Minimal Clinically Important Difference of Grip and Pinch Strength in Women With Thumb Carpometacarpal Osteoarthritis When Compared to Healthy Subjects

2017 ◽  
Vol 42 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Jorge Hugo Villafañe ◽  
Kristin Valdes ◽  
Lucia Bertozzi ◽  
Stefano Negrini
Keyword(s):  
Healthy Subjects ◽  
Minimal Clinically Important Difference ◽  
Pinch Strength ◽  
Clinically Important Difference ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

scholarly journals Weaker Functional Pinch Strength Is Associated With Early Thumb Carpometacarpal Osteoarthritis

2015 ◽  
Vol 474 (2) ◽  
pp. 557-561 ◽  
Author(s):  
Thomas J. McQuillan ◽  
Deborah Kenney ◽  
Joseph J. Crisco ◽  
Arnold-Peter Weiss ◽  
Amy L. Ladd
Keyword(s):  
Pinch Strength ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

scholarly journals Comparison of arthrodesis and arthroplasty of Chinese thumb carpometacarpal osteoarthritis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jianfeng Li ◽  
Dacun Li ◽  
Guanglei Tian ◽  
Wentong Zhang
Keyword(s):  
Grip Strength ◽  
Ligament Reconstruction ◽  
Subjective Evaluation ◽  
Chinese Patients ◽  
Pinch Strength ◽  
Dash Score ◽  
Advantages And Disadvantages ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Carpometacarpal Osteoarthritis

Abstract Background The thumb carpometacarpal (CMC) osteoarthritis is very common. Multiple methods are used to treat progressive thumb CMC osteoarthritis, among which trapeziometacarpal arthrodesis and trapezial excision with ligament reconstruction and tendon interposition (LRTI) are the most common. These two surgical treatment methods have received mixed reviews in previous studies in the west patients. This retrospective study studied the effects, advantages, and disadvantages of arthrodesis and arthroplasty for treating thumb carpometacarpal osteoarthritis in Chinese patients. Methods Between February 2012 and September 2017, 39 Chinese patients with stage II or III thumb carpometacarpal osteoarthritis underwent surgery (trapeziometacarpal arthrodesis in 22, trapezial excision with ligament reconstruction and tendon interposition in 17). Postoperative objective and subjective evaluations were performed. The objective evaluation involved grip strength, pinch strength, thumb abduction degree (palmar and radial), and Kapandji opposition scores. The subjective evaluation involved visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Results Intergroup differences in pinch strength, thumb abduction degrees (palmar and radial), and Kapandji opposition scores were obvious, whereas those in grip strength, VAS score, and DASH score were not. Conclusion In Chinese patients, both techniques relieved pain and improve grip strength. Arthrodesis displayed better pinch strength, while arthroplasty displayed better motor function. Patients were satisfied with the effects of both techniques.

The Minimal Clinically Important Difference for PROMIS Physical Function in Patients With Thumb Carpometacarpal Arthritis

Hand ◽  
2019 ◽  
pp. 155894471988002 ◽  
Author(s):  
Daniel J. Lee ◽  
Ryan P. Calfee
Keyword(s):  
Confidence Interval ◽  
Physical Function ◽  
Minimal Clinically Important Difference ◽  
Statistical Testing ◽  
Patient Age ◽  
Clinically Important Difference ◽  
Patient Âgé ◽  
Mild Improvement ◽  
Thumb Carpometacarpal

Background: This study was performed to determine the minimal clinically important difference (MCID) of Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) computer adaptive test (CAT) for patients with thumb carpometacarpal (CMC) arthritis. Methods: This study retrospectively analyzed data from 152 adults receiving surgical and nonsurgical care for unilateral thumb CMC arthritis at a single institution between January 2016 and January 2018. Patients completed PROMIS PF v1.2/2.0 CAT at each visit. At follow-up, patients also completed two 6-item anchor questions assessing the degree of perceived improvement. Statistical testing analyzed the ability of the clinical anchor to discriminate levels of improvement. An anchor-based MCID estimate was calculated as the mean PROMIS PF change score in the mild improvement group. The anchor-based MCID value was examined for the influence of patient age, initial and final PROMIS scores, and follow-up interval. A distribution-based MCID value was calculated incorporating the standard error of measurement and effect size. Results: The change in PROMIS PF scores was significantly different between encounters where patients reported no change, mild improvement, and much improvement. The anchor-based MCID estimate for PROMIS PF was 3.9 (95% confidence interval, 3.3-4.7). Individual MCID values were weakly correlated with the final absolute PROMIS PF score but did not correlate with patient age, time between visits, or the initial absolute PROMIS PF score. The distribution-based MCID value was 3.5 (95% confidence interval, 3.1-3.9). Conclusions: The estimated range of MCID values for PROMIS PF is 3.5 to 3.9 points in patients treated for thumb CMC arthritis.

scholarly journals A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

2021 ◽  
pp. 026921552110251
Author(s):  
Marla K Beauchamp ◽  
Rudy Niebuhr ◽  
Patricia Roche ◽  
Renata Kirkwood ◽  
Kathryn M Sibley
Keyword(s):  
Stroke Rehabilitation ◽  
Minimal Clinically Important Difference ◽  
Clinical Importance ◽  
Minimal Detectable Change ◽  
Global Rating ◽  
Detectable Change ◽  
Clinically Important Difference ◽  
Before And After ◽  
Small Change ◽  
A Prospective Study

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

scholarly journals FRI0635-HPR PATIENTS’ MOTIVATION AND GOALS FOR THUMB CARPOMETACARPAL OSTEOARTHRITIS SURGERY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 921.2-922
Author(s):  
E. M. H. Gravås ◽  
I. Kjeken ◽  
R. Nossum ◽  
R. E. Mehl Eide ◽  
Å. Klokkeide ◽  
...  
Keyword(s):  
Pharmacological Treatment ◽  
Cross Sectional Study ◽  
Activity Limitations ◽  
Hand Osteoarthritis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eular Recommendations ◽  
High Motivation ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

Background:Osteoarthritis (OA) in the thumb carpometacarpal joint (CMCJ) is a prevalent disease which may lead to structural damage, severe pain and functional limitations, but for which there is yet no cure. Evidence-based treatment recommendations state that all patients with hand OA should be offered patient education, hand exercises, and provision of assistive devices and orthoses. Pharmacological therapy is recommended as a symptom relieving supplement. The main indication for CMCJ surgery is pain and poor function, and such surgery should be considered only when other treatment has proven insufficient in relieving pain (1). Previous research has shown that high motivation is a significant predictor for deciding to undergo CMCJ surgery (2), but there is little knowledge regarding which factors that motivates patients for undergoing such surgery.Objectives:The objective of this study was to explore patient goals and motivation for surgery, and factors characterizing patients highly motivated for surgery.Methods:This cross-sectional study included 180 patients referred from their general practitioner for CMCJ surgical consultation. Goals for surgery were collected with an open-ended question and analysed by linking the content of each goal to domains in the International Classification of Functioning, Disability and Health coding system. Motivation for surgery was rated with a Numeric Rating Scale (NRS, 0-10, 0=no motivation). Activity limitations was self-reported using the Measure of Activity Performance of the Hand (MAP-Hand, score 1 to 4, 1=no activity problems) and the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH; score 0-100, 0=no disability). Factors that characterized patients highly motivated for surgery (NRS≥8) were explored with multivariate regression analyses.Results:Mean age of participants was 63 years (SD 7.6) and 142 (79%) were women. The most common goals for surgery were to reduce pain and improve arm and hand use. Fifty-six (31%) of the patients were characterized as highly motivated for surgery. High motivation for surgery was strongly associated with more activity limitations (MAP-Hand; (OR 4.00, p=0.008)), living alone (OR 3.18, p=0.007) and a young age (OR 0.94, p=0.002).Conclusion:Decisions on CMCJ OA surgery should be based on assessment and discussion of patients’ life situation, hand pain, activity limitations and motivation and goals for surgery. According to the EULAR recommendations, previously received conservative and pharmacological treatment should also be evaluated.References:[1] Kloppenburg, M., et al. (2018). “2018 update of the EULAR recommendations for the management of hand osteoarthritis.” Ann Rheum Dis. 0; 1-9[2] Gravas, E. M. H., et al. (2019). “Non-pharmacological treatment gap preceding surgical consultation in thumb carpometacarpal osteoarthritis - a cross-sectional study.” BMC Musculoskelet Disord 20(1): 180.Disclosure of Interests:None declared

Letter: Contemporary Analysis of Minimal Clinically Important Difference in the Neurosurgical Literature

Neurosurgery ◽  
2021 ◽  
Author(s):  
Sumit Raj ◽  
Pradeep Chouksey ◽  
Adesh Shrivastava ◽  
Rakesh Mishra ◽  
Amit Agrawal
Keyword(s):  
Minimal Clinically Important Difference ◽  
Clinically Important Difference
Sign in / Sign up

Export Citation Format

Share Document