An Assessment of the Usefulness of Patient Evaluation Measure Questionnaire as an Outcome Measure after Carpal Tunnel Surgery
Outcome assessment of carpal tunnel release has relied upon objective measurements including grip strength and sensory testing as well as subjective parameters such as relief from pain and improvement of hand function. The latter can be obtained by the use of standardized questionnaires.The aim of the study was to assess the usefulness of Patient Evaluation Measure (PEM) questionnaire as an outcome measure after carpal tunnel surgery.Material and methods. Fifty patients, 43 women and 7 men with an average age of 55 years with carpal tunnel syndrome received mini-invasive carpal tunnel release. Patients were examined before the operation, and at 1 and 6 months after, according the same protocol. They had measured a total grip and key-pinch strengths and sensation by the filament test. They completed also the PEM questionnaire. The following parameters of the questionnaire were determined: responsiveness, concurrent validity and internal consistency.Results. Over a half-year follow-up, the sensation improved statistically significantly during the first month after operation. Power of the hand decreased initially comparing to baseline values, following by further gradual increasing throughout the follow-up. PEM scores showed continuous improvement of the hand status at each assessment. The PEM questionnaire showed excellent responsiveness to change of considered parameters, comparing to baseline values. The PEM showed also high concurrent validity with total grip and pinch strengths, as well as with Sensory Index, but only at 6 months assessment. However, the PEM showed a discordance with total grip and key-pinch strength at 1 month assessment. The instrument showed excellent internal consistency.Conclusion. The PEM questionnaire is, with some exceptions, a good and useful instrument for outcome measurement after carpal tunnel treatment surgery.
- Żyluk A, Piotuch B: zastosowanie kwestionariuszy w ocenie wyników leczenia w chirurgii ręki. Chir Narz Ruchu Ortop Pol 2009; 74: 193-201.
- Levine DW, Simmons BP, Koris MJ et al.: A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg 1993; 75A: 1585-92.
- Macey AC, Burke FD: Outcomes in hand surgery. J Hand Surg 1995; 20B: 841-55.
- Dias JJ, Bhowal B, Wildin CJ et al.: Assessing the outcome of disorders of the hand. Is the patient evaluation measure (PEM) reliable, valid, responsive and without bias? J Bone Joint Surg 2001; 83B: 235-40.[Crossref]
- Hudak PL, Amadio PC, Bombardier C: Upper Extremity Collaborative Group. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand). Am J Industr Med 1996; 29: 602-08.
- Chung KC, Hamil JB, Walters MR: The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change. Ann Plast Surg 1999; 42: 619-22.[Crossref]
- Hobby JL, Watts C, Elliot D: Validity and responsiveness of the patients evaluation measure as an outcome measure for carpal tunnel syndrome. J Hand Surg 2005; 30B: 350-54.
- Forward DP, Sithole JS, Davis TR: The internal consistency and validity of the patient evaluation measure for outcomes assessment in distal radius fractures. J Hand Surg 2007; 32E: 262-67.[Crossref][WoS]
- Żyluk A, Strychar J: A comparison of two limited open techniques for carpal tunnel syndrome release. J Hand Surg 2006; 31B: 466-72.[WoS]
- Bednarski M, Żyluk A, Żyluk B: Ocena ewolucji siły chwytów po dekompresji kanału nadgarstka. Chir Narz Ruchu Ortop Pol 2005; 70: 21-26.
- Greenslade JR, Mehta LR, Belward P et al.: DASH and Boston questionnaire assessment of the carpal tunnel outcome: what is the responsiveness of an outcome questionnaire? J Hand Surg 2004; 29B: 159-64.
- Gay RE, Amadio PC, Johnson JC: Comparative responsiveness of the DASH, the Carpal Tunnel Questionnaire and the SF-36 to clinical change after carpal tunnel release. J Hand Surg 2003; 28A: 250-54.[WoS]
- Amadio PC, Silverstein MC, Ilstrup DM et al.: Outcome assessment for the carpal tunnel surgery: the relative responsiveness of generic, arthritis specific, diesease specific and physical examination measures. J Hand Surg 1996; 21A: 338-46.