Artikel
The Validity of PRWHE and QuickDASH as Outcome Measures Following Surgery to Treat Scapholunate Ligament Dissociation
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Autoren
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Libby J. Anderson
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
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Greg Couzens
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
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Silvia Manzanero
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
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Bhavana Jha
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
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Susan E. Peters
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
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Mark Ross
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Injury to the scapholunate ligament is a common cause of wrist instability. As there are no specific scores to report treatment efficacy, clinicians and researchers currently rely on generic upper limb patient-reported outcome measures, such as PRWHE and the QuickDASH. This study's aim was to evaluate the validity of these measures in detecting changes in patient outcomes after treatment of scapholunate dissociation.
Methods: 92 patients (15 female, average age 40.5) were retrospectively identified from a prospective cohort treated for wrist instability. Data was collected at baseline and at least one follow-up time point (3, 6, or 12 months). At each follow-up time point, subjects were assigned to one of four groups according to their reported global rating of change (PGRC) for both the symptoms (PGRCs) and function (PGRCf) categories. Groups were labelled: 0, PGRC (-7) to (0) inclusive - no change or worse; 1, PGRC (+1) to (+3) - small improvement; 2, PGRC (+4) or (+5) - medium improvement; and 3, PGRC (+6) or (+7) - large improvement. Analysis of variance (ANOVA) and Tukey HSD test for post-hoc multiple comparisons of means were used to test differences between groups in PRWHE and QuickDASH scores at each time point. The significance level was set at p=0.05.
Results and Conclusions: At 3 months, neither PRWHE nor QuickDASH showed significant differences between the groups according to PGRCs or PGRCf. At 6 months, neither score showed significant differences between the groups according to PGRCs; as for PGRCf, both scores showed significant differences between the two extremes (group 0 vs group 3) but failed to reveal differences in the mid-ranges (groups 1 and 2). At 12 months, PRWHE showed significant differences across groups 0 and 2, groups 1 and 3, groups 0 and 3 of PGRCs, whereas QuickDASH only showed significance between group 3 and each of the other groups; as for PGRCf, both scores showed significant differences between the extremes (group 0 and group 3) but failed to reveal differences in the mid-ranges of PGRCf (groups 1 and 2).
PRWHE and QuickDASH may not be able to detect nuances in functional changes at key time points in the context of wrist instability. These preliminary findings have implications for clinicians aiming to select valid and sensitive outcome measures and suitable time points for measurement. The results suggest that the development of a reliable, valid and responsive score for patients with wrist instability may be warranted.
