Uchiyama S, Imaeda T, Toh S, Kusunose K, Sawaizumi T, Wada T, Okinaga S, Nishida J, Omokawa S
Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
J Orthop Sci. 2007 May;12(3):249-53. doi: 10.1007/s00776-007-1128-z. Epub 2007 May 31.
The Japanese Society for Surgery of -the Hand version of the Carpal Tunnel Syndrome Instrument (CTSI-JSSH), which consists of two parts--one for symptom severity (CTSI-SS) and the other for functional status (CTSI-FS)--is a self-administered questionnaire specifically designed for carpal tunnel syndrome. The responsiveness of the CTSI-JSSH was compared with that of the JSSH version of the Disability of Arm, Shoulder, and Hand questionnaire (DASH), the official Japanese version of the 36-Item Short Form Health Survey (SF-36, version 1.2), and physical examinations to elucidate the role of the CTSI-JSSH for evaluating patients with carpal tunnel syndrome.
Preoperatively, a series of 60 patients with carpal tunnel syndrome completed the CTSI-JSSH, DASH, and SF-36. Results of physical examinations, including grip strength, pulp pinch, and static two-point discrimination of the thumb, index, and long fingers, were recorded. Three months after carpal tunnel release surgery the patients were asked to fill out the same questionnaires, and the physical examinations were repeated. The responsiveness of all the instruments was examined by calculating the standardized response mean (SRM) and effect size (ES). Correlation coefficients were calculated between questionnaire change scores and patient satisfaction scores as well as between the CTSI change scores and those of the DASH and SF-36.
The largest responsiveness was observed in the CTSI-SS (SRM/ES: -1.00/-1.08) followed by the CTSI-FS (-0.76/-0.63), and bodily pain subscale of SF-36 (SF-36-BP, 0.45/0.55), and the DASH (-0.46/-0.47). Only the change scores of the CTSI-SS had significant correlation with patient satisfaction (r = 0.34, P < 0.01). An absolute value of Spearman's correlation coefficient of >0.5 was observed between the change scores of the CTSI-SS and the DASH, the CTSI-SS and the SF-36-BP, the CTSI-FS and the DASH, and the DASH and the SF-36-BP.
The CTSI-JSSH was proven to be more sensitive to clinical changes after carpal tunnel release than the other outcome measures and should be used to evaluate patients with carpal tunnel syndrome who speak Japanese as their native language.
日本手部外科学会版腕管综合征量表（CTSI-JSSH）由两部分组成——一部分用于评估症状严重程度（CTSI-SS），另一部分用于评估功能状态（CTSI-FS），是一种专门为腕管综合征设计的自评问卷。将CTSI-JSSH的反应度与日本版手臂、肩部和手部功能障碍问卷（DASH）、官方日文版36项简短健康调查问卷（SF-36，版本1.2）以及体格检查的反应度进行比较，以阐明CTSI-JSSH在评估腕管综合征患者中的作用。
术前，60例腕管综合征患者完成了CTSI-JSSH、DASH和SF-36问卷。记录体格检查结果，包括握力、指尖捏力以及拇指、示指和中指的静态两点辨别觉。腕管松解术后3个月，要求患者填写相同问卷，并重复体格检查。通过计算标准化反应均值（SRM）和效应量（ES）来检验所有工具的反应度。计算问卷变化得分与患者满意度得分之间的相关系数，以及CTSI变化得分与DASH和SF-36变化得分之间的相关系数。
CTSI-SS的反应度最大（SRM/ES：-1.00/-1.08），其次是CTSI-FS（-0.76/-0.63）、SF-36的身体疼痛分量表（SF-36-BP，0.45/0.55）和DASH（-0.46/-0.47）。只有CTSI-SS的变化得分与患者满意度有显著相关性（r = 0.34，P < 0.01）。CTSI-SS与DASH、CTSI-SS与SF-36-BP、CTSI-FS与DASH以及DASH与SF-36-BP的变化得分之间的Spearman相关系数绝对值>0.5。
事实证明，CTSI-JSSH比其他结局指标对腕管松解术后的临床变化更敏感，应用于评估以日语为母语的腕管综合征患者。
