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Farzad M, MacDermid J, Hemmati M, Farhoud AR. Occupational Performance 1 Year After a Distal Radius Fracture From the Perspective of the International Classification of Functioning, Disability and Health. Am J Occup Ther 2023; 77:7705205040. [PMID: 37793017 DOI: 10.5014/ajot.2023.050180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
IMPORTANCE Distal radius fractures (DRFs) frequently compromise independent functioning. OBJECTIVE To analyze occupational performance post-DRF using the Canadian Occupational Performance Measure (COPM) and related interviews, guided by the International Classification of Functioning, Disability and Health (ICF). COPM score was compared with standard metrics: Patient-Reported Wrist Evaluation (PRWE) and Participation Behavior Questionnaire (PBQ). METHOD Through a semistructured COPM interview, participants highlighted self-care, productivity, and leisure. They completed the PRWE and PBQ, linking results to ICF sets. DESIGN Prospective cohort. SETTING Outpatient hand surgery clinic at a trauma center. PARTICIPANTS Patients (N = 120), 1 yr post-DRF. OUTCOMES AND MEASURES Incorporated COPM, PRWE, and PBQ, linked to ICF. RESULTS Analysis identified 73 codes, aligning with 30 ICF Hand Conditions codes. Main concerns related to self-care (15.21%), leisure (12.16%), and productivity (16.22%). Major challenges pertained to domestic (67.00%) and civic life (64.53%) within ICF. Occupational performance was positively correlated with participation (r = .62) and inversely with disability (r = -.62). CONCLUSIONS AND RELEVANCE DRFs result in varied occupational challenges that are not always reflected in standard measures. The COPM offers a comprehensive insight into post-DRF patient challenges, emphasizing the value of diverse clinical assessment approaches. What This Article Adds: This study highlights the importance of a holistic approach in occupational therapy for DRF patients, revealing that standard measurements might overlook key challenges that they face. By adopting broader evaluative methods, occupational therapists can better address patient-specific needs and enhance their rehabilitation outcomes.
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Affiliation(s)
- Maryam Farzad
- Maryam Farzad, PhD, MSc, BSc, is Postdoctoral Associate, School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada, and Assistant Professor, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran;
| | - Joy MacDermid
- Joy MacDermid, PhD, MSc, BSc, is Professor, Department of Physical Therapy and Surgery, Western University, London, Ontario, Canada; Codirector, Clinical Research Laboratory, Hand and Upper Limb Center, St. Joseph's Health Center, London, Ontario, Canada; and Professor, Department of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Motahar Hemmati
- Motahar Hemmati, BSc OT, is Master's Student, Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Amir Reza Farhoud
- Amir Reza Farhoud, MD, is Assistant Professor, Department of Orthopedic Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Joint Reconstruction Research Center, Tehran, Iran
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Moulaei K, Sheikhtaheri A, Haghdoost AA, Nezhadd MS, Bahaadinbeigy K. A data set for the design and implementation of the upper limb disability registry. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:130. [PMID: 37397108 PMCID: PMC10312779 DOI: 10.4103/jehp.jehp_721_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/14/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND If the data elements needed for patient registries are not identified, designing and implementing them can be very challenging. Identifying and introducing a Data Set (DS) can help solve this challenge. The aim of this study was to identify and present a DS for the design and implementation of the upper limb disability registry. MATERIALS AND METHODS This cross-sectional study was conducted in two phases. In the first phase, to identify the administrative and clinical data elements required for registry, a comprehensive study was conducted in PubMed, Web of Science, and Scopus databases. Then, the necessary data elements were extracted from the studies and a questionnaire was designed based on them. In the second phase, in order to confirm the DS, the questionnaire was distributed to 20 orthopedic, physical medicine and rehabilitation physicians and physiotherapists during a two-round Delphi. In order to analyze the data, the frequency and mean score of each data element were calculated. Data elements that received an agreement more than 75% in the first or two-round Delphi were considered for the final DS. RESULTS A total of 81 data elements in five categories of "demographic data", "clinical presentation", "past medical history", "psychological issues", and "pharmacological and non-pharmacological treatments" were extracted from the studies. Finally, 78 data elements were approved by experts as essential data elements for designing a patient registry for upper limb disabilities. CONCLUSION In this study, the data elements necessary for the design and implementation of the upper limb disability registry were suggested. This DS can help registry designers and health data administrators know what data needs to be included in the registry system in order to have a successful design and implementation. Moreover, this standardized DS can be effective for integrating and improving the information management of people with upper limb disabilities and used to accurately gather the upper limb disabilities data for research and policymaking purposes.
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Affiliation(s)
- Khadijeh Moulaei
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali A. Haghdoost
- HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansour S. Nezhadd
- Department of Physical Therapy, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Farzad M, MacDermid J, Rassafiani M. Factor structure of Participation Behavioural Questionnaire (PBQ) in patients with hand injuries. PLoS One 2023; 18:e0267872. [PMID: 36662736 PMCID: PMC9858033 DOI: 10.1371/journal.pone.0267872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Participation is considered a critical outcome of successful rehabilitation and should be evaluated. OBJECTIVE We aimed to evaluate the structural validity of the Participation Behaviour Questionnaire (PBQ) in people with hand injuries. METHODOLOGY The PBQ contains 30 items that measure participation as conceptualized in the ICF. PBQ was developed with Rasch analysis to measure participation in hand injured. A sample of 404 patients with hand injuries and a mean age of 37 (16.0) participated and was randomly split for exploratory and confirmatory factor analysis (EFA/CFA). RESULTS Both EFA and CFA confirmed a four factor-solution. These factors were named: Social Participation and Interpersonal Relationships, Autonomy and Role, Subjective Satisfaction with Participation, Recreational, Sport, and Leisure Time. The value of Cronbach's alpha was 0.96 for the total scale and >0.85 for each subscale. CONCLUSIONS The structural validity of the PBQ was confirmed using both EFA and CFA. The PBQ measures four dimensions of participation.
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Affiliation(s)
- Maryam Farzad
- School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, Ontario, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada
- Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Joy MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario, Canada
- Rehabilitation Science McMaster University, Hamilton, ON, Canada
| | - Mehdi Rassafiani
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
- Paediatric Neurorehabilitation Research Centre, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Farzad M, Lu Z, MacDermid JC, Kachooei AR, Shafiee E. Measurement properties of the Michigan hand outcomes questionnaire: Rasch analysis of responses from a traumatic hand injury population. Disabil Rehabil 2021; 44:4081-4089. [PMID: 33683933 DOI: 10.1080/09638288.2021.1894246] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE This study aimed to use Rasch analysis to test the content, scoring, and measurement properties of the Michigan Hand Outcomes Questionnaire (MHQ). METHODS MHQ scores from 196 patients with hand and wrist conditions were collected in an outpatient hand rehabilitation facility. Rasch analysis was conducted to assess the fit statistics of MHQ to confirm the scaling structure of disability subscales, and to identify differential item functioning. RESULTS The MHQ did not fit with the Rasch model (χ2 = 2376.78, df = 74, p < 0.001), and most thresholds of item responses were disordered. The original scoring algorithm derived from 5-point Likert response options was adjusted to 3-point Likert (10 items) and 4-point Likert (11 items) based on the visual inspection of the thresholds map. Differential item functioning was present in the revised scale based on the age, sex, and dominant hand. Only 3 revised subscales of the MHQ including activities daily living (one hand), aesthetics, and satisfaction showed acceptable fit to the Rasch model. Unidimensionality was achieved in all revised subscales. CONCLUSIONS The overall MHQ had a substantial misfit from the Rasch model. Despite efforts of item reduction and rescoring, we did not reach a satisfactory solution. This calls into question the validity of the statistical evaluations performed on this scale using the traditional scoring.Implications for rehabilitationThe MHQ was designed to measure different dimensions of pain and disability but demonstrates multiple measurement problems that undermine it use in present form.It is not appropriate to sum all 37 items of the MHQ into a single score.Three subscales of activities daily living (one hand), aesthetics, and satisfaction can provide unidimensional subscales scores with interval level scaling if scored with our proposed Rasch-based revised scoring.The 27-item version of the MHQ is shown to have strong psychometric properties for administration with patients with hand injuries; however, it requires further validation.
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Affiliation(s)
- Maryam Farzad
- School of Physical Therapy, University of Western Ontario, London, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Canada.,Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ze Lu
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Canada.,The School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Joy C MacDermid
- The School of Rehabilitation Science, McMaster University, Hamilton, Canada.,School of Physical Therapy and Surgery, Western University, London, Canada.,Clinical Research Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario
| | - Amir R Kachooei
- Rothman Institute, Thomas Jefferson University.,Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Erfan Shafiee
- School of Physical Therapy, University of Western Ontario, London, Canada.,Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Farzad M, MacDermid JC, Lu Z, Shafiee E. Validation of Persian Version of Patient-Rated Wrist and Hand Evaluation: Confirmatory Factor Analysis and Rasch Analysis. Arch Rehabil Res Clin Transl 2020; 2:100076. [PMID: 33543101 PMCID: PMC7853362 DOI: 10.1016/j.arrct.2020.100076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Objectives To determine the factor structure and test the clinometric properties of wrist and hand version of the Patient-Rated Wrist Evaluation. Design Cross-sectional study using Rasch analysis and factor analysis. Confirmatory factor analysis was conducted to assess the factor structure. Higher-order factor analysis was used to explore the hierarchical structure of the items. The Rasch model was used to assess the overall fit, reliability, validity, and construct unidimensionality. Rasch analysis and factor analysis were conducted using RUMM2030 and LISREL software, respectively. Setting Outpatient hand rehabilitation clinic. Participants A convenience sample of patients (N=206) with various hand injuries who completed the Persian version of the Patient-Rated Wrist and Hand Evaluation (PRWHE-P) at 2 months postinjury. The study included 66 men and 139 women, with a mean age of 40 years. Intervention Not applicable. Main Outcome Measures The PRWHE-P was used as a patient-reported measure of pain and disability in wrist and hand conditions. Results Factor analysis confirmed 3-factor models of the PRWHE-P. Items fit well to the Rasch model in 3 subscales. The PRWHE-P had a good item reliability (0.82) and good internal consistency (0.8). No differential item functioning was detected for age, sex, dominant hand, or injured hand. Conclusions The results of this study indicated that the PRWHE-P with 3 sub scales is a reliable and valid measurement tool and could be used in patients with different wrist and hand disabilities.
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Key Words
- CFA, confirmatory factor analysis
- CFI, comparative fit index
- DIF, differential item functioning
- FA, factor analysis
- Factor analysis
- GFI, goodness of fit index
- ICC, item characteristic curve
- ICF, International Classification of Functioning, Disability and Health
- PRWE, Patient-Rated Wrist Evaluation
- PRWHE, Patient-Rated Wrist and Hand Evaluation
- PRWHE-P, Persian version of the Patient-Rated Wrist and Hand Evaluation
- PSI, person separation index
- RMSEA, root means square error of approximation
- Rehabilitation
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Affiliation(s)
- Maryam Farzad
- School of Physical Therapy, Western University, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Joy C MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada.,Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
| | - Ze Lu
- School of Physical Therapy, Western University, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Erfan Shafiee
- School of Physical Therapy, Western University, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.,Department of Occupational Therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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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.
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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
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Naughton N, Algar L. Linking commonly used hand therapy outcome measures to individual areas of the International Classification of Functioning: A systematic review. J Hand Ther 2020; 32:243-261. [PMID: 29433763 DOI: 10.1016/j.jht.2017.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 11/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION Identifying outcome measures that correspond to the International Classification of Functioning (ICF) provides insight into selecting appropriate outcome tools in hand therapy practice. PURPOSE OF THE STUDY The objective of this study is to systematically review patient-reported outcome measures commonly used in hand therapy to determine the extent to which the content represents the biopsychosocial view of the ICF. METHODS A comprehensive literature search was conducted. Studies that met inclusion criteria were identified, and outcome measures were extracted. The meaningful concept was determined for each item on the measure and linked to the most specific ICF category. Summary linkage calculations were completed. RESULTS Eleven patient-reported outcomes were identified from 43 included studies. Activity and participation had the highest content coverage followed by body functions. There was linking to personal factors and not defined-disability and mental health. Environmental factors were not represented in any of the included outcome measures. The core set representation of unique codes ranged from 8.55% to 18.80% (mean: 11.97%) for the Comprehensive ICF Core Set for Hand Conditions and from 30.43% to 47.83% (mean: 31.40%) for the Brief ICF Core Set for Hand Conditions. The percent representation of the Comprehensive ICF Core Set for Hand Conditions for unique disability ranged from 21.62% to 43.24% (mean: 20.33%) and from 62.50% to 87.50% (mean: 72.22%) for the Brief ICF Core Set for Hand Conditions. DISCUSSION None of the included measures represent all categories of the ICF Core Sets for Hand Conditions. CONCLUSION Utilizing the most recent refinement rules for the linking process, this study provides comparisons of measures along with clarity of content coverage for the most commonly used tools in the practice of hand therapy.
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Affiliation(s)
| | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
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Self-reported upper limb functioning of pupils with cerebral palsy by the International Classification of Functioning, Disability, and Health. Int J Rehabil Res 2018; 41:262-266. [PMID: 29664754 DOI: 10.1097/mrr.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
International Classification of Functioning, Disability, and Health: Children and Youth Version has shown an increasing role in the assessment of children with cerebral palsy (CP), but just a few researchers use it for individuals' self-assessment. In this study, we present the self-assessment of functioning of students with CP and changes by the end of a school year. Thirty-seven pupils with spastic CP involving upper limbs, 24 pupils with typical development, and 20 pupils with speech and language disorders were studied by International Classification of Functioning, Disability, and Health core sets for CP. The CP group reported limitations in sensory functions (P<0.05), movement-related functions (P<0.001), and mobility (P<0.001) as well as products and technology and support and relationships as supportive (P<0.05). Correlation between expert and self-evaluation was weak to moderate. The CP core set may appropriately serve in the self-assessment of pupils' functioning in longitudinal studies.
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Farzad M, Layeghi F, Hosseini SA, Hamidreza K, Asgari A. Are the Domains Considered by ICF Comprehensive Enough to Conceptualize Participation in the Patient with Hand Injuries? J Hand Microsurg 2018; 9:139-153. [PMID: 29302138 DOI: 10.1055/s-0037-1608693] [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: 02/04/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022] Open
Abstract
Background Although participation is a core concept in multiple models of disability, there is no consensus on its definition. Objective The aim of this study was to extract participation domains based on review of theories, available outcome measures, and interviews with experts and the person with hand injuries to compare with the ICF domains of participation. Methods A qualitative approach using a deductive content analysis was employed to extend definitions of participation from theories. Later on, inductive qualitative method using semistructured interview with five experts in different fields and 30 patients with different hand injuries was used. Coding was performed with extracted domains from the content of data, and finally, the extracted domains were compared with the ICF domains of participation. Results Some of the extracted domains were not considered in ICF. Conclusion Subjective participation is the main forbearance part. Role, leisure, domestic life, environment, and others are also main missing meanings. This limitation can hinder measuring disability and health.
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Affiliation(s)
- Maryam Farzad
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereydoun Layeghi
- Department of Clinical Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyyed Ali Hosseini
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Khanke Hamidreza
- Department of Clinical Science and Education, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Asgari
- Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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ICF components of outcome measures for mallet finger: A systematic review. J Hand Ther 2017; 29:388-395. [PMID: 27780628 DOI: 10.1016/j.jht.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/18/2016] [Accepted: 06/17/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for the assessment of the conservative management of mallet finger to determine if they characterize the International Classification of Functioning, Disability, and Health components of activity, participation, environmental factors, or quality of life. METHODS/RESULTS Five studies published within the last 10 years were included in the systematic review. A majority, 19 of the outcomes used by the authors, fell within the body functions and structures category. Six were related to activity, and 1 was related to participation. One was linked to environmental factors. Five were found to be not definable and related to quality of life. DISCUSSION/CONCLUSION This systematic review suggests that many outcome measures focus on body structures and functions in the current research on the conservative treatment of mallet finger injuries. LEVEL OF EVIDENCE 2a.
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Valdes K, Naughton N, Algar L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: A systematic review. J Hand Ther 2017; 29:396-404. [PMID: 27662802 DOI: 10.1016/j.jht.2016.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/24/2016] [Accepted: 06/06/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION/PURPOSE The purpose of this study was to systematically review outcome measures used for assessment of orthotic intervention in the conservative management of thumb carpometacarpal osteoarthritis to determine if they characterize International Classification of Functioning, Disability, and Health (ICF) components. The determinants of patient satisfaction regarding the orthotic intervention were also extracted from the studies. METHODS A comprehensive literature search was conducted. Outcome measures in the included studies were linked to the ICF. Determinants of patient satisfaction regarding the orthotic intervention were also extracted. RESULTS Nine studies met inclusion criteria. Eight (47.1%) outcomes were linked to body structures and functions, 8 (47.1%) to activity limitations and participation restrictions, and 1 (5.9%) outcome fell into the nondefinable quality of life category. Four studies assessed patient satisfaction. DISCUSSION/CONCLUSIONS This systematic review on orthotic intervention for thumb carpometacarpal osteoarthritis found opportunities related to assessment and outcome measures when present studies are linked to the ICF. LEVEL OF EVIDENCE 2a.
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Affiliation(s)
- K Valdes
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA; Hand Works Therapy, Venice, FL, USA.
| | | | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
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Farzad M, Layeghi F, Hosseini A, Whiteneck G, Asgari A. Using the Rasch Model to Develop a Measure of Participation Capturing the Full Range of Participation Characteristics for the Patients with Hand Injuries. J Hand Microsurg 2017; 9:84-91. [PMID: 28867908 DOI: 10.1055/s-0037-1604060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022] Open
Abstract
Objective The purpose of this paper was to report on the first step in the development of a new instrument to measure participation including the full range of its characteristics. Methods The 30-item participation behavior questionnaire (PBQ) was developed from four main sources (a literature review of the theatrical basis of participation, available participation measures, and interviews with patients and experts about participation). Item selection and the reliability and validity of the measure were explored using Rasch measurement modeling for analysis. Participants A total of 404 individuals referred to rehabilitation after hand, wrist, or upper extremity surgery to reduce impairment from trauma, at least 2 months post-injury. Results An initial pool of 100 items; reflecting 14 characteristics of participation was initially reduced to 91 items after review by 15 participation experts and then further reduced to 30 items by three rounds of Rasch analysis removing misfitting items. The final PBQ has a person reliability of 0.91 with separation of 3.22, indicating it can reliably differentiate four levels of participation. There are no misfitting items and the instrument is unidimensional. All 14 characteristics of participation were retained in the PBQ, and none of the 30 items refer specifically to upper extremity issues. Conclusion The 30 participation behavior items of the PBQ show promise of being a psychometrically sound measure of participation. Further research is needed to validate the PBQ in samples of people with a range of other disabilities.
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Affiliation(s)
- Maryam Farzad
- Department of Occupational therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereydoun Layeghi
- Department of Clinical Science, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Hosseini
- Department of Occupational therapy, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gale Whiteneck
- Department of Research, Craig Hospital, Englewood, Colorado, United States
| | - Ali Asgari
- The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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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.
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