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Pelsma ICM, Kroon HM, van Trigt VR, Pereira AM, Kloppenburg M, Biermasz NR, Claessen KMJA. Clinical and radiographic assessment of peripheral joints in controlled acromegaly. Pituitary 2022; 25:622-635. [PMID: 35726113 PMCID: PMC9345810 DOI: 10.1007/s11102-022-01233-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Acromegalic arthropathy is a well-known phenomenon, occurring in most patients regardless of disease status. To date, solely hips, knees, hands, and spinal joints have been radiographically assessed. Therefore, this study aimed to assess the prevalence of joint symptoms and radiographic osteoarthritis (OA) of new, and established peripheral joint sites in well-controlled acromegaly. METHODS Fifty-one acromegaly patients (56% female, mean age 64 ± 12 years) in long-term remission for 18.3 years (median, IQR 7.2-25.4) were included. Nineteen patients currently received pharmacological treatment. Self-reported joint complaints were assessed using standardized interviews. Self-reported disability of the upper and lower limbs, and health-related quality of life (HR-QoL) were evaluated using validated questionnaires. Radiographic OA [defined as Kellgren & Lawrence (KL) ≥ 2] was scored using (modified) KL methods. RESULTS Radiographic signs of OA were present in 46 patients (90.2%) with ≥ 2 joints affected in virtually all of these patients (N = 44; 95.7%). Radiographic MTP1 OA was as prevalent as radiographic knee OA (N = 26, 51.0%), and radiographic glenohumeral OA was similarly prevalent as hip OA [N = 21 (41.2%) vs. N = 24 (47.1%)]. Risk factors for radiographic glenohumeral OA were higher pre-treatment IGF-1 levels [OR 1.06 (1.01-1.12), P = 0.021], and current pharmacological treatment [OR 5.01 (1.03-24.54), P = 0.047], whereas no risk factors for MTP1 joint OA could be identified. CONCLUSION Similar to previously-assessed peripheral joints, clinical and radiographic arthropathy of the shoulder and feet were prevalent in controlled acromegaly. Further studies on adequate management strategies of acromegalic arthropathy are needed.
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Affiliation(s)
- Iris C M Pelsma
- Department of Medicine, Division of Endocrinology and Metabolism, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands.
| | - Herman M Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Victoria R van Trigt
- Department of Medicine, Division of Endocrinology and Metabolism, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Alberto M Pereira
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nienke R Biermasz
- Department of Medicine, Division of Endocrinology and Metabolism, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Kim M J A Claessen
- Department of Medicine, Division of Endocrinology and Metabolism, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands
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Tore NG, Tuna Z, Mete O, Gokkurt A, Seven B, Oskay D. Test-retest reliability, convergent validity and cross-cultural adaptation of Turkish version of the Hand10 questionnaire. J Orthop Sci 2022; 27:380-383. [PMID: 33549401 DOI: 10.1016/j.jos.2020.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/24/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Hand10 Questionnaire is composed of 10 short, easy to understand and illustrated questions and was developed to measure upper extremity disorders. Thanks to these features, unlike other questionnaires that assess upper extremity disorders, it can be used in the elderly and children as well as adults. The aim of this study was to cross-culturally adapt the Hand10 into Turkish and to test its reliability and validity. METHODS Translation and back-translation of the Hand10 were performed according to Beaton guidelines. Patients completed the Disabilities of the Arm, Shoulder and Hand Questionnaire once and the final version of the Hand10 Questionnaire twice, with 7-days interval. Test-retest reliability and internal consistency were determined using Intraclass Correlation Coefficient analysis and Cronbach's alpha, respectively. Convergent validity of Hand10 was determined with Disabilities of the Arm, Shoulder and Hand Questionnaire using Pearson Correlation Coefficient analysis. RESULTS One hundred patients participated in the study. Cronbach's alpha value was 0.919, indicating an excellent internal consistency. Intraclass Correlation Coefficient value for test-retest reliability were found to be 0.890 that indicates a high reliability. Hand10 showed very good correlation with Disabilities of the Arm, Shoulder and Hand Questionnaire (r: 0.669). CONCLUSIONS The Turkish version of the Hand10 met set criteria of reliability and validity. As a result of this study, we determined that Hand10 is a useful instrument to measure upper extremity disorders in Turkish-speaking patients. It is recommended to be used in clinical settings and researches.
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Affiliation(s)
- Nurten Gizem Tore
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
| | - Zeynep Tuna
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Oguzhan Mete
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ahmet Gokkurt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Baris Seven
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Lattré T, Claeys K, Parmentier S, VAN Holder C. A Detailed Comparison of Preoperative Complaints in Severe Carpal Tunnel Syndrome versus Recurrent Carpal Tunnel Syndrome Using the Boston Carpal Tunnel Questionnaire. J Hand Surg Asian Pac Vol 2022; 27:98-104. [PMID: 35037583 DOI: 10.1142/s2424835522500060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The Boston Carpal Tunnel Questionnaire (BCTQ) has a symptom severity scale (SSS) with 11 questions and a functional status scale (FSS) with 8 questions. The final score for each scale is the sum divided by the number of questions and ranges between 1 and 5. A score of 1 indicates they have no complaints and 5 indicates high severity and functional loss. Unfortunately, this single digit score does not permit a detailed analysis of the symptoms and functional status. The aim of this study is to conduct an in-depth comparison of preoperative complaints using the BCTQ between patients with severe carpal tunnel syndrome (SCTS) and recurrent carpal tunnel syndrome (RCTS). Methods: This is a retrospective cohort study on the preoperative status of 37 patients with SCTS and 18 patients with RCTS using the BCTQ. The questions in the SSS and FSS were classified into four groups based on the responses of patients, namely a low complaint (LC) (1-1.99), moderate complaint (MC) (2-2.99), high complaint (HC) (3-3.99), and severe complaint (SC) (4-5) groups. The patients in the SCTS and RCTS groups were compared to find differences in age, gender, hand dominance, and responses to questions in the SSS and FSS. Results: The age of patients in the SCTS group (76.06 years) was significantly higher compared to the RCTS group (51.11 years). There was no significant difference between the two groups with regard to gender or hand dominance. The top question with SC or HC response in the SCTS group was problems in grasping small objects (SSS) and fastening buttons (FSS) and in the RCTS group was tingling in the hand (SSS) and difficulty with opening a jar (FSS). Conclusions: An in-depth analysis of the BCTQ allowed us to compare and understand differences in symptoms and function between patients with SCTS and RCTS. Level of Evidence: Level III (Therapeutic).
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Affiliation(s)
- Tom Lattré
- Departments of Plastic Surgery and Physical Rehabilitation, Ziekenhuis Waregem, Vijfseweg 150, Waregem, Belgium
| | - Kurt Claeys
- Campus Bruges, Department of Rehabilitation Sciences, Katholic University Leuven, Spoorwegstraat 12, Bruges, Belgium
| | - Steven Parmentier
- Departments of Plastic Surgery and Physical Rehabilitation, Ziekenhuis Waregem, Vijfseweg 150, Waregem, Belgium
| | - Carlo VAN Holder
- Departments of Plastic Surgery and Physical Rehabilitation, Ziekenhuis Waregem, Vijfseweg 150, Waregem, Belgium
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Using Carpal Tunnel Questionnaire in clinical practice: A systematic review of its measurement properties. J Hand Ther 2021; 33:493-506. [PMID: 32151499 DOI: 10.1016/j.jht.2019.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/09/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Carpal Tunnel Questionnaire (CTQ) is widely used for assessing condition-specific impairments in individuals with carpal tunnel syndrome (CTS) or for assessing outcomes after carpal tunnel surgery (carpal tunnel release [CTR]). A systematic review of its measurement properties can greatly facilitate its evidence-based use in clinical practice. The purpose of this study was to systematically locate, appraise, and synthesize the evidence concerning the reliability, responsiveness, validity, minimal detectable change (MDC), and minimal clinically important difference (MCID) for the CTQ and its scales. STUDY DESIGN This is a systematic review of measurement properties. METHODS Using predefined keywords, PubMed, CINAHL, PsychInfo, and ProQuest were searched to locate primary studies that assessed measurement properties of the CTQ. The methodological quality of the included studies was assessed using a standardized tool. Data concerning the measurement properties were extracted and synthesized. The pooled estimates for the indices of test-retest reliability, standard error of measurement, responsiveness, MDC, and MCID were calculated from the included studies. RESULTS A total of 34 articles were deemed eligible and included in this review. The methodological quality of these 34 studies was generally good. Most studies suggested that the CTQ and its scales had good test-retest reliability and internal consistency. However, few studies found that the Symptom Severity Scale had more than one factor. The responsiveness of the CTQ and its scales was excellent across the studies. The pooled estimates for the MDC90 and MCID for Symptom Severity Scale/Functional Status Scale were 0.72/0.79 and 1.05/1.13, respectively. DISCUSSION The results of this review support the use of CTQ and its scales in assessing conditions-specific impairments in individuals with CTS or after CTR. However, an effort should be made to review and modify the content of the symptom severity scale due to multiple reports challenging its unidimensional structure. CONCLUSIONS The totality of evidence emerging from this systematic review suggests that the CTQ and its scales provide reliable and valid estimate of impairments resulting from CTS or after CTR.
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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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Translation, cross-cultural and construct validity of the Dutch-Flemish PROMIS® upper extremity item bank v2.0. Qual Life Res 2020; 29:1123-1135. [PMID: 31894506 DOI: 10.1007/s11136-019-02388-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To develop a Dutch-Flemish translation of the PROMIS® upper extremity (PROMIS-UE) item bank v2.0, and to investigate its cross-cultural and construct validity as well as its floor and ceiling effects in patients with musculoskeletal UE disorders. METHODS State of the art translation methodology was used to develop the Dutch-Flemish PROMIS-UE item bank v2.0. The item bank and four legacy instruments were administered to 205 Dutch patients with musculoskeletal UE disorders visiting an orthopedic outpatient clinic. The validity of cross-cultural comparisons between English and Dutch patients was evaluated by studying differential item functioning (DIF) for language (Dutch vs. English) with ordinal logistic regression models and McFadden's pseudo R2-change of ≥ 2% as critical value. Construct validity was assessed by formulating a priori hypotheses and calculating correlations with legacy instruments. Floor/ceiling effects were evaluated by determining the proportion of patients who achieved the lowest/highest possible raw score. RESULTS Eight items showed DIF for language, but their impact on the test score was negligible. The item bank correlated, as hypothesized, moderately with the Dutch-Flemish PROMIS pain intensity item (Pearson's r = - 0.43) and strongly with the Disabilities of the Arm, Shoulder and Hand questionnaire, Subscale Disability/Symptoms (Spearman's ρ = - 0.87), the Functional Index for Hand Osteoarthritis (ρ = - 0.86), and the Michigan Hand Outcomes Questionnaire, Subscale Activities of Daily Living (ρ = 0.87). No patients achieved the lowest or highest possible raw score. CONCLUSIONS A Dutch-Flemish PROMIS-UE item bank v2.0 has been developed that showed sufficient cross-cultural and construct validity as well as absence of floor and ceiling effects.
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Töre NG, Oskay D. Validity and reliability study of the Turkish version of the Hand20 questionnaire. Turk J Med Sci 2019; 49:1243-1248. [PMID: 31291708 PMCID: PMC7018235 DOI: 10.3906/sag-1808-168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background/aim This study aimed to translate and validate the Turkish version of the Hand20 questionnaire. Materials and methods Patients who had upper extremity involvement and stable symptoms for the previous 4 weeks in their upper extremities were included in the study. Patients who were illiterate or used a splint during the day were excluded from the study. Participants completed the Turkish version of the Disabilities of the Arm, Shoulder, and Hand (DASH-T) questionnaire once and the final version of the Hand20 questionnaire twice in a 7-day interval. Internal consistency and reliability of the questionnaire was assessed. Moreover, correlations between Hand20 and DASH-T scores were analyzed using Spearman’s correlation coefficient. Results A total of 104 patients participated in the study. The Turkish version of the Hand20 met the set criteria of reliability and validity. Internal consistency (Cronbach’s alpha = 0.93) and test-retest reliability were excellent (r = 0.82). Hand20 showed a positive and statistically significant correlation with DASH-T (r = 0.76, P < 0.001). Conclusion The results showed that the Turkish version of the Hand20 had excellent test-retest reliability and validity. As a result of this study, it was determined that Hand20 was a valid and reliable instrument to measure the upper extremity disabilities of Turkish-speaking patients.
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Affiliation(s)
- Nurten Gizem Töre
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Iwatsuki K, Nishikawa K, Chaki M, Sato A, Morita A, Hirata H. Comparative responsiveness of the Hand 20 and the DASH-JSSH questionnaires to clinical changes after carpal tunnel release. J Hand Surg Eur Vol 2014; 39:145-51. [PMID: 23592539 DOI: 10.1177/1753193413485524] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study compared the responsiveness of the Hand 20 and the Japanese version of the disabilities of the arm, shoulder and hand (DASH-JSSH) questionnaires in carpal tunnel syndrome. The scores before and 3 months after surgery were used to calculate the standardized response mean and effect size. Of 57 patients enrolled in the study, 13 underwent open carpal tunnel release and 44 had endoscopic carpal tunnel release. The standardized response mean and the effect size of the Hand 20 scale were 0.60 and 0.54, respectively, and those of the disabilities of the arm, shoulder and hand scale were 0.39 and 0.36, respectively. Compared with the Disabilities of the Arm, Shoulder and Hand questionnaire, the Hand 20 questionnaire appears to have better responsiveness for assessing the effect of treatment by carpal tunnel release.
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Affiliation(s)
- K Iwatsuki
- 1Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Karsdorp PA, Nijst SE, Goossens ME, Vlaeyen JW. The role of current mood and stop rules on physical task performance: An experimental investigation in patients with work-related upper extremity pain. Eur J Pain 2012; 14:434-40. [DOI: 10.1016/j.ejpain.2009.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Revised: 07/12/2009] [Accepted: 07/12/2009] [Indexed: 01/30/2023]
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Jeon SH, Lee JH, Chung MS, Baek GH, Oh JH, Lee YH, Gong HS. Responsiveness of the Korean version of the disabilities of the arm, shoulder and hand questionnaire (K-DASH) after carpal tunnel release. Clin Orthop Surg 2011; 3:147-51. [PMID: 21629476 PMCID: PMC3095786 DOI: 10.4055/cios.2011.3.2.147] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 10/05/2010] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Korean version of the Disability of the Arm, Shoulder and Hand Questionnaire (K-DASH) was recently validated, but its responsiveness, which is the degree to which an instrument is sensitive to change, has not been thoroughly evaluated in a specific condition in Koreans. We evaluated the responsiveness of the K-DASH in a homogenous cohort of patients with carpal tunnel syndrome (CTS) and we compared it with that of the disease-specific Carpal Tunnel Questionnaire (CTQ). METHODS Fifty-six patients with CTS prospectively completed the K-DASH and CTQ before and 6 months after surgery. The responsiveness statistics were assessed for both the K-DASH and CTQ by using the standardized response mean (SRM) and the effect size (ES). Pearson correlation coefficients were calculated between the K-DASH and CTQ. RESULTS The SRM and ES of the K-DASH were all 0.8. The SRM of the symptom and function part of the CTQ was 1.5 and 1.1, and the ES was 1.5 and 1.1, respectively. The K-DASH had moderate correlations with the symptom and function parts of the CTQs, but the postoperative K-DASH had a weak correlation with the symptom part of the postoperative CTQ. CONCLUSIONS The K-DASH was found to have a large degree of responsiveness (SRM, ES ≥ 0.8) after carpal tunnel release in Korean patients with CTS, which is comparable to the other language versions of the DASH. Although it was less responsive than the CTQ, which is disease-specific, the region-specific K-DASH can be used as an effective outcome measurement tool for CTS, and especially for research that compares CTS with other upper limb conditions.
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Affiliation(s)
- Suk Ha Jeon
- Department of Orthopedic Surgery, National Medical Center, Seoul, Korea
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van de Meent H, Oerlemans M, Bruggeman A, Klomp F, van Dongen R, Oostendorp R, Frölke JP. Safety of "pain exposure" physical therapy in patients with complex regional pain syndrome type 1. Pain 2011; 152:1431-1438. [PMID: 21474244 DOI: 10.1016/j.pain.2011.02.032] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 02/14/2011] [Accepted: 02/14/2011] [Indexed: 02/07/2023]
Abstract
"Pain exposure" physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of pain-avoidance behavior without the use of specific CRPS-1 medication or analgesics. The aim of this study was to investigate primarily whether PEPT could be applied safely in patients with CRPS-1. Twenty patients with CRPS-1 were consecutively enrolled in the study after giving informed consent. The diagnosis of CRPS-1 was defined using the Bruehl and Harden/IASP diagnostic criteria. CRPS-1 was diagnosed between 3 and 18 months after the inciting event (trauma). According to a multiple single-case design (baseline [A1], treatment [B], follow-up [A2]), multiple baseline and follow-up measurements were performed to evaluate changes in CRPS signs and symptoms and to assess functional parameters. When comparing the baseline with the follow-up phase, patients improved significantly with respect to pain on the visual analogue scale (57%), pain intensity (48%), muscle strength (52%), arm/shoulder/hand disability (36%), 10-meter walking speed (29%), pain disability index (60%), kinesiophobia (18%), and the domains of perceived health change in the SF-36 survey (269%). Three patients initially showed increased vegetative signs but improved in all other CRPS parameters and showed good functional recovery at follow-up. We conclude that PEPT is a safe and effective treatment for patients with CRPS-1. A progressive-loading exercise program and management of pain-avoidance behavior without the use of specific medication ("pain exposure" physical therapy) is safe and effective for patients with complex regional pain syndrome.
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Affiliation(s)
- Hendrik van de Meent
- Department of Rehabilitation, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Orthopedic Surgery, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Scientific Institute for Quality of Healthcare, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Surgery, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Anesthesiology, Pain and Palliative Medicine, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Cross-cultural adaptation, validation, and reliability process of the Michigan Hand Outcomes Questionnaire in a Turkish population. J Hand Surg Am 2011; 36:486-92. [PMID: 21295925 DOI: 10.1016/j.jhsa.2010.11.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 11/09/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE The Michigan Hand Outcomes Questionnaire (MHQ) is a domain-specific questionnaire that was developed to be used as a standardized instrument capable of measuring outcomes for patients with all types of hand disorders. The purpose of this study was to develop the Turkish version of the MHQ and to examine whether it is a valid and reliable tool for assessing the outcomes in hand disorders. METHODS Translation and back-translation of the MHQ were performed, according to published guidelines. A total of 70 patients with hand complaints completed the final version of the MHQ and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire Turkish version (DASH-T) twice, on their first visit and after an interval of 7 days. Visual analog scale (VAS) results for pain intensity and grip strength measurements of the individuals were also taken in both assessments consecutively. RESULTS Translation and back-translation revealed no major difficulties. The Turkish version of the MHQ met set criteria of reliability and validity. The intraclass correlation coefficient of the test-retest reliability for the 6 subscales ranged from 0.79 to 0.96. The internal consistency of the MHQ, estimated by Cronbach's alpha, ranged from 0.85 to 0.96 for all subscale scores. There were high to moderate correlations between MHQ and DASH scores and VAS and grip strength scores of the injured side. CONCLUSIONS The Turkish version of the MHQ has excellent test-retest reliability and validity, and it is an adequate and useful instrument for measuring functional disability in hand disorders of Turkish-speaking patients.
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Rosales RS, Diez de la Lastra I, McCabe S, Ortega Martinez JI, Hidalgo YM. The relative responsiveness and construct validity of the Spanish version of the DASH instrument for outcomes assessment in open carpal tunnel release. J Hand Surg Eur Vol 2009; 34:72-5. [PMID: 19091735 DOI: 10.1177/1753193408094156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.
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Affiliation(s)
- R S Rosales
- Hand Surgery Unit and Institute for Research in Hand Surgery, G.E.C.O.T., Tenerife, Spain.
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