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Kämppä N, Hulkkonen S, Grahn P, Laaksonen T, Repo J. The construct validity and internal consistency of QuickDASH in pediatric patients with upper extremity fractures. Acta Orthop 2024; 95:192-199. [PMID: 38686529 PMCID: PMC11058482 DOI: 10.2340/17453674.2024.40181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/14/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND PURPOSE Investigation of treatment options in the pediatric population necessitates the use of valid patient-reported outcome measures (PROMs). We aimed to assess the construct validity and internal consistency of the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) in the pediatric population with upper extremity fractures treated both operatively and conservatively. PATIENTS AND METHODS QuickDASH, along with several reference PROMs and objective outcome measures, was obtained from 148 5- to 18-year-old patients with a humeral medial epicondyle fracture or a fracture of the distal forearm in a cross-sectional setting with a single follow-up visit. Spearman's rank correlation and linear regression models were used to assess convergent validity, exploratory factor analysis (EFA) to assess structural validity, and Cronbach's alpha to investigate internal consistency. RESULTS The direction and magnitude of correlation showed by QuickDASH with reference outcome measures was consistent and demonstrated good convergent validity. EFA indicated a 3-factor model with poor fit indices and structural validity remained questionable. Construct validity was considered acceptable overall. QuickDASH demonstrated good internal consistency with an acceptable Cronbach's alpha (α = 0.75). CONCLUSION QuickDASH demonstrated acceptable construct validity and good internal consistency and is thus a valid instrument, with some limitations, to assess disability and quality of life in pediatric patients with upper extremity fractures.
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Affiliation(s)
- Niko Kämppä
- Department of Hand Surgery, Helsinki University Hospital and University of Helsink.
| | - Sina Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki
| | - Petra Grahn
- Department of Pediatric Orthopedics and Traumatology, New Children's Hospital, HUS Helsinki University Hospital, University of Helsinki
| | - Topi Laaksonen
- Department of Pediatric Orthopedics and Traumatology, New Children's Hospital, HUS Helsinki University Hospital, University of Helsinki
| | - Jussi Repo
- Unit of Musculoskeletal Surgery, Department of Orthopedics and Traumatology, Tampere University Hospital and Tampere University, Finland
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Ager AL, Roy JS, Dubé MO, Cools AM, Borms D. Relationship between pain and proprioception among individuals with rotator cuff-related shoulder pain. J Hand Ther 2024; 37:224-233. [PMID: 38350810 DOI: 10.1016/j.jht.2023.10.007] [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: 07/12/2023] [Revised: 10/06/2023] [Accepted: 10/14/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Individuals with rotator cuff-related shoulder pain (RCRSP) have altered proprioception. The relationship between shoulder pain and proprioception is not well understood. PURPOSE This study aimed to investigate the relationship between shoulder pain and proprioception. STUDY DESIGN This was a cross-sectional comparative study. METHODS Twenty-two participants with RCRSP (mean age 27.6 ± 4.8 years) and 22 matched pain-free participants (23.4 ± 2.5 years) performed two upper limb active joint position sense tests: (1) the Upper Limb Proprioception Reaching Test (PRO-Reach; reaching toward seven targets) in centimeters and (2) Biodex System at 90% of maximum internal rotation in degrees. Participants performed three memorization and three reproduction trials blindfolded. The proprioception error (PE) is the difference between the memorized and estimation trials. Pain levels were captured pre- and post-evaluation (11-point Likert Numerical Pain Rating Scale). Relationships between PE and pain were investigated using independent t-tests and Spearman rank correlations. RESULTS Overall, 22.7% RCRSP participants indicated an increase in pain following the PRO-Reach (X̅ increase of 1.4 ± 1.5 points), while 59% did so with the Biodex (X̅ increase of 2.3 ± 1.8 points), reflecting a clinically important increase in pain. Weak-to-moderate correlations between pain and PEs were found with the Biodex (r = 0.39-0.53) and weak correlations with the PRO-Reach (r = -0.26 to 0.38). Concerning PEs, no significant differences were found between groups with the Biodex (p = 0.32, effect size d = -0.31 [-0.90 to 0.29]). The RCRSP participants demonstrated lower PEs with the PRO-Reach in elevation compared to pain-free participants (global X̅ = 4.6 ± 1.2 cm vs 5.5 ± 1.5 cm; superior 3.8 ± 2.1 cm vs 5.7 ± 2.9 cm; superior-lateral nondominant targets 4.3 ± 2.2 cm vs 6.1 ± 2.8 cm; p = 0.02-0.05, effect size d = 0.72-0.74 [0.12-1.3]). CONCLUSIONS Individuals with RCRSP demonstrated better upper limb proprioception in elevation, suggesting a change to interoception (sensory reweighting) in the presence of pain.
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Affiliation(s)
- Amanda L Ager
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
| | - Marc-Olivier Dubé
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.
| | - Ann M Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Dorien Borms
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Bastard C, Sandman E, Balg F, Patenaude N, Chapleau J, Rouleau D. Validity, reliability and responsiveness of the French translation of the Patient-Rated Wrist Evaluation Questionnaire (PRWE). Orthop Traumatol Surg Res 2024; 110:103549. [PMID: 36642404 DOI: 10.1016/j.otsr.2023.103549] [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: 06/27/2022] [Accepted: 10/12/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The patient-rated wrist evaluation questionnaire (PRWE) is a specific wrist questionnaire, developed in Canada that has been validated and proved reliable and sensitive. It assesses pain and function. Unfortunately, there was no validated French-language version. It is important that a translation should be methodologically rigorous, as both linguistic and cultural factors come into play. OBJECTIVE To produce a French-language version of the PRWE, culturally adapted to the French-speaking populations of Europe and North America. MATERIALS AND METHODS A validated protocol was used to produce a French-language version of the PRWE (PRWE-Fr) that would be culturally acceptable for the French-speaking populations of Europe and North America. Reliability and responsiveness analyses were performed and PRWE-Fr scores were compared to F-QuickDASH-D/S (French translation of short-form Disabilities of the Arm, Shoulder and Hand-Disability/Symptoms) scores to assess validity. RESULTS A French-language version of the PRWE (PRWE-Fr) was accepted by a multinational committee, then validated in 65 French-speaking subjects, divided into 2 groups for analyses. A strong positive correlation was found between PRWE-Fr and F-QuickDASH-D/S scores. Comparison of results between two PRWE-Fr sessions at a 1-week interval found a very strong correlation (ρ=0.93; r2=0.868; p<0.001). The intraclass correlation coefficient for total PRWE-Fr score demonstrated excellent reliability (ICC: 0.93; 95% CI: [0.859; 0.969]; p<0.001). Responsiveness analysis revealed greater sensitivity to change than for the F-QuickDASH-D/S (standardized response mean [SRM], 1.14 versus 1.04 respectively). DISCUSSION A French-language version of the PRWE was produced and validated for use in French-speaking populations. It should facilitate evaluation of results in French-speaking settings, collaboration in multinational studies and comparison between studies performed in different countries. LEVEL OF EVIDENCE II; Multicenter cohort study.
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Affiliation(s)
- Claire Bastard
- CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, C2095-5400, boulevard Gouin O, Montréal, QC, H4J 1C5, Canada; Centre Hospitalier Universitaire Henri Mondor, Créteil, France.
| | - Emilie Sandman
- CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, C2095-5400, boulevard Gouin O, Montréal, QC, H4J 1C5, Canada
| | - Frederic Balg
- CIUSSS-de-l'Estrie-CHUS, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Nicolas Patenaude
- CIUSSS-de-l'Estrie-CHUS, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Julien Chapleau
- CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, C2095-5400, boulevard Gouin O, Montréal, QC, H4J 1C5, Canada
| | - Dominique Rouleau
- CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, C2095-5400, boulevard Gouin O, Montréal, QC, H4J 1C5, Canada
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Pyörny J, Sletten IN, Jokihaara J. Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. BMC Musculoskelet Disord 2024; 25:86. [PMID: 38263085 PMCID: PMC10804815 DOI: 10.1186/s12891-024-07183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation. METHODS This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland-Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach's alpha coefficients and item-total correlations. RESULTS We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97-0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001). CONCLUSION QuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Joonas Pyörny
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Jarkko Jokihaara
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
- Center for Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland.
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Delamarre M, Leroy M, Barbarin M, Chantelot C, Saab M. Long-term clinical and radiological results after scaphoid non-union treatment: a retrospective study about 60 cases. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:507-515. [PMID: 37635175 DOI: 10.1007/s00590-023-03687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Scaphoid non-union treatment remains nonconsensual and is based on vascularized or non-vascularized bone grafting. This study aimed to evaluate with a long follow-up the functional, clinical, and radiological outcomes, reported complications and reoperations and studied non-union treatment prognostic factors. METHODS Patients who had undergone bone graft surgery for scaphoid non-union were retrospectively reviewed. The evaluated outcomes were pain, qDASH, PRWE and MWS scores, active range of motion, grip strength, union rate, scapholunate angle, carpal height, and presence of arthrosis. Complications and reinterventions were also reported. RESULTS This study included 60 scaphoid non-union treatments with a mean follow-up of 7.7 (1.5-20.3) years. Twenty (33.3%) non-unions were located at the proximal pole, including 6 (10%) with preoperative avascular necrosis (AVN). Union occurred in 51 patients (85%). The functional, clinical, and radiological results were good. The complication rate was 21.3% and the reintervention rate was 16.7%. Subgroup union rate analysis found no difference if the non-union is localized in the proximal pole or if there is AVN. CONCLUSION With a representative sample of the population and a long follow-up, we have found a good union rate, clinical and functional results regardless of the treatment method chosen. Scaphoid non-union treatment is still controversial and more studies are needed to accurate indications of each graft according to the patient and non-union characteristics. LEVEL OF EVIDENCE IV Retrospective cohort study.
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Affiliation(s)
- Morgane Delamarre
- Service d'Orthopédie 1, Hôpital Roger Salengro, rue Émile Laine, 59000, Lille, France
| | - Maxime Leroy
- Statistics, Economic Evaluation, Data-Management (SEED), CHU Lille, 59037, Lille Cedex, France
| | - Maxime Barbarin
- Service d'Orthopédie 1, Hôpital Roger Salengro, rue Émile Laine, 59000, Lille, France
| | - Christophe Chantelot
- Service d'Orthopédie 1, Hôpital Roger Salengro, rue Émile Laine, 59000, Lille, France
| | - Marc Saab
- Service d'Orthopédie 1, Hôpital Roger Salengro, rue Émile Laine, 59000, Lille, France.
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Stirling PHC, McEachan JE, Rodrigues JN, Harrison CJ. Improving the structural validity of the QuickDASH questionnaire: Exploratory factor analysis and structural equation modelling in 1798 patients with carpal tunnel syndrome. J Hand Ther 2023; 36:523-527. [PMID: 36914493 DOI: 10.1016/j.jht.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 03/16/2023]
Abstract
STUDY DESIGN Retrospective cohort. BACKGROUND The QuickDASH is a commonly used questionnaire for the assessment of carpal tunnel patients, although it is unclear whether the questionnaire has suitable structural validity PURPOSE: This study aimed to evaluate the structural validity of the QuickDASH patient-reported outcome measure (PROM), when used in CTS, through exploratory factor analysis (EFA) and structural equation modelling (SEM). METHODS Between 2013 and 2019, we recorded preoperative QuickDASH scores of 1916 patients undergoing carpal tunnel decompressions at a single unit. One hundred and eighteen patients with incomplete datasets were excluded leaving a final study group of 1798 patients with complete data. EFA was undertaken using the R statistical computing environment. We then conducted SEM in a random sample of 200 patients. Model fit was assessed using the chi-square (χ2) test, comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA) and standardized root mean square residuals (SRMR). A second "validation" SEM analysis was undertaken by repeating the analysis with a separate sample of 200 randomly-selected patients. RESULTS EFA revealed a 2-factor model: items 1-6 represented the first factor ("function") and items 9-11 measured a different factor ("symptoms"). SEM demonstrated excellent fit (χ2 p value 0.167, CFI 0.999, TLI 0.999, RMSEA 0.032, SRMR 0.046) and this was supported in our "validation" sample. CONCLUSIONS This study demonstrates that the QuickDASH PROM measures 2 distinct factors in CTS. This is comparable with the findings of a previous EFA that assessed the full-length Disabilities of the Arm, Shoulder and Hand PROM in patients with Dupuytren's disease.
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Affiliation(s)
- Paul H C Stirling
- Queen Margaret Hospital, Dunfermline, Fife, UK; Fife Virtual Hand Clinic, Dunfermline, Fife, UK.
| | - Jane E McEachan
- Queen Margaret Hospital, Dunfermline, Fife, UK; Fife Virtual Hand Clinic, Dunfermline, Fife, UK.
| | - Jeremy N Rodrigues
- Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.
| | - Conrad J Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Maximen J, Rossetti A, Vallée N, DE Geyer A, Dreano T, Ropars M. Fractures of the fifth metacarpal neck treated by syndactyly: functional and quality of life outcomes of a series of 39 patients. Acta Orthop Belg 2023; 89:225-231. [PMID: 37924538 DOI: 10.52628/89.2.11778] [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: 11/06/2023]
Abstract
The management of the fractures of the fifth metacarpal neck is still debated between surgical, orthopedic, and functional treatments. The main objective of our study was to report the functional results at two, six, and twelve weeks of patients treated with syndactyly for fifteen days for a fracture of the neck of the fifth metacarpal and to determine if these results were compatible with a short-term medical follow-up and if they allowed for a quick return to work. Thirty-nine patients were retrospectively included. Functional results and their variations were analyzed at two, six, and twelve weeks using self-questionnaires filled out during consultation (VAS scores, QuickDASH, EuroQol-5D-5L, and EuroQol- 5D-VAS). The duration of work leave was extracted from medical records. Two weeks after the trauma, patients mostly had a very moderate impact of their fracture on their daily life with an average VAS of 4.2±1, QuickDASH of 42.2±20.9, and EuroQol-5D-VAS of 78±11. QuickDASH and EuroQol-5D-VAS scores showed significant improvement between two and twelve weeks of follow-up, decreasing from 42.2±20.9 to 2.1±6 and from 78±11 to 96±6, respectively (p<0.0001). The dimensions of common activities, pain, and autonomy had the most patients in the "moderate impairment" subgroup at two weeks. Only the dimension of common activities still had 21% of patients moderately impacted. Twenty-five patients returned to work at an average of 21.8±1.5 days. Syndactyly treatment offers good functional results at two weeks that are confirmed during follow-up, compatible with reduced medical follow-up and early return to work.
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Daste C, Mihoubi F, Roren A, Dumitrache A, Carlier N, Benghanem S, Ruttimann A, Mira JP, Pène F, Roche N, Seror P, Nguyen C, Rannou F, Drapé JL, Lefèvre-Colau MM. Early shoulder-girdle MRI findings in severe COVID-19-related intensive care unit-acquired weakness: a prospective cohort study. Eur Radiol 2023:10.1007/s00330-023-09468-5. [PMID: 36912923 PMCID: PMC10010198 DOI: 10.1007/s00330-023-09468-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 12/23/2022] [Accepted: 01/22/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To describe clinical and early shoulder-girdle MR imaging findings in severe COVID-19-related intensive care unit-acquired weakness (ICU-AW) after ICU discharge. METHODS A single-center prospective cohort study of all consecutive patients with COVID-19-related ICU-AW from November 2020 to June 2021. All patients underwent similar clinical evaluations and shoulder-girdle MRI within the first month and then 3 months (± 1 month) after ICU discharge. RESULTS We included 25 patients (14 males; mean [SD] age 62.4 [12.5]). Within the first month after ICU discharge, all patients showed severe proximal predominant bilateral muscular weakness (mean Medical Research Council total score = 46.5/60 [10.1]) associated with bilateral, peripheral muscular edema-like MRI signals of the shoulder girdle in 23/25 (92%) patients. At 3 months, 21/25 (84%) patients showed complete or quasi-complete resolution of proximal muscular weakness (mean Medical Research Council total score > 48/60) and 23/25 (92%) complete resolution of MRI signals of the shoulder girdle, but 12/20 (60%) patients experienced shoulder pain and/or shoulder dysfunction. CONCLUSIONS Early shoulder-girdle MRI findings in COVID-19-related ICU-AW included muscular edema-like peripheral signal intensities, without fatty muscle involution or muscle necrosis, with favorable evolution at 3 months. Precocious MRI can help clinicians distinguish critical illness myopathy from alternative, more severe diagnoses and can be useful in the care of patients discharged from intensive care with ICU-AW. KEY POINTS • We describe the clinical and shoulder-girdle MRI findings of COVID-19-related severe intensive care unit-acquired weakness. • This information can be used by clinicians to achieve a nearly specific diagnosis, distinguish alternative diagnoses, assess functional prognosis, and select the more appropriate health care rehabilitation and shoulder impairment treatment.
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Affiliation(s)
- Camille Daste
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur Et Des Pathologies du Rachis, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004, Paris, France
| | - Fadila Mihoubi
- INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Radiologie Ostéo-Articulaire, 75014, Paris, France
| | - Alexandra Roren
- AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur Et Des Pathologies du Rachis, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004, Paris, France
| | - Alina Dumitrache
- AP-HP. Centre-Université de Paris Cité, Hôpital Corentin Celton, Service de Rééducation Et de Réadaptation, 92130, Issy-Les-Moulineaux, France
| | - Nicolas Carlier
- AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Pneumologie, 75014, Paris, France
| | - Sarah Benghanem
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Médecine Intensive Et Réanimation, 75014, Paris, France.,Neurophysiology Department, GHU Psychiatrie Et Neurosciences, Sainte Anne Hospital, 75014, Paris, France
| | - Aude Ruttimann
- AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Médecine Intensive Et Réanimation, 75014, Paris, France
| | - Jean-Paul Mira
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Médecine Intensive Et Réanimation, 75014, Paris, France
| | - Frédéric Pène
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Médecine Intensive Et Réanimation, 75014, Paris, France.,Institut Cochin, INSERM U1016, CNRS UMR8104, 75006, Paris, France
| | - Nicolas Roche
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Pneumologie, 75014, Paris, France
| | - Paul Seror
- Laboratoire d'électroneuromyographie, 146 Av Ledru Rollin, 75011, Paris, France
| | - Christelle Nguyen
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur Et Des Pathologies du Rachis, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire Et Biomarqueurs (T3S), Centre Universitaire Des Saints-Pères, 75006, Paris, France
| | - François Rannou
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur Et Des Pathologies du Rachis, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire Et Biomarqueurs (T3S), Centre Universitaire Des Saints-Pères, 75006, Paris, France
| | - Jean-Luc Drapé
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004, Paris, France.,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Radiologie Ostéo-Articulaire, 75014, Paris, France
| | - Marie-Martine Lefèvre-Colau
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France. .,AP-HP. Centre-Université de Paris Cité, Hôpital Cochin, Service de Rééducation Et de Réadaptation de L'Appareil Locomoteur Et Des Pathologies du Rachis, 27, Rue du Faubourg Saint-Jacques, 75014, Paris, France. .,INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004, Paris, France.
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Blaquière R, Rousvoal A, Delgove A, Belaroussi Y, Michot A. [Morbidity and quality of life following breast reconstruction by autologous latissimus dorsi, muscle sparing and perforator flaps]. ANN CHIR PLAST ESTH 2023; 68:26-34. [PMID: 36028410 DOI: 10.1016/j.anplas.2022.07.015] [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: 06/15/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Morbidity following autologous latissimus dorsi flap (ALD), muscle sparing latissimus dorsi flap (MSLD) and thoracodorsal artery perforator flap (TAP) is controversial. The purpose of this study was to measure morbity using Quick Dash at 1 month and 1 year following breast reconstruction with one of these three flaps. The second objective was the evaluation of quality of life using Breast-Q. PATIENTS AND METHOD Thirty four consecutive patients who had undergone breast reconstruction were included in this monocentric and prospective study: 10 patients in the ALD group, 12 patients in the MSLD group and 12 patients in the TAP group. RESULTS At 1 month and 1 year following surgery, the variation of Quick Dash was 13,63 and 2,38 in the ALD group, 3,41 and -1,13 in the MSLD group and 5,69 and 0 in the TAP group. Satisfaction whith breasts, psychosocial, sexual and chest well-being were higher in the ALD group. Satisfaction with back was higher in the MSLD and TAP groups. Back and shoulder well-being was comparable regardless of the flap. Seroma occurrence was very rare in case of TAP, rare and not abundant in case of MSLD and frequent in case of ALD. CONCLUSION This study appears to confirm that immediate morbidity is less important with MSLD or TAP than ALD. Hoewever at one year following surgery, morbity seems to be comparable with the 3 flaps. Patients satisfaction seems to be higher with ALD except for the aspect of the back.
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Affiliation(s)
- R Blaquière
- Service de chirurgie plastique, reconstructrice et esthétique, CHU de Bordeaux, place Amélie Raba Léon, 33000 Bordeaux, France.
| | - A Rousvoal
- Nouvelle Clinique Bel-Air, 138, avenue de la République, 33200 Bordeaux, France
| | - A Delgove
- Service de chirurgie plastique, reconstructrice et esthétique, CHU de Bordeaux, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Y Belaroussi
- Service de chirurgie thoracique, CHU de Haut-Lévèque, avenue Magellan, 33600 Pessac, France
| | - A Michot
- Institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux, France
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Abbot S, Proudman S, Sim YP, Williams N. Psychometric properties of patient-reported outcomes measures used to assess upper limb pathology: a systematic review. ANZ J Surg 2022; 92:3170-3175. [PMID: 35959939 PMCID: PMC10087017 DOI: 10.1111/ans.17973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/18/2022] [Accepted: 07/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND With the continued development of patient-centred healthcare models, patient-reported outcome measures (PROMs) are increasingly used to evaluate outcomes in patients with upper limb pathology. The aim was to identify valid, reliable and responsive PROMs used to assess outcomes following upper limb pathology, and ascertain how their psychometric properties had been established. A secondary aim was to identify PROMs that have been validated to assess upper limb pathology in the paediatric population. METHODS A review of the Medline and EMBASE database was performed. Articles that analysed the validity of an established PROM used for upper limb pathology were included. Extracted study data included: author, country, PROM(s) investigated, year of publication, study type, sample size, demographics and duration of follow-up. RESULTS Twenty-five articles were included, which together investigated the psychometric properties of 23 different PROMs that have been used to assess outcomes in adults following upper limb pathology. No study evaluated the psychometric properties of PROMs used in the paediatric population. Among PROMs that have been used in adults, the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) had strong content- and construct-validity, reliability and responsiveness in comparison to others. CONCLUSION There are currently no studies that have analysed the content validity of PROMs used to assess upper limb pathology in the paediatric population. Prospective studies are required for the development of PROMs that can be utilized in children to assess upper limb pathology.
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Affiliation(s)
- Samuel Abbot
- Department of Orthopaedics and Trauma, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.,Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Orthopaedics and Trauma, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Susanna Proudman
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Yih Ping Sim
- Department of Orthopaedics and Trauma, Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - Nicole Williams
- Department of Orthopaedics and Trauma, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Centre for Orthopaedic and Trauma Research, University of Adelaide, South Australia, Australia
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11
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Bouteille C, Saade F, Barret H, Loisel F, Obert L. Le devenir du ciment phosphocalcique dans les cures d’enchondromes des phalanges et métacarpiens. Une étude rétrospective de 13 cas. ANN CHIR PLAST ESTH 2022:S0294-1260(22)00179-0. [DOI: 10.1016/j.anplas.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022]
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12
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Fouasson-Chailloux A, Daley P, Menu P, Gadbled G, Bouju Y, Gautier G, Pomares G, Dauty M. Use of hand hydraulic dynamometers as an overall evaluation of the upper-limb weakness in patients with thoracic outlet syndrome. Front Neurol 2022; 13:919312. [PMID: 36046630 PMCID: PMC9420998 DOI: 10.3389/fneur.2022.919312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/01/2022] [Indexed: 02/02/2023] Open
Abstract
Patients with neurogenic thoracic outlet syndrome report pain and upper-limb weakness. They complain about weakness occurring on the entire upper-limb, especially at the hand and the shoulder levels. Hydraulic dynamometers can reliably assess the strength of the hand, and isokinetic shoulder testing can provide accurate and reliable evaluations of the rotators strength. Yet, isokinetic proximal assessment needs expensive tools, whereas hydraulic hand dynamometers are cheap and easy to use. We aimed to assess the correlation between the isokinetic shoulder strength and the hand grip and the key pinch strength. The grip strength was evaluated with a hydraulic hand dynamometer and the key pinch with a pinch gauge. Isokinetic rotators strength tests were performed using a Humac Norm® dynamometer at 60 and 180°/s. One-hundred and thirty patients had been included, 72% of women, mean age of 39.8 ± 9.5. Symptomatic hands presented a strength deficit of 12.2% on the grip (p < 0.0001) and 10% on the key pinch (p = 0.01). Isokinetic strength was lower on the symptomatic shoulders at 60 and 180°/s concerning medial rotators [−10.3 and −8.8%, respectively (p = 0.02)] and lateral rotators [−10.8 and −10%, respectively (p = 0.04 and p = 0.03)]. There was a moderate correlation between the grip strength of the symptomatic upper-limbs and the isokinetic rotators strength (p < 0.001). The key pinch strength was moderately correlated to the isokinetic medial and lateral rotators strength at 60°/s (p < 0.001). Hand dynamometers could prove useful during medical consultations or in outpatient management to assess upper-limb overall weakness, but isokinetic measurement remains the gold standard for a precise evaluation.
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Affiliation(s)
- Alban Fouasson-Chailloux
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes Université, Nantes, France
- IRMS, Institut Régional de Médecine du Sport, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Nantes Université, ONIRIS, Nantes, France
- *Correspondence: Alban Fouasson-Chailloux
| | - Pauline Daley
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes Université, Nantes, France
| | - Pierre Menu
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes Université, Nantes, France
- IRMS, Institut Régional de Médecine du Sport, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Nantes Université, ONIRIS, Nantes, France
| | - Guillaume Gadbled
- Clinique Chirurgicale Orthopédique et Traumatologique, CHU Nantes, Nantes Université, Nantes, France
| | - Yves Bouju
- Institut Main Atlantique, Saint Herblain, France
| | - Giovanni Gautier
- Explorations Fonctionnelles Vasculaires, CHU Nantes, Nantes Université, Nantes, France
| | - Germain Pomares
- Institut Européen de la Main, Hopital Kirchberg, Luxembourg, Luxembourg
| | - Marc Dauty
- Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, Nantes, France
- Service de Médecine du Sport, CHU Nantes, Nantes Université, Nantes, France
- IRMS, Institut Régional de Médecine du Sport, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Nantes Université, ONIRIS, Nantes, France
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13
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Ponce-Fuentes F, Cuyul-Vásquez I, Bustos-Medina L, Fuentes J. Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial. Physiother Theory Pract 2022:1-10. [PMID: 35412432 DOI: 10.1080/09593985.2022.2061394] [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: 10/18/2022]
Abstract
OBJECTIVE To compare the effectiveness of pain neuroscience education (PNE) versus biomedical education (BME) in a rehabilitation program following arthroscopic rotator cuff repair (ARCR) in patients with chronic shoulder pain. METHODS Twenty-nine patients who participated in a rehabilitation program were randomly assigned to either an experimental PNE group (N = 16) or a control BME group (N = 13). Measurements included pain intensity at rest and in movement, pain catastrophizing, kinesiophobia, disability and health-related quality of life (HRQoL). Outcomes were evaluated at baseline and at 4 and 8 weeks after the intervention. RESULTS A main effect for time was observed for: intensity of pain at rest (p < .01); pain with movement (p < .01); pain catastrophizing (p < .01); kinesiophobia (p < .01); disability (p < .01); and HRQoL (p < .01). No group interactions were significant for any variable, except for pain with movement, which favored the PNE group (p = .03). Large effect sizes (ranging from d = 0.79 to d = 2.65) were found for both interventions in all outcomes. CONCLUSION A rehabilitation program including either PNE or BME are equally effective in improving rest pain, pain catastrophizing, kinesiophobia, disability, and HRQoL in patients after ARCR, except for pain at movement in favor of the PNE group. The inclusion of PNE in the rehabilitation program appears to lead to clinically meaningful improvements in pain at rest in short term when treating patients with ARCR.
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Affiliation(s)
| | - Iván Cuyul-Vásquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Luis Bustos-Medina
- Gestión para la Salud (CIGES), Facultad de Medicina, Universidad de La FronteraDepartamento de Salud Pública, Centro de Investigación y , Temuco, Chile
| | - Jorge Fuentes
- Clinical Research Lab, Department of Physical Therapy, Catholic University of Maule, Talca, Chile.,Faculty of Rehab Medicine, University of Alberta, Edmonton,AB, Canada
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14
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Santoso G, Sugiharto S, Mughni A, Ammarullah MI, Bayuseno AP, Jamari J. Chairless Chairs for Orthopedic Surgery Purpose – A Literature Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further explored to close the existing research gap.
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15
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Ruterana P, Abitbol A, Castel LC, Gregory T. WALANT technique versus locoregional anesthesia in the surgical management of metacarpal and phalangeal fractures: Lessons from the Covid-19 crisis. HAND SURGERY & REHABILITATION 2021; 41:220-225. [PMID: 34923166 PMCID: PMC8675121 DOI: 10.1016/j.hansur.2021.12.002] [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: 09/13/2021] [Revised: 11/21/2021] [Accepted: 12/03/2021] [Indexed: 10/27/2022]
Abstract
Wide Awake Local Anesthesia No Tourniquet (WALANT) is an anesthetic method which uses a local injection of anesthetic and epinephrine, avoiding use of a tourniquet. During the COVID-19 pandemic, human and logistic resources had to be reorganized, and WALANT ensured resilience in our department to maintain access to surgical care. The objective of the present study was to compare hand function recovery 3 months after surgery for unstable metacarpal or phalangeal fracture under regional anesthesia versus WALANT. From November 2020 to May 2021, 36 patients presenting a metacarpal or phalangeal fracture requiring surgical treatment were included in a single-center study in a university hospital center. Nineteen patients underwent surgery under locoregional anesthesia with tourniquet, and 17 under WALANT. The main endpoint was functional recovery at 3 months on QuickDASH score. Need for complementary anesthesia, surgery duration, analgesic consumption, reintervention rate, and patient satisfaction were also assessed. There was no significant difference between groups in functional recovery at 3 months or on the secondary endpoints. In the COVID-19 context, WALANT proved to be a safe and effective method in hand fracture surgery, ensuring access to surgical care. It should be included in surgical training to optimize day-to-day surgical care and face future crises.
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Affiliation(s)
- P Ruterana
- Service de Chirurgie Orthopédique, Hôpital Avicenne - Université Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000 Bobigny, France; Université de Paris, 45 Rue des Saints-Pères, 75006 Paris, France.
| | - A Abitbol
- Service de Chirurgie Orthopédique, Hôpital Avicenne - Université Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000 Bobigny, France; Université de Paris, 45 Rue des Saints-Pères, 75006 Paris, France
| | - L-C Castel
- Service de Chirurgie Orthopédique, Hôpital Avicenne - Université Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000 Bobigny, France; Université de Paris, 45 Rue des Saints-Pères, 75006 Paris, France
| | - T Gregory
- Service de Chirurgie Orthopédique, Hôpital Avicenne - Université Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000 Bobigny, France; MOVEO Institute, University Paris Seine-Saint-Denis, 11 Rue de Cambrai, Immeuble 028, 75019 Paris, France
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16
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Measurement properties of the Nepali version of the Quick-DASH in patients with shoulder pain. Musculoskelet Sci Pract 2021; 56:102437. [PMID: 34416559 DOI: 10.1016/j.msksp.2021.102437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 07/31/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the measurement properties of the Nepali version of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH-NP). MATERIALS AND METHODS The Nepali DASH and Shoulder Pain and Disability Index (SPADI) were completed at baseline assessment, and again at follow-up with the Nepali Global Rating of Change (GROC-NP) score. The 11 items of the QuickDASH-NP were extracted from the DASH and tested for confirmatory factory analysis (CFA), exploratory factor analysis (EFA), internal consistency (α), item-total correlation (ITC), test-retest reliability (ICC), measurement errors, hypothesis testing (correlation with DASH and SPADI) and responsiveness (effect size-ES, standardised response mean-SRM). RESULTS A total of 156 participants completed questionnaires at baseline and 121 at follow-up with all questionnaires valid (no participant leaving more than one question blank). CFA suggested a poor fit for the single-factor model. The EFA demonstrated two factors with acceptable internal consistency (α = 0.79 and 0.75) for each factor. The test-retest reliability was excellent (ICC = 0.94; 95%CI:0.92-0.98), correlation was positive and very strong with the DASH-NP (r = 0.96) and strong with the SPADI-NP (r = 0.81). The Standard Error of Measurement was 2.83 and Smallest Detectable Change 7.84/100. The ES and SRM were moderate to high. CONCLUSIONS The QuickDASH-NP is reliable, valid, and able to detect change in shoulder symptoms among Nepali participants. It offers a short, easy to complete self-reporting tool for clinical use and research.
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17
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Daley P, Pomares G, Menu P, Gadbled G, Dauty M, Fouasson-Chailloux A. Shoulder Isokinetic Strength Deficit in Patients with Neurogenic Thoracic Outlet Syndrome. Diagnostics (Basel) 2021; 11:diagnostics11091529. [PMID: 34573871 PMCID: PMC8465876 DOI: 10.3390/diagnostics11091529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Neurogenic thoracic outlet syndrome (NTOS) is an impairing painful condition. Patients usually report upper-limb pain, weakness and paresthesia. Shoulder weakness is frequently reported but has never been described with objective strength evaluation. We aimed to compare isokinetic shoulder strength between patients with NTOS and healthy controls. Patients and controls were prospectively evaluated with an isokinetic strength test at 60 and 180°/s, and an endurance test (30 repetitions at 180°/s) of the shoulder rotators. Patients were functionally assessed with QuickDASH questionnaires. One hundred patients and one hundred healthy subjects were included. Seventy-one percent of patients with NTOS were females with a mean age of 39.4 ± 9.6. They were compared to controls, 73% females and the mean age of 38.8 ± 9.8. Patients' mean QuickDASH was 58.3 ± 13.9. Concerning the peak of strength at 60°/s, the symptomatic limbs of patients with NTOS had significantly 21% and 29% less strength than the control limbs for medial and lateral rotators, respectively (p ≤ 0.001). At 180°/s, the symptomatic limbs had significantly 23% and 20% less strength than the controls for medial and lateral rotators, respectively (p ≤ 0.001). The symptomatic limbs had significantly 45% and 30% less endurance than the controls for medial and lateral rotators, respectively (p ≤ 0.001). These deficits were correlated to the QuickDASH. Patients with NTOS presented a significant deficit of strength and endurance of the shoulder rotators correlated to disability. This highlights the interest in upper-limb strength evaluation in the diagnostic process and the follow-up of NTOS.
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Affiliation(s)
- Pauline Daley
- CHU Nantes, Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France
| | - Germain Pomares
- Institut Européen de la Main, 2540 Luxembourg, Luxembourg;
- Medical Training Center, Hopital Kirchberg, 2540 Luxembourg, Luxembourg
| | - Pierre Menu
- CHU Nantes, Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042 Nantes, France
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
| | - Guillaume Gadbled
- CHU Nantes, Clinique Chirurgicale Orthopédique et Traumatologique, 44093 Nantes, France;
| | - Marc Dauty
- CHU Nantes, Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042 Nantes, France
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
| | - Alban Fouasson-Chailloux
- CHU Nantes, Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, 44042 Nantes, France
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
- Correspondence: ; Tel.: +33-240-846-211
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18
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Regas I, Saizonou I, Pichonnat M, Menez C, Menu G, El Rifai S, Echalier C, Boyer E, Loisel F, Aubry S, Obert L, Feuvrier D, Pluvy I. Influence of the level of arterial resection on the replanting and revascularization results in hand surgery: prospective study over 22 months. HAND SURGERY & REHABILITATION 2021; 40:660-669. [PMID: 34111576 DOI: 10.1016/j.hansur.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022]
Abstract
The objective of this work was to assess whether the injury mechanisms are responsible for histological arterial lesions. This prospective single-center study included adults with wrist or hand arterial injury. Arterial resection of at least 2 mm from the proximal and distal stumps was performed before the arterial anastomosis. Histological analysis of the arterial stumps was performed. An ultrasound was performed 1 month postoperatively to check arterial patency. A clinical and functional evaluation was done at 1 month postoperative, then every 3 months. From 2018 to 2020, 46 patients were included with a maximum follow-up of 13 months. There were 35 cuts, 2 crush injuries, 8 amputation and 1 blast injury. Macroscopically, 37% of the margins were considered damaged. Histological analysis showed significant damage in 59% of the sections (27 out of 46 patients) with 50% for crush injury, 55% for cuts by mechanical tool, 62% for cuts by power tool, 62% for amputations and 100% for blasts. The failure rate was 9%: 2 replantations and 2 asymptomatic thromboses diagnosed by ultrasound. Postoperative pain on VAS was 1.75/10, range of motion was 87%, Quick DASH was 8%, SF36 PCS was 69% and SF36 MCS was 70%. Factors influencing the success or failure of anastomosis were the mechanism of injury (p = 0.02), associated nerve damage (p = 0.014) and length of proximal arterial cut (p = 0.046). Histological arterial lesions seem to correlate with the injury mechanism. Cuts caused by glass or crush injuries do not seem to require arterial resections of more than 2 mm. A continuation of the study with a larger number of subjects may generate statistically significant results.
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Affiliation(s)
- I Regas
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France.
| | - I Saizonou
- Service d'Anatomo-Pathologie, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France
| | - M Pichonnat
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - C Menez
- Service d'Orthopédie et de Traumatologie, Hôpital Chaumont, 17 Avenue des Etats Unis, 52000 Chaumont, France
| | - G Menu
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - S El Rifai
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France
| | - C Echalier
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - E Boyer
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - F Loisel
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - S Aubry
- Service d'Imagerie Ostéoarticulaire, Radiologie Interventionnelle, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France
| | - L Obert
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
| | - D Feuvrier
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France
| | - I Pluvy
- Service d'Orthopédie, de Traumatologie, de Chirurgie Plastique, Reconstructrice et Assistance Main, CHU de Besançon, 3 Boulevard Alexandre Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France; Nanomédecine, Imagerie, Thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences Médicales et Pharmaceutiques, 19 Rue Ambroise Paré, 25030 Besançon, France
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19
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Alnahdi AH. Validity and reliability of the Arabic quick disabilities of the arm, Shoulder and Hand (QuickDASH-Arabic). Musculoskelet Sci Pract 2021; 53:102372. [PMID: 33780697 DOI: 10.1016/j.msksp.2021.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The QuickDASH is a commonly used upper extremity region-specific outcome measure assessing activity limitation and symptoms. The Arabic version of QuickDASH is available in the official outcome measure website, but no prior studies have examined its psychometric properties. OBJECTIVE To examine the psychometric properties of the Arabic QuickDASH in patients with upper extremity musculoskeletal disorders. METHODS Participants with upper extremity musculoskeletal disorders were recruited (N = 109) using convenience sampling and completed the Arabic QuickDASH, Numeric Pain Rating Scale, Global Assessment of Function, and RAND 36-item Health Survey in two testing sessions (2-7 days apart). The Arabic QuickDASH structural validity, internal consistency, floor and ceiling effect, test-retest reliability, measurement error, and construct validity were examined. RESULTS Exploratory factor analysis indicated a one factor underlying the Arabic QuickDASH. The Arabic QuickDASH had Cronbach's alpha of 0.90 and ICC2.1 of 0.91 indicating excellent internal consistency and test-retest reliability. None of the participant reached the minimum or the maximum score. The scale's standard error of measurement and minimal detectable change were 7.0 and 16.3. Five out of the six construct validity predefined hypotheses were supported by the results. CONCLUSION The Arabic QuickDASH is a unidimensional scale with excellent internal consistency, test-retest reliability and acceptable measurement error. The Arabic Quick DASH is a valid and reliable outcome measure that can be used in Arabic speaking countries with Arabic patients suffering from various upper extremity activity limitations and symptoms.
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Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical, Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
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Fouasson-Chailloux A, Daley P, Menu P, Louguet B, Gadbled G, Bouju Y, Abraham P, Dauty M. Hand Strength Deficit in Patients with Neurogenic Thoracic Outlet Syndrome. Diagnostics (Basel) 2021; 11:diagnostics11050874. [PMID: 34068245 PMCID: PMC8153137 DOI: 10.3390/diagnostics11050874] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022] Open
Abstract
Neurogenic thoracic outlet syndrome (NTOS) is a chronic painful and disabling condition. Patients complain about upper-limb paresthesia or weakness. Weakness has been considered one of the diagnostic criteria of NTOS, but objective comparisons to healthy controls are lacking. We compared the grip and the key pinch strengths between NTOS patients and healthy controls. Grip strength was evaluated with a hydraulic hand dynamometer and the key pinch with a pinch gauge. All the patients with NTOS completed a QuickDASH. We included prospectively 85 patients with NTOS, 73% female and 27% male. The mean age was 40.4 ± 9.6. They were compared to 85 healthy subjects, 77.6% female and 22.4% male. Concerning the grip, symptomatic hands of NTOS patients had significantly 30% less strength compared to control hands (p ≤ 0.001), and 19% less strength compared to asymptomatic hands (p = 0.03). Concerning the key pinch, symptomatic hands of patients with NTOS had significantly 19.5% less strength compared to control hands (p ≤ 0.001). Grip and key pinch strengths had a significant correlation with the QuickDASH (r = −0.515 and r = −0.403, respectively; p ≤ 0.001). Patients with NTOS presented an objective hand strength deficit compared to healthy controls. This deficit was significantly correlated to the upper-limb disability. These findings confirm the interest of hand strength evaluation in the diagnostic process of patients with NTOS.
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Affiliation(s)
- Alban Fouasson-Chailloux
- CHU Nantes, Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France;
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, F-44042 Nantes, France
- Correspondence: ; Tel.: +33-240-846-211
| | - Pauline Daley
- CHU Nantes, Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France;
| | - Pierre Menu
- CHU Nantes, Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France;
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, F-44042 Nantes, France
| | - Bastien Louguet
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France;
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
| | - Guillaume Gadbled
- CHU Nantes, Clinique Chirurgicale Orthopédique et Traumatologique, 44093 Nantes, France;
| | - Yves Bouju
- Institut Main Atlantique, 44800 Saint Herblain, France;
| | - Pierre Abraham
- Sports Medicine Department, University Hospital of Angers, 49100 Angers, France;
- Vascular Medicine Department, University Hospital of Angers, 49100 Angers, France
- Mitovasc, UMR CNRS 6015 INSERM 1083, LUNAM University, 49100 Angers, France
| | - Marc Dauty
- CHU Nantes, Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, 44093 Nantes, France; (P.D.); (P.M.); (M.D.)
- CHU Nantes, Service de Médecine du Sport, 44093 Nantes, France;
- IRMS, Institut Régional de Médecine du Sport, 44093 Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, F-44042 Nantes, France
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Shubert DJ, Shubert SB. Patient-Reported Outcomes of Shoulder Surgery in a Community Orthopedic Practice: A 5-Year Quality Improvement Project Using the QuickDASH Questionnaire. Orthopedics 2020; 43:e383-e388. [PMID: 32602924 DOI: 10.3928/01477447-20200619-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/01/2019] [Indexed: 02/03/2023]
Abstract
There has been a shift in US health care to a system that emphasizes value. Patient-reported outcomes have become a critical component of that valuation. A 5-year quality improvement project at the community private practice level was undertaken to assess the authors' delivery of care and practice processes for shoulder surgery as compared with established standards. QuickDASH questionnaires were collected from 1304 consecutive shoulder surgery patients, and data were collected at 4 time points. Mean QuickDASH scores for each procedure and scores assessing biceps tenodesis, distal clavicle excision, workers' compensation status, and sex were analyzed for statistical significance. Rotator cuff repair patients who also underwent biceps tenodesis had statistically significant worse function preoperatively and at 3 and 6 months postoperatively but not at 1 year postoperatively (P<.05). Rotator cuff repair patients undergoing concomitant distal clavicle excision had statistically significantly higher pre-operative scores (P<.01). Male shoulder arthroplasty patients had statistically significant higher preoperative scores (P<.02). Non-workers' compensation patients had statistically significant higher scores at 1 year (P<.05), whereas workers' compensation patients were statistically significantly younger (P<.01). Maximum changes in scores that met minimal clinically important differences occurred between surgery and 6 months postoperatively in all procedures. Quality outcome studies can be performed in private practice by a single surgeon and yield helpful results that lead to quality improvement through practice and delivery of care processes. [Orthopedics. 2020;43(5):e383-e388.].
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da Silva NC, Chaves TC, Dos Santos JB, Sugano RMM, Barbosa RI, Marcolino AM, Mazzer N, Fonseca MCR. Reliability, validity and responsiveness of Brazilian version of QuickDASH. Musculoskelet Sci Pract 2020; 48:102163. [PMID: 32560867 DOI: 10.1016/j.msksp.2020.102163] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To analyse the construct validity, test-retest reliability and responsiveness of the Brazilian version of Quick-DASH (QD-Br) in patients with upper limb disorders. METHOD Participants completed the full Brazilian DASH, the QD-Br and the SF-12 Brazil questionnaires at the beginning of treatment, after 48-72h and the after 2-12 months. Construct validity was analysed by Pearson's correlation coefficient (r). To evaluate the test-retest reliability we used the Intraclass Correlation Coefficient (ICC) and the Cronbach's alpha coefficient to test the internal consistency. Responsiveness was analysed by Standardized Response Mean (SRM) and Effect Size (ES). The Minimal detectable change (MDC) score was based upon calculations of the standard error of measurement (SEM), confidence interval of 95%. RESULTS The construct validity presented strong direct correlation with the total QD-Br score and the Brazilian DASH (r = 0.91), a moderate inverse correlation between the total QD-Br score and the physical component of the SF- 12 Brazil (r = -0.55) and weak inverse correlation between the QD-Br and the mental component of SF-12 Brazil (r = -0.49). The ICC test-retest showed good reliability of 0.81 (0.72-0.87). QD-BR presented high responsiveness, with ES of 1.06 and SRM of 0.94. The MDC was 17.27 points. CONCLUSION These results provide evidence that the QD-Br was a valid, reliable and responsive instrument when utilized in patients with upper limb traumatic and no-traumatic disorders in the Brazilian population.
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Affiliation(s)
| | - Thais Cristina Chaves
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | - Raquel Metzker Mendes Sugano
- Rehabilitation Centre, Ribeirao Preto Clinical Hospital, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | | | - Nilton Mazzer
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.
| | - Marisa C Registro Fonseca
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Rysstad T, Grotle M, Klokk LP, Tveter AT. Responsiveness and minimal important change of the QuickDASH and PSFS when used among patients with shoulder pain. BMC Musculoskelet Disord 2020; 21:328. [PMID: 32460743 PMCID: PMC7254648 DOI: 10.1186/s12891-020-03289-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/14/2020] [Indexed: 01/22/2023] Open
Abstract
Background The Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and the Patient-Specific Functional Scale (PSFS) are commonly used outcome instruments for measuring self-reported disability in patients with shoulder pain. To date, few studies have evaluated the responsiveness and estimated their minimal important change (MIC). Further assessment will expand the current knowledge and improve the interpretability of these instruments in clinical and research practice. The purpose of this prospective cohort study with 3 months follow-up was to evaluate the responsiveness of the QuickDASH and PSFS in patients with shoulder pain, and to estimate their MICs by using two different anchor-based methods. Methods Patients with shoulder pain recruited at a multidisciplinary hospital outpatient clinic completed the QuickDASH and PSFS at baseline and at 3 months follow-up. The responsiveness was evaluated by using a criterion approach with the area under the receiver operating characteristic curve (AUC) and a construct approach by testing 9 a-priori hypotheses. The MIC was assessed using two anchor-based MIC methods. Results 134 patients participated at baseline and 117 (87.3%) at 3 months follow-up. The AUC was acceptable for both QuickDASH (0.75) and PSFS (0.75). QuickDASH met 7 (77.8%) and PSFS 8 (88.9%) of the hypotheses. None of the instruments showed signs of floor and ceiling effects. The MIC estimates ranged from 10.8 to 13.6 for QuickDASH and from 1.9 to 2.0 for PSFS, depending on the method used. Conclusion This study demonstrates that both the QuickDASH and PSFS are responsive measures of disability in patients with shoulder pain. The estimated MIC values were presented.
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Affiliation(s)
- Tarjei Rysstad
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, P.O. Box 4, St Olavs Plass, Oslo, Norway.
| | - Margreth Grotle
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, P.O. Box 4, St Olavs Plass, Oslo, Norway.,Research and Communication Unit, Oslo University Hospital, Oslo, Norway
| | - Lars Petter Klokk
- Multidisciplinary outpatient clinic, Department of physical medicine and rehabilitation, Ålesund hospital, Ålesund, Norway
| | - Anne Therese Tveter
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, P.O. Box 4, St Olavs Plass, Oslo, Norway
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Konzelmann M, Burrus C, Gable C, Luthi F, Paysant J. Prospective multicentre validation study of a new standardised version of the 400-point hand assessment. BMC Musculoskelet Disord 2020; 21:313. [PMID: 32434509 PMCID: PMC7240941 DOI: 10.1186/s12891-020-03303-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand rehabilitation needs valid evaluation tools; the 400-point Hand Assessment (HA) is an exhaustive but not standardised tool. The aim of this study was to validate a standardised version of this test. METHODS A modified version and a standardised prototype was made for this prospective validation study (four centres, three countries). Psychometric properties studied: reliability (intra-rater and inter-rater, standard error of measurement [SEM], minimum detectable change [MDC],internal consistency); content validity, construct validity with Jebsen Taylor hand function test, QuickDASH, MOS-SF 36 and pain; responsiveness, using an anchor-based approach (ROC curve with area under curve, mean response change) with calculation of MCID. For SEM, MDC and responsiveness, QuickDASH was used for comparison. RESULTS One hundred and seventy-six patients with hand/wrist injuries were included between May 2013 and February 2015. One hundred and seventy were available for final analysis: 67% men; mean age 43.4 ± 13.2 years; both manual and office workers (46, 5% of each); 37% had a hand or wrist fracture. Reliability: ICC intra-rater = 0.967 [0.938-0.982]; inter-rater = 0.868 [0.754-0.932]. Distribution-based approach: for 400-point HA/QuickDASH: SEM = 3.48/4.52, MDC = 9.065/12.53, internal consistency of 400-point HA: Cronbach α = 0.886. VALIDITY Content validity was good according to COSMIN guidelines. Construct validity: correlation coefficient: Jebsen-Taylor hand function test = - 0.573 [- 0.666-0.464], QuickDASH = - 0.432 at T0 [- 0.545-0.303], - 0.551 at T3 [- 0.648-0.436]; MOS-SF 36 physical component = 0.395 [0.263-0.513]; no correlation with MOS-SF 36 mental component = 0.142 [- 0.009 + 0.286] and pain = - 0.166 [- 0.306 + 0.018]. Responsiveness: Anchor-based approach: AUC Δ400-point HA = 0.666 [0.583-0.749], AUC ΔQuickDASH = 0.556 [0.466-0.646]. MCID (optimal ROC curve cut-off): 6.07 for 400-point HA, - 2.27 for QuickDASH. MCID with mean response change + 12.034 ± 9.067 for 400-point HA and - 8.03 ± -9.7 for QuickDASH. The patient's global impression of change was only correlated with the Δ400-point HA. CONCLUSIONS The 400-point HA standardised version has good psychometric properties. For responsiveness, we propose an MCID of at least 12.3/100. However, these results must be confirmed in other populations and pathologies. TRIAL REGISTRATION This study was retrospectively registered into ISCTRN registry (Number ISRCTN25874481) the 07/02/2019.
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Affiliation(s)
- Michel Konzelmann
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland. .,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.
| | - Cyrille Burrus
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland
| | - Colette Gable
- Regional institute of physical medecine and rehabilitation, 75 boulevard Lobeau, CS 34209, 54042, Nancycedex, France
| | - François Luthi
- Department for Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Institute for Research in Rehabilitation, Clinique Romande de Réadaptation suva, avenue du grand champsec, 1950 Sion, Switzerland.,Department of Physical Medicine and Rehabilitation,Orthopaedic Hospital, Lausanne University Hospital, Avenue Pierre Decker, 1011, Lausanne, Switzerland
| | - Jean Paysant
- Regional institute of physical medecine and rehabilitation, 75 boulevard Lobeau, CS 34209, 54042, Nancycedex, France
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25
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Villers JF, Burch J, Scheller M, Huang HH. Physical therapy prehabilitation on a reverse total shoulder replacement candidate: a case study. J Phys Ther Sci 2020; 32:197-205. [PMID: 32158084 PMCID: PMC7032973 DOI: 10.1589/jpts.32.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/28/2019] [Indexed: 01/27/2023] Open
Abstract
[Purpose] The purpose of this report is to describe the PT evaluation, prehab interventions, and outcomes of a patient pursuing reverse total shoulder replacement (rTSR) for pain reduction and functional gains. [Participant and Methods] A 62-year-old male self-referred to PT two months before his right rTSR. His chief complaints were right shoulder pain, stiffness, and functional impairment due to rotator cuff tendon tears and shoulder arthritis. He demonstrated poor posture, limited ROM, decreased strength, and diminished function. The PT prehab program consisted of an initial encounter followed by six treatment sessions across approximately one month. [Results] On the last visit, the patient's pain had meaningfully decreased along with improved posture, AROM, and muscle strength producing a clinically significant improvement in function resulting in the postponing of his rTSR. On a three months follow-up, the patient had maintained or improved in his test and measures and functional outcomes. He expressed satisfaction with the prehab outcomes and that he had indefinitely postponed his rTSR. [Conclusion] PT prehab program improved pre-operative measures on pain, posture, joint mobility, muscle strength, and function on a patient who had been scheduled for rTSR surgery. PT prehab program may delay the need for rTSR surgery.
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Affiliation(s)
- James F Villers
- Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA
| | - Jacob Burch
- Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA
| | - Mark Scheller
- Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA
| | - Han-Hung Huang
- Department of Physical Therapy, Angelo State University: ASU Station No. 10923, San Angelo, TX 76909-0923, USA
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Larrivée S, Balg F, Léonard G, Bédard S, Tousignant M, Boissy P. Wrist-Based Accelerometers and Visual Analog Scales as Outcome Measures for Shoulder Activity During Daily Living in Patients With Rotator Cuff Tendinopathy: Instrument Validation Study. JMIR Rehabil Assist Technol 2019; 6:e14468. [PMID: 31793896 PMCID: PMC6918212 DOI: 10.2196/14468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Shoulder pain secondary to rotator cuff tendinopathy affects a large proportion of patients in orthopedic surgery practices. Corticosteroid injections are a common intervention proposed for these patients. The clinical evaluation of a response to corticosteroid injections is usually based only on the patient's self-evaluation of his function, activity, and pain by multiple questionnaires with varying metrological qualities. Objective measures of upper extremity functions are lacking, but wearable sensors are emerging as potential tools to assess upper extremity function and activity. OBJECTIVE This study aimed (1) to evaluate and compare test-retest reliability and sensitivity to change of known clinical assessments of shoulder function to wrist-based accelerometer measures and visual analog scales (VAS) of shoulder activity during daily living in patients with rotator cuff tendinopathy convergent validity and (2) to determine the acceptability and compliance of using wrist-based wearable sensors. METHODS A total of 38 patients affected by rotator cuff tendinopathy wore wrist accelerometers on the affected side for a total of 5 weeks. Western Ontario Rotator Cuff (WORC) index; Short version of the Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH); and clinical examination (range of motion and strength) were performed the week before the corticosteroid injections, the day of the corticosteroid injections, and 2 and 4 weeks after the corticosteroid injections. Daily Single Assessment Numeric Evaluation (SANE) and VAS were filled by participants to record shoulder pain and activity. Accelerometer data were processed to extract daily upper extremity activity in the form of active time; activity counts; and ratio of low-intensity activities, medium-intensity activities, and high-intensity activities. RESULTS Daily pain measured using VAS and SANE correlated well with the WORC and QuickDASH questionnaires (r=0.564-0.815) but not with accelerometry measures, amplitude, and strength. Daily activity measured with VAS had good correlation with active time (r=0.484, P=.02). All questionnaires had excellent test-retest reliability at 1 week before corticosteroid injections (intraclass correlation coefficient [ICC]=0.883-0.950). Acceptable reliability was observed with accelerometry (ICC=0.621-0.724), apart from low-intensity activities (ICC=0.104). Sensitivity to change was excellent at 2 and 4 weeks for all questionnaires (standardized response mean=1.039-2.094) except for activity VAS (standardized response mean=0.50). Accelerometry measures had low sensitivity to change at 2 weeks, but excellent sensitivity at 4 weeks (standardized response mean=0.803-1.032). CONCLUSIONS Daily pain VAS and SANE had good correlation with the validated questionnaires, excellent reliability at 1 week, and excellent sensitivity to change at 2 and 4 weeks. Daily activity VAS and accelerometry-derived active time correlated well together. Activity VAS had excellent reliability, but moderate sensitivity to change. Accelerometry measures had moderate reliability and acceptable sensitivity to change at 4 weeks.
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Affiliation(s)
- Samuel Larrivée
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,Department of Surgery, Division of Orthopedics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédéric Balg
- Department of Surgery, Division of Orthopedics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center of CHUS, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Guillaume Léonard
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sonia Bédard
- Department of Surgery, Division of Orthopedics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center of CHUS, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Michel Tousignant
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrick Boissy
- Research Center on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,Department of Surgery, Division of Orthopedics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center of CHUS, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
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Cao S, Zhou R, Zhou H, Chen Y, Cui H, Lu Z, Qian Q, Ding Y. Reliability and validity of Simplified Chinese version of Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire: cross-cultural adaptation and validation. Clin Rheumatol 2019; 38:3281-3287. [DOI: 10.1007/s10067-019-04661-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 06/05/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
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Prodinger B, Hammond A, Tennant A, Prior Y, Tyson S. Revisiting the disabilities of the arm, shoulder and hand (DASH) and QuickDASH in rheumatoid arthritis. BMC Musculoskelet Disord 2019; 20:41. [PMID: 30683082 PMCID: PMC6347833 DOI: 10.1186/s12891-019-2414-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Limitations in upper limb functioning are common in Musculoskeletal disorders and the Disabilities of the Arm, Shoulder and Hand scale (DASH) has gained widespread use in this context. However, various concerns have been raised about its construct validity and so this study seeks to examine this and other psychometric aspects of both the DASH and QuickDASH from a modern test theory perspective. Methods Participants in the study were eligible if they had a confirmed diagnosis of Rheumatoid Arthritis (RA). They were mailed a questionnaire booklet which included the DASH. Construct validity was examined by fit to the Rasch measurement model. The degree of precision of both the DASH and QuickDASH were considered through their Standard Error of Measurement (SEM). Results Three hundred and thirty-seven subjects with confirmed RA took part, with a mean age of 62.0 years (SD12.1); 73.6% (n = 252) were female. The median standardized score on the DASH was 33 (IQR 17.5–55.0). Significant misfit of the DASH and QuickDASH was observed but, after accommodating local dependency among items in a two-testlet solution, satisfactory fit was obtained, supporting the unidimensionality of the total sets and the sufficiency of the raw (ordinal or standardized) scores. Conclusion Having accommodated local response dependency in the DASH and QuickDASH item sets, their total scores are shown to be valid, given they satisfy the Rasch model assumptions. The Rasch transformation should be used whenever all items are used to calculate a change score, or to apply parametric statistics within an RA population. Significance and innovations Most previous modern psychometric analyses of both the DASH and QuickDASH have failed to fully address the effect of a breach of the local independence assumption upon construct validity. Accommodating this problem by creating ‘super items’ or testlets, removes this effect and shows that both versions of the scale are valid and unidimensional, as applied with a bi-factor equivalent solution to an RA population. The Standard Error of Measurement of a scale can be biased by failing to take into account the local dependency in the data which inflates reliability and thus making the SEM appear better (i.e. smaller) than the true value without bias.
Electronic supplementary material The online version of this article (10.1186/s12891-019-2414-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland. .,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland. .,Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, Germany.
| | - A Hammond
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Salford, UK
| | - A Tennant
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
| | - Y Prior
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Salford, UK.,Mid Cheshire NHS Trust Foundation Hospitals, Leighton Hospital, Crewe, UK
| | - S Tyson
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
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Hong SW, Gong HS, Park JW, Roh YH, Baek GH. Validity, Reliability and Responsiveness of the Korean Version of Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire in Patients with Carpal Tunnel Syndrome. J Korean Med Sci 2018; 33:e249. [PMID: 30275805 PMCID: PMC6159106 DOI: 10.3346/jkms.2018.33.e249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) is one of the most widely used questionnaires for assessing functional ability of the patients with upper extremity diseases. Carpal tunnel syndrome (CTS) is the most common neuropathic disease in the upper extremities. The aim of this study was to verify the validity, reliability, and responsiveness of Korean version of QuickDASH questionnaire (K-QuickDASH) in the patients with CTS. METHODS In total, 83 subjects who underwent open carpal tunnel release (CTR) operation were selected. They fulfilled Korean version of Disabilities of the Arm, Shoulder and Hand questionnaire (K-DASH) and K-QuickDASH at two different time points: before and six months after the surgery. Both criterion-related and construct validities were evaluated using Pearson's correlation coefficient and factor analysis. Internal consistency was estimated using Cronbach's alpha, and test-retest reliability was assessed to verify the reliability of K-QuickDASH using intraclass correlation coefficient (ICC). The standardized response mean and the effect size were analyzed to confirm the responsiveness of the K-QuickDASH in CTS patients. RESULTS Significant positive correlation was found between K-QuickDASH and K-DASH. All the questionnaire items were categorized into three factors. Acceptable internal consistency was confirmed in three categories of K-QuickDASH. A high test-retest reliability and responsiveness of K-QuickDASH were detected. CONCLUSION K-QuickDASH in Korean patients with CTS was confirmed to have high degree of validity and reliability, and responsiveness after CTR. Therefore, the K-QuickDASH would be a good evaluation tool for evaluating clinical symptoms and determination of treatment outcomes in the patients with CTS.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Ewha Womans University Hospital, Seoul, Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Wee Park
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Young Hak Roh
- Department of Orthopedic Surgery, Ewha Womans University Hospital, Seoul, Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
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Reynard F, Vuistiner P, Léger B, Konzelmann M. Immediate and short-term effects of kinesiotaping on muscular activity, mobility, strength and pain after rotator cuff surgery: a crossover clinical trial. BMC Musculoskelet Disord 2018; 19:305. [PMID: 30134883 PMCID: PMC6106764 DOI: 10.1186/s12891-018-2169-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kinesiotape (KT) is widely used in musculoskeletal rehabilitation as an adjuvant to treatment, but minimal evidence supports its use. The aim of this study is to determine the immediate and short-term effects of shoulder KT on muscular activity, mobility, strength and pain after rotator cuff surgery. METHODS Thirty-nine subjects who underwent shoulder rotator cuff surgery were tested 6 and 12 weeks post-surgery, without tape, with KT and with a sham tape (ST). KT and ST were applied in a randomized order. For each condition, the muscular activity of the upper trapezius, three parts of the deltoid and the infraspinatus were measured during shoulder flexion, and range of motion (ROM) and pain intensity were assessed. At 12 weeks, the isometric strength at 90° of shoulder flexion, related muscular activity and pain intensity were also measured. Subjects maintained the last tape that was applied for three days and recorded the pain intensity at waking up and during the day. RESULTS Modifications in muscle activity were observed with KT and with ST. Major changes in terms of decreased recruitment of the upper trapezius were observed with KT (P < 0.001). KT and ST also increased flexion ROM at 6 weeks (P = 0.004), but the differences with the no tape condition were insufficient to be clinically important. No other differences between conditions were found. CONCLUSIONS Shoulder taping has the potential to decrease over-activity of the upper trapezius, but no clinical benefits of KT on ROM, strength or pain were noted in a population of subjects who underwent rotator cuff surgery. TRIAL REGISTRATION The study was retrospectively registered on ClinicalTrials.gov PRS ( NCT03379636 ) on 21st December 2017.
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Affiliation(s)
- Fabienne Reynard
- Department of Physiotherapy, Clinique romande de réadaptation Suva, Sion, Switzerland.
| | - Philippe Vuistiner
- Institute for Research in Rehabilitation, Clinique romande de réadaptation Suva, Sion, Switzerland
| | - Bertrand Léger
- Institute for Research in Rehabilitation, Clinique romande de réadaptation Suva, Sion, Switzerland
| | - Michel Konzelmann
- Department of Musculoskeletal Rehabilitation, Clinique romande de réadaptation Suva, Sion, Switzerland
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Hillesund S, Fromreide I, Foss OA, Finsen V. The value of remembered pre-operative quick disabilities of the arm, shoulder and hand (QuickDASH) scores. J Plast Surg Hand Surg 2018; 52:294-300. [PMID: 30015548 DOI: 10.1080/2000656x.2018.1483938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
It would be useful if it were possible for the patients to recreate their pre-operative QuickDASH scores in audits where this score had not been recorded before surgery. We assessed the accuracy of remembered pre-operative QuickDASH scores among 229 consecutive patients and the value of a previously developed algorithm for correcting these scores. Real pre-operative scores and remembered pre-operative scores were compared after a mean of 21 months. Furthermore, the scores of a subgroup of 79 patients with carpal tunnel syndrome, subacromial impingement, thumb basal joint arthrosis or Dupuytren's contracture were corrected using an algorithm. The mean difference between remembered and real pre-operative scores for all patients showed heteroscedacity in the Bland-Altman plot. The scores of the 79 sub-analysis patients were homoscedastic. The mean difference between remembered and real pre-operative scores was 9 (SD 16, SEM 1.85). Correcting the scores of the sub-group patients using our algorithm decreased the variation only moderately. The remembered pre-operative score is too inaccurate to be useful in individual patients, also when using our algorithm. However, subtracting nine from the mean remembered pre-operative score in a group of patients with any of the above diagnoses gives the real pre-operative score within the 95% confidence interval of four above and four below the real score.
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Affiliation(s)
- Sigrun Hillesund
- a Faculty of Medicine , Norwegian University of Science and Technology, NTNU , Trondheim , Norway
| | - Ida Fromreide
- a Faculty of Medicine , Norwegian University of Science and Technology, NTNU , Trondheim , Norway
| | - Olav A Foss
- b Department of Orthopaedic Surgery , St. Olav´s University Hospital , Trondheim , Norway.,c Department of Neuroscience , Norwegian University of Science and Technology, NTNU , Trondheim , Norway
| | - Vilhjalmur Finsen
- b Department of Orthopaedic Surgery , St. Olav´s University Hospital , Trondheim , Norway.,c Department of Neuroscience , Norwegian University of Science and Technology, NTNU , Trondheim , Norway
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Functional outcome of displaced radial head fractures in children treated by elastic stable intramedullary nailing. J Pediatr Orthop B 2018; 27:296-303. [PMID: 28984681 DOI: 10.1097/bpb.0000000000000502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The objectives of this study were to retrospectively investigate the clinical and radiological outcomes of displaced radial head fractures in children treated by elastic stable intramedullary nailing (ESIN) and evaluate the functional outcome of these injuries using the short version of the Disabilities of the Arm, Shoulder and Hand outcome questionnaire (Quick DASH). A total of 24 patients (nine males and 15 females) fulfilled the inclusion criteria. The mean age at the time of injury was 10.7±2.8 years (range: 9.5-16.33 years). Before surgery, the mean angulation was 53.8°±18.4° (range: 28°-82°) differentiating fractures on the basis of Judet's classification. The mean Quick DASH score was a good 4 (range: 0-15.9). Functional outcomes were similar irrespective of the severity of fracture displacement (P>0.05), presence or absence of associated fracture (P>0.05), and time immobilized (P>0.05). The Quick DASH score was better in children younger than 9 years of age (1.62) than children older than 9 years of age (4.95), but without a statistically significant difference (P=0.058). Children with displaced radial head fractures treated with ESIN showed good functional outcomes. Associated fracture injuries were not a predictive factor of functional outcome. Open reduction must be avoided as it carries an increased risk of complications.
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Chuang C, Azurdia J, Asuzu D, Ragins KT, Tomany K, Islam S, Williams S, Safanda J, Thomson JG. Functional and Quality of Life Outcomes of a Hand Surgery Mission to Honduras. Hand (N Y) 2018; 13:305-312. [PMID: 28452578 PMCID: PMC5987978 DOI: 10.1177/1558944717704515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: The objective of this study was to assess functional, quality of life, and satisfaction outcomes of a hand surgery short-term surgical mission (STSM) to Honduras, and determine whether patient demographics and surgery characteristics during a surgical mission correlate with outcome. Methods: A total of 63 patients who received upper extremity surgery at a week-long hand surgery STSM to Honduras in March 2013 participated in the study. A before-after study design was used. Before receiving surgery, participants completed the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the Short Form 12 Health Survey version 2 (SF12v2). Four months postoperatively, participants completed the QuickDASH, SF12v2, and Satisfaction Survey. Results: The mean QuickDASH score significantly improved preoperatively to postoperatively. Demographics measures of age, sex, education, and income did not correlate with QuickDASH scores. Preoperative QuickDASH statistically significantly correlated with surgery type: Carpal tunnel patients had the highest scores (worst functioning). Postoperatively, mass excision and scar contracture/skin graft patients were correlated with the lowest scores. Carpal tunnel and tendon surgery patients showed greatest correlation with QuickDASH improvement. SF-12 scores revealed improvements in mental domains and declines in physical domains. Conclusions: Hand surgery performed during STSMs can result in significant functional improvement, regardless of socioeconomic status. Patients benefited from both simpler and more complex operations. Four months after surgery, general health-related quality of life measures showed improved mental indices. Measured physical indices declined despite improved QuickDASH scores. This may be due to the early general postoperative state. Further outcome research in STSMs in additional countries and specialties is required to expand our conclusions to other STSM contexts and guide best practices in STSMs.
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Affiliation(s)
| | | | | | | | - Kevin Tomany
- Merrimack Valley Orthopedic Associates,
Chelmsford, MA, USA
| | | | | | - John Safanda
- The Permanente Medical Group, San
Rafael, CA, USA
| | - J. Grant Thomson
- Yale University, New Haven, CT,
USA,J. Grant Thomson, Professor of Plastic
Surgery, Director, Yale Hand & Microsurgery Program, Section of Plastic and
Reconstructive Surgery, Department of Surgery, School of Medicine, Yale
University, PO Box 208041, New Haven, CT 06520, USA.
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Marot V, Bayle-Iniguez X, Cavaignac E, Bonnevialle N, Mansat P, Murgier J. Results of non-operative treatment of olecranon fracture in over 75-year-olds. Orthop Traumatol Surg Res 2018; 104:79-82. [PMID: 29258962 DOI: 10.1016/j.otsr.2017.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/07/2017] [Accepted: 10/14/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Surgery is the gold-standard treatment of displaced olecranon fracture, but is associated with numerous complications, especially in the elderly. Functional results of non-operative treatment in this population have never been analyzed in a prospective study. STUDY HYPOTHESIS Non-operative treatment of isolated olecranon fracture with stable elbow-joint in over 75-year-olds gives functional results comparable to those of surgery as reported in the literature, with fewer complications. MATERIAL AND METHODS A prospective study analyzed functional results of non-operative treatment of isolated closed Mayo I and II olecranon fracture with stable elbow, in patients aged ≥75 years. The principal assessment criterion was functional recovery on the Mayo Elbow Performance Score (MEPS) and QuickDASH at 6 months. RESULTS Twenty-two fractures in 21 patients were included. Mean MEPS was 95.26/100 (range, 85-100), and mean QuickDASH 4.3 (range, 0-29.55). Eighteen fractures showed osteoarthritis of the olecranon. There were no cases of elbow instability. There were no complications. DISCUSSION Non-operative treatment of olecranon fracture in patients aged ≥75 years provided excellent functional results at 6 months, without associated complications. TYPE OF STUDY Single-center prospective observation cohort study. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- V Marot
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - X Bayle-Iniguez
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - E Cavaignac
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - N Bonnevialle
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - P Mansat
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - J Murgier
- Département de chirurgie orthopédique et traumatologique, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
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Iordens GIT, Den Hartog D, Tuinebreijer WE, Eygendaal D, Schep NWL, Verhofstad MHJ, Van Lieshout EMM. Minimal important change and other measurement properties of the Oxford Elbow Score and the Quick Disabilities of the Arm, Shoulder, and Hand in patients with a simple elbow dislocation; validation study alongside the multicenter FuncSiE trial. PLoS One 2017; 12:e0182557. [PMID: 28886018 PMCID: PMC5590744 DOI: 10.1371/journal.pone.0182557] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 07/19/2017] [Indexed: 11/19/2022] Open
Abstract
Study design Validation study using data from a multicenter, randomized, clinical trial (RCT). Objectives To evaluate the reliability, validity, responsiveness, and minimal important change (MIC) of the Dutch version of the Oxford Elbow Score (OES) and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) in patients with a simple elbow dislocation. Background Patient-reported outcome measures are increasingly important for assessing outcome following elbow injuries, both in daily practice and in clinical research. However measurement properties of the OES and Quick-DASH in these patients are not fully known. Methods OES and Quick-DASH were completed four times until one year after trauma. Mayo Elbow Performance Index, pain (VAS), Short Form-36, and EuroQol-5D were completed for comparison. Data of a multicenter RCT (n = 100) were used. Internal consistency was determined using Cronbach’s alpha. Construct and longitudinal validity were assessed by determining hypothesized strength of correlation between scores or changes in scores, respectively, of (sub)scales. Finally, floor and ceiling effects, MIC, and smallest detectable change (SDC) were determined. Results OES and Quick-DASH demonstrated adequate internal consistency (Cronbach α, 0.882 and 0.886, respectively). Construct validity and longitudinal validity of both scales were supported by >75% correctly hypothesized correlations. MIC and SDC were 8.2 and 12.0 point for OES, respectively. For Quick-DASH, these values were 11.7 and 25.0, respectively. Conclusions OES and Quick-DASH are reliable, valid, and responsive instruments for evaluating elbow-related quality of life. The anchor-based MIC was 8.2 points for OES and 11.7 for Quick-DASH.
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Affiliation(s)
- Gijs I. T. Iordens
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dennis Den Hartog
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wim E. Tuinebreijer
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, The Netherlands
| | - Niels W. L. Schep
- Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Michael H. J. Verhofstad
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther M. M. Van Lieshout
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
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Rasch Model Analysis Gives New Insights Into the Structural Validity of the QuickDASH in Patients With Musculoskeletal Shoulder Pain. J Orthop Sports Phys Ther 2017; 47:664-672. [PMID: 28704620 DOI: 10.2519/jospt.2017.7288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional secondary analysis of a prospective cohort study. Background The shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) is a widely used outcome measure that has been extensively evaluated using classical test theory. Rasch model analysis can identify strengths and weaknesses of rating scales and goes beyond classical test theory approaches. It uses a mathematical model to test the fit between the observed data and expected responses and converts ordinal-level scores into interval-level measurement. Objective To test the structural validity of the QuickDASH using Rasch analysis. Methods A prospective cohort study of 1030 patients with shoulder pain provided baseline data. Rasch analysis was conducted to (1) assess how the QuickDASH fits the Rasch model, (2) identify sources of misfit, and (3) explore potential solutions to these. Results There was evidence of multidimensionality and significant misfit to the Rasch model (χ2 = 331.09, P<.001). Two items had disordered threshold responses with strong floor effects. Response bias was detected in most items for age and sex. Rescoring resulted in ordered thresholds; however, the 11-item scale still did not meet the expectations of the Rasch model. Conclusion Rasch model analysis on the QuickDASH has identified a number of problems that cannot be easily detected using traditional analyses. While revisions to the QuickDASH resulted in better fit, a "shoulder-specific" version is not advocated at present. Caution needs to be exercised when interpreting results of the QuickDASH outcome measure, as it does not meet the criteria for interval-level measurement and shows significant response bias by age and sex. J Orthop Sports Phys Ther 2017;47(9):664-672. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7288.
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The SPADI and QuickDASH Are Similarly Responsive in Patients Undergoing Physical Therapy for Shoulder Pain. J Orthop Sports Phys Ther 2017; 47:538-547. [PMID: 28683232 DOI: 10.2519/jospt.2017.7195] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Prospective multicenter longitudinal cohort study. Background A key component of assessing clinical effectiveness is to compare instruments measuring similar outcomes and to select one that is sufficiently responsive. Despite their widespread use in reporting outcomes, the responsiveness of the Shoulder Pain and Disability Index (SPADI) and the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) has not been compared and reported within the same population. Objective To compare the responsiveness of the SPADI and QuickDASH in a single large cohort of patients. Methods Seven hundred sixty-seven patients referred to physical therapy with shoulder pain completed the SPADI and QuickDASH at baseline, 6 weeks, and 6 months. Patients who improved (improvers) and those who did not improve (nonimprovers) were defined using a 7-point global rating of change scale. Internal and external responsiveness was evaluated. Results For improvers, the effect size and standardized response mean were large (greater than 1.00) at 6 weeks for both the SPADI and QuickDASH and further increased for both measures at 6 months. For participants who worsened, negative effect sizes and standardized response means were larger at 6 weeks than at 6 months. The area under the curve was similar for both the SPADI (0.81) and QuickDASH (0.78), increasing to 0.85 for both at 6 months. Conclusion Both instruments are similarly able to discriminate between clinical improvers and nonimprovers at either follow-up point. J Orthop Sports Phys Ther 2017;47(8):538-547. Epub 6 Jul 2017. doi:10.2519/jospt.2017.7195.
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Tempelaere C, Brun M, Doursounian L, Feron JM. Traumatic avulsion of the flexor digitorum profundus tendon. Jersey finger, a 29 cases report. HAND SURGERY & REHABILITATION 2017; 36:368-372. [PMID: 28694076 DOI: 10.1016/j.hansur.2017.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/21/2016] [Accepted: 06/19/2017] [Indexed: 11/30/2022]
Abstract
Traumatic avulsion of flexor digitorum profundus (jersey finger) is an uncommon injury. Our study aimed to describe functional outcomes of jersey fingers after surgical treatment. From January 2004 to 2014, we performed surgery on 32 patients who had jersey finger. Twenty-six of these patients were male and 6 were female with a mean age of 37.2years (range 16-68). Of the 32 cases, 11 were sports injuries, 16 presented on the ring finger and 13 on the little finger. Using the Leddy and Packer and Smith classifications, 16 of the injuries were type I, 4 were type II, 5 were type III, 7 were type IV. The mean time between injury and surgery was 6.8days (range: 0-32). The surgical techniques used were anchor, pull-out, or an association of both these techniques. Prior to the patient discharge, functional outcomes were evaluated. Twenty-nine patients were evaluated in total and three patients were lost. Of the 29, the average time between surgery and discharge was 36.6months ranging from 4.5 to 118months. According to the Buck-Gramcko classification, six patients had an excellent result, six had a good result, seven had a satisfactory result and ten a poor result. The mean Quick DASH score immediately to prior discharge was 5.66 (range: 0-56.82). Twelve complications were reported on nine patients. No infections were reported. Rapid diagnosis and rapid surgical treatment led to restoration of full range motion.
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Affiliation(s)
- C Tempelaere
- Service de chirurgie orthopédique, CHU Saint Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - M Brun
- Service de chirurgie orthopédique, CHU Saint Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France; Clinique du Mont-Louis, 8-10, rue de la Folie-Regnault, 75011 Paris, France
| | - L Doursounian
- Service de chirurgie orthopédique, CHU Saint Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - J-M Feron
- Service de chirurgie orthopédique, CHU Saint Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
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Kinematic analysis of the shoulder complex after anatomic and reverse total shoulder arthroplasty: A cross-sectional study. Musculoskelet Sci Pract 2017; 29:84-90. [PMID: 28347934 DOI: 10.1016/j.msksp.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 03/10/2017] [Accepted: 03/18/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND The movement of the arm relative to the trunk results from coordinated 3D glenohumeral and scapulothoracic movements. Changes in scapula kinematics may occur after total shoulder arthroplasty and could affect clinical and functional outcomes. OBJECTIVES To assess the 3D movement of the scapula during arm elevation after anatomic and reverse total shoulder arthroplasty. DESIGN/METHODS This was a single-centre, non-randomized, controlled cross-sectional study. Patients with anatomic (n = 14) and reverse total shoulder arthroplasty (n = 9) were prospectively enrolled and were compared to age-matched asymptomatic controls (n = 23). 3D scapular kinematics were assessed by a non-invasive, electromagnetic method during arm abduction and flexion. 3D scapular rotations and 3D linear displacements of the barycentre (geometrical centre) at rest and at 30°, 60° and 90° arm elevation; as well as scapulohumeral rhythm were analysed. Participant groups were compared using one-way ANOVA and Bonferroni post-hoc testing for normally distributed data, and Mann-Whitney U test for non-normally distributed data. RESULTS/FINDINGS Total range of scapular lateral rotation and barycentre displacement were increased, and scapulohumeral rhythm was reduced, in patients with anatomic and reverse total shoulder arthroplasty compared with age-matched controls; however, the global scapular kinematic pattern was preserved. CONCLUSION/INTERPRETATION For patients after total shoulder arthroplasty, the increased contribution of the scapula to arm elevation is consistent with a compensatory mechanism for the reduced glenohumeral mobility. The stability of the global scapula kinematic pattern reflects its mechanical and neuromotor strength.
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Peyronnet A, Marc C, Lancigu R, Rony L, Cronier P, Hubert L. Percutaneous reduction of proximal radius fracture in adults. A 12-case series. Orthop Traumatol Surg Res 2017; 103:315-318. [PMID: 28153481 DOI: 10.1016/j.otsr.2016.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/16/2016] [Accepted: 12/06/2016] [Indexed: 02/02/2023]
Abstract
UNLABELLED Fractures of the head or neck of the radius account for 5% of elbow fractures in adults. Treatment varies between authors. We report a retrospective series of 12 cases of percutaneous reduction of Mason II radial head fracture, without internal fixation. All fractures consolidated, without secondary displacement. There were no postoperative complications. Mean ranges of motion were 136° flexion-extension and 175° pronation-supination. Mean QuickDASH score was 11. Results in the present series were at least comparable to those for other techniques, validating percutaneous treatment as a solution for radial head fracture. TYPE OF STUDY Case series. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- A Peyronnet
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
| | - C Marc
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - R Lancigu
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - L Rony
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - P Cronier
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - L Hubert
- CHU d'Angers, 4, rue Larrey, 49100 Angers, France
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Perrin C, Khiami F, Beguin L, Calmels P, Gresta G, Edouard P. Translation and validation of the French version of the Western Ontario Shoulder Instability Index (WOSI): WOSI-Fr. Orthop Traumatol Surg Res 2017; 103:141-149. [PMID: 28069409 DOI: 10.1016/j.otsr.2016.10.024] [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: 09/19/2015] [Revised: 09/30/2016] [Accepted: 10/17/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The Western Ontario Shoulder Instability Index (WOSI) is a specific self-administered questionnaire measuring the functional impact on patients with chronic glenohumeral instability. In its English version, it is valid, reliable, and sensitive to change. The objective of the present study was to provide a linguistic and cross-cultural adaptation of the original version of the WOSI to French and to assess the metrologic properties of this version in patients with chronic shoulder instability. MATERIAL AND METHODS The WOSI was translated and adapted both linguistically and culturally to French (WOSI-Fr) according to current guidelines. The metrologic properties of the WOSI-Fr were analyzed in the following groups - unoperated patients with chronic shoulder instability (UOG), operated patients with chronic shoulder instability (OG), patients with instability (TotG=UOG+OG), and control patients (ContG) - through analysis of the construct validity by comparing the WOSI-Fr with the Rowe, Walch-Duplay, QuickDASH, and VAS pain scores, and through analysis of reliability through the reproducibility of internal consistency. RESULTS The WOSI-Fr version was established and then accepted by an expert group (n=7). There was a statistically significant correlation between the WOSI and the different pain and function scores for TotG, OG, and UOG (except with the VAS pain score and the QuickDASH for UOG). Reproducibility (n=27) was good: the ICC value for the total score was 0.88 (95% CI, 0.47-0.98), varying from 0.80 to 0.94 according to the four domains of the WOSI-Fr, and from 0.70 to 0.94 for the different items separately. For TotG, Cronbach's alpha was 0.953, the SEM and the MDC were 120.2 (5.7%) and 333 (15.9%), respectively. CONCLUSION The French version of the WOSI (WOSI-Fr) is available, adapted linguistically and culturally, valid, and reliable. We recommend using it in following up patients with shoulder instability. LEVEL OF EVIDENCE Prospective, level 2.
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Affiliation(s)
- C Perrin
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM EA 7424), Université Jean-Monnet, Université de Lyon, F-42055 Saint-Etienne, France; Unité de Médecine du Sport, Service de Physiologie Clinique et de l'Exercice, Hôpital Nord, IRMIS Campus Santé Innovations, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 2, France; Service de Médecine Physique et de Réadaptation, Hôpital de Bellevue, CHU de Saint-Etienne, boulevard Pasteur, 42055 Saint-Etienne cedex 2, France.
| | - F Khiami
- Service de Chirurgie Orthopédique et Traumatologie du sport, Hôpital de La Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, 75013 Paris, France
| | - L Beguin
- Centre Orthéo, 42100 Saint Etienne, France
| | - P Calmels
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM EA 7424), Université Jean-Monnet, Université de Lyon, F-42055 Saint-Etienne, France; Service de Médecine Physique et de Réadaptation, Hôpital de Bellevue, CHU de Saint-Etienne, boulevard Pasteur, 42055 Saint-Etienne cedex 2, France
| | - G Gresta
- Service de Chirurgie Orthopédie, Hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 2, France
| | - P Edouard
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM EA 7424), Université Jean-Monnet, Université de Lyon, F-42055 Saint-Etienne, France; Unité de Médecine du Sport, Service de Physiologie Clinique et de l'Exercice, Hôpital Nord, IRMIS Campus Santé Innovations, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 2, France
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Reproducibility: Reliability and agreement of short version of Western Ontario Rotator Cuff Index (Short-WORC) in patients with rotator cuff disorders. J Hand Ther 2017; 29:281-91. [PMID: 27496983 DOI: 10.1016/j.jht.2015.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 10/10/2015] [Accepted: 11/24/2015] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Recently, a shorter version of Western Ontario Rotator Cuff Index (Short-WORC) was proposed as a subset of 7 items from the original 21-item WORC. However, the reproducibility of the Short-WORC has not been established. PURPOSE OF THE STUDY To determine reproducibility (reliability and agreement) of the Short-WORC among patients with rotator cuff disorders (RCDs). METHODS Patients (n = 153) diagnosed with RCD completed the WORC at baseline and at 3 months post-operatively (n = 146). The Short-WORC was extracted from the full version of WORC. From this retrospective cohort, 43 patients were retested within 5 weeks, if they remained stable. Cronbach's alpha (α) and intra class correlation coefficients (ICC2,1) were used to assess internal consistency and test-retest reliability respectively. Standard error measurement (SEM), minimal detectable change (MDC90) and Bland Altman (BA) plots were used to assess agreement. RESULTS No floor and ceiling effects were reported for either the Short-WORC or WORC. Cronbach's α were 0.84 and 0.90 at baseline and 0.89 and 0.95 at 3 month of follow up for Short-WORC and WORC respectively. The ICC2,1 were 0.89 and 0.91 for the Short-WORC and WORC respectively. The agreement parameters for the Short-WORC were: SEMagreement = 8.8, MDC90individual = 20.3, MDC90group = 5.1. We found substantial agreement between the two versions of WORC on BA plots with minimal (mean difference (d) <1) systematic differences between them. The limits of agreement (LOA) between two versions of WORC were similar across sessions and fell within range of -11.7 to 13.2 points at test and -14.7 to 14.7 points at retest. CONCLUSION Short-WORC and WORC demonstrates strong reproducibility and can be used for group and individual comparison of health-related quality of life (HRQoL) among patients with RCD. Wider LOA may be expected when using the Short-WORC for individual patient assessment. Reproducibility data is essential, but should be supplemented by validation of actual Short-WORC with samples representing the spectrum of RCD. LEVEL OF EVIDENCE N/A.
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Wormdal AH, Tallaksen SH, Hagen Ø, Foss OA, Finsen V. Remembered preoperative Quick disabilities of the arm, shoulder and hand (QuickDASH) scores. J Hand Surg Eur Vol 2017; 42:78-83. [PMID: 27601465 DOI: 10.1177/1753193416665299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED The Quick disabilities of the arm, shoulder and hand (QuickDASH) patient-reported outcome measure is frequently used to assess disabilities and symptoms of the upper extremity. This study compares real preoperative QuickDASH scores and remembered preoperative QuickDASH scores. Remembered preoperative QuickDASH scores were obtained 45 months (39-67) after surgery. Patient material consisted of 160 patients operated for Dupuytren's contracture, carpal tunnel syndrome, thumb basal joint arthrosis, and shoulder pain. All patients had completed QuickDASH questionnaires before surgery. Paired T-tests, linear mixed models, and limits of agreement were used for analyses. There was a significant difference between remembered and real preoperative scores (mean 7.6, SD 15.6; SEM 1.2). Neither diagnosis, age, gender, nor time between surgery and review influenced the difference significantly. A linear mixed model was constructed to investigate the ability to retrospectively predict preoperative QuickDASH scores. Remembered preoperative QuickDASH cannot be used in individual patients because of the high inaccuracy. LEVEL OF EVIDENCE III.
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Affiliation(s)
- A H Wormdal
- 1 Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S H Tallaksen
- 1 Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ø Hagen
- 2 Department of Orthopaedic Surgery, Martina Hansen's Hospital, Sandvika, Norway
| | - O A Foss
- 3 Department of Orthopaedic Surgery, St.Olav's University Hospital, Trondheim, Norway
| | - V Finsen
- 1 Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,3 Department of Orthopaedic Surgery, St.Olav's University Hospital, Trondheim, Norway
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Lanhers C, Pereira B, Gay C, Hérisson C, Levyckyj C, Dupeyron A, Coudeyre E. Evaluation of the efficacy of a short-course, personalized self-management and intensive spa therapy intervention as active prevention of musculoskeletal disorders of the upper extremities (Muska): a research protocol for a randomized controlled trial. BMC Musculoskelet Disord 2016; 17:497. [PMID: 27938361 PMCID: PMC5148841 DOI: 10.1186/s12891-016-1353-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/28/2016] [Indexed: 02/01/2023] Open
Abstract
Background Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies. The disease needs to be prevented, not only for medical and economic reasons, but also for legal reasons, owing to the requirement of assessing occupational risks. The strategy envisaged may thus revolve around active, multimodal prevention that has employees fully involved at the heart of their care. Although physical exercise is widely recommended, few studies with a good level of evidence have enabled us to base a complete, well-constructed intervention on exercise that can be offered as secondary prevention in these disorders. Methods A prospective, multicenter, comparative (intervention arm vs. control arm), randomized (immediate vs. later treatment) study using Zelen’s design. This study falls under active prevention of MSDs of the upper extremities (UE-MSDs). Participants are workers aged between 18 and 65 years with latent or symptomatic MSDS, with any type of job or workstation, with or without an history of sick leave. The primary aim is to show the superiority at 3 months of a combination of spa therapy, exercise, and self-management workshops for 6 days over usual care in the management of MSDs in terms of employee functional capacity in personal and professional daily life. Secondary aims are to assess the benefit of the intervention in terms of pain, quality of life, and accumulated duration of sick leave. Discussion This randomized controlled trial is the first that will aim to evaluate multidisciplinary management of UE-MSDs using nonpharmacological treatment combining exercise, self-management, and spa therapy. The originality of this intervention lies, in its short, intensive format, which is compatible with remaining in work; and in its multidisciplinary approach. This trial has the potential to demonstrate, with a good level of evidence, the benefits of a short course of spa therapy combined with a personalized self-management program on the functional capacity, pain, and quality of life of employees in their daily life. Trial registration Clinical trial.gov NCT02702466 retrospectively registered. Protocol: Version 4 of 9/10/2015. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1353-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charlotte Lanhers
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France. .,University of Clermont-Ferrand Auvergne, Auvergne University, 28, Place Henri-Dunant, 63000, Clermont-Ferrand, France. .,Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France.
| | - Bruno Pereira
- Clinical Research and Innovation Direction, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Chloé Gay
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France
| | - Christian Hérisson
- Physical Medicine and Rehabilitation, University of Montpellier 1, Hopital of Lapeyronie, CHRU Montpellier, 371 Av. du Doyen Gaston Giraud, 34295 Cedex 5, Montpellier, France
| | - Christine Levyckyj
- Research and Development, Thermal Cure Center de Royat, 1 place Allard, CS 20053 Royat, 63408, Chamalières Cedex, France
| | - Arnaud Dupeyron
- Physical Medicine and Rehabilitation, Hospital of Caremeau, University of Montpellier 1, 30029 Cedex 09, Nîmes, France
| | - Emmanuel Coudeyre
- Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU), 58, rue de Montalembert, 63000, Clermont-Ferrand, France.,University of Clermont-Ferrand Auvergne, Auvergne University, 28, Place Henri-Dunant, 63000, Clermont-Ferrand, France.,INRA, Unity of Human Nutrition (UNH, UMR 1019), CRNH Auvergne, Clermont-Ferrand, France
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Moradi A, Menendez ME, Kachooei AR, Isakov A, Ring D. Update of the Quick DASH Questionnaire to Account for Modern Technology. Hand (N Y) 2016; 11:403-409. [PMID: 28149205 PMCID: PMC5256652 DOI: 10.1177/1558944715628006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Almost 2 decades have passed since the development of the items contained in the Quick Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and during this time, daily tasks have changed to adapt to changes in technology. Methods: A cohort of 108 patients completed demographic information, the Quick DASH (both standard and technologically updated versions), and 2 Patient-Reported Outcomes Measurement Information System (PROMIS)-based computerized adaptive testing questionnaires: PROMIS pain interference and upper-extremity function. To create a technologically updated Quick DASH, we substituted 3 items from the standard Quick DASH questionnaire with 3 other items related to the use of technology: (1) Text or dial with your cell phone, (2) Type on a keyboard, and (3) Use a computer mouse. Results: The technologically updated Quick DASH questionnaire had lower scores compared with the standard Quick DASH (37 vs. 33, respectively), but they had a large correlation and both had high internal consistency. The items "Text or dial with your cell phone" and "Use a computer mouse" in the updated Quick DASH questionnaire had the lowest scores. Except for affected side, the standard Quick DASH and updated Quick DASH were influenced by the same factors. PROMIS pain interference was the only independent variable affecting both questionnaire scores. Conclusions: A technologically updated Quick DASH had no advantage over the standard Quick DASH.
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Affiliation(s)
- Ali Moradi
- Mashhad University of Medical Sciences, Orthopedics Research Center, Ghaem Hospital, Mashhad, Iran,Harvard Medical School, Boston, MA, USA
| | | | - Amir Reza Kachooei
- Mashhad University of Medical Sciences, Orthopedics Research Center, Ghaem Hospital, Mashhad, Iran,Harvard Medical School, Boston, MA, USA
| | | | - David Ring
- Harvard Medical School, Boston, MA, USA,David Ring, Chief of Hand Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114, USA.
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van Aaken J, Holzer N, Wehrli L, Delaquaize F, Gonzalez IA, Beaulieu JY. Unacceptable failure of the PI2® implant. J Hand Surg Eur Vol 2016; 41:917-922. [PMID: 27281160 DOI: 10.1177/1753193416651573] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED The PI2® spacer is designed for treatment of trapeziometacarpal (TM) osteoarthritis. However, the shape of this implant has raised concerns about its stability. We retrospectively investigated 45 implants in 41 patients treated for trapeziometacarpal osteoarthritis in our hospital between 2004 and 2009 who underwent trapeziectomy and insertion of a PI2® spacer. Outcome parameters included revision rates and clinical outcomes correlated with implant position and scaphometacarpal distance, assessed using standard radiographs. A total of 12 implants (27%) were removed at a median time of 10 months (interquartile range (IQR), 7-22 months). These included five dislocations and one early infection. Additionally, a further six patients underwent revision due to persistent pain. Three of these had scapho-trapezoid osteoarthritis, two had developed subluxation of the implant, and one did not show any radiographic abnormalities. A review of patient records revealed that 33 implants remained in place at a median time of 29 months (IQR, 20-57). However, of those, only 21 implants (64%) in 17 patients were available for clinical evaluation at a median follow-up of 29 months (IQR, 19-62 months). No significant differences in clinical outcomes including functional results were observed between in-place ( n = 8) and subluxated ( n = 13) implants. Due to the high revision rate (12/45), consistent with other reports in the literature, we have abandoned the use of the PI2® spacer. We recommend the establishment of a registry for evaluation of future implants. TYPE OF STUDY/LEVEL OF EVIDENCE Case-series study/level IV.
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Affiliation(s)
- J van Aaken
- 1 Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Universitaire de Genève, Genève, Switzerland
| | - N Holzer
- 1 Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Universitaire de Genève, Genève, Switzerland
| | - L Wehrli
- 2 Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - F Delaquaize
- 1 Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Universitaire de Genève, Genève, Switzerland
| | - I A Gonzalez
- 1 Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Universitaire de Genève, Genève, Switzerland
| | - J Y Beaulieu
- 1 Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Hôpital Universitaire de Genève, Genève, Switzerland
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Uddin Z, MacDermid JC, Moro J, Galea V, Gross AR. Psychophysical and Patient Factors as Determinants of Pain, Function and Health Status in Shoulder Disorders. Open Orthop J 2016; 10:466-480. [PMID: 29399220 PMCID: PMC5765212 DOI: 10.2174/1874325001610010466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/04/2016] [Accepted: 08/16/2016] [Indexed: 12/15/2022] Open
Abstract
Objective: To estimate the extent to which psychophysical quantitative sensory test (QST) and patient factors (gender, age and comorbidity) predict pain, function and health status in people with shoulder disorders. To determine if there are gender differences for QST measures in current perception threshold (CPT), vibration threshold (VT) and pressure pain (PP) threshold and tolerance. Design: A cross-sectional study design. Setting: MacHAND Clinical Research Lab at McMaster University. Subjects: 34 surgical and 10 nonsurgical participants with shoulder pain were recruited. Method: Participants completed the following patient reported outcomes: pain (Numeric Pain Rating, Pain Catastrophizing Scale, Shoulder Pain and Disability Index) and health status (Short Form-12). Participants completed QST at 4 standardized locations and then an upper extremity performance-based endurance test (FIT-HaNSA). Pearson r’s were computed to determine the relationships between QST variables and patient factors with either pain, function or health status. Eight regression models were built to analysis QST’s and patient factors separately as predictors of either pain, function or health status. An independent sample t-test was done to evaluate the gender effect on QST. Results: Greater PP threshold and PP tolerance was significantly correlated with higher shoulder functional performance on the FIT-HANSA (r =0.31-0.44) and lower self-reported shoulder disability (r = -0.32 to -0.36). Higher comorbidity was consistently correlated (r =0.31-0.46) with more pain, and less function and health status. Older age was correlated to more pain intensity and less function (r =0.31-0.57). In multivariate models, patient factors contributed significantly to pain, function or health status models (r2 =0.19-0.36); whereas QST did not. QST was significantly different between males and females [in PP threshold (3.9 vs. 6.2, p < .001) and PP tolerance (7.6 vs. 2.6, p < .001) and CPT (1.6 vs. 2.3, p =.02)]. Conclusion: Psychophysical dimensions and patient factors (gender, age and comorbidity) affect self-reported and performance-based outcome measures in people with shoulder disorders.
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Affiliation(s)
- Zakir Uddin
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Physiotherapy, College of Health Sciences, University of Sharjah, UAE
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada.,Department of Physical Therapy, Western University, London, Ontario, Canada
| | - Jaydeep Moro
- Division of Orthopaedic Surgery, Departments of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Galea
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Anita R Gross
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Tuton D, Barbe C, Salmon JH, Dramé M, Nérot C, Ohl X. Transcultural validation of the Oxford Shoulder Score for the French-speaking population. Orthop Traumatol Surg Res 2016; 102:555-8. [PMID: 27460650 DOI: 10.1016/j.otsr.2016.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/09/2016] [Accepted: 05/30/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) have been gaining in popularity over the last decade. The Oxford Shoulder Score (OSS) is a well-established self-administered questionnaire for shoulder evaluation adapted for the English-speaking population. The aim of the present study was to develop a translation and a transcultural adaptation of the OSS and to assess its validity in native French-speaker patients with shoulder pain. METHODS The translation process was carried out following a translation/back-translation methodology by two translators. All patients completed the French OSS, the Subjective Shoulder Value (SSV), and the Constant score. Internal consistency was tested using Cronbach's α coefficient. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and the Constant score and the SSV. RESULTS One hundred forty-four patients suffering from degenerative or inflammatory diseases of the shoulder were included in this study. The average time required to complete the French OSS was 2min and 45s. Seventy patients were asked to complete the questionnaire twice (test/retest reliability). Internal consistency was high with Cronbach's α coefficient=0.93. The intraclass correlation coefficient was 0.91 (95% CI: 0.88-0.94) for test/retest reliability. The French OSS score was significantly correlated with the Constant-Murley score (r=0.73 and P<0.0001) and with the SSV (r=0.68 and P<0.0001). CONCLUSIONS The present study shows that the French version of the OSS is reliable, valid, and reproducible. The sensitivity to change now needs to be evaluated. This score was adapted to the French-speaking population for the self-assessment of patients with degenerative or inflammatory disorders of the shoulder. LEVEL OF EVIDENCE Level 1, Test of previously developed criteria, diagnostic test study.
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Affiliation(s)
- D Tuton
- Département de chirurgie orthopédique et traumatologique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France
| | - C Barbe
- Unité d'aide méthodologique, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France
| | - J-H Salmon
- Département de rhumatologie, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France
| | - M Dramé
- Unité d'aide méthodologique, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51100 Reims, France
| | - C Nérot
- Département de chirurgie orthopédique et traumatologique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France
| | - X Ohl
- Département de chirurgie orthopédique et traumatologique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
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Lateral band translocation for swan-neck deformity: Outcomes of 41 digits after a mean follow-up of eight years. Orthop Traumatol Surg Res 2016; 102:S221-4. [PMID: 27036508 DOI: 10.1016/j.otsr.2016.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/24/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Swan-neck deformity (SND) of the fingers can cause major functional impairment. The Zancolli-Tonkin procedure is a crossed dynamic tenodesis that prevents overextension of the proximal interphalangeal (PIP) joint and promotes extension of the distal interphalangeal (DIP) joint. We assessed the outcomes of this procedure in patients with SND due to various causes. HYPOTHESIS The Zancolli-Tonkin procedure provides effective and stable correction of SND due not only to RA, but also to other conditions. PATIENTS AND METHODS Consecutive patients managed at two centres between 2000 and 2013 were included. The causes of SND were inflammatory joint disease, trauma, iatrogenic events, and neurological disorders. The same operative technique was used in all patients. RESULTS Forty-one fingers in 14 patients were evaluated. After a mean follow-up of 8 years, all patients could harmoniously flex the operated fingers and none had recurrence of the deformity. At the PIP joints, mean active flexion was 86° (range: 40°-90°) and mean loss of extension was 15° (range: 0°-40°). At the DIP joints, mean active flexion was 65° (range: 0°-70°) and mean extension lag was 4° (range: 0°-30°). The mean visual analogue scale pain score was 1/10 (range: 0/10-8/10) and the mean patient satisfaction score was 7.5/10 (range: 4/10-10/10). DISCUSSION The SND was corrected and the results were stable after 8 years in all cases. Advantages of the Zancolli-Tonkin procedure include limited invasiveness, with no need to harvest a distant tendon, and rapid active postoperative rehabilitation. The moderate excessive PIP joint flexion has no adverse impact on the overall functional outcome. The high level of patient satisfaction reflects the improvements in function. CONCLUSION The Zancolli-Tonkin procedure is a simple and reliable technique that provides lasting correction of an incapacitating deformity associated with impaired overall hand function. LEVEL OF EVIDENCE IV.
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Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR, Birjandinejad A. Validity and Reliability of the Persian Version of Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Quick-DASH). Int J Prev Med 2015; 6:59. [PMID: 26288703 PMCID: PMC4521304 DOI: 10.4103/2008-7802.160336] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 04/05/2015] [Indexed: 11/06/2022] Open
Abstract
Background: The aim was to assess the validity and reliability of the Persian version of shortened disabilities of the arm, shoulder, and hand (Quick-DASH) questionnaire in patients with upper extremity conditions. Methods: We administered the Persian version of Quick-DASH to 202 patients with upper extremity conditions, of which 71 patients randomly returned after 3 days to respond to the questionnaire for the 2nd time. In order to test the construct validity of the questionnaire, patients responded to the Michigan Hand Outcome Questionnaire (MHOQ) and Short Form 36 Health Survey (SF-36) as well. Internal consistency was tested using the Cronbach's alpha, and test-retest reliability was measured using intra-class correlation coefficient (ICC). Results: Cronbach's alpha was 0.90. ICC was 0.89. Convergent validity was confirmed, as the Spearman correlation between the Quick-DASH and MHOQ was 0.67 and ranged from 0.24 to 0.56 between the subscales of the SF-36 and Quick-DASH. Conclusions: Observation of excellent internal consistency, good to excellent test-retest reliability, and moderate to strong construct validity confirms the validity and reliability of the Persian version of Quick-DASH for evaluating the magnitude and level of disability in upper extremity conditions.
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Affiliation(s)
| | - Ali Moradi
- Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - Ehsan Vahedi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Reza Kachooei
- Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA
| | - Ali Birjandinejad
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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