0 ± 11.7 years with the diagnoses of medial epicondylitis (n = 72; 13.0%), lateral epicondylitis (n = 224; 40.4%), biceps tendon rupture (n = 139; 25.0%), triceps tendon rupture (n = 21; 3.8%), and elbow arthritis (n = 99; 17.8%) were included in this analysis. There was moderate correlation between the SANE-E and the ASES-E (r = 0.623; P < .001), with strongest correlation with the visual analog scale (VAS) (r = -0.518; P < .001) compared with any individual question and moderate to strong correlations based on specific diagnoses. SANE-E and ASES-E scores for the entire cohort were 42.9 ± 26.7 and 56.9 ± 21.4, respectively (P < .001). Age (r = 0.027; P = .526), sex (r = 0.026; P = .555), VAS (r = -0.106; P = .013), and chronicity of the problem (r = -0.037; P = .384) were not found to be correlated with differences in ASES-E and SANE-E. CONCLUSION The SANE-E score is a simple way to assess patient-perceived function relative to normal. The findings of this study demonstrated moderate to strong correlation between the ASES-E and the SANE-E score for a variety of commonly encountered elbow conditions.
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Affiliation(s)
| | - Jacob M Kirsch
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
| | | | | | - Frank Alberta
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
| | | | - Joseph A Abboud
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
| | - Surena Namdari
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
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Takahashi R, Sano K, Kimura K, Ishioka T, Suzuki M, Nakaya N, Ozeki S, Hamaguchi T. Reproducibility and reliability of performance indicators to evaluate the therapeutic effectiveness of biofeedback therapy after elbow surgery: An observational case series. Medicine (Baltimore) 2020; 99:e21889. [PMID: 32846850 PMCID: PMC7447474 DOI: 10.1097/md.0000000000021889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Electromyographic biofeedback (EMG-BF) therapy provides information on the state of contraction of the targeted muscles and relaxation of their antagonists, which can facilitate early active range of motion (RoM) after elbow surgery. Our aim in this study was to calculate the minimum detectable change (MDC) during EMG-BF therapy, initiated in the early postoperative period after elbow surgery.This study is an observational case series. EMG-BF of muscle contraction and relaxation was provided during active elbow flexion and extension exercises. Patients completed 3 sets of 10 trials each of flexion and extension over 4 weeks. The total range of flexion-extension motion and scores on the Japanese Society for Surgery of the Hand version of the disability of the arm, shoulder, and hand questionnaire and the Japanese version of the Patient-Rated Elbow Evaluation were obtained at baseline and weekly during the 4-week intervention period. A prediction formula was developed from the time-series data obtained during the intervention period, using the least-squares method. The estimated value was calculated by removing the slope from the prediction formula and adding the initial scores to residuals between the measured scores and predicted scores individually. Systematic error, MDC at the 95th percentile cutoff (MDC95), repeatability of the measures, and the change from the baseline to each time-point of intervention were assessed.The MDC95 was obtained for all 3 outcome measures and the range of values was as follows: RoM, 8.3° to 22.5°; Japanese version of the Patient-Rated Elbow Evaluation score, 17.6 to 30.6 points; and disability of the arm, shoulder, and hand questionnaire subscale: disability and symptoms score, 14.2 to 22.9 points.The efficacy of EMG-BF after elbow surgery was reflected in earlier initiation of elbow RoM after surgery and improvement in patient-reported upper limb function scores. The calculated MDC95 cut-offs could be used as reference values to assess the therapeutic effects of EMG-BF in individuals.
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Affiliation(s)
- Rina Takahashi
- Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kazufumi Sano
- Department of Plastic and Reconstructive Surgery, Juntendo University Hospital, Tokyo
| | - Kazumasa Kimura
- Department of Orthopaedic Surgery, Koshigaya Seiwa Hospital, Saitama
| | - Toshiyuki Ishioka
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama
| | - Makoto Suzuki
- Faculty of Health Sciences, Tokyo Kasei University, Saitama
| | - Naoki Nakaya
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama
| | - Satoru Ozeki
- First Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama
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