Chu Mary Ml, Chan Josephine, Chan Chetwyn Ch
The Hong Kong Polytechnic University, China.
Texas Woman University, USA.
Hong Kong J Occup Ther. 2021 Jun;34(1):39-49. doi: 10.1177/1569186121997937. Epub 2021 Mar 19.
To identify predicting factors of treatment outcomes of a two stage group-based and then individual-based intervention programme for patients with carpal tunnel syndrome (CTS).
A prospective cohort study where patients diagnosed with CTS were recruited from an out-patient occupational therapy clinic to join the two-stage CTS programme. The Stage-One programme consisted of splinting and educational talks in a group format, while the Stage-Two programme consisted of four weekly individual sessions providing psychosocial support, reinforcing correct ergonomics and mobilization. Baseline assessment on six potential predicting factors and four outcome measures was done for all patients. Patients were re-assessed at the end of the Stage-One and the Stage-Two programme. Analysis was done by binary logistic regression adjusted for baseline covariates.
One hundred and sixty-six patients completed the Stage-One programme and 46 patients also completed the Stage-Two programme. Results showed that the Chinese Symptom Severity Scale (SSS) baseline score was the only significant predictor for the Stage-One programme outcomes (AUC for ROC was 0.708) with an optimum cut-off score of 23.5. On the other hand, the Chinese QuickDASH baseline score was the only significant predictor for the Stage-Two programme outcomes (AUC for ROC was 0.801) with an optimum cut-off score of 27.4.
The significant predictor for the Stage One Programme was the Chinese SSS baseline score and that for the Stage Two Programme was the Chinese QuickDASH baseline score. The optimum cut-off scores identified may be applied clinically to guide client-centered treatment planning.
确定针对腕管综合征（CTS）患者的两阶段基于群体然后基于个体的干预计划治疗结果的预测因素。
一项前瞻性队列研究，从门诊职业治疗诊所招募被诊断为CTS的患者参加两阶段CTS计划。第一阶段计划包括以小组形式进行夹板固定和教育讲座，而第二阶段计划包括每周四次的个体疗程，提供心理社会支持、强化正确的人体工程学和活动。对所有患者进行了六个潜在预测因素和四个结果指标的基线评估。在第一阶段和第二阶段计划结束时对患者进行重新评估。通过对基线协变量进行调整的二元逻辑回归进行分析。
166名患者完成了第一阶段计划，46名患者也完成了第二阶段计划。结果表明，中国症状严重程度量表（SSS）基线评分是第一阶段计划结果的唯一显著预测因素（ROC的AUC为0.708），最佳截断评分为23.5。另一方面，中国QuickDASH基线评分是第二阶段计划结果的唯一显著预测因素（ROC的AUC为0.801），最佳截断评分为27.4。
第一阶段计划的显著预测因素是中国SSS基线评分，第二阶段计划的显著预测因素是中国QuickDASH基线评分。确定的最佳截断评分可在临床上用于指导以患者为中心的治疗计划。
