Article

Validation of a manual ability questionnaire in patients with systemic sclerosis.

Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Arthritis & Rheumatology (Impact Factor: 7.48). 06/2009; 61(5):695-703. DOI: 10.1002/art.24426
Source: PubMed

ABSTRACT To adapt and validate a manual ability questionnaire, the ABILHAND, developed through the Rasch methodology in patients with systemic sclerosis (SSc).
The original version of the ABILHAND, which includes 81 manual daily activities, was presented to 156 patients with SSc. They were asked to provide their perceived difficulty in performing each manual activity on a 3-level scale: impossible, difficult, or easy. Items were selected from well-established psychometric criteria. The patients were reassessed 1 month later to test the reproducibility. Concomitantly, they were clinically evaluated for their disease activity/severity, and their functional ability was tested with the Health Assessment Questionnaire (HAQ).
The 26 selected items defined a unidimensional and linear measure of manual ability and showed a continuous progression in their difficulty. The item difficulty hierarchy was invariant across 12 patient-related factors and the manual ability score was reproducible over time. Finally, the manual ability was significantly poorer in SSc patients with more severe disease, and was negatively correlated with the HAQ score (rho = -0.733).
The SSc-adapted ABILHAND questionnaire is a reliable, valid, reproducible, linear, and unidimensional measure to assess and followup on the manual ability of patients with SSc; therefore, it could become a useful additional tool in clinical trials to assess treatment efficacy.

0 Bookmarks
 · 
245 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To assess the tendon and joint involvement at wrists and ankles of patients suffering from diffuse SSc and to identify the morphological substrate of tendon friction rubs (TFRs).Methods. Fifteen consecutive patients suffering from diffuse SSc were included. All patients had two musculoskeletal US (MSUS) examinations of the wrists and ankles. MRI was performed at the most affected joints as detected by MSUS and in all sites in which TFRs were present.Results. No clinically overt arthritis or tenosynovitis was detected in the wrists and/or ankles prior to MSUS. Synovitis, tenosynovitis and tendon tear were identified in 8, 4 and 2 of 15 patients, respectively, by both MSUS and MRI. At entry, 5 patients had palpable TFRs (4 bilateral and 1 unilateral) and 10 patients did not. Tenosynovitis was more frequently found in ankles with TFRs (3/9) than in those without TFRs (3/21), although the difference was not statistically different (P = 0.3). Using MRI, deep connective tissue infiltrates surrounding tendons were present in all sites with TFRs but in only one patient without TFRs.Conclusion. Both MSUS and MRI are effective in detecting synovitis and tenosynovitis in diffuse SSc patients. Tenosynovitis, synovitis and thickened retinacula are not infrequently seen in these patients. Our data suggest that juxta-tendinous connective tissue infiltrates might be the morphological substrate of tendon friction rubs, which may thus be a misnomer for tissue friction rubs.
    Rheumatology (Oxford, England) 11/2012; · 4.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hand involvement is very common in patients with systemic sclerosis and represents an important tool for the early diagnosis of the disease. Vascular involvement of the hands is at the forefront of systemic sclerosis, with Raynaud's phenomenon, which may be complicated by digital ulcers, digital necrosis causing pain, infection and significant disability. Joint inflammation can also be disabling and causes the occurrence of contractures and deformities resulting in a marked hand disability. Skin sclerosis involving fingers and hands leads to the occurrence of pain and functional impairment. Hand involvement contributes to 75 % of global disability in patients with systemic sclerosis. Only a comprehensive care, taking into account the vascular, skin and joint manifestations, including physical therapy if needed can improve hand function in patients with systemic sclerosis.
    La Presse Médicale 11/2013; · 0.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To be able to evaluate recovery, effects of rehabilitation interventions and changes over time, reliable and valid outcome measures are needed. The ABILHAND Questionnaire is a measure of self-reported ability to perform complex daily hand activities. It is commonly used in stroke rehabilitation, but data about the measurement variability are missing. To assess the test-retest reliability of the ABILHAND Questionnaire in chronic stroke and to define limits for the smallest change that indicates a real change, both for a group of individuals and a single individual. A test-retest reliability study. University Hospital. A convenience sample of 43 individuals (11 women and 32 men; mean age 64 years) with mild to moderate impairments of hand function 6 to 48 months after stroke. Not applicable. The ABILHAND Questionnaire is Rasch analysed, enabling ordinal data to be converted into an interval scale (logits) and the use of parametric statistical analyses. The participants responded to 23 items in the ABILHAND Questionnaire on two occasions, two weeks apart. Reliability was assessed with the intraclass correlation coefficient (ICC22.1), the mean difference between the test sessions (đ) together with the 95% confidence intervals for đ, the standard error of measurement (SEM and SEM%), the smallest real difference (SRD and SRD%) and a Bland & Altman graph. Four outliers, with high mean logit scores (>4.0), were identified in the sample. The results are therefore presented for the whole sample (n=43) and without the four outliers (n=39). The test-retest agreement was high, ICC2,1 = 0.85 (n=43) and 0.91 (n=39). The SEM%, representing the smallest change that indicates a real improvement for a group of individuals, was 21% (n=43) and 15% (n=39). The SRD%, representing the smallest change that indicates a real clinical improvement for a single individual, was 59% (n=43) and 42% (n=39), respectively. The ABILHAND Questionnaire is reliable in persons with chronic stroke and can be recommended to evaluate recovery, rehabilitation interventions and changes over time in a group of individuals but is less suitable for a single individual.
    PM&R 10/2013; · 1.37 Impact Factor

Full-text (2 Sources)

View
106 Downloads
Available from
May 29, 2014