1
|
Çelik EB, Tuncer A. Comparing the Efficacy of Manual Therapy and Exercise to Synchronized Telerehabilitation with Self-Manual Therapy and Exercise in Treating Subacromial Pain Syndrome: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1074. [PMID: 38891149 PMCID: PMC11171729 DOI: 10.3390/healthcare12111074] [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: 04/08/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SAPS). Sixty individuals diagnosed with SPS, aged 18-50 years, were randomly assigned to home exercise (HE), manual therapy (MT), and telerehabilitation (TR) groups. Treatment protocols were administered over 8 weeks and included specific exercises and therapy interventions. Outcome measures included the Visual Pain Scale (VAS), shoulder range of motion (ROM) via goniometric measurements, Quick Disability Arm-Shoulder-Hand Problems Survey (Q-DASH), and patient satisfaction. Results revealed that both MT and TR groups exhibited reduced pain, increased ROM, lower Q-DASH scores, and higher patient satisfaction than the HE group. However, no significant differences were found between the MT and TR groups regarding pain levels, ROM, Q-DASH scores, or patient satisfaction. The study concludes that both telerehabilitation and manual therapy effectively alleviate pain and are well-received by patients with SPS. Additionally, manual therapy demonstrates superiority in enhancing functional levels compared to exercise-based interventions (Registration: NCT05200130).
Collapse
Affiliation(s)
- Erman Berk Çelik
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Mardin Artuklu University, 47200 Mardin, Türkiye
| | - Aysenur Tuncer
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hasan Kalyoncu University, 27410 Gaziantep, Türkiye;
| |
Collapse
|
2
|
Brindisino F, Venturin D, Bartoli M, Caselli S, Pellicciari L, Poser A. Psychometric properties of the Disability of Arm Shoulder and Hand (DASH) in subjects with frozen shoulder: a reliability and validity study. BMC Musculoskelet Disord 2024; 25:260. [PMID: 38566086 PMCID: PMC10986124 DOI: 10.1186/s12891-024-07371-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Frozen Shoulder (FS) is a painful condition characterized by severe pain and progressive restriction of shoulder movement, leading to functional impairment and reduced quality of life. While different Patient Reported Outcome Measurements (PROMs) tools exist for assessing shoulder diseases, few specific PROMs are validated for FS patients. PURPOSE This study aims to assess the psychometric properties of the Disability of Arm, Shoulder, and Hand (DASH) questionnaire in FS patients. METHODS One hundred and twenty-four subjects (mean ± SD age = 55.4 ± 7.9 years; 55.6% female) diagnosed with FS were included and completed the DASH questionnaire, the Numerical Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), and the Short-Form Health Survey 36 (SF-36). Floor or ceiling effects were investigated. Structural validity was analysed through a unidimensional Confirmatory Factor Analysis (CFA), internal consistency through Cronbach's alpha, test-retest reliability through the Intraclass Correlation coefficient (ICC), measurement error through the Standard Error of Measurement (SEM), and the Minimum Detectable Change (MDC), and construct validity through the hypothesis testing with the correlation with the other outcome measures used. RESULTS No floor or ceiling effects were observed. CFA confirmed a one-factor structure after addressing local item dependency (Root Mean Square Error of Approximation = 0.055; Standardized Root Mean Square Residual = 0.077; Comparative Fit Index = 0.970; Tucker-Lewis Index = 0.968). Cronbach's alpha was high (= 0.951), and test-retest reliability was excellent (ICC = 0.999; 95% CI: 0.998-1.000). SEM was equal to 0.5 points, and MDC to 1.5 points. Construct validity was considered satisfactory as 80% of the a-priori hypotheses were met. CONCLUSION The DASH questionnaire demonstrated good psychometric properties in FS patients, supporting its use as a valuable tool for assessing the impact of FS in clinical and research settings.
Collapse
Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, 86100, Italy
| | - Davide Venturin
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, 86100, Italy
| | - Matteo Bartoli
- Physiotherapy private practice KinesiLab, via Marcantonio Colonna 88, Marino, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Leonardo Pellicciari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, Bologna, I-40139, Italy.
| | - Antonio Poser
- Physiotherapy private practice Kinè, Kinè s.r.l, Viale della Quercia 2/B,, Treviso, Italy
- University of Siena, c/o via Banchi di Sotto, 55, Siena, Italy
| |
Collapse
|
3
|
Seoane-Martín ME, Cuesta-Barriuso R, Rodríguez-Martínez MC. Occupational therapy in the management of haemophilia patients: A scoping review. Haemophilia 2024; 30:51-58. [PMID: 38111119 DOI: 10.1111/hae.14913] [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] [Received: 09/13/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Haemophilia is a haematological disease, although most haemorrhages occur in the locomotor system. Patients are physically disabled from an early age and have a poorer perception of quality of life. In the day-to-day lives of patients and their families, psychosocial well-being, the disease's physical, personal, and social impact, as well as work-related problems are the most complicated aspects of the disease that need to be addressed. OBJECTIVE To identify the role of occupational therapy in managing patients with haemophilia and to analyse the therapeutic potential of occupational therapy in treating these patients. METHODS A scoping review was conducted to identify the role of occupational therapy in managing patients with haemophilia and to analyse the therapeutic potential of occupational therapy in treating these patients. The review was registered in the international registry PROSPERO (Id: CRD42022319637). The databases consulted were SCOPUS, PubMed, PsycINFO, Web of Science and Science Direct, including all studies published until 14 August 2023. RESULTS No single study was found that specifically developed an occupational therapy intervention for patients with haemophilia. Measurement instruments have been identified, specific for patients with haemophilia and generic, that can be useful for the functional evaluation of these patients in the occupational therapy approach. Different studies showed the importance of multidisciplinary treatment, including occupational therapy. CONCLUSIONS The use of occupational therapy could be effective in improving autonomy and quality of life in haemophilia patients. Therefore, it is of paramount importance to conduct research studies within the field of occupational therapy.
Collapse
Affiliation(s)
| | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
| | - María Carmen Rodríguez-Martínez
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga-Nanomedicine Platform (IBIMA-BIONAND Platform), Málaga, Spain
| |
Collapse
|
4
|
Alonso-Muñoz MB, Calvache-Mateo A, Martín-Núñez J, López-López L, Navas-Otero A, Heredia-Ciuró A, Valenza MC. Musculoskeletal, Functional and Performance Impairment in Female Overhead Athletes with a Previous Shoulder Injury. Healthcare (Basel) 2023; 12:21. [PMID: 38200927 PMCID: PMC10779138 DOI: 10.3390/healthcare12010021] [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: 11/23/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Shoulder injuries are substantial problems in overhead athletes, and more studies are necessary to deepen the knowledge on this type of injury. The objective of this study was to compare the overall function and performance of female overhead athletes with and without a previous history of shoulder injuries. METHODS In this cross-sectional study, female overhead athletes with and without a previous shoulder injury were included. Muscular impairment, the stability of the shoulder, strength, scapular dyskinesia, functionality and sports performance were evaluated. A total of 50 females were included. RESULTS There were significant differences in strength (p = 0.046) and stability (p = 0.039) between groups, with a poorer score in the group with a history of shoulder injury. Regarding scapular dyskinesia, significant differences were also observed between groups (p = 0.048), with higher levels of dyskinesia in the group with previous shoulder injury. Also, muscular impairment showed significant differences between groups for the three muscles evaluated (p < 0.005). Additionally, the group without a previous shoulder injury presented with a significantly greater score in functionality (p = 0.046) and sports performance (p = 0.004). CONCLUSION In conclusion, previous shoulder injuries are an important factor to take into account in female overhead athletes. Players with a history of shoulder injury present clinical impairments during the game, leading to poorer functional status and performance in sport.
Collapse
Affiliation(s)
| | | | | | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, 18071 Granada, Spain; (M.B.A.-M.); (A.C.-M.); (J.M.-N.); (A.N.-O.); (A.H.-C.); (M.C.V.)
| | | | | | | |
Collapse
|
5
|
Harrison CJ, Hossain A, Bruce J, Rodrigues JN. Psychometric sensitivity analyses can identify bias related to measurement properties in trials that use patient-reported outcome measures: a secondary analysis of a clinical trial using the disabilities of the arm, shoulder, and hand questionnaire. J Clin Epidemiol 2023; 163:21-28. [PMID: 37774956 DOI: 10.1016/j.jclinepi.2023.09.008] [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] [Received: 02/13/2023] [Revised: 06/23/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES Demonstrate psychometric sensitivity analyses for testing the stability of study findings to assumptions made about patient-reported outcome measures. STUDY DESIGN AND SETTING We performed secondary analyses of Disability of Arm, Shoulder, and Hand (DASH) data collected within the Prevention of Shoulder Problems clinical trial, which compared upper limb function scores in women who had undergone breast cancer surgery, randomized to either an exercise program or usual care. We repeated the principal trial analyses after grouping DASH items into subscales suggested by factorial analyses in this dataset and applied item response theory to account for unequal item weighting. We checked for measurement invariance by participant age and response shift bias using established techniques. RESULTS Our analyses suggested that the DASH measured two constructs: motor function and sensory symptoms. The majority of the six-month difference in DASH score was driven by motor function. With item response theory scoring, we found differences in both constructs at 12 months (P = 0.019 and P = 0.007), but in neither construct at 6 months, contrary to the original trial results. We found no differential item function by age or between baseline and 12-month measurements. CONCLUSIONS Psychometric sensitivity analyses aid in the interpretation of the Prevention of Shoulder Problems trial's results.
Collapse
Affiliation(s)
- Conrad J Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Surgical Intervention Trials Unit, University of Oxford, Oxford, UK.
| | - Anower Hossain
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Julie Bruce
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK; University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Jeremy N Rodrigues
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Salomon M, Pastore C, Maselli F, Di Bari M, Pellegrino R, Brindisino F. Manipulation under Anesthesia versus Non-Surgical Treatment for Patients with Frozen Shoulder Contracture Syndrome: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9715. [PMID: 35955074 PMCID: PMC9368476 DOI: 10.3390/ijerph19159715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Purpose: To investigate the efficacy of manipulation under anesthesia (MUA) compared to other non-surgical therapeutic strategies for patients with frozen shoulder contracture syndrome (FSCS). Methods: A systematic review of literature was conducted. A literature search was performed in MEDLINE, EMBASE, PEDro, Cochrane Central Library and Scopus. Only randomized controlled trials were included and assessed for critical appraisal through the Cochrane Collaborations tools. Results: Five randomized controlled trials were included. The overall risk of bias (RoB) was high in 4 out of 5 of the included studies. MUA was found to be not superior in terms of reduction of pain and improvement of function when compared to cortisone injections with hydrodilatation (mean regression coefficient MUA −2.77 vs. injection −2.75; 95% CI (−1.11 to 1.15)) and home exercise (mean difference 95% CI: 0.2 (−0.64 to 1.02)) in the short term (3 months), and cortisone injections with hydrodilatation (mean regression coefficient MUA 3.13 vs. injection 3.23; 95% CI (−0.90 to 1.11)) in the long term (>6 months). Moreover, if compared to structured physiotherapy, MUA highlighted a higher Oxford Shoulder Score at final 1-year follow up (mean difference 95% CI: 1.05 (−1.28 to 3.39); p = 0.38). Similar results were obtained for disability, with statistically no significant long-term (>12 months) differences between MUA and home exercise (mean difference 95% CI: 0 (−3.2 to 3.2)) or structured physiotherapy (mean difference 95% CI: −0.50 (−5.70 to 4.70); p = 0.85)). Only two trials reported adverse events. Conclusions: This review suggested that limited and inconsistent evidence currently exists on the efficacy of MUA compared to other non-surgical strategies in the management of patients with FSCS. Future research should focus on clinical trials with higher methodological quality.
Collapse
Affiliation(s)
- Mattia Salomon
- Department of Clinical Science and Translational Medicine, University of Roma “Tor Vergata”, 00133 Rome, Italy
| | - Chiara Pastore
- Department of Clinical Science and Translational Medicine, University of Roma “Tor Vergata”, 00133 Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, University of Roma “Sapienza”, 00185 Rome, Italy
| | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Clinical and Experimental Medicine, University of Florence, 50121 Florence, Italy
- Unit of Geriatrics—Geriatrics Intensive Care Unit, Department of Medicine and Geriatrics, “Careggi Hospital”, 50134 Florence, Italy
| | - Raffaello Pellegrino
- Antalgic Mini-Invasive and Rehab-Outpatients Unit, Department of Medicine and Aging Sciences, University “G. D’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | - Fabrizio Brindisino
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, “Cardarelli Hospital”, 86100 Campobasso, Italy
| |
Collapse
|
8
|
Sekhon M, Cartwright M, Francis JJ. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. BMC Health Serv Res 2022; 22:279. [PMID: 35232455 PMCID: PMC8887649 DOI: 10.1186/s12913-022-07577-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background The theoretical framework of acceptability (TFA) was developed in response to recommendations that acceptability should be assessed in the design, evaluation and implementation phases of healthcare interventions. The TFA consists of seven component constructs (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy) that can help to identify characteristics of interventions that may be improved. The aim of this study was to develop a generic TFA questionnaire that can be adapted to assess acceptability of any healthcare intervention. Methods Two intervention-specific acceptability questionnaires based on the TFA were developed using a 5-step pre-validation method for developing patient-reported outcome instruments: 1) item generation; 2) item de-duplication; 3) item reduction and creation; 4) assessment of discriminant content validity against a pre-specified framework (TFA); 5) feedback from key stakeholders. Next, a generic TFA-based questionnaire was developed and applied to assess prospective and retrospective acceptability of the COVID-19 vaccine. A think-aloud method was employed with two samples: 10 participants who self-reported intention to have the COVID-19 vaccine, and 10 participants who self-reported receiving a first dose of the vaccine. Results 1) The item pool contained 138 items, identified from primary papers included in an overview of reviews. 2) There were no duplicate items. 3) 107 items were discarded; 35 new items were created to maximise coverage of the seven TFA constructs. 4) 33 items met criteria for discriminant content validity and were reduced to two intervention-specific acceptability questionnaires, each with eight items. 5) Feedback from key stakeholders resulted in refinement of item wording, which was then adapted to develop a generic TFA-based questionnaire. For prospective and retrospective versions of the questionnaire, no participants identified problems with understanding and answering items reflecting four TFA constructs: affective attitude, burden, perceived effectiveness, opportunity costs. Some participants encountered problems with items reflecting three constructs: ethicality, intervention coherence, self-efficacy. Conclusions A generic questionnaire for assessing intervention acceptability from the perspectives of intervention recipients was developed using methods for creating participant-reported outcome measures, informed by theory, previous research, and stakeholder input. The questionnaire provides researchers with an adaptable tool to measure acceptability across a range of healthcare interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07577-3.
Collapse
Affiliation(s)
- Mandeep Sekhon
- School of Health Sciences, City University of London, Northampton Square, London, EC1V 0JB, UK. .,Department of Population Health Sciences, Faculty of life Sciences and Medicine, Kings College London, London, SE1 1UL, UK.
| | - Martin Cartwright
- School of Health Sciences, City University of London, Northampton Square, London, EC1V 0JB, UK
| | - Jill J Francis
- School of Health Sciences, City University of London, Northampton Square, London, EC1V 0JB, UK.,Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC, 3010, Australia.,Centre of Implementation Research, Ottawa Hospital Research Institute - General Campus, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| |
Collapse
|
9
|
Bruce J, Mazuquin B, Mistry P, Rees S, Canaway A, Hossain A, Williamson E, Padfield EJ, Lall R, Richmond H, Chowdhury L, Lait C, Petrou S, Booth K, Lamb SE, Vidya R, Thompson AM. Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT. Health Technol Assess 2022; 26:1-124. [PMID: 35220995 DOI: 10.3310/jknz2003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Upper limb problems are common after breast cancer treatment. OBJECTIVES To investigate the clinical effectiveness and cost-effectiveness of a structured exercise programme compared with usual care on upper limb function, health-related outcomes and costs in women undergoing breast cancer surgery. DESIGN This was a two-arm, pragmatic, randomised controlled trial with embedded qualitative research, process evaluation and parallel economic analysis; the unit of randomisation was the individual (allocated ratio 1 : 1). SETTING Breast cancer centres, secondary care. PARTICIPANTS Women aged ≥ 18 years who had been diagnosed with breast cancer and were at higher risk of developing shoulder problems. Women were screened to identify their risk status. INTERVENTIONS All participants received usual-care information leaflets. Those randomised to exercise were referred to physiotherapy for an early, structured exercise programme (three to six face-to-face appointments that included strengthening, physical activity and behavioural change strategies). MAIN OUTCOME MEASURES The primary outcome was upper limb function at 12 months as assessed using the Disabilities of Arm, Hand and Shoulder questionnaire. Secondary outcomes were function (Disabilities of Arm, Hand and Shoulder questionnaire subscales), pain, complications (e.g. wound-related complications, lymphoedema), health-related quality of life (e.g. EuroQol-5 Dimensions, five-level version; Short Form questionnaire-12 items), physical activity and health service resource use. The economic evaluation was expressed in terms of incremental cost per quality-adjusted life-year and incremental net monetary benefit gained from an NHS and Personal Social Services perspective. Participants and physiotherapists were not blinded to group assignment, but data collectors were blinded. RESULTS Between 2016 and 2017, we randomised 392 participants from 17 breast cancer centres across England: 196 (50%) to the usual-care group and 196 (50%) to the exercise group. Ten participants (10/392; 3%) were withdrawn at randomisation and 32 (8%) did not provide complete baseline data. A total of 175 participants (89%) from each treatment group provided baseline data. Participants' mean age was 58.1 years (standard deviation 12.1 years; range 28-88 years). Most participants had undergone axillary node clearance surgery (327/392; 83%) and 317 (81%) had received radiotherapy. Uptake of the exercise treatment was high, with 181 out of 196 (92%) participants attending at least one physiotherapy appointment. Compliance with exercise was good: 143 out of 196 (73%) participants completed three or more physiotherapy sessions. At 12 months, 274 out of 392 (70%) participants returned questionnaires. Improvement in arm function was greater in the exercise group [mean Disabilities of Arm, Hand and Shoulder questionnaire score of 16.3 (standard deviation 17.6)] than in the usual-care group [mean Disabilities of Arm, Hand and Shoulder questionnaire score of 23.7 (standard deviation 22.9)] at 12 months for intention-to-treat (adjusted mean difference Disabilities of Arm, Hand and Shoulder questionnaire score of -7.81, 95% confidence interval -12.44 to -3.17; p = 0.001) and complier-average causal effect analyses (adjusted mean difference -8.74, 95% confidence interval -13.71 to -3.77; p ≤ 0.001). At 12 months, pain scores were lower and physical health-related quality of life was higher in the exercise group than in the usual-care group (Short Form questionnaire-12 items, mean difference 4.39, 95% confidence interval 1.74 to 7.04; p = 0.001). We found no differences in the rate of adverse events or lymphoedema over 12 months. The qualitative findings suggested that women found the exercise programme beneficial and enjoyable. Exercise accrued lower costs (-£387, 95% CI -£2491 to £1718) and generated more quality-adjusted life years (0.029, 95% CI 0.001 to 0.056) than usual care over 12 months. The cost-effectiveness analysis indicated that exercise was more cost-effective and that the results were robust to sensitivity analyses. Exercise was relatively cheap to implement (£129 per participant) and associated with lower health-care costs than usual care and improved health-related quality of life. Benefits may accrue beyond the end of the trial. LIMITATIONS Postal follow-up was lower than estimated; however, the study was adequately powered. No serious adverse events directly related to the intervention were reported. CONCLUSIONS This trial provided robust evidence that referral for early, supported exercise after breast cancer surgery improved shoulder function in those at risk of shoulder problems and was associated with lower health-care costs than usual care and improved health-related quality of life. FUTURE WORK Future work should focus on the implementation of exercise programmes in clinical practice for those at highest risk of shoulder problems. TRIAL REGISTRATION This trial is registered as ISRCTN35358984. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 15. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Julie Bruce
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Bruno Mazuquin
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Pankaj Mistry
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Sophie Rees
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Alastair Canaway
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Anower Hossain
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, Bangladesh
| | - Esther Williamson
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Emma J Padfield
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Helen Richmond
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada
| | - Loraine Chowdhury
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Clare Lait
- Gloucestershire Care Services NHS Trust, Gloucester, UK
| | - Stavros Petrou
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Katie Booth
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Sarah E Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
| | | | | |
Collapse
|
10
|
David SL, Farnsworth JL, Theige M. Content Validity of the Disability of the Arm, Shoulder, and Hand Questionnaire in a College-Age Patient Population. JSES Int 2022; 6:512-517. [PMID: 35572428 PMCID: PMC9091923 DOI: 10.1016/j.jseint.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective The Disability of the Arm, Shoulder, and Hand questionnaire (DASH) is a region-specific Patient Reported Outcome Measure and has been found to be valid and reliable. However, it has not been evaluated in a young patient population. Our objective was to understand how often the uninjured ‘collegiate’ population completes the specific tasks on the DASH. Design A questionnaire-based survey. Methods A total of 256 participants (age: 19.44 ± 1.83) completed the study. Participants were asked to track how often they completed 21 tasks taken from the DASH over a 14-day period. Data were analyzed using descriptive statistics and A Rasch partial-credit model. Results The 3 most commonly completed tasks are Recreational Activities in which you take some force or impact through your arm, shoulder, or hand (e.g., golf, hammering, tennis, etc.), Wash or blow-dry your hair, and Put on a pullover sweater while the least most commonly completed tasks were garden or do yard work, change a light bulb overhead, and sexual activities. Infit statistics ranged from .94 to 1.12, and Outfit ranged from .27 to 1.33. Person and item separation indices were 0.40 and 5.24, respectively. Person and item reliability indices were 0.14 and 0.96, respectively. Conclusions Findings from this study suggest that clinicians should be cautious when using the DASH with the ‘college aged’ patient population.
Collapse
|
11
|
Goudie ST, Broll R, Warwick C, Dixon D, Ring D, McQueen M. The Association Between Psychological Factors and Outcomes After Distal Radius Fracture. J Hand Surg Am 2022; 47:190.e1-190.e10. [PMID: 34112544 DOI: 10.1016/j.jhsa.2021.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 02/09/2021] [Accepted: 04/15/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this study was to identify psychological factors associated with pain intensity and disability following distal radius fracture. METHODS We prospectively followed 216 adult patients with distal radius fracture for 9 months. Demographics, injury and treatment details, and psychological measures (Hospital Anxiety and Depression Score [HADS], Pain Catastrophizing Scale, Posttraumatic Stress Disorder Checklist-Civilian, Tampa Scale for Kinesiophobia, Illness Perception Questionnaire Brief [IPQB], General Self-Efficacy Scale, and Recovery Locus of Control [RLOC]) were collected at enrollment. Multivariable linear regression was used to identify factors associated with Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Likert pain scores. RESULTS Higher 10-week DASH scores were associated with increased age, the presence of a nerve pathology, increased HADS Depression subscale scores, increased IPQB scores, and lower RLOC scores. Higher 9-month DASH scores were associated with increased age, increased deprivation scores, increased numbers of medical comorbidities, a greater degree of radial shortening, increased HADS Depression subscale scores, and lower RLOC scores. A higher 10-week pain score was associated with increased deprivation and IPQB scores. A higher pain score at 9 months was associated with an increased number of medical comorbidities. CONCLUSIONS Psychosocial factors measured early after fracture are associated with pain and disability up to 9 months after distal radius fracture. Illness perception is a potentially modifiable psychological construct not previously studied in hand conditions. It may provide a suitable target for psychological interventions that could enhance recovery. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
Collapse
Affiliation(s)
- Stuart T Goudie
- Department of Orthopaedics, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
| | - Ryan Broll
- Department of Orthopaedics, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Catherine Warwick
- Department of Orthopaedics, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Diane Dixon
- Department of Psychology, University of Strathclyde, Glasgow, United Kingdom
| | - David Ring
- Dell Medical School, University of Texas at Austin, Dell Medical School Health Learning Building, Austin, TX
| | - Margaret McQueen
- Department of Orthopaedics, Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
12
|
Bruce J, Mazuquin B, Canaway A, Hossain A, Williamson E, Mistry P, Lall R, Petrou S, Lamb SE, Rees S, Padfield E, Vidya R, Thompson AM. Exercise versus usual care after non-reconstructive breast cancer surgery (UK PROSPER): multicentre randomised controlled trial and economic evaluation. BMJ 2021; 375:e066542. [PMID: 34759002 PMCID: PMC8579424 DOI: 10.1136/bmj-2021-066542] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether a structured exercise programme improved functional and health related quality of life outcomes compared with usual care for women at high risk of upper limb disability after breast cancer surgery. DESIGN Multicentre, pragmatic, superiority, randomised controlled trial with economic evaluation. SETTING 17 UK National Health Service cancer centres. PARTICIPANTS 392 women undergoing breast cancer surgery, at risk of postoperative upper limb morbidity, randomised (1:1) to usual care with structured exercise (n=196) or usual care alone (n=196). INTERVENTIONS Usual care (information leaflets) only or usual care plus a physiotherapy led exercise programme, incorporating stretching, strengthening, physical activity, and behavioural change techniques to support adherence to exercise, introduced at 7-10 days postoperatively, with two further appointments at one and three months. MAIN OUTCOME MEASURES Disability of Arm, Hand and Shoulder (DASH) questionnaire at 12 months, analysed by intention to treat. Secondary outcomes included DASH subscales, pain, complications, health related quality of life, and resource use, from a health and personal social services perspective. RESULTS Between 26 January 2016 and 31 July 2017, 951 patients were screened and 392 (mean age 58.1 years) were randomly allocated, with 382 (97%) eligible for intention to treat analysis. 181 (95%) of 191 participants allocated to exercise attended at least one appointment. Upper limb function improved after exercise compared with usual care (mean DASH 16.3 (SD 17.6) for exercise (n=132); 23.7 (22.9) usual care (n=138); adjusted mean difference 7.81, 95% confidence interval 3.17 to 12.44; P=0.001). Secondary outcomes favoured exercise over usual care, with lower pain intensity at 12 months (adjusted mean difference on numerical rating scale -0.68, -1.23 to -0.12; P=0.02) and fewer arm disability symptoms at 12 months (adjusted mean difference on Functional Assessment of Cancer Therapy-Breast+4 (FACT-B+4) -2.02, -3.11 to -0.93; P=0.001). No increase in complications, lymphoedema, or adverse events was noted in participants allocated to exercise. Exercise accrued lower costs per patient (on average -£387 (€457; $533) (95% confidence interval -£2491 to £1718; 2015 pricing) and was cost effective compared with usual care. CONCLUSIONS The PROSPER exercise programme was clinically effective and cost effective and reduced upper limb disability one year after breast cancer treatment in patients at risk of treatment related postoperative complications. TRIAL REGISTRATION ISRCTN Registry ISRCTN35358984.
Collapse
Affiliation(s)
- Julie Bruce
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Bruno Mazuquin
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Alastair Canaway
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Anower Hossain
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, Bangladesh
| | - Esther Williamson
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Pankaj Mistry
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Institute of Health Research, University of Exeter, Exeter, UK
| | - Sophie Rees
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Emma Padfield
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | | | - Alastair M Thompson
- Department of Surgery, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
13
|
Gkotsi A, Bourdon C, Robert C, Schuind F. Normative values of the DASH questionnaire in healthy individuals over 50 years of age. HAND SURGERY & REHABILITATION 2021; 40:258-262. [PMID: 33636383 DOI: 10.1016/j.hansur.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
This study aimed to define the normative values of the DASH score in healthy individuals over 50 years of age. One hundred and twenty subjects equally representing both genders and six age categories (50-54, 55-59, 60-64, 65-69, 70-74 and 75-80 years), with no past medical history affecting the upper limb, were asked to complete the DASH questionnaire. A visual analogue scale for pain and an HAQ-DI questionnaire were also completed to confirm the absence of symptomatic untreated upper limb pathologies. In this series of a priori normal subjects, most had a DASH score greater than 0. Moreover, the DASH score was found to rise with age, with a statistically significant difference between women and men. The DASH questionnaire is widely accepted in the everyday medical practice as a tool to evaluate upper limb function. However, age adjustment of the DASH questionnaire is necessary to correctly evaluate the clinical status and progression of individuals over the age of 50.
Collapse
Affiliation(s)
- A Gkotsi
- Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.
| | - C Bourdon
- Physiotherapy and Rehabilitation Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - C Robert
- Physiotherapy and Rehabilitation Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - F Schuind
- Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| |
Collapse
|
14
|
Vinet-Jones H, F Darr K. Clinical use of autologous micro-fragmented fat progressively restores pain and function in shoulder osteoarthritis. Regen Med 2020; 15:2153-2161. [PMID: 33275470 DOI: 10.2217/rme-2020-0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: We aim to show that the use of nondigested micro-fragmented adipose tissue (MFat™, Lipogems®) is a viable alternative for treatment of joint pain and inflammation associated dysfunction in shoulder osteoarthritis (OA). Materials & methods: A total of 25 subjects with OA received an injection of MFat™ and were followed at 6, 18 and 52 weeks intervals. Quantitative analysis of pain and function modalities were performed using the visual analog scale and the disabilities of the arm, shoulder and hand, respectively. Results: All study participants reported significant progressive improvement (p < 0.001) from baseline in visual analog scale and disabilities of the arm, shoulder and hand in shoulder OA cases up to a year post. Conclusion: MFat™ therapy improves pain and function in patients with shoulder OA and can provide a long-term alternative to surgical intervention.
Collapse
Affiliation(s)
- Heather Vinet-Jones
- Regenerative Medicine Covington, Orthopedic Sports Medicine Institute, Covington, LA 70433, USA
| | - Kevin F Darr
- Regenerative Medicine Covington, Orthopedic Sports Medicine Institute, Covington, LA 70433, USA
| |
Collapse
|
15
|
Kaya Aytutuldu G, Birinci T, Tarakcı E. Musculoskeletal pain and its relation to individual and work-related factors: a cross-sectional study among Turkish office workers who work using computers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:790-797. [PMID: 32965164 DOI: 10.1080/10803548.2020.1827528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective. Office workers are commonly exposed to work-related musculoskeletal pain. This study investigated the individual and work-related risk factors linked to musculoskeletal pain and pain-related disability among Turkish office workers who work using computers. Methods. One-hundred and fifty office workers were included. Data were collected using an online survey with a combination of the Nordic musculoskeletal questionnaire, Oswestry disability index (ODI), neck disability index (NDI) and disabilities of the arm, shoulder, and hand questionnaire short-form (Q-DASH). The participants were divided into four subgroups: no pain (n = 26), lower back pain (n = 37), neck pain (n = 49) and upper-extremity pain (n = 38). Results. There were differences between subgroups in terms of the condition that feet touch the floor and the condition that the keyboard, mouse and wrist are in a straight line (p = 0.013 and p = 0.025, respectively). Working years was correlated with the ODI score (ρ = 0.802, p = 0.041). There was also a significant correlation between the NDI score and working hours (ρ = 0.415, p = 0.003), while Q-DASH was correlated with body mass index and working years (ρ = 0.406, p = 0.014, and ρ = 0.327, p = 0.043, respectively). Conclusions. Pain-related disability was associated with various risk factors such as physical inactivity, body mass index, working hours, working years and workplace ergonomics in the office workers.
Collapse
Affiliation(s)
- Guzin Kaya Aytutuldu
- Istanbul University-Cerrahpasa, Institute of Graduate Studies, Turkey.,Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Yeditepe University, Turkey
| | - Tansu Birinci
- Istanbul University-Cerrahpasa, Institute of Graduate Studies, Turkey.,Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Turkey
| | - Ela Tarakcı
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Turkey
| |
Collapse
|
16
|
Louwerens JKG, Kuijer PPFM, Sierevelt IN, van den Bekerom MPJ, van Royen BJ, Eygendaal D, van Noort A. The Impact of Minimally Invasive Treatment for Rotator Cuff Calcific Tendinitis on Self-Reported Work Ability and Sick Leave. Arthrosc Sports Med Rehabil 2020; 2:e821-e827. [PMID: 33376997 PMCID: PMC7754604 DOI: 10.1016/j.asmr.2020.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To examine the impact of rotator cuff calcific tendinitis on patients' self-reported work ability and sick leave, to compare work ability and sick leave with shoulder function after minimally invasive treatment, and to assess which prognostic factors influence the change in work ability. Methods A prospective cohort was analyzed in this study. The primary outcome measure was the single-question work ability score (0-10 points). Secondary outcome measures were quality and quantity of work, sick leave, functional outcome, and radiographic resorption. Potential predictive factors (treatment method, age, sex, resorption of the calcific deposit, physical work load, and work status) were tested in a statistical model. Follow-up was at 6 months and 1 year. Results The study cohort consisted of 67 patients. The mean age was 49.6 ± 6.4 years and 45 (67%) were female. Physical workload was categorized as light (58%), medium (24%), and heavy (18%). Work ability score improved from a mean of 6.1 ± 2.8 to 8.5 ± 2.0 points after 1 year. Treatment with minimally invasive treatment techniques was associated with a reduction in partial or full-time sick leave from 28% to 6%. The mean days of sick leave a month declined from 3.3 to 0.8 days. Functional disability was greater in patients with partial or full-time sick leave. The physical workload turned out to be the most important patient associated factor predicting change in work ability. Conclusions This study supports the hypothesis that rotator cuff calcific tendinitis has a significant impact on work ability and sick leave. Minimally invasive treatment resulted in a clinically relevant improvement in work ability score and decline in sick leave. In particular, patients with medium and high physically demanding work for the shoulder benefit from minimally invasive treatment to improve their work ability. Level of Evidence Level II, prospective comparative study.
Collapse
Affiliation(s)
| | - P Paul F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam
| | | | | | - Barend J van Royen
- Department of Orthopaedic Surgery, Amsterdam University Medical Center, Amsterdam
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amsterdam University Medical Center, Amsterdam.,Department of Orthopaedic Surgery, Amphia, Breda, the Netherlands
| | | |
Collapse
|
17
|
Scharan KO, Bernardelli RS, Corrêa KP, Moser ADDL. Instrumentos da prática clínica com versão em português e a abrangência de seus conteúdos usando a CIF como referência: uma revisão sistemática. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/18032527032020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A prática clínica tem sido subsidiada por instrumentos que permitem acessar e registrar informações de funcionalidade e saúde dos indivíduos. Uma forma de conhecer qual conteúdo da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) os instrumentos contemplam é usá-la como referência para auxiliar o profissional na escolha do mais adequado para acessar informações biopsicossociais. O objetivo foi identificar instrumentos da prática clínica em saúde que tiveram seu conteúdo ligado com a CIF e a existência de versão na língua portuguesa deles. Para tanto foi realizada uma revisão sistemática nas bases de dados SciELO Brasil, Lilacs e PubMed com os descritores “CIF”, “questionário” e “regra de ligação” em português e inglês. Três pesquisadores independentes realizaram a seleção, e o nível de concordância foi obtido pelo coeficiente Kappa. Os critérios de elegibilidade foram: estudos primários de ligação de conteúdo de questionários, escalas, índices e checklists com a CIF publicados após 2001 em língua portuguesa ou inglesa. Foram incluídos 61 artigos, sendo 19 de origem brasileira. Dos 250 instrumentos ligados à CIF, 158 (63,2%) apresentaram versão em português sendo que dos 37 que mais se repetiram nos estudos, dois não apresentam essa versão. O coeficiente Kappa mostrou concordância entre moderada e boa (p<0,001). Este estudo apresentou um panorama da ligação de conteúdo de instrumentos da prática clínica à CIF identificando quais têm versão em língua portuguesa, o que contribuirá para o potencial fortalecimento da abordagem biopsicossocial dos profissionais de saúde.
Collapse
|
18
|
Louwerens JKG, Sierevelt IN, Kramer ET, Boonstra R, van den Bekerom MPJ, van Royen BJ, Eygendaal D, van Noort A. Comparing Ultrasound-Guided Needling Combined With a Subacromial Corticosteroid Injection Versus High-Energy Extracorporeal Shockwave Therapy for Calcific Tendinitis of the Rotator Cuff: A Randomized Controlled Trial. Arthroscopy 2020; 36:1823-1833.e1. [PMID: 32114063 DOI: 10.1016/j.arthro.2020.02.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/15/2020] [Accepted: 02/16/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare clinical and radiographic outcomes after treatment with standardized high-energy extracorporeal shock wave therapy (ESWT) and ultrasound-guided needling (UGN) in patients with symptomatic calcific tendinitis of the rotator cuff who were nonresponsive to conservative treatment. METHODS The study was designed as a randomized controlled trial. The ESWT group received ESWT (2000 pulses, energy flux density 0.35 mJ/mm2) in 4 sessions with 1-week intervals. UGN was combined with a corticosteroid ultrasound-guided subacromial bursa injection. Shoulder function was assessed at standardized follow-up intervals (6 weeks and 3, 6, and 12 months) using the Constant Murley Score (CMS), the Disabilities of the Arm, Shoulder, and Hand questionnaire, and visual analog scale for pain and satisfaction. The size, location, and morphology of the deposits were evaluated on radiographs. The a priori sample size calculation computed that 44 participants randomized in each treatment group was required to achieve a power of 80%. RESULTS Eighty-two patients were treated (56 female, 65%; mean age 52.1 ± 9 years) with a mean baseline CMS of 66.8 ± 12 and mean calcification size of 15.1 ± 4.7 mm. One patient was lost to follow-up. At 1-year follow-up, the UGN group showed similar results as the ESWT group with regard to the change from baseline CMS (20.9 vs 15.7; P = .23), Disabilities of the Arm, Shoulder, and Hand questionnaire (-20.1 vs -20.7; P = .78), and visual analog scale for pain (-3.9 and -2.6; P = .12). The mean calcification size decreased by 13 ± 3.9 mm in the UGN group and 6.7 ± 8.2 mm in the ESWT group (<P = .001). In total, 22% of the UGN and 41% of the ESWT patients received an additional treatment during follow-up because of persistent symptoms. CONCLUSIONS This RCT compares the clinical and radiographic results of UGN and high-energy ESWT in the treatment of calcific tendinitis of the rotator cuff. Both techniques are successful in improving function and pain, with high satisfaction rates after 1-year follow-up. However, UGN is more effective in eliminating the calcific deposit, and the amount of additional treatments was greater in the ESWT group. LEVEL OF EVIDENCE II, randomized controlled trial.
Collapse
Affiliation(s)
- Jan K G Louwerens
- Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
| | - Inger N Sierevelt
- Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | - Erik T Kramer
- Verheul & Weerman Physical Therapists, Nieuw-Vennep, the Netherlands
| | - Rob Boonstra
- Paramedical Shoulder Clinic, Haarlem, the Netherlands
| | | | - Barend J van Royen
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Breda, the Netherlands
| | - Arthur van Noort
- Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands
| |
Collapse
|
19
|
Burak M, Kavlak E. Investigation of the relationship between quality of life, activity participation and environmental factors in adolescents with cerebral palsy. NeuroRehabilitation 2020; 45:555-565. [PMID: 31561397 DOI: 10.3233/nre-191288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study is to examine the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy. METHODS Seventy-five (75) adolescents (M:45, F:30) aged between 14-18 years (mean: 15.52±1.60 yrs) were included in the study. Participants were divided into three groups: Level I, Level II and Level III according to the Gross Motor Function Classification System. Gross Motor Function Classification System, Gross Motor Function Measure, Functional Independence Scale, Manual Ability Classification System, Pediatric Quality of Life Inventory and International Classification of Functioning, Disability and Health Child-Youth version Short Form (ICF-CY) (14-18 yrs) were used for assessments. RESULTS It is found that there is a moderate and high level of correlation between quality of life and activity participation and body functions, a moderate and high level of correlation between quality of life and activity participation and body functions with gross motor function levels, and a moderate and low level correlation between environmental factors and gross motor function levels (p < 0.05). CONCLUSIONS The fact that the ICF-CY short form used for cerebral palsied children is compatible with other assessment scales suggests that the use of ICF-CY short forms may be useful in assessing the health status of individuals.
Collapse
Affiliation(s)
- Mustafa Burak
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Erdoğan Kavlak
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
| |
Collapse
|
20
|
Cantero-Téllez R, Naughton N, Algar L, Valdes K. Linking hand therapy outcome measures used after carpal tunnel release to the International Classification of Functioning, Disability and Health: A systematic review. J Hand Ther 2020; 32:233-242. [PMID: 30017411 DOI: 10.1016/j.jht.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/23/2017] [Accepted: 02/17/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The goal of hand therapy after carpal tunnel release (CTR) is restoration of function. Outcome assessment tools that cover the concepts contained in the International Classification of Functioning, Disability and Health (ICF), a framework for describing functioning and disability, are appropriate for hand therapy treatment of this diagnosis. PURPOSE OF THE STUDY To identify and review outcome measures used in studies on rehabilitation after CTR and link these to the concepts contained in the ICF. METHODS A comprehensive literature search was conducted. Outcome measures in the included studies were linked to the ICF. For data calculation purposes, outcome measures were linked to the specific ICF category, which matched the majority of assessment items if there were components that fit into more than 1 category. The quality of the studies was evaluated, and effect sizes for the treatment interventions were calculated for a comprehensive systematic review. RESULTS Seven studies met the inclusion criteria. Eleven outcomes (68.75%) were linked to body function, 1 (6.25%) to body structure, 3 (18.75%) to activity and participation, and 1 (6.25%) to environmental factors. No outcomes were associated with environmental factors or personal factors. Structured Effectiveness for Quality Evaluation of Study scores of the included studies ranged from 23 to 43/48. DISCUSSION The predominant outcome tools in the current research on rehabilitation after CTR are impairment measures and are linked to the category of body structures and body functions. CONCLUSIONS Functional measures, associated with the activity and participation category, are only modestly represented, and there is a lack of representation of environmental and personal factors for outcome measures used following CTR.
Collapse
Affiliation(s)
- Raquel Cantero-Téllez
- Physical Therapy Section, Faculty of Health Sciences, University of Málaga, Málaga, Spain; Tecan Hand Rehabilitation Center, Málaga, Spain.
| | - Nancy Naughton
- Department of Occupational Therapy, Hand Surgery Associates, Olyphant, PA, USA
| | - Lori Algar
- Department of Occupational Therapy, Orthopaedic Specialty Group, Fairfield, CT, USA
| | - Kristin Valdes
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA
| |
Collapse
|
21
|
Naughton N, Algar L. Linking commonly used hand therapy outcome measures to individual areas of the International Classification of Functioning: A systematic review. J Hand Ther 2020; 32:243-261. [PMID: 29433763 DOI: 10.1016/j.jht.2017.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 11/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION Identifying outcome measures that correspond to the International Classification of Functioning (ICF) provides insight into selecting appropriate outcome tools in hand therapy practice. PURPOSE OF THE STUDY The objective of this study is to systematically review patient-reported outcome measures commonly used in hand therapy to determine the extent to which the content represents the biopsychosocial view of the ICF. METHODS A comprehensive literature search was conducted. Studies that met inclusion criteria were identified, and outcome measures were extracted. The meaningful concept was determined for each item on the measure and linked to the most specific ICF category. Summary linkage calculations were completed. RESULTS Eleven patient-reported outcomes were identified from 43 included studies. Activity and participation had the highest content coverage followed by body functions. There was linking to personal factors and not defined-disability and mental health. Environmental factors were not represented in any of the included outcome measures. The core set representation of unique codes ranged from 8.55% to 18.80% (mean: 11.97%) for the Comprehensive ICF Core Set for Hand Conditions and from 30.43% to 47.83% (mean: 31.40%) for the Brief ICF Core Set for Hand Conditions. The percent representation of the Comprehensive ICF Core Set for Hand Conditions for unique disability ranged from 21.62% to 43.24% (mean: 20.33%) and from 62.50% to 87.50% (mean: 72.22%) for the Brief ICF Core Set for Hand Conditions. DISCUSSION None of the included measures represent all categories of the ICF Core Sets for Hand Conditions. CONCLUSION Utilizing the most recent refinement rules for the linking process, this study provides comparisons of measures along with clarity of content coverage for the most commonly used tools in the practice of hand therapy.
Collapse
Affiliation(s)
| | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
| |
Collapse
|
22
|
Parker J, Powell L, Mawson S. Effectiveness of Upper Limb Wearable Technology for Improving Activity and Participation in Adult Stroke Survivors: Systematic Review. J Med Internet Res 2020; 22:e15981. [PMID: 31913131 PMCID: PMC6996755 DOI: 10.2196/15981] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/16/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND With advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Upper limb (UL) impairment affects up to 77% of stroke survivors impacting on their ability to carry out everyday activities. However, despite an increase in research exploring these devices for UL rehabilitation, little is known of their effectiveness. OBJECTIVE This review aimed to assess the effectiveness of UL wearable technology for improving activity and participation in adult stroke survivors. METHODS Randomized controlled trials (RCTs) and randomized comparable trials of UL wearable technology for poststroke rehabilitation were included. Primary outcome measures were validated measures of activity and participation as defined by the International Classification of Functioning, Disability, and Health. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the RCTs and the Downs and Black Instrument for the quality of non RCTs. RESULTS In the review, we included 11 studies with collectively 354 participants at baseline and 323 participants at final follow-up including control groups and participants poststroke. Participants' stroke type and severity varied. Only 1 study found significant between-group differences for systems functioning and activity (P≤.02). The 11 included studies in this review had small sample sizes ranging from 5 to 99 participants at an average (mean) age of 57 years. CONCLUSIONS This review has highlighted a number of reasons for insignificant findings in this area including low sample sizes and the appropriateness of the methodology for complex interventions. However, technology has the potential to measure outcomes, provide feedback, and engage users outside of clinical sessions. This could provide a platform for motivating stroke survivors to carry out more rehabilitation in the absence of a therapist, which could maximize recovery. TRIAL REGISTRATION PROSPERO CRD42017057715; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=57715.
Collapse
|
23
|
Nowak LL, Davis AM, Mamdani M, Beaton D, Schemitsch EH. A concept analysis and overview of outcome measures used for evaluating patients with proximal humerus fractures. Disabil Rehabil 2019; 43:1450-1462. [PMID: 31479302 DOI: 10.1080/09638288.2019.1649728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE It is unclear to which degree existing studies evaluate the primary goal of treatment for patients with proximal humerus fractures (restoration of daily activities). Our purpose was to systematically review and analyze the concepts reflected by outcome measures used in studies of patients with proximal humerus fractures. METHODS We reviewed three databases from 2000 to 2018. Two reviewers categorized outcomes in each study into concepts of the International Classification of Functioning, Disability and Health framework. RESULTS The most commonly represented concept across 35 studies was "Body Function/Structure Impairment", followed by aggregate measures that reflect multiple concepts to varying degrees. All patient-reported aggregate measures such as the Disabilities of the Arm, Shoulder, and Hand, American Shoulder and Elbow Surgeon's, and Oxford Shoulder scores better reflected "Activity Limitations", however, these measures were only reported in 34% of studies. CONCLUSION There may be misalignment between what studies measure, and the primary goal of treatment for patients with proximal humerus fractures. The Disabilities of the Arm, Shoulder and Hand, American Shoulder and Elbow Surgeon's, and Oxford Shoulder scores reflect concepts that more adequately address the restoration of daily activities following these injuries, and future studies should include at least one of these measures.Implications for rehabilitationWe have shown that there is a misalignment between what existing studies are measuring (primarily objective measures of impairment) and the primary goal of treatment and rehabilitation (restoring activities of daily living).This suggests that existing studies evaluating different treatment types for proximal humerus fracture patients are providing inadequate information to make evidence-based treatment and rehabilitation decisions following theses injuries.Our results tentatively suggest that the Disabilities of the Arm, Shoulder and Hand, the American Shoulder and Elbow Surgeon's, and Oxford Shoulder scores may better reflect limitations in daily activities following these injuries and should be used in future studies and by clinicians.
Collapse
Affiliation(s)
- Lauren L Nowak
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Clinical Orthopaedic Research, St. Michael's Hospital, Toronto, Canada
| | - Aileen M Davis
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Muhammad Mamdani
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Canada
| | - Dorcas Beaton
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Musculoskeletal Health & Outcomes Research, Institute for Work Health, Toronto, Canada
| | - Emil H Schemitsch
- Institute of Medical Science, University of Toronto, Toronto, Canada.,Clinical Orthopaedic Research, St. Michael's Hospital, Toronto, Canada.,Division of Orthopaedic Surgery, London Health Sciences Centre, London, Canada
| |
Collapse
|
24
|
Oliver WM, Carter TH, Graham C, White TO, Clement ND, Duckworth AD, Molyneux SG. A prospective randomised controlled trial of operative versus non-operative management of fractures of the humeral diaphysis: the HUmeral Shaft Fracture FIXation (HU-FIX) Study protocol. Trials 2019; 20:475. [PMID: 31383027 PMCID: PMC6683573 DOI: 10.1186/s13063-019-3576-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 07/16/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Humeral shaft fractures constitute around 1% of adult fractures in the UK, with an annual incidence of approximately 13 per 100,000 population. Historically, these injuries have been primarily managed non-operatively, with operative fixation reserved for specific indications. Although some recent retrospective studies have suggested there are potential benefits of operative fixation over humeral bracing, there is a deficiency in level 1 evidence to support operative management as the primary treatment for humeral shaft fractures. METHODS/DESIGN This single-centre prospective randomised controlled trial aims to recruit 70 adult patients with an isolated closed fracture of the humeral diaphysis into one of two treatment arms: operative (n = 35) or non-operative (n = 35). The operative arm will undergo open reduction and internal fixation (ORIF) of the fracture using a standard fixation technique (plate and screws). The non-operative arm will be fitted with a prefabricated humeral brace until fracture union. All patients will be followed up for 1 year post-intervention. The primary outcome measure will be the Disabilities of the Arm, Shoulder and Hand (DASH) score at 3 months post-intervention. Secondary outcome measures will include pain, treatment complications, return to work or sporting activities, shoulder and elbow range of motion, radiographic assessment, EuroQol (EQ-5D) Health Outcome score and 12-item Short Form (SF-12) Health Survey score. A health economic analysis will be performed to compare the cost implications of each treatment strategy. DISCUSSION This randomised controlled trial will provide level 1 evidence comparing a standard ORIF technique against functional bracing for isolated closed humeral shaft fractures. The investigators hope that the study results will assist surgeons in their decision-making when managing patients with these injuries. TRIAL REGISTRATION ClinicalTrials.gov, NCT03689335 . Registered on 28 September 2018 (retrospectively).
Collapse
Affiliation(s)
- William M. Oliver
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Thomas H. Carter
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Catriona Graham
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Timothy O. White
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Nicholas D. Clement
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Andrew D. Duckworth
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| | - Samuel G. Molyneux
- Edinburgh Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Midlothian, EH16 4SA UK
| |
Collapse
|
25
|
Stanhope J, Pisaniello D, Tooher R, Weinstein P. How do we assess musicians' musculoskeletal symptoms?: a review of outcomes and tools used. INDUSTRIAL HEALTH 2019; 57:454-494. [PMID: 30555103 PMCID: PMC6685794 DOI: 10.2486/indhealth.2018-0065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Recent reviews of musicians' musculoskeletal symptoms (MSS) have reported heterogeneity in the outcomes reported and data collection tools used, making it difficult to compare and synthesise findings. The purpose of this present review was to improve the consistency of future research, by documenting the outcomes reported in recent studies of musicians' MSS and the data collection tools used. All English language, peer-reviewed studies, published 2007-2016 that reported musicians' self-reported MSS outcomes were identified. Details of the types of outcomes reported and the tools used were extracted, and synthesised descriptively. A range of MSS outcomes were reported, including MSS with a temporal relationship to activities performed, and the consequences of symptoms. Only 24% of studies used standardised questionnaires, with the Nordic Musculoskeletal Questionnaire (NMQ) being the most commonly used. To improve the homogeneity of outcomes and data collection tools when investigating musicians' MSS, we recommend using the NMQ, where appropriate. Recall periods of 12-months and 7-d are the most appropriate for prevalence, and 7-d recall periods for ratings. Importantly, outcomes and the tools used to collect data should be reported in sufficient detail to ensure that the study can be replicated, critiqued, and accurately interpreted.
Collapse
Affiliation(s)
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Australia
| | - Rebecca Tooher
- School of Public Health, The University of Adelaide, Australia
| | - Philip Weinstein
- School of Biological Sciences, The University of Adelaide, Australia
| |
Collapse
|
26
|
Burak M, Kavlak E. Investigation of the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy. NeuroRehabilitation 2019:NRE192688. [PMID: 31282433 DOI: 10.3233/nre-192688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study is to examine the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy. METHODS Seventy-five adolescents (M:45, F:30) ages between 14-18 yrs (mean: 15.52±1.60 yrs) were included in the study. Participants were divided into three groups: Level I, Level II and Level III according to the Gross Motor Function Classification System. Gross Motor Function Classification System, Gross Motor Function Measure, Functional Independence Scale, Manuel Ability Classification System, Pediatric Quality of Life Inventory and International Classification of Functioning, Disability and Health Child-Youth version Short Form (ICF-CY) (14-18 yrs) were used for assessments. RESULTS It is found that there is a moderate and high level of correlation between quality of life and activity participation and body functions; moderate and high level of correlation between quality of life and activity participation and body functions with the gross motor function levels; moderate and low level correlation between environmental factors and gross motor function levels (p < 0,05). CONCLUSIONS The fact that the ICF-CY short form used for cerebral palsied children is compatible with other assessment scales suggests that the use of ICF-CY short forms may be useful in assessing the health status of individuals.
Collapse
Affiliation(s)
- Mustafa Burak
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Erdogan Kavlak
- Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
| |
Collapse
|
27
|
Dixon D, Johnston M. Content validity of measures of theoretical constructs in health psychology: Discriminant content validity is needed. Br J Health Psychol 2019; 24:477-484. [PMID: 31066141 DOI: 10.1111/bjhp.12373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/08/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Diane Dixon
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Marie Johnston
- Institute of Health Sciences, University of Aberdeen, UK
| |
Collapse
|
28
|
Ye SM, Yu Y, Jing JH, Zhou Y, Zhang JS, Teng XF, Xu CG, Cheng WD, Li ZY, Xu YJ. One-stage reconstruction of complex soft tissue defects in the hands using multidigit, chimeric, lateral arm, perforator flaps. J Plast Reconstr Aesthet Surg 2018; 72:902-908. [PMID: 30630749 DOI: 10.1016/j.bjps.2018.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 09/21/2018] [Accepted: 12/02/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe our experience using microsurgically fabricated, multilobed, chimeric, lateral arm (LA) flaps to reconstruct hand injuries with complex, multidigit, soft tissue defects and to evaluate the morbidity and esthetic and functional outcomes of the donor sites. METHODS We performed a single center, retrospective analysis of 21 patients with hand wounds treated from October 2013 to February 2016. All patients underwent reconstruction using multilobed, chimeric, free, LA flaps. A self-reported questionnaire was used to assess donor site morbidity and satisfaction with the esthetic and overall functional result. Outcome measures were the Disabilities of the Arm, Shoulder and Hand (DASH) score, static 2-point discrimination score, and visual analogue scale. RESULTS The study included 21 patients (20 males and 1 female), with an average age of 32.14 years (range 18-45 years), who sustained traumatic injuries in road traffic accidents (n = 2) or industrial devices (n = 19). The average DASH score was 28.25 ± 2.3, the average 2-PD score was 7.20 ± 1.30, and the average visual analogue scale (VAS) was 0.38 ± 0.40. All 21 patients had sensory disorders at the donor site. Postoperative donor site complications comprised wound dehiscence (n = 1) and hematoma (n = 3). The patient-rated satisfaction score for the donor site was 5.40 ± 0.90, and 70% of the patients would undergo the same surgery again. CONCLUSION Microsurgical fabrication of multilobed, chimeric, LA flaps can exhibit sensory recovery and minimal pain but may cause hematoma and sensory disorders at the donor site. The flaps are a viable alternative for the reconstruction of complex, multidigit, soft tissue defects of the hands.
Collapse
Affiliation(s)
- Shu-Ming Ye
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Soochow University, SuZhou, 235131, Jiangsu, China; Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Yue Yu
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Jue-Hua Jing
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Yun Zhou
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Ji-Sen Zhang
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Xiao-Feng Teng
- Department of Orthopaedics Surgery, the Sixth Hospital of Ningbo, Ningbo, 315000, Zhejiang, China
| | - Chun-Gui Xu
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Wen-Dan Cheng
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Zi-Yu Li
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - You-Jia Xu
- Department of Orthopaedics Surgery, the Second Affiliated Hospital of Soochow University, SuZhou, 235131, Jiangsu, China.
| |
Collapse
|
29
|
The Functional Difficulties Questionnaire: A New Tool for Assessing Physical Function of the Thoracic Region in a Cardiac Surgery Population. Cardiopulm Phys Ther J 2018. [DOI: 10.1097/cpt.0000000000000074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
30
|
Kabul EG, Aslan UB, Başakçı Çalık B, Taşçı M, Çobankara V. Exploring the relation between impairment rating by DAS-28 and body function, activity participation, and environmental factors based on ICF hand core set in the patient with rheumatoid arthritis. Rheumatol Int 2018; 38:1267-1275. [PMID: 29850963 DOI: 10.1007/s00296-018-4060-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
Abstract
Hand problems associated with rheumatoid arthritis lead to subjective impairment, activity limitation, and restrictions on participation. This relation is very complex. Assessment of individuals' activities is important to determine how hand problems affect not only body functions but also daily life activities. The aim of this study was to link and allocate items of disability questionnaires with ICF components based on ICF hand core set. The other objective was to examine the relationship between impairment and ICF components determined on the basis of disability questionnaires in participants with rheumatoid arthritis. Impairment was evaluated by use of Disease Activity Score-28. Disability questionnaires were Disabilities of Arm, Shoulder and Hand Questionnaire, Michigan Hand Outcomes Questionnaire, Duruoz Hand Index, and Arthritis Impact Measurement Scales 2 (n = 100). Items of disability questionnaires were linked with ICF hand core set as a result of three expert opinions. Michigan Hand Outcomes Questionnaire covered the highest number of body function categories and Arthritis Impact Measurement Scales 2 covered the highest number of ICF hand core set. For all questionnaires, while impairment (Disease Activity Score-28) had moderate correlation with subjective impairment (body function scores) and activity/participation; subjective impairment had high and moderate correlation with activity participation. Arthritis Impact Measurement Scale 2 is the most appropriate to perform a more comprehensive biopsychosocial assessment. Clinician's assessments and impairment levels reported by patients with rheumatoid arthritis are interrelated. Impairment levels reported by patients with rheumatoid arthritis are also affected by environmental factors.
Collapse
Affiliation(s)
- Elif Gür Kabul
- School of Physical Therapy and Rehabilitation, Pamukkale University, Kinikli, 20070, Denizli, Turkey
| | - Ummuhan Baş Aslan
- School of Physical Therapy and Rehabilitation, Pamukkale University, Kinikli, 20070, Denizli, Turkey
| | - Bilge Başakçı Çalık
- School of Physical Therapy and Rehabilitation, Pamukkale University, Kinikli, 20070, Denizli, Turkey.
| | - Murat Taşçı
- Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
| | - Veli Çobankara
- Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
| |
Collapse
|
31
|
Bruce J, Williamson E, Lait C, Richmond H, Betteley L, Lall R, Petrou S, Rees S, Withers EJ, Lamb SE, Thompson AM. Randomised controlled trial of exercise to prevent shoulder problems in women undergoing breast cancer treatment: study protocol for the prevention of shoulder problems trial (UK PROSPER). BMJ Open 2018; 8:e019078. [PMID: 29574439 PMCID: PMC5875650 DOI: 10.1136/bmjopen-2017-019078] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
UNLABELLED Musculoskeletal shoulder problems are common after breast cancer treatment. Early postoperative exercises targeting the upper limb may improve shoulder function. This protocol describes a National Institute for Health Research-funded randomised controlled trial (RCT) to evaluate the clinical and cost-effectiveness of an early supervised structured exercise programme compared with usual care, for women at high risk of developing shoulder problems after breast cancer surgery. METHODS This pragmatic two-armed, multicentre RCT is underway within secondary care in the UK. PRevention Of Shoulder ProblEms tRial (PROSPER) aims to recruit 350 women from approximately 15 UK centres with follow-up at 6 weeks, 6 and 12 months after randomisation. Recruitment processes and intervention development were optimised through qualitative research during a 6-month internal pilot phase. Participants are randomised to the PROSPER intervention or best practice usual care only. The PROSPER intervention is delivered by physiotherapists and incorporates three main components: shoulder-specific exercises targeting range of movement and strength; general physical activity and behavioural strategies to encourage adherence and support exercise behaviour. The primary outcome is upper arm function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at 12 months postrandomisation. Secondary outcomes include DASH subscales, acute and chronic pain, complications, health-related quality of life and healthcare resource use. We will interview a subsample of 20 participants to explore their experiences of the trial interventions. DISCUSSION The PROSPER study is the first multicentre UK clinical trial to investigate the clinical and cost-effectiveness of supported exercise in the prevention of shoulder problems in high-risk women undergoing breast cancer surgery. The findings will inform future clinical practice and provide valuable insight into the role of physiotherapy-supported exercise in breast cancer rehabilitation. PROTOCOL VERSION Version 2.1; dated 11 January 2017 TRIAL REGISTRATION NUMBER: ISRCTN35358984; Pre-results.
Collapse
Affiliation(s)
- Julie Bruce
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Esther Williamson
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, UK
| | - Clare Lait
- Gloucestershire Care Services NHS Trust, Gloucester, UK
| | - Helen Richmond
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Lauren Betteley
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Ranjit Lall
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Stavros Petrou
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Sophie Rees
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Emma J Withers
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Sarah E Lamb
- Division of Health Sciences, Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, UK
| | - Alastair M Thompson
- Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
32
|
Klymenko G, Liu KPY, Bissett M, Fong KNK, Welage N, Wong RSM. Development and initial validity of the in-hand manipulation assessment. Aust Occup Ther J 2018; 65:135-145. [PMID: 29341133 DOI: 10.1111/1440-1630.12447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM A review of the literature related to in-hand manipulation (IHM) revealed that there is no assessment which specifically measures this construct in the adult population. This study reports the face and content validity of an IHM assessment for adults with impaired hand function based on expert opinion. METHODS The definition of IHM skills, assessment tasks and scoring methods identified from literature was discussed in a focus group (n = 4) to establish face validity. An expert panel (n = 16) reviewed the content validity of the proposed assessment; evaluating the representativeness and relevance of encompassing the IHM skills in the proposed assessment tasks, the clarity and importance to daily life of the task and the clarity and applicability to clinical environment of the scoring method. The content validity was calculated using the content validity index for both the individual task and all tasks together (I-CVI and S-CVI). Feedback was incorporated to create the assessment. RESULTS The focus group members agreed to include 10 assessment tasks that covered all IHM skills. In the expert panel review, all tasks received an I-CVI above 0.78 and S-CVI above 0.80 in representativeness and relevance ratings, representing good content validity. With the comments from the expert panel, tasks were modified to improve the clarity and importance to daily life. A four-point Likert scale was identified for assessing both the completion of the assessment tasks and the quality of IHM skills within the task performance. CONCLUSION Face and content validity were established in this new IHM assessment. Further studies to examine psychometric properties and use within clinical practice are recommended.
Collapse
Affiliation(s)
- Gabrielle Klymenko
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
| | - Karen P Y Liu
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
| | - Michelle Bissett
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Nandana Welage
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
| | - Rebecca S M Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| |
Collapse
|
33
|
|
34
|
de Witte PB, Kolk A, Overes F, Nelissen RGHH, Reijnierse M. Rotator Cuff Calcific Tendinitis: Ultrasound-Guided Needling and Lavage Versus Subacromial Corticosteroids: Five-Year Outcomes of a Randomized Controlled Trial. Am J Sports Med 2017; 45:3305-3314. [PMID: 28898104 DOI: 10.1177/0363546517721686] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Barbotage (needling and lavage) is often applied in the treatment of calcific tendinitis of the rotator cuff (RCCT). In a previously published randomized controlled trial, we reported superior clinical and radiological 1-year outcomes for barbotage combined with a corticosteroid injection in the subacromial bursa (SAIC) compared with an isolated SAIC. There are no trials with a midterm or long-term follow-up of barbotage available. PURPOSE To compare the 5-year results of 2 regularly applied treatments of RCCT: ultrasound (US)-guided barbotage combined with a SAIC (group 1) versus an isolated US-guided SAIC (group 2). STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Patients were randomly assigned to group 1 or 2 and evaluated before and after treatment at regular time points until 12 months and also at 5 years using the Constant score (CS), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand (DASH). The calcification location and size and Gärtner classification were assessed on radiographs. The rotator cuff condition was evaluated with US. Results were analyzed using t tests, linear regression, and a mixed model for repeated measures. RESULTS Forty-eight patients were included (mean age, 52.0 ± 7.3 years; 25 [52%] female) with a mean baseline CS of 68.7 ± 11.9. After a mean follow-up of 5.1 ± 0.5 years, the mean CS was 90 (95% CI, 83.0-95.9) in group 1 versus 87 (95% CI, 80.5-93.5) in group 2 ( P = .58). The mean improvement in the CS in group 1 was 18 (95% CI, 12.3-23.0) versus 21 (95% CI, 16.2-26.2) in group 2 ( P = .32). There was total resorption in 62% of group 1 and 73% of group 2 ( P = .45). The US evaluation of the rotator cuff condition showed no significant differences between the groups. With the mixed model for repeated measures, taking into account the baseline CS and Gärtner classification, the mean treatment effect for barbotage was 6 (95% CI, -8.9 to 21.5), but without statistical significance. Follow-up scores were significantly associated with baseline scores and the duration of follow-up. Results for the DASH and WORC were similar. There were no significant complications, but 4 patients in group 1 and 16 in group 2 underwent additional treatment during the follow-up period ( P < .001). CONCLUSION No more significant differences were found in the clinical and radiological outcomes between barbotage combined with a SAIC versus an isolated SAIC after 5 years of follow-up. Registration: NTR2282 (Dutch Trial Registry).
Collapse
Affiliation(s)
- Pieter Bas de Witte
- Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
| | - Arjen Kolk
- Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
| | - Ferdinand Overes
- Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
| | - Rob G H H Nelissen
- Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
| | - Monique Reijnierse
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
35
|
ICF components of outcome measures for mallet finger: A systematic review. J Hand Ther 2017; 29:388-395. [PMID: 27780628 DOI: 10.1016/j.jht.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/18/2016] [Accepted: 06/17/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for the assessment of the conservative management of mallet finger to determine if they characterize the International Classification of Functioning, Disability, and Health components of activity, participation, environmental factors, or quality of life. METHODS/RESULTS Five studies published within the last 10 years were included in the systematic review. A majority, 19 of the outcomes used by the authors, fell within the body functions and structures category. Six were related to activity, and 1 was related to participation. One was linked to environmental factors. Five were found to be not definable and related to quality of life. DISCUSSION/CONCLUSION This systematic review suggests that many outcome measures focus on body structures and functions in the current research on the conservative treatment of mallet finger injuries. LEVEL OF EVIDENCE 2a.
Collapse
|
36
|
Valdes K, Naughton N, Algar L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: A systematic review. J Hand Ther 2017; 29:396-404. [PMID: 27662802 DOI: 10.1016/j.jht.2016.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/24/2016] [Accepted: 06/06/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for assessment of orthotic intervention in the conservative management of thumb carpometacarpal osteoarthritis to determine if they characterize International Classification of Functioning, Disability, and Health (ICF) components. The determinants of patient satisfaction regarding the orthotic intervention were also extracted from the studies. METHODS A comprehensive literature search was conducted. Outcome measures in the included studies were linked to the ICF. Determinants of patient satisfaction regarding the orthotic intervention were also extracted. RESULTS Nine studies met inclusion criteria. Eight (47.1%) outcomes were linked to body structures and functions, 8 (47.1%) to activity limitations and participation restrictions, and 1 (5.9%) outcome fell into the nondefinable quality of life category. Four studies assessed patient satisfaction. DISCUSSION/CONCLUSIONS This systematic review on orthotic intervention for thumb carpometacarpal osteoarthritis found opportunities related to assessment and outcome measures when present studies are linked to the ICF. LEVEL OF EVIDENCE 2a.
Collapse
Affiliation(s)
- K Valdes
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA; Hand Works Therapy, Venice, FL, USA.
| | | | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
| |
Collapse
|
37
|
Öksüz Ç, Akel BS, Aran OT, Sığırtmaç İC, Leblebicioğlu AG. Do hand outcome measures reflect cultural influences? ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:325-330. [PMID: 28709741 PMCID: PMC6197564 DOI: 10.1016/j.aott.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/10/2017] [Accepted: 05/20/2017] [Indexed: 10/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare the activities listed in DASH, MHQ, QuickDASH with the activities listed in Canadian Occupational Performance Measure (COPM) in a Turkish patient population with hand injury. METHODS COPM questionnaire was administered to 163 participants (61 male and 102 female; mean age 40.72 ± 13.70 years). The activities that were stated in COPM were categorized and checked whether they were present in DASH-T, MHQ, QuickDASH. RESULTS The highest rated stated activities were "carrying a heavy object" (39.2%), "cleaning the house" (25.7%) and "writing" (15.9%). DASH reflects 30% whereas MHQ and QuickDASH reflect 16.32% and 10.2% of the problematic activities, respectively. CONCLUSION None of three questionnaires have satisfactory results for reflecting the problematic activities among hand injured Turkish people. Open ended interviews should be irrevocable part of assessment process in order to describe a person-center treatment program.
Collapse
Affiliation(s)
- Çiğdem Öksüz
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy, Ankara, Turkey
| | - Burcu Semin Akel
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy, Ankara, Turkey.
| | - Orkun Tahir Aran
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy, Ankara, Turkey
| | - İlkem Ceren Sığırtmaç
- Hacettepe University, Faculty of Health Sciences, Occupational Therapy, Ankara, Turkey
| | - A Gürsel Leblebicioğlu
- Hacettepe University, Faculty of Medicine, Orthopedics and Traumatology Department, Ankara, Turkey
| |
Collapse
|
38
|
Nordqvist JM, Johansson KM, Holmgren TM, Adolfsson LE, Öberg BE. A short activity-related scale for measuring shoulder function in patients with subacromial pain: the DASH 7. JSES OPEN ACCESS 2017; 1:113-118. [PMID: 30675551 PMCID: PMC6340831 DOI: 10.1016/j.jses.2017.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Subacromial pain is a common cause of shoulder dysfunction that negatively affects quality of life. Currently, most outcome measures for shoulder pain are applied to a heterogeneous group of patients. Of these measures, the Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely recognized test with which to assess patients with subacromial pain. The primary aim of this study was to assess the content validity of DASH for patients with subacromial pain, with a secondary aim to test responsiveness to a modified set of DASH items tailored to these patients. Methods There were 129 patients who reported activities in the Patient-Specific Functional Scale (PSFS). To assess validity, 5 independent physiotherapists matched PSFS activities to the most appropriate DASH item. DASH items identified as being of greatest importance to patients were those corresponding to the highest number of PSFS-matched activities. Calculations were made for responsiveness and internal consistency. Results Physiotherapists matched DASH items to 271 PSFS activities, reaching agreement for almost 80%. Seven DASH items (DASH 7) were identified as being particularly important. Effect size data (Cohen's d) were 0.93 for DASH 7, 0.92 for DASH 30, and 0.85 for QuickDASH; the corresponding Cronbach's α values (for DASH 7, DASH 30, and QuickDASH) were 0.84, 0.94, and 0.86, respectively. Conclusions DASH 7 is a short, patient-centered, and activity-related scale that can measure shoulder function in patients with subacromial pain using a quarter of the original DASH items. DASH 7 demonstrated responsiveness, with a satisfactory level of internal consistency.
Collapse
Affiliation(s)
- Jenny M Nordqvist
- Division of Physiotherapy, Institution of Medical and Health Sciences, Linköping University, Sweden
| | - Kajsa M Johansson
- Division of Physiotherapy, Institution of Medical and Health Sciences, Linköping University, Sweden
| | - Theresa M Holmgren
- Department of Orthopedic Surgery, Institution for Clinical and Experimental Medicine, Linköping University Hospital, Sweden
| | - Lars E Adolfsson
- Department of Orthopedic Surgery, Institution for Clinical and Experimental Medicine, Linköping University Hospital, Sweden
| | - Birgitta E Öberg
- Division of Physiotherapy, Institution of Medical and Health Sciences, Linköping University, Sweden
| |
Collapse
|
39
|
Effects of client-centered multimodal treatment on impairment, function, and satisfaction of people with thumb carpometacarpal osteoarthritis. J Hand Ther 2017; 30:307-313. [PMID: 28454772 DOI: 10.1016/j.jht.2017.03.004] [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: 06/02/2016] [Revised: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Prepost design. INTRODUCTION Previous research regarding the non-surgical treatment of thumb carpometacarpal joint osteoarthritis has been based on protocol driven research designs that primarily examined impairment level changes. Exploration is therefore needed to determine the benefits of individually prescribed orthoses, joint protection and assistive device education programs that are based on the activities the person needs to regularly perform. PURPOSE OF THE STUDY The primary objective of this study was to examine the effect of client-centered multimodal treatment on activity, participation, impairment, and satisfaction of people with thumb carpometacarpal joint osteoarthritis. METHODS A total of 60 participants completed the study that used a prepost design. The Canadian Occupational Performance Measure (COPM) was used to identify the participants' performance and satisfaction concerning their self-identified occupational performance issues. Additional outcome measures that were used included the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, total active range of motion (TAROM), lateral pinch strength, and the visual analog scale for pain. All participants completed a client-centered 6-week program that consisted of the use of an orthosis, joint protection, and assistive device education as well as exercises. RESULTS At 6 weeks after initiation of treatment, pain, pinch strength, TAROM, the DASH questionnaire and the performance and satisfaction scales of the COPM had significantly improved. The changes in pain, TAROM, and the performance and satisfaction scales of the COPM were all greater than the minimal clinically important difference. The changes in pain and lateral pinch strength were significantly associated with changes in activity and participation. DISCUSSION This study demonstrated that a multimodal, client-centered treatment approach resulted in statistically and clinically significant improvement in pain, TAROM and performance and satisfaction as measured by the COPM. The improvement in pain was associated with the participants' improved ability to engage in activities assessed by the DASH. CONCLUSIONS Our results support the use of client-centered treatment strategies that are targeted to control pain during meaningful activity when working with patients with thumb carpometacarpal joint osteoarthritis therapists. LEVEL OF EVIDENCE 4.
Collapse
|
40
|
Inter-rater and intra-rater reliability of an adapted Wolf motor function test for older patients with shoulder injuries. Z Gerontol Geriatr 2017; 51:293-300. [DOI: 10.1007/s00391-017-1226-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/27/2017] [Accepted: 03/13/2017] [Indexed: 01/17/2023]
|
41
|
Weinstock-Zlotnick G, Mehta SP. A structured literature synthesis of wrist outcome measures: An evidence-based approach to determine use among common wrist diagnoses. J Hand Ther 2017; 29:98-110. [PMID: 27264897 DOI: 10.1016/j.jht.2016.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Structured literature synthesis. INTRODUCTION Hand therapists and researchers have numerous options when selecting outcome measures for patients with wrist pathologies. An evidence-based approach to determining which measures are used most often can inform choices. PURPOSE OF THE STUDY To describe how frequently outcome measures are used in recent randomized controlled trials of patients with wrist diagnoses. Identifying assessment design and related International Classification of Functioning, Disability and Health (ICF) domains provides additional consideration for selection. METHODS Systematic PubMed and Cumulative Index to Nursing and Allied Health Literature searches for the time frame between January 2005 and March 2015 captured measures used in randomized controlled trials researching wrist-specific fractures, ligament injuries, nerve injuries, arthritis/arthroplasty, or stress injuries/wrist pain. RESULTS Three most frequent measures used within each diagnostic category are detailed with assessment design described and ICF domain identified. Across diagnoses, grip/pinch strength and Disabilities of Arm, Shoulder and Hand were the most frequently used physical and patient-reported outcome measures, respectively. The Jebsen-Taylor Hand Function Test was the most frequently used performance measure. DISCUSSION AND CONCLUSIONS Consideration of the evidence, ICF domains, wrist diagnoses, and assessment design can help hand therapists select the measure most appropriate for use. LEVEL OF EVIDENCE 2a.
Collapse
Affiliation(s)
| | - Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, WV, USA; Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| |
Collapse
|
42
|
Qi DW, Wang P, Ye ZM, Yu XC, Hu YC, Zhang GC, Yan XB, Zheng K, Zhao LM, Zhang HL. Clinical and Radiographic Results of Reconstruction with Fibular Autograft for Distal Radius Giant Cell Tumor. Orthop Surg 2017; 8:196-204. [PMID: 27384728 DOI: 10.1111/os.12242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 02/07/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate the result of en bloc resection and reconstruction of the distal radius with a non-vascularized fibular autograft for giant cell tumor (GCT) of bone. METHODS Between 2005 and 2015, 12 eligible patients (seven males, five females, mean age 31.3 years) with grade III GCT of the distal radius were treated by en bloc resection and reconstruction with non-vascularized proximal fibular autografts in four Chinese institutions (members of Giant Cell Tumor Team of China). The patients had a clinical and radiographic review every 6 months for the first 2 years then annually thereafter. The functional, oncologic and radiological outcomes of the patients were analyzed. RESULTS The mean duration of follow-up was 39.6 months. Bony union was achieved in all cases. None of the patients were dissatisfied with the shape and appearance of the wrist. The mean MSTS score was 25.23 ± 2.38 (range, 22-29). The mean DASH score was 13.0 (range, 6.7-33.3). The average range of motion of the wrist was: 35.8° ± 14.5° of extension, 14.0° ± 8.4° of flexion, 15.5° ± 6.7° of radial deviation, 19.4° ± 10.1° of ulnar deviation, 57.2° ±18.9° of pronation and 44.0° ± 24.8° of supination. The average percentage of grip strength was 55.2% ± 29.0% compared with that of the contralateral side. One localized soft tissue recurrence occurred; it was successfully managed by excision. Lung metastases developed postoperatively in one case and were treated by gamma knife radiotherapy. There was radiographic evidence of radiocarpal arthritis in eleven patients, bone resorption in ten, distal radioulnar joint diastasis in six, ulnar deviation of the wrist in seven, subluxation of the carpal bone in three and dislocation of the carpal bone in one patient. CONCLUSIONS Reconstruction with a non-vascularized proximal fibular autograft is a reasonable option after en bloc resection of the distal radius for giant cell tumor of bone.
Collapse
Affiliation(s)
- Dian-Wen Qi
- Department of Musculoskeletal Tumor, Key Biomechanical Laboratory of Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peng Wang
- Graduate School, Hebei Medical University, Tianjin, China
| | - Zhao-Ming Ye
- Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xiu-Chun Yu
- Department of Orthopaedics, General Hospital of Jinan Military Region, Jinan, China
| | - Yong-Cheng Hu
- Department of Bone Oncology, Tianjin Hospital, Tianjin, China
| | - Guo-Chuan Zhang
- Department of Musculoskeletal Tumor, Key Biomechanical Laboratory of Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiao-Bo Yan
- Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Kai Zheng
- Department of Orthopaedics, General Hospital of Jinan Military Region, Jinan, China
| | - Li-Ming Zhao
- Graduate School, Tianjin Medical University, Tianjin, China
| | - Hui-Lin Zhang
- Graduate School, Tianjin Medical University, Tianjin, China
| |
Collapse
|
43
|
Ajidahun AT, Mudzi W, Myezwa H, Wood WA. Upper extremity disability among string instrumentalists–use of the quick DASH and the NDI. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1234535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Adedayo Tunde Ajidahun
- Faculty of Health Sciences, Department of Physiotherapy, University of the Witwatersrand, 7 York road, Parktown, 2193, Johannesburg, South Africa
| | - Witness Mudzi
- Faculty of Health Sciences, Department of Physiotherapy, University of the Witwatersrand, 7 York road, Parktown, 2193, Johannesburg, South Africa
| | - Hellen Myezwa
- Faculty of Health Sciences, Department of Physiotherapy, University of the Witwatersrand, 7 York road, Parktown, 2193, Johannesburg, South Africa
| | - Wendy-Ann Wood
- Faculty of Health Sciences, Department of Physiotherapy, University of the Witwatersrand, 7 York road, Parktown, 2193, Johannesburg, South Africa
| |
Collapse
|
44
|
Langer D, Luria S, Bar-Haim Erez A, Michailevich M, Rogev N, Maeir A. Stenosing flexor tenosynovitis: Validity of standard assessment tools of daily functioning and quality of life. J Hand Ther 2016. [PMID: 26209164 DOI: 10.1016/j.jht.2015.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN Cross-sectional. INTRODUCTION Stenosing flexor tenosynovitis (SFT) is a common hand disease, yet there is a lack of valid standard assessments for this population. PURPOSE OF THE STUDY Validation of assessment for the evaluation of disability and quality of life related to SFT clinical severity. METHODS Sixty five participants with SFT were matched to 71 controls. Participant's symptoms were graded using the Quinnell classification. Disability and quality of life were evaluated using the DASH and WHOQOL-BREF questionnaires. RESULTS Small to moderate correlations were found between SFT grade and the DASH and WHOQOL-BREF. Both questionnaires differentiated between the first and third clinical grades and between SFT and healthy groups. DISCUSSION Both questionnaires are useful tools to distinguish between participants with SFT and controls and between mild and severe clinical grades. CONCLUSION The DASH and WHOQOL-BREF may be implemented in the clinical management and research of SFT. LEVEL OF EVIDENCE Diagnostic III.
Collapse
Affiliation(s)
- Danit Langer
- School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel.
| | - Shai Luria
- Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | | | - Neta Rogev
- School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| |
Collapse
|
45
|
Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess 2016; 19:1-188. [PMID: 26616119 DOI: 10.3310/hta19990] [Citation(s) in RCA: 336] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) - the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health. OBJECTIVE (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development. DESIGN AND PARTICIPANTS Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive 'bottom-up' and theory-driven 'top-down' open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test-retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test-retest) and by experimentally testing its value (n = 190). RESULTS Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a 'bottom-up' open-sort procedure; there was overlap between these and groupings produced by a theory-driven, 'top-down' procedure. Both training methods improved validity (both p < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (both p < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results. CONCLUSIONS The developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions. FUNDING This project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.
Collapse
Affiliation(s)
- Susan Michie
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Caroline E Wood
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marie Johnston
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Institute of Applied Health Sciences, College of Life Science and Medicine, University of Aberdeen, Health Sciences Building, Aberdeen, UK
| | - Charles Abraham
- University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, UK
| | - Jill J Francis
- School of Health Sciences, City University London, London, UK
| | - Wendy Hardeman
- Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| |
Collapse
|
46
|
Engstrand C, Krevers B, Kvist J. Factors affecting functional recovery after surgery and hand therapy in patients with Dupuytren's disease. J Hand Ther 2016; 28:255-59; quiz 260. [PMID: 25998546 DOI: 10.1016/j.jht.2014.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/22/2014] [Accepted: 11/21/2014] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Prospective cohort study. INTRODUCTION The evidence of the relationship between functional recovery and impairment after surgery and hand therapy are inconsistent. PURPOSE OF THE STUDY To explore factors that were most related to functional recovery as measured by DASH in patients with Dupuytren's disease. METHODS Eighty-one patients undergoing surgery and hand therapy were consecutively recruited. Functional recovery was measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Explanatory variables: range of motion of the finger joints, five questions regarding safety and social issues of hand function, and health-related quality of life (Euroqol). RESULTS The three variables "need to take special precautions", "avoid using the hand in social context", and health-related quality of life (EQ-5D index) explained 62.1% of the variance in DASH, where the first variable had the greatest relative effect. DISCUSSION Safety and social issues of hand function and quality of life had an evident association with functional recovery. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Christina Engstrand
- Department of Hand Surgery, Plastic Surgery and Burns, County Council of Östergötland, Rehabilitation Unit, Floor 09, 581 85 Linköping, Sweden; Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Barbro Krevers
- Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Joanna Kvist
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden
| |
Collapse
|
47
|
Philbois SV, Martins J, Souza CS, Sampaio RF, Oliveira AS. Health professionals identify components of the International Classification of Functioning, Disability and Health (ICF) in questionnaires for the upper limb. Braz J Phys Ther 2016; 20:15-25. [PMID: 26786076 PMCID: PMC4835162 DOI: 10.1590/bjpt-rbf.2014.0135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 08/20/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Several Brazilian studies have addressed the International Classification of
Functioning, Disability and Health (ICF), but few have analyzed the knowledge of
the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese
versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities
Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals
who worked with patients having upper limb injuries, could be related to ICF
components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of
the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity
of the ICF (PSNF)". The participants judged whether the items on the two
questionnaires belonged to the ICF body function, body structure or
activity-participation component, and marked a confidence level for each trial
using a numerical scale ranging from zero to 10. The items were classified by the
discriminant content validity method using the Student'st-test
and the Hochberg correction. The ratings were compared to the literature by the
percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with
the literature was equal to or greater than 77%. For the DASH, the agreement of
the PSNF and PHF groups with the literature were, respectively, moderate
(Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for
most items on the 2 questionnaires, demonstrating some ease of understanding the
ICF components. However, the relation of concept of pain with body function
component is not clear for professional and deserves a more attentive
approach.
Collapse
Affiliation(s)
- Stella V Philbois
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Jaqueline Martins
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Cesário S Souza
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rosana F Sampaio
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Anamaria S Oliveira
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
48
|
Farzad M, Asgari A, Layeghi F, Yazdani F, Hosseini SA, Rassafiani M, Kus S. Exploring the Relation Between Impairment Rating by AMA Guide and Activity and Participation Based on ICF in the Patients with Hand Injuries. J Hand Microsurg 2015; 7:261-7. [PMID: 26578828 PMCID: PMC4642479 DOI: 10.1007/s12593-015-0197-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022] Open
Abstract
The aim of this paper is to analyze the relation between components of disability with distinguished score of impairment, activity and participation questionnaire based on clinical data of persons with hand injuries. Impairment was evaluated by use of AMA guide 6th edition and disability by DASH questionnaire on Convenience sample of patients (N = 117), with chronic hand injuries. Linking and allocating items of the DASH were done based on the ICF Core Set for Hand Conditions and the opinions of a group of experts from different related fields. Data was analyses by using Kappa index, Chi square test and a set of Pearson, Part and Partial correlations coefficient. Most of the DASH items were allocated to the activity; one to four of the items could not be classified and 0 to 22 were classified as having overlap. Participation and activity scores correlated positively with each other (r > 0.80). Impairment had high correlation with activity and participation scores (>73). With controlling the effect of each or both construct, this relation between them with impairment diminished but still significant between activity and impairment. There is a huge overlap in definition of activity and participation. The most effecting item in relation of disability and impairment is activity restriction. Participation had no relation with impairment.
Collapse
Affiliation(s)
- Maryam Farzad
- />Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran 1985713831 Iran
| | - Ali Asgari
- />Department of Educational Psychology, The University of Kharazmi, Khaghani Ave, Somayeh St., Tehran, Iran
| | - Fereydoun Layeghi
- />Department of Basic Science, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran 1985713831 Iran
| | - Farzaneh Yazdani
- />Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straw’s Lane, Marston Oxford, OX3 0FL UK
| | - Seyyed Ali Hosseini
- />Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran 1985713831 Iran
| | - Mehdi Rassafiani
- />Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Kodakyar St, Daneshjo Blvd, Evin, Tehran 1985713831 Iran
| | - Sandra Kus
- />Department of Medical Informatics, Biometry and Epidemiology – IBE/Chair for public Health Services Research, Marchioninistr. 17, 81377 Munich, Germany
| |
Collapse
|
49
|
Abstract
BACKGROUND Any loss or deviation in body function and structure is considered impairment, whereas limitations on activities are fundamental to the definition of disability. Although it seems intuitive that the two should be closely related, this might not be the case; there is some evidence that psychosocial factors are more important determinants of disability than are objective impairments. However, the degree to which this is the case has been incompletely explored. QUESTIONS/PURPOSES The purpose of this study was to determine if disability (as measured by the Disabilities of the Arm, Shoulder and Hand [DASH] and the Michigan Hand Questionnaire [MHQ]) and pain intensity correlate with impairment (as measured by the American Medical Association [AMA] impairment guide). Secondary study questions addressed the effect of pain intensity and symptom of depression on predicting disability. METHODS Impairment and disability were evaluated in a sample of 107 hand-injured patients a mean of 11 months after injury. Impairment rating was performed prospectively. From the patients who came for therapy, they were invited to fill out the questionnaire and evaluated for impairment rating. Response variables of DASH, MHQ, and visual analog scale pain intensity values were collected at the same setting. Other explanatory variables included demographic, injury-related, and psychological factors (symptoms of depression measured with the Beck Depression Inventory). Initial bivariate and multivariate analyses were performed to determine correlations of disability and pain to impairment rating and other exploratory variables. RESULTS Disability as measured by the DASH showed intermediate correlation with AMA impairment (r = 0 .38, beta = 0.36, p = 0.000). Together with gender, it accounted for only 22% of the variability in DASH scores. Similarly, MHQ score correlated with impairment rating (r = -0.24, beta = -0.23, p < 0.05). However, together with age, injured hand accounted for only 19% of the variability in MHQ scores. However, pain intensity did not correlate with impairment (r = -0.46, p > 0.05). Interestingly, pain intensity did correlate with the time passed from surgery but it was correlated with symptom of depression (r(2) = 0.10, beta = 0.33, p = 0.001). CONCLUSIONS The limited correlation between impairment and disability emphasizes the importance of factors other than pathophysiology in human illness behavior. These may include physical (pain, dominant injured hand) and conditional factors (time since surgery) or psychological factors such as depression and adapting; all mentioned can be considered as personal factors that may be different in each patient. So considering personal difference and any other condition except the impairment alone can help to better plan interventions and also diminish disability level. LEVEL OF EVIDENCE Level III, therapeutic study.
Collapse
|
50
|
Yang EJ, Kang E, Kim SW, Lim JY. Discrepant Trajectories of Impairment, Activity, and Participation Related to Upper-Limb Function in Patients With Breast Cancer. Arch Phys Med Rehabil 2015; 96:2161-8. [PMID: 26343172 DOI: 10.1016/j.apmr.2015.08.426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To explore upper-limb disability with respect to health outcomes, operationalized by Disabilities of the Arm, Shoulder, and Hand, and to identify factors associated with each element of upper-limb disability over a 2-year period in breast cancer survivors. DESIGN Prospective cohort study. SETTING University hospital cancer center. PARTICIPANTS Individuals (N=191) recruited from all the patients with newly diagnosed breast cancer before cancer surgery at a university hospital between April 2006 and March 2007. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We evaluated demographics, social variables, and upper-limb disability in a baseline assessment preoperatively. Follow-up evaluations were conducted in outpatient clinics 3 months after surgery and at 12 and 24 months after surgery. Linear regression models with the generalized estimating equations of the compound symmetry covariance structure were used. RESULTS Time since surgery was inversely associated with the impairment items score (β=-.20; 95% confidence interval [CI], -.49 to -.08) and positively associated with the activity limitation items score (β=.59; 95% CI, .29-.88). The impact of upper-limb disability preoperatively on the items involving both the activity limitation and participation restrictions scores was positive (β=2.89; 95% CI, .76-5.02) after adjusting for demographic, treatment type, and socioeconomic factors. CONCLUSIONS Our study revealed that upper-limb impairment recovered with time after breast cancer surgery; however, upper-limb function-related activity and participation were reduced through 2 years after surgery.
Collapse
Affiliation(s)
- Eun Joo Yang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul, Republic of Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
| |
Collapse
|