Sensitivity of the Patient-rated Forearm Evaluation Questionnaire in Lateral Epicondylitis

doi:10.1197/j.jht.2005.07.001

Journal of Hand Therapy

Volume 18, Issue 4, October–December 2005, Pages 400-406

https://doi.org/10.1197/j.jht.2005.07.001 Get rights and content

Abstract

The purpose of this study was to examine the sensitivity, reliability, and concurrent validity of the Patient-rated Forearm Evaluation Questionnaire (PRFEQ). Reliability on three consecutive days was evaluated with 22 of 94 subjects who had chronic lateral epicondylitis (LE) and who concomitantly participated in an outcome study. The PRFEQ results were compared with results of the Visual Analogue Scale; the Disabilities of the Arm, Shoulder, and Hand questionnaire; the Medical Outcomes Study 36-Item Short Form Health Survey; and the pain-free grip strength measurement. Questionnaires were completed at baseline, six weeks, and 12 weeks. Reliability was excellent using variance components and interclass correlation coefficients (PRFEQ function subscale, 0.92; PRFEQ pain subscale, 0.96; PRFEQ total scale, 0.96). Generally, correlations were moderate between the PRFEQ subscales and total scale and the other outcome scales. Effect size and standardized response mean were good in many outcome scales, being slightly higher in the PRFEQ than in the other outcome measures. The PRFEQ is reliable, reproducible, and sensitive for assessment of LE. It is at least as sensitive to change as the other outcome tools tested. The PRFEQ should be a standard primary outcome measure in LE research.

Section snippets

Subjects

We obtained approval from the Mayo Foundation Institutional Review Board before initiating this study, and each subject gave written informed consent for participation. Subjects were enrolled in a concurrent trial analyzing treatments for LE at a large multidisciplinary medical center.¹⁸ They received remuneration for participating in the collection of baseline data and in the six-week follow-up. Participation in the 12-week follow-up was optional because funding for remuneration at 12 weeks

Subjects

Of the 94 subjects included in the treatment trial, 44 were males (46.8%) and 50 were females (53.2%). Mean age (±SD) was 45.5 ± 7.7 years. Eighty-one subjects (86.2%) completed the study questionnaires at six weeks, and 49 (52.1%) completed them at 12 weeks. By six weeks, 13 subjects had dropped out of the study. There was no significant difference in age, sex, or baseline scores between the dropouts and the other study participants. As compared with subjects who completed the questionnaires at

Discussion

The PRFEQ appears to be a useful outcome tool in LE. As shown by Overend et al.⁴ and as supported by our data, it is highly reliable. We demonstrated reliability over consecutive days as well as after six weeks, adjusting for treatment. The PRFEQ also has an excellent SRM and effect size, indicating that it is sensitive to change.

There was a statistically significant correlation between the PRFEQ and the VAS, DASH, PFG, and bodily pain SF-36 subclass. However, the highest correlation was 0.74

Conclusions

The PRFEQ is reliable, reproducible, and sensitive in the assessment of LE. It is at least as sensitive to change as other commonly used outcome tools. Because the PRFEQ focuses on the elbow and forearm, whereas other instruments do not, we recommend that it be used as a standard outcome measure in LE research.

Quiz: Article #009

Record your answers on the Return Answer Form found at the back of this issue. There is only one best answer for each question.

#1.
PRFEQ results were compared with:
- a.
  DASH
- b.
  VAS
- c.
  SF-36
- d.
  all of the above
#2.
Lateral epicondylitis occurs in approximately ––––– of the population:
- a.
  75%
- b.
  25%
- c.
  1–3%
- d.
  5–10%
#3.
Diagnostic inclusionary criteria were:
- a.
  localized tenderness to the lateral epicondyl and pain to two of three provocative maneuvers
- b.
  pain with isometric testing of the extensor carpi radialis brevis (only)
- c.
  pain with isometric

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There are more references available in the full text version of this article.

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Scientific/Clinical ArticleSensitivity of the Patient-rated Forearm Evaluation Questionnaire in Lateral Epicondylitis

Abstract

Section snippets

Subjects

Subjects

Discussion

Conclusions

Quiz: Article #009

J Hand Ther

Lancet

Aust J Physiother

Med Care

Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes

Scand J Rheumatol

Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow: an attempted meta-analysis

J Bone Joint Surg Br

Effectiveness of physiotherapy for lateral epicondylitis: a systematic review

Ann Med

Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature

Med Sci Sports Exerc

Randomized trial of oral naproxen or local injection of betamethasone in lateral epicondylitis of the humerus

Orthopedics

Low-energy extracorporeal shock wave therapy for persistent tennis elbow

Int Orthop

Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Corrected. The Upper Extremity Collaborative Group (UECG)

Am J Ind Med

Scientific/Clinical Article
Sensitivity of the Patient-rated Forearm Evaluation Questionnaire in Lateral Epicondylitis