Rosales R S, Diez de la Lastra I, McCabe S, Ortega Martinez J I, Hidalgo Y M
Hand Surgery Unit and Institute for Research in Hand Surgery, G.E.C.O.T., Tenerife, Spain.
J Hand Surg Eur Vol. 2009 Feb;34(1):72-5. doi: 10.1177/1753193408094156. Epub 2008 Dec 17.
The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.
本研究的目的是评估西班牙语版的上肢功能障碍量表（DASH）作为腕管手术结果测量指标的反应性和结构效度。研究对象为42例根据临床和电生理标准诊断为腕管综合征（CTS）的患者。临床设计为经典队列研究，在开放性腕管松解术前一天和术后12周进行测量。将西班牙语版的DASH与体格检查指标进行比较，包括灵巧时间、握力和捏力、腕关节活动范围（ROM）和两点辨别觉（2PPD）。基于效应量（ES）和标准化反应均值（SRM）评估反应性。对同一研究人群自行发放西班牙语版的CTS问卷（CTQ）和36项简短健康调查问卷（SF - 36）西班牙语版，并遵循相同的临床设计。建立了DASH工具应呈现高于SF - 36且低于CTQ的反应性水平的假设，以证明结构效度。DASH工具的ES为0.68，SRM为1.00。传统体格检查指标的反应性较低，灵巧时间的SRM为0.35，关键捏力的ES为0.00。SF - 36的反应性水平（范围为0.07至0.14）低于DASH。CTQ显示出最高的反应性水平（ES = 1.41和0.7）（SRM = 1.75和0.51）。总之，在CTS术后12周进行的临床结局研究中，DASH工具在检测临床变化方面比体格检查指标更敏感。西班牙语版DASH的反应性低于CTQ且高于SF - 36，证明其具有良好的结构效度。
