Reliability and validity of Duruoz Hand Index in carpal tunnel syndrome

Validity and reliability of the Duruöz Hand Index in patients with psoriatic arthritis

OBJECTIVE

The Duruöz Hand Index (DHI) is a valuable scale developed for evaluating hand functions of patients with rheumatoid arthritis and subsequently proven to be valid and reliable in various diseases. This study aims to investigate the validity and reliability of the DHI in patients with psoriatic arthritis (PsA).

METHODS

Patients diagnosed with PsA according to CASPAR criteria were enrolled. The demographic, clinical, and functional characteristics of patients were evaluated. Functional assessment was performed with DHI, Hand Functional Index, Health Assessment Questionnaire, and VAS-disability scale. C-reactive protein level, patients' and physicians' global VAS, swelling and tenderness of the hand joints, gross grip strength and thumb strength, and disease activity assessments were recorded as non-functional parameters related to active disease status. Reliability was assessed by internal consistency (with Cronbach's-a) and test-retest intraclass correlation coefficient. Face, content, convergent, and divergent validities were applied.

RESULTS

One hundred and forty-four patients (74.3% female) were included in this study. The Cronbach's alpha coefficient was 0.963, and for the test-retest reliability of the DHI, the intraclass correlation coefficient was 0.904 (p < 0.001). DHI showed good correlations with the functional disability scales (Hand Functional Index, Health Assessment Questionnaire, VAS-disability), indicating its convergent validity and moderate to non-significant correlations with the non-functional parameters supporting its divergent validity.

CONCLUSIONS

Despite the occurrence of significant deformities and functional loss in PsA patients, there is a noticeable absence of specific tools tailored for PsA. Considering the intricacies associated with skin, nail, tendon, entheseal involvement, and arthritis, there is a need for straightforward tools in both clinical practice and studies involving patients with PsA. The DHI is a valid and reliable scale to evaluate the functional disability of hands in patients with PsA.

Validity and reliability of the Duruöz Hand Index in patients with lateral epicondylitis

Objectives

This study aims to investigate the validity, reliability and clinimetric features of the Duruöz Hand Index (DHI) in patients with lateral epicondylitis.

Patients and methods

Between October 2019 and January 2020, a total of 78 patients (28 males, 50 females; mean age: 46.4±9.4 years; range, 20 to 65 years) who presented with pain in the forearm and were diagnosed with lateral epicondylitis were included in the study. The patients were evaluated using the Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ), the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEEQ), the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire at Weeks 0, 1 and 4. The DHI reliability (Cronbach alpha, intraclass correlation [ICC]), validity and factor analyses were performed with the data of 70 and 49 patients who attended to follow-up visit at Weeks 1 and 4. The effect size (ES), standard response mean (SRM), and minimum detectable change (MDC) values of the DHI were calculated.

Results

Of the patients, 84.6% were right-handed. The ICC coefficients of DHI were found to be perfect with the test-retest method (ICC; total=0.943). It showed a well-excellent consistency with the internal consistency method (Cronbach alpha; total=0.90). In the structural validity of the DHI, it was very strongly correlated with the DASH (r=0.801; p<0.01), strongly correlated with the PRTEEQ and HAQ total scores (r=0.793; p<0.01; r=0.785; p<0.01), and acceptably correlated with PRTEEQ pain score (r=0.570; p<0.01). The DHI was acceptably correlated with the VAS and grip strength as measured by the hand dynamometer (p<0.05). In our study, three main factors were obtained and MDC and responsiveness sensitivity were found to be moderate (MDC=4.4; SEM=1.61; ES=0.246 p<0.001; SRM=0.538 p<0.001).

Conclusion

Duruöz Hand Index is a reliable, valid, and practical functional assessment scale in patients with lateral epicondylitis.

The Investigation of the Results of Clinical Evaluation, Pain, Functional Status and Sleep Quality According to Electrodiagnostic Test Results in Females with Carpal Tunnel Syndrome: A Pilot Study

Amaç: Çalışmamız, elektrodiagnostik test sonuçlarına göre hafif ve orta düzey Karpal Tünel Sendromu (KTS) tanısı almış kadın hastaların klinik semptom şiddetleri, el fonksiyonları ve uyku kalitelerinin karşılaştırılması ve hastaların semptom şiddetleri ile el fonksiyonelliği ve uyku kalitesi arasındaki ilişkinin incelenmesi amacıyla planlandı.Yöntem: Çalışmamız, Erzurum Atatürk Üniversitesi Eğitim ve Araştırma Hastanesi Fizik Tedavi Polikliniğine başvuran, hafif-orta düzey KTS tanısı alan ve 35-65 yaş aralığında olan 32 kadın hasta ile gerçekleştirildi. KTS şiddetinin elektrofizyolojik tanılaması için elektromiyografi (EMG), ağrı ölçümü için Vizüel Analog Skalası (VAS), KTS fonksiyonel durum şiddeti ve semptom şiddeti için Boston KTS Anketi, el fonksiyonelliği için Duruöz El İndeksi, uyku kalitesi için Jenkins Uyku Skalası kullanıldı. Veriler SPSS programı ile değerlendirildi.Bulgular: Çalışmamız sonuçlarına göre hafif ve orta şiddette KTS tanısı almış hastaların ağrı, Boston KTS Anketi, Jenkins Uyku Skalası sonuçlarının benzer olduğu (p&gt;0.05); Duruöz El İndeksi sonuçlarının ise orta şiddette KTS tanısı almış hastalarda hafif şiddette KTS hastalarına göre daha yüksek olduğu belirlendi (p&lt;0.05). Hastaların semptom şiddetleri ile el fonksiyonelliği ve uyku kalitesi arasındaki ilişki incelendiğinde ise; semptom şiddeti yüksek olan hastalarda fonksiyonel durum ve uyku kalitelerinin daha kötü olduğu belirlendi (p&lt;0.01).Sonuç: KTS hastalarında EMG sonuçları ile klinik semptomlar her zaman birbiri ile uyumlu olmayabilmekte, EMG sonuçlarına göre farklı şiddette KTS’si olan hastaların yaşadığı semptomlar hastaya özgü değişiklikler gösterebilmektedir. Buna göre KTS hastalarının klinik durumları ile EMG sonuçlarının birlikte değerlendirilmesi ile hastaya özgü planlanacak tedaviler ile daha etkili sonuçlara ulaşılabileceğini düşünmekteyiz.

Effects of Orem's Self-Care Model of Nursing on Hand Symptoms and Life Activities in Geriatric Individuals Diagnosed with Rheumatoid Arthritis: A Pilot Study

BACKGROUND AND PURPOSE

According to Orem's self-care deficit theory, when patients cannot meet their care needs, they need nursing systems for maintaining their health. Nursing care for elderly patients with rheumatoid arthritis (RA) should be based on maintaining self-care. This study aims to determine the effects of Orem's self-care model of nursing care given to geriatric patients with RA on hand symptoms, life activities, and hand pain.

METHODS

The study sample comprised a total of 22 patients (intervention group, 11; control group, 11) who met the sample selection criteria at a rheumatology outpatient clinic of a university hospital between June 17, 2019 and September 20, 2019. All interviews with patients in the intervention group were conducted by daily phone calls and a face-to-face interview at the hospital every 4 weeks. Patients continued to receive routine prescription by a physician during the course of application.

RESULTS

No difference was observed between the groups in terms of descriptive patient characteristics (p > .05). Hand pain, hand symptoms, and life activities of patients in the intervention group were measured at study initiation, week 4, and week 8. Intragroup comparison revealed that hand pain, hand symptoms, and life activity scores were lowest at week 8 in the intervention group (p < .05).

IMPLICATIONS FOR PRACTICE

This study indicates that nursing care given according to Orem's self-care model is effective in reducing pain, improving hand functions, and performing life activities.

Evaluation of Duruöz Hand Index in diagnosis and staging of Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the upper limb. In this cross-sectional study our aim is to investigate the value of Duruöz Hand Index (DHI) in diagnosis and staging of CTS patients and comparing it with Boston Carpal Tunnel Questionnaire (BQ) and provocative tests. Among 423 patients who were referred to the EMG laboratory at the physical medicine and rehabilitation unit with the symptoms of CTS, 294 patients were included in the study. Patients' demographic data, weight, height, body mass index (BMI) measurements, physical examinations, Tinel and Phalen provocative test results, visual analog scale for pain, DHI and BQ scores were recorded. Electrophysiological examinations were also performed. The mean age was 45.1 ± 11.6 years and 254 (86.4%) patients were women. Based on the results of EMG, 120 (40.8%) patients were found negative for CTS, 57 (19.4%) patients had mild CTS, 89 (30.3%) patients had moderate CTS and 28 (9.5%) patients had severe CTS. Among the parameters evaluated, DHI scores were found to be significantly higher in the severe CTS group. DHI (r: 0.306, p < 0.001) and Boston functional status scale (FSS) (r: 0.257p = 0.001) were found to be correlated with CTS severity. Tinel positivity (OR: 2.36, p: 0.01), Phalen positivity (OR: 2.22, p: 0.02), Boston symptom severity scale (SSS) scores (OR: 1.76, p: 0.024), increasing age (OR: 1.06, p < 0.001) and increased BMI (OR: 1.07, p: 0.03) were found to be associated with increased likelihood of CTS diagnosis. In conclusion, DHI was found to be correlated with CTS severity similar to Boston FSS.