Original CommunicationsResponsiveness 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*,**,*,**
Section snippets
Patient testing
Patients with wrist fractures (n = 59 for whom all questionnaires were completed at all 3 visits) were tested on 3 occasions. All patients signed consent forms approved by the local university ethics board. Primary emergency care took place either in local or outlying hospitals. The baseline orthopedic clinic visit and definitive treatment occurred within the first 10 days after fracture. Patients were assessed again at 3 and 6 months after injury. At all visits the patients completed the SF-36,
Results
Over both the 0- to 3-month and 0- to 6-month time periods, the PRWE SRM was larger (more responsive) than the DASH (ph < .001) or the SF-36 (ph < .0001) SRMs (Table 4).Empty Cell SRM Effect Size Empty Cell Empty Cell Months 0–3 3–6 0–6 0–3 3–6 0–6 PRWE Pain 1.52 0.67 1.95 1.87 0.50 2.42 Specific function 2.47 0.62 3.62 5.87 0.44 7.01 Usual function 1.62 0.44 2.24 1.95 0.36 2.29 Total 2.27 0.74 2.95 3.16 0.50 3.91 DASH 2.01 0.68 2.52 1.86 0.44 2.32 SF-36 Physical function 1.33 0.28 1.07 0.82 0.14 0.91 Physical
Discussion
The results of this study demonstrate that questionnaires that were more specific to the wrist were more responsive in detecting clinical change. The largest change in outcome scores was observed between the baseline measurement and the 3-month follow-up examination. Baseline measurements can be taken immediately with questionnaires, but measures of physical performance must await fracture healing and removal of external hardware. Thus, questionnaires provide important information regarding
References (33)
Development of a scale for patient rating of wrist pain and disability
J Hand Ther
(1996)- et al.
A methodological framework for assessing health indices
J Chronic Dis
(1985) - et al.
A comparison of different indices of responsiveness
J Clin Epidemiol
(1997) - et al.
Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach
J Clin Epidemiol
(1997) - et al.
Outcome after Colles fracture: the relative responsiveness of three questionnaires and physical examination measures
J Hand Surg
(1996) - et al.
Reliability and validity of grip and pinch strength evaluations
J Hand Surg
(1984) - et al.
Reliability of range-of-motion measurement in the elbow and forearm
J Shoulder Elbow Surg
(1998) - et al.
Evaluating changes in health status: reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders
J Clin Epidemiol
(1997) - et al.
Reliability of the NK dexterity board
J Hand Ther
(1999) - et al.
Responsiveness of functional status in low back pain: a comparison of different instruments
Pain
(1996)
Epidemiology of acute wrist trauma
Int J Epidemiol
Fractures of the distal radius
Functional bracing of Colles' fractures: a prospective study of immobilization in supination vs. pronation
Clin Orthop
SF-36 health survey: manual and interpretation guide
Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and head[sic])
Am J Ind Med
Patient rating of wrist pain and disability: a reliable and valid measurement tool
J Orthop Trauma
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No benefits in any form have been received or will be recieved from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Joy C. MacDermid, PhD, Clinical Research Laboratory, Hand and Upper Limb Centre, St Joseph's Health Centre, PO Box 5777, London, Ontario, N6A 4L6 Canada.
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0363-5023/00/25A02-0008$3.00/0.
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J Hand Surg 2000;25A:330–340.