Which Outcome Measure is the Best? Evaluating Responsiveness of the Disabilities of the Arm,Shoulder,and Hand Questionnaire,the Michigan Hand Questionnaire and the Patient-Specific Functional Scale following Hand and Wrist Surgery
Restricted accessResearch articleFirst published online September, 2009
Which Outcome Measure is the Best? Evaluating Responsiveness of the Disabilities of the Arm,Shoulder,and Hand Questionnaire,the Michigan Hand Questionnaire and the Patient-Specific Functional Scale following Hand and Wrist Surgery
The purpose of this study was to determine and compare the responsiveness of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Michigan Hand Questionnaire (MHQ), and the Patient-Specific Functional Scale (PSFS) in patients with carpal tunnel syndrome, wrist pain, finger contracture, or tumor. Eighty-one subjects prospectively completed each questionnaire shortly before and 3 and 6 months after surgery. Data were analyzed using one-way analysis of variance and Newman–Keuls multiple comparison tests. Responsiveness to clinical change was calculated using standardized response means. The DASH was responsive for those with carpal tunnel syndrome (0.77), wrist pain (0.61), and tumor (0.55); the MHQ was responsive for those with carpal tunnel syndrome (1.04), wrist pain (0.87), and finger contracture (0.62); and the PSFS was responsive for those with carpal tunnel syndrome (0.65) and finger contracture (0.64). The interval during which the highest responsiveness occurred for the carpal tunnel, wrist pain, and finger contracture groups was the preoperative to 6-month period. The tumor group experienced the highest responsiveness during the preoperative to 3-month period. Our results indicate that one or more of the instruments evaluated are suitable for outcomes research related to surgery to treat carpal tunnel syndrome, wrist pain, finger contracture, and tumor.
BeatonDEBombardierCKatzJN. A taxonomy for responsiveness. J Clin Epidemiol.2001;54:1204–17. doi:10.1016/S0895-4356(01)00407-3.
2.
BeatonDEKatzJNFosselAH. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther.2001;14:128–46.
3.
ChangulaniMOkonkwoUKeswaniT. Outcome evaluation measures for wrist and hand: which one to choose. Int Orthop.2008;32:1–6. doi:10.1007/s00264-007-0368-z.
4.
ChatmanABHyamsSPNeelJM. The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction. Phys Ther.1997;77:820–9.
5.
ChungKCKotsisSV. Outcomes of multiple microvascular toe transfers for reconstruction in 2 patients with digitless hands: 2-and 4-year follow-up case reports. J Hand Surg [Am].2002;27: 652–8. doi:10.1053/jhsu.2002.33706.
6.
ChungKCWeiFC. An outcome study of thumb reconstruction using microvascular toe transfer. J Hand Surg [Am].2000;25: 651–8. doi:10.1053/jhsu.2000.6913.
7.
ChungKCPillsburyMSWaltersMR. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg [Am].1998;23:575–87. doi:10.1016/S0363-5023(98)80042-7.
8.
ChungKCHamillJBWaltersMR. The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change. Ann Plast Surg.1999;42:619–22. doi:10.1097/00000637-199906000-00006.
9.
ChungKCKotsisSVKimHM. Predictors of functional outcomes after surgical treatment of distal radius fractures. J Hand Surg [Am].2007;32:76–83. doi:10.1016/j.jhsa.2006.10.010.
10.
ClelandJAFritzJMWhitmanJM. Predictors of short-term outcome in people with a clinical diagnosis of cervical radiculopathy. Phys Ther.2007;87:1619–32. doi:10.2522/ptj.20060155.
11.
CohenJ. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Erlbaum; 1988. p. 8–14.
12.
De SmetL. Responsiveness of the DASH score in surgically treated basal joint arthritis of the thumb: preliminary results. Clin Rheumatol.2004;23:223–4. doi:10.1007/s10067-004-0866-y.
13.
GayREAmadioPCJohnsonJC. Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release. J Hand Surg [Am].2003;28:250–4. doi:10.1053/jhsu.2003. 50043.
14.
GoldfarbCASternPJ. Metacarpophalangeal joint arthroplasty in rheumatoid arthritis. A long-term assessment. J Bone Jt Surg Am.2003;85-A:1869–78.
15.
GreensladeJRMehtaRLBelwardP. Dash and Boston questionnaire assessment of carpal tunnel syndrome outcome: what is the responsiveness of an outcome questionnaire. J Hand Surg [Br].2004;29:159–64. doi:10.1016/j.jhsb.2003.10.010.
16.
GummessonCAtroshiIEkdahlC. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord.2003;4:11. doi:10.1186/1471-2474-4-11.
17.
HerweijerHDijkstraPUNicolaiJP. Postoperative hand therapy in Dupuytren's disease. Disabil Rehabil.2007;29:1736–41.
18.
HudakPLAmadioPCBombardierC. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med.1996;29:602–8. doi:10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L.
19.
JollesBMBuckbinderRBeatonDE. A study compared nine patient-specific indices for musculoskeletal disorders. J Clin Epidemiol.2005;58:791–801. doi:10.1016/j.jclinepi.2005.01.012.
20.
KleinRDKotsisSVChungKC. Open carpal tunnel release using a 1-centimeter incision: technique and outcomes for 104 patients. Plast Reconstr Surg.2003;111:1616–22. doi:10.1097/01. PRS.0000057970.87632.7e.
21.
KotsisSVChungKC. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire in carpal tunnel surgery. J Hand Surg [Am].2005;30:81–6. doi:10.1016/j.jhsa.2004.10.006.
22.
KotsisSVLauFHChungKC. Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment. J Hand Surg [Am].2007;32:84–90. doi:10.1016/j.jhsa.2006.10.003.
23.
LawMBaptisteSCarswellA. Canadian occupational performance measure, 2nd ed. Ottawa, ON: CAOT Publications ACE; 1998.
24.
MacDermidJCRichardsRSDonnerA. Responsiveness of the short form-36, Disability of the Arm, Shoulder, and Hand questionnaire, patient-rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture. J Hand Surg [Am].2000;25:330–40. doi:10.1053/jhsu.2000.jhsu25a0330.
25.
Massy-WestroppNKrishnanJAhernM. Comparing the AUSCAN Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and Sequential Occupational Dexterity Assessment for patients with rheumatoid arthritis. J Rheumatol.2004;31:1996–2001.
26.
NavsarikarAGladmanDDHustedJA. Validity assessment of the Disabilities of Arm, Shoulder, and Hand questionnaire (DASH) for patients with psoriatic arthritis. J Rheumatol.1999;26:2191.
27.
NourbakhshMRFearonFJ. The effect of oscillating-energy manual therapy on lateral epicondylitis: a randomized, placebo-control, double-blinded study. J Hand Ther.2008;21:4–13.
28.
SambandamSNPriyankaPGulA. Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome. Int Orthop.2008;32:497–504. doi:10.1007/s00264-007-0344-7.
29.
SooHooNFMcDonaldAPSeilerJG3rd. Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. J Hand Surg [Am].2002;27:537–41. doi:10.1053/jhsu.2002. 32964.
30.
StewartMMaherCGRefshaugeKM. Responsiveness of pain and disability measures for chronic whiplash. Spine.2007;32:580–5. doi:10.1097/01.brs.0000256380.71056.6d.
31.
StratfordPWBinkleyFMRiddleDL. Health status measures: strategies and analytic methods for assessing change scores. Phys Ther.1996;76:1109–23.
32.
SzaboRM. Outcomes assessment in hand surgery: when are they meaningful. J Hand Surg [Am].2001;26:993–1002. doi:10.1053/jhsu.2001.29487.
33.
VitielloALBonelloRPollardH. The effectiveness of ENAR for the treatment of chronic neck pain in Australian adults: a preliminary single-blind, randomised controlled trial. Chiropr Osteopat.2007;15:9. doi:10.1186/1746-1340-15-9.
34.
WalkerMJ. Manual physical therapy examination and intervention of a patient with radial wrist pain: a case report. J Orthop Sports Phys Ther.2004;34:761–9.
35.
WestawayMDStratfordPWBinkleyJM. The patient-specific functional scale: validation of its use in persons with neck dysfunction. J Orthop Sports Phys Ther.1998;27:331–8.
36.
WestphalTPiatekSSchubertS. Reliability and validity of the upper limb DASH questionnaire in patients with distal radius fractures. Z Orthop Ihre Grenzgeb.2002;140:447–51. doi:10.1055/s-2002-33396.
