Article

The active wrist joint
position sense (JPS) test has been determined to be a clinically useful test for
assessing wrist sensorimotor (SM) status after distal radius fracture (DRF). Its
responsiveness is yet to be determined. PURPOSE OF THE STUDY: Primary study aim
was to determine the active wrist JPS test responsiveness to detect change in
wrist SM status at 8 and 12 weeks after DRF treatment intervention. Secondary
aims were to compare group (nonsurgical, surgical, high, and low pain) test
responsiveness; compare pain-level group participants test scores; determine the
relationship between test minimal clinically important difference (MCID) value
and function; compare functional outcomes across assessment times; and determine
the Patient Global Impression of Change Scale intrarater reliability. METHODS: A
total of 33 male and female participants were tested at baseline, 8, and 12 weeks
after nonsurgical (n = 13) and surgical (n = 20) DRF treatment interventions.
Distribution-based analysis encompassed both group-
(ie, effect size,
standardized response mean) and individual-based (ie, minimum detectable change)
statistical indices. Anchor-based analysis determined the MCID value by linking
test scores to the Patient Global Impression of Change Scale. RESULTS: The active
wrist JPS test is highly responsive based on effect size (8 weeks = 1.53 and 12
weeks = 2.36) and standardized response mean (8 weeks = 1.57 and 12 weeks =
2.14). Statistically significant minimum detectable change values were 4.28
degrees and 4.94 degrees at 8 and 12 weeks, respectively. Clinically meaningful
MCID values were 5.00 degrees and 7.09 degrees at 8 and 12 weeks, respectively.
Between treatment type and pain-level group responsiveness levels were not
significantly different. High-pain participants demonstrated significantly
greater JPS deficit. Test MCID values and function were significantly associated.
DISCUSSION: This is the first study to determine the active wrist JPS test
responsiveness as reflected by its group- and individual-based statistical
indices following DRF surgical and non-surgical interventions among low- and
high-pain level participants. The statistical analysis approach, which was used
to determine the aforementioned variables of the active wrist JPS test, is
consistent with current research. This study's strengths included its design,
methodology, and statistical approach. The study findings must be interpreted,
however, within the content of several methodological limitations. CONCLUSIONS:
The active wrist JPS test was determined to be highly responsive to detect wrist
SM status change at 8 and 12 weeks regardless of treatment type or pain level.
Clinicians can use this test with confidence to measure clinically meaningful SM
impairment after DRF treatment. LEVEL OF EVIDENCE: 2b.
CI - Copyright A(c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS