Please use this identifier to cite or link to this item: http://buratest.brunel.ac.uk/handle/2438/7488
Title: Optimal functional outcome measures for assessing treatment for Dupuytren's disease: A systematic review and recommendations for future practice
Authors: Ball, C
Pratt, AL
Nanchahal, J
Keywords: Dupuytren’s disease;Hand function;Outcome measures;Systematic review
Issue Date: 2013
Publisher: Biomed Central Ltd
Citation: BMC Musculoskeletal Disorders, 14: 131, Apr 2013
Abstract: Background: Dupuytren's disease of the hand is a common condition affecting the palmar fascia, resulting in progressive flexion deformities of the digits and hence limitation of hand function. The optimal treatment remains unclear as outcomes studies have used a variety of measures for assessment. Methods: A literature search was performed for all publications describing surgical treatment, percutaneous needle aponeurotomy or collagenase injection for primary or recurrent Dupuytren’s disease where outcomes had been monitored using functional measures. Results: Ninety-one studies met the inclusion criteria. Twenty-two studies reported outcomes using patient reported outcome measures (PROMs) ranging from validated questionnaires to self-reported measures for return to work and self-rated disability. The Disability of Arm, Shoulder and Hand (DASH) score was the most utilised patient-reported function measure (n=11). Patient satisfaction was reported by eighteen studies but no single method was used consistently. Range of movement was the most frequent physical measure and was reported in all 91 studies. However, the methods of measurement and reporting varied, with seventeen different techniques being used. Other physical measures included grip and pinch strength and sensibility, again with variations in measurement protocols. The mean follow-up time ranged from 2 weeks to 17 years. Conclusions: There is little consistency in the reporting of outcomes for interventions in patients with Dupuytren’s disease, making it impossible to compare the efficacy of different treatment modalities. Although there are limitations to the existing generic patient reported outcomes measures, a combination of these together with a disease-specific questionnaire, and physical measures of active and passive individual joint Range of movement (ROM), grip and sensibility using standardised protocols should be used for future outcomes studies. As Dupuytren’s disease tends to recur following treatment as well as extend to involve other areas of the hand, follow-up times should be standardised and designed to capture both short and long term outcomes.
Description: This article is available through the Brunel Open Access Publishing Fund. Copyright © 2013 Ball et al.; licensee BioMed Central Ltd.
URI: http://www.biomedcentral.com/1471-2474/14/131
http://bura.brunel.ac.uk/handle/2438/7488
DOI: http://dx.doi.org/10.1186/1471-2474-14-131
ISSN: 1471-2474
Appears in Collections:Publications
Community Health and Public Health
Brunel OA Publishing Fund
Dept of Clinical Sciences Research Papers

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