Abstract
Study design
Clinical measurement.
Introduction
Few studies describe the responsiveness of functional outcomes measures in patients
sustaining hand fractures.
Purpose
1 – To explore the responsiveness of three function-oriented Patient Report Outcome
(PRO) measures with a cohort of hand fracture patients. 2 – To examine patients' PRO
preference.
Methods
60 participants with 74 hand fractures at an outpatient hospital-based hand therapy
clinic consented to participate in this study. They completed the Disabilities of
the Arm, Shoulder, and Hand Questionnaire (DASH), Michigan Hand Outcomes Questionnaire
(MHQ), and Patient-Rated Wrist/Hand Evaluation (PRWHE) at three trials: T1 (evaluation),
T2 (one month later), and T3 (two months later). Participants also identified which
PRO they felt best reflected their hand use and which was easiest to complete. Descriptive
statistics, analyses of variance (ANOVA), effect size, and standardized response mean
(SRM) were employed to describe participants, determine functional change between
trials, and examine and compare PRO responsiveness. Questionnaire preference at T1
was reported.
Results
Participants demonstrated functional improvement, as measured by the DASH, PRWHE,
and MHQ. T1 scores: DASH = 41.85 (SD ± 22.78), MHQ = 50.13 (SD ± 18.36), and PRWHE = 48.18
(SD ± 22.07). T2 scores: DASH = 22.11 (SD ± 18.18), MHQ = 69.89 (SD ± 15.93), and
PRWHE = 22.62 (SD ± 18.15). T3 scores: DASH = 17.56 (SD ± 18.01), MHQ = 75.37 (SD ± 19.19),
and PRWHE = 22.40 (SD ± 19.04). Each PRO demonstrated significant test score differences
between trials (p < .001). Large responsiveness (≥.80) was noted between T1 and T2: (effect size: .98–1.23;
SRM: 1.31–1.49) and T1 and T3 (effect size: 1.21–1.54; SRM 1.49–1.84). Smaller responsiveness
effects were noted between T2 and T3 (effect size: .35–.64, SRM: .38–.81). No significant
differences between questionnaire responsiveness were found. Patients reported PRWHE
easiest to complete and MHQ best reflecting their hand use.
Conclusions
DASH, MHQ, and PRWHE were each able to describe functional limitations in this cohort
of patients with hand fractures. In capturing improvement over time they demonstrated
comparable responsiveness in assessing change in patients with hand fractures.
Level of evidence
2c.
Keywords
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JHT Read for Credit
Quiz: #389
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The purpose of the study was to measure the responsiveness of the following in a population of patients with hand fractures
- a.the PRWHE
- b.the MHQ
- c.the DASH
- d.all of the above
- a.
- #2.The PRO(s) was(were) administered to each subject on
- a.initial evaluation
- b.a clinical visit agreed to by both the testing therapist and the patient
- c.3 separate occasions
- d.initial and final visits
- a.
- #3.The greatest responsiveness was found between
- a.T1 and T2
- b.T1 and T3
- c.T2 and T3
- d.T2 and T4
- a.
- #4.Within the scientific community it is generally accepted that
- a.reliability and validity are not consistent across diagnoses
- b.PRO responsiveness is not consistent for all diagnoses
- c.validity, but not reliability, is consistent across diagnoses
- d.the WHO is the final arbiter in approving all definitions
- a.
- #5.The authors expressed a strong preference for the MHQ
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: May 26, 2015
Accepted:
May 19,
2015
Received in revised form:
May 14,
2015
Received:
February 2,
2014
Identification
Copyright
© 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
