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哪种结局指标是最佳的?评估手部和腕部手术后上肢、肩部和手部功能障碍问卷、密歇根手部问卷以及患者特定功能量表的反应性。

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.

作者信息

McMillan Catherine R, Binhammer Paul A

机构信息

Division of Plastic Surgery, Sunnybrook Health Sciences Centre, M1 500 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5.

出版信息

Hand (N Y). 2009 Sep;4(3):311-8. doi: 10.1007/s11552-009-9167-x. Epub 2009 Mar 4.

Abstract

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.

摘要

本研究的目的是确定并比较手臂、肩部和手部功能障碍(DASH)问卷、密歇根手部问卷(MHQ)以及患者特定功能量表(PSFS)在腕管综合征、手腕疼痛、手指挛缩或肿瘤患者中的反应性。81名受试者在手术前以及术后3个月和6个月时前瞻性地完成了每份问卷。使用单因素方差分析和纽曼-基尔斯多重比较检验对数据进行分析。使用标准化反应均值计算对临床变化的反应性。DASH对腕管综合征患者(0.77)、手腕疼痛患者(0.61)和肿瘤患者(0.55)有反应;MHQ对腕管综合征患者(1.04)、手腕疼痛患者(0.87)和手指挛缩患者(0.62)有反应;PSFS对腕管综合征患者(0.65)和手指挛缩患者(0.64)有反应。腕管综合征、手腕疼痛和手指挛缩组出现最高反应性的时间段是术前至术后6个月。肿瘤组在术前至术后3个月期间反应性最高。我们的结果表明,所评估的一种或多种工具适用于与治疗腕管综合征、手腕疼痛、手指挛缩和肿瘤的手术相关的结局研究。

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