Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature

2018 ◽  
Vol 44 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Floriaan G.C.M. De Kleermaeker ◽  
Hieronymus D. Boogaarts ◽  
Jan Meulstee ◽  
Wim I.M. Verhagen
Keyword(s):  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Minimal Clinically Important Difference ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Clinically Important Difference ◽  
Boston Carpal Tunnel Questionnaire ◽  
Scale Scores ◽  
Carpal Tunnel Questionnaire

No consensus exists about the minimal clinically important difference for the Boston Carpal Tunnel Questionnaire, which hampers its clinical application. This study assessed the minimal clinically important difference of this questionnaire. The Boston Carpal Tunnel Questionnaire was completed by 180 patients, with clinically defined carpal tunnel syndrome, preoperatively and at about 8 months follow-up after carpal tunnel release, together with a six-point scale for perceived improvement. Receiver operator characteristics curves showed that relative changes in Symptom Severity Scale and Functional Status Scale scores correspond better to a clinically relevant improvement than absolute changes. The minimal clinically important difference should be individually calculated from baseline Symptom Severity Scale and Functional Status Scale scores, as patients experiencing more symptoms require more improvement to notice a clinically important difference. By taking this into account, the Boston Carpal Tunnel Questionnaire is more meaningful as an outcome measure in research and clinical practice.

scholarly journals Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients

2019 ◽  
Vol 109 (4) ◽  
pp. 343-350
Author(s):  
J. Multanen ◽  
J. Ylinen ◽  
T. Karjalainen ◽  
H. Kautiainen ◽  
J. P. Repo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Scale ◽  
Floor Effect ◽  
Symptom Severity Scale ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Background and Aims: The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. Materials and Methods: We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated construct validity, internal consistency, test–retest reliability, and coefficient of repeatability. We also examined floor and ceiling effects. Results: The cross-cultural adaptation required only minor modifications to the questions. Both subscales of the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Functional Status Scale) correlated significantly with the CTS-6 and EuroQol 5 Dimensions, indicating good construct validity. The Cronbach’s alpha was 0.93 for both the Symptom Severity Scale and Functional Status Scale, indicating high internal consistency. Test–retest reliability was excellent, with an intraclass correlation coefficient greater than 0.8 for both scales. The coefficient of repeatability was 0.80 for the Symptom Severity Scale and 0.68 for the Functional Status Scale. We observed a floor effect in the Functional Status Scale in 28% of participants. Conclusion: Our study shows that the present Finnish version of the Boston Carpal Tunnel Questionnaire is reliable and valid for the evaluation of symptom severity and functional status among surgically treated carpal tunnel syndrome patients. However, owing to the floor effect, the Functional Status Score may have limited ability to detect differences in patients with good post-operative outcomes.

scholarly journals Retinaculotomía endoscópica de doble portal en el síndrome del túnel carpiano

2020 ◽  
Vol 85 (4) ◽  
pp. 349-356
Author(s):  
Álvaro C. Ojeda ◽  
Víctor A. Contreras ◽  
Edgardo S. Sanzana
Keyword(s):  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Palabras Clave ◽  
Boston Carpal Tunnel Questionnaire ◽  
Carpal Tunnel Questionnaire

Objetivo: Evaluar los resultados de la retinaculotomía endoscópica para tratar el síndrome del túnel carpiano mediante la técnica de doble portal de Chow, entre enero de 2006 y diciembre de 2015. Materiales y Métodos: Estudio de 179 pacientes (edad promedio 48.2 años [rango 32-68]), con 217 casos de síndrome del túnel carpiano idiopático y un seguimiento promedio de 97.9 meses. Los pacientes eran 145 mujeres (81%) (31 bilaterales) y 34 hombres (19%) (7 bilaterales) y fueron evaluados con la Symptom Severity Scale (SSS) y la Functional Status Scale (FSS) del Boston Carpal Tunnel Questionnaire (BCTQ). Resultados: El puntaje medio de la SSS-BCTQ fue de 3,20 + 0,26 antes de la cirugía, mejoró a 1,30 + 0,12 a los 6 meses y se mantuvo en 1,25+ 0,11 a largo plazo. El puntaje medio de la FSS-BCTQ fue de 2,57 + 0,29 antes de la cirugía, mejoró a 1,28 + 0,18 a los 6 meses y se mantuvo en 1,20 + 0,09 a largo plazo. Hubo 7 casos (3,2%) de neuropraxia posquirúrgica transitoria. No hubo conversiones a técnica abierta. Conclusión: La liberación endoscópica del túnel carpiano con la técnica de Chow es un método quirúrgico eficaz y seguro para tratar el síndrome del túnel carpiano idiopático. Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano. Nivel de Evidencia: III

scholarly journals Reliability and Validation of the Greek Version of the Boston Carpal Tunnel Questionnaire

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 593-599 ◽  
Author(s):  
Anastasia Bougea ◽  
Thomas Zambelis ◽  
Panagiota Voskou ◽  
Paraskevi Zacharoula Katsika ◽  
Chara Tzavara ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Severity Scale ◽  
Greek Version ◽  
Symptom Severity Scale ◽  
Severity Grading ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Background: The Boston Carpal Tunnel Questionnaire (BCTQ) is an easy, brief, self-administered questionnaire developed by Levine et al for the assessment of severity of symptoms and functional status of patients with carpal tunnel syndrome. The aim of our study was to develop and validate the Greek version of BCTQ. Methods: We conducted a cross-sectional study of 90 patients with idiopathic carpal tunnel syndrome. The original English version of BCTQ was adapted into Greek using forward and backward translation. Reliability was assessed by internal consistency (Cronbach α and item-total correlation) and reproducibility. Validity was examined by correlating the Boston Questionnaire scores to Canterbury severity scale for electrodiagnostic severity grading. Results: The Greek version showed high reliability (Cronbach α 0.89 for Symptom Severity Scale and 0.93 for Functional Status Scale) and construct validity (Pearson correlation coefficient 0.53 for Symptom Severity Scale and 0.68 for Functional Status Scale). Test-retest were 0.75 for Symptom Severity Scale and 0.79 for Functional Status Scale ( P < .05). Receiver operating characteristic curve analysis showed that the optimal cutoff of Symptom Severity Scale for the discrimination of subjects with low electrodiagnostic severity grading than subjects with high electrodiagnostic severity grading was 1.95 with sensitivity equal to 75.5% and specificity equal to 68.3%. Conclusions: The Greek version of the BCTQ is a valid, reliable screening tool for assessment in daily practice of symptoms and functional status in patients with carpal tunnel syndrome.

scholarly journals PENGARUH TEKNIK INJEKSI STEROID DENGAN TUNTUNAN ULTRASONOGRAFI TERHADAP LUARAN KLINIS PASIEN CARPAL TUNNEL SYNDROME

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Mariana Sutopo ◽  
Yudy Goysal ◽  
David Gunawan Umbas ◽  
Susi Aulina ◽  
Louis Kwandou ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Ultrasound Guidance ◽  
Steroid Injection ◽  
Control Group ◽  
Severity Scale ◽  
Symptom Severity Scale ◽  
Tunnel Syndrome

     EFFECT OF STEROID INJECTION TECHNIQUE WITH ULTRASOUND GUIDANCE ON CLINICAL OUTCOMES IN CARPAL TUNNEL SYNDROME PATIENTSABSTRACTIntroduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper extremity and one of the diseases that causes disability, thereby reducing productivity. This study purpose is to determine the effect of steroid injection techniques with and without ultrasound guidance on clinical outcomes in patients with CTS.Method: This study was a clinical trial with a non-randomized pretest-posttest-control group design. This study subjects were 36 patients with CTS, consisting of 18 wrists receiving steroid injection with ultrasound guidance and 18 wrists without ultrasound guidance.Results: The results showed a significant change in the Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (p<0.05) after treatment in the steroid injection group with and without ultrasound guidance. The results of the unpaired t-test on changes in the SSS between the groups who received steroid injection with ultrasound guidance and without ultrasound guidance showed no significant difference (p>0.05). The results of the Mann-Whitney test on changes in FSS scores between groups who received steroid injections with and without ultrasound guidance showed no significant differences (p>0.05).Discussion: Decrease in Boston SSS and FSS after steroid injections in both groups were in accordance with theory that steroid injection can quickly bind directly to nerve cell receptors and inhibit production of proinflammatory mediators. Whereas results of the study comparing effectiveness of steroid injection techniques with ultrasound guidance and without ultrasound guidance were not significant because observations were only made for 1 week.Keywords: Carpal tunnel syndrome, functional status scale, steroid injection, symptom severity scale, USG-guidedABSTRAKPendahuluan: Carpal tunnel syndrome (CTS) adalah neuropati jebakan yang paling sering pada ekstremitas atas dan merupakan salah satu penyakit yang menyebabkan disabilitas, sehingga menurunkan produktivitas. Penelitian ini bertujuan mengetahui pengaruh teknik injeksi steroid dengan dan tanpa tuntunan ultrasonografi terhadap luaran klinis pada pasien carpal tunnel syndrome.Metode: Penelitian ini adalah uji klinis dengan rancangan non-randomized pretest-posttest-control-group. Penelitian ini dilakukan terhadap 36 pasien CTS, terdiri dari 18 pergelangan tangan yang mendapat injeksi steroid dengan tuntunan USG dan 18 pergelangan tangan tanpa tuntunan USG.Hasil: Hasil penelitian menunjukkan adanya perubahan Symptom Severity Scale (SSS) dan Functional Status Scale (FSS) yang bermakna (p<0,05) setelah perlakuan pada kelompok injeksi steroid dengan dan tanpa tuntunan USG. Hasil uji-t tidak berpasangan terhadap perubahan SSS antara kelompok yang mendapat injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG menunjukkan perbedaan tidak bermakna (p>0,05). Hasil uji Mann-Whitney terhadap perubahan skor FSS antara kelompok yang mendapat injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG menunjukkan perbedaan tidak bermakna (p>0,05).Diskusi: Penurunan SSS dan FSS kuesioner Boston setelah dilakukan injeksi steroid pada kedua kelompok ini sesuai dengan teori bahwa injeksi steroid dapat dengan cepat berikatan langsung dengan reseptor sel saraf. Ikatan steroid dengan reseptor di sel saraf dapat menghambat produksi mediator proinflamasi. Sedangkan hasil penelitian yang membandingkan efektivitas teknik injeksi steroid dengan tuntunan USG dan tanpa tuntunan USG tidak bermakna karena pengamatan hanya dilakukan selama 1 minggu.Kata kunci: Carpal tunnel syndrome, functional status scale, injeksi steroid, symptom severity scale, USG-guided

scholarly journals Cross-Cultural Adaptation, Validity and Reliability of Malay Version Boston Carpal Tunnel Questionnaire

2019 ◽  
Vol 4 (12) ◽  
pp. 149
Author(s):  
Anwar Abdullah ◽  
Ahmad Zamir Che Daud ◽  
Akehsan Dahlan ◽  
Rashdeen Fazwi Muhammad Nawawi
Keyword(s):  
Carpal Tunnel ◽  
Publishing House ◽  
Psychometric Testing ◽  
Cross Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Symptom Severity Scale ◽  
Boston Carpal Tunnel Questionnaire ◽  
Carpal Tunnel Questionnaire ◽  
Test Retest Reliability

This study aimed to assess the validity and reliability of the Malay version Boston Carpal Tunnel Questionnaire (M-BCTQ). A cross-sectional study was used to generate the final version of M-BCTQ that was administered to 55 patients for psychometric testing. M-BCTQ had excellent test-retest reliability with ICCs value 0.837 for Symptom Severity Scale (SSS) and 0.913 for Functional Status Scale (FSS). The Cronbach alpha coefficient for the internal consistencies was reported at 0.864 for SSS and 0.893 for the FSS. A strong correlation was found with the Malay version of Disability of Arm, Shoulder and Hand Questionnaire (MV-DASH) as Spearman correlation for construct validity was 0.791 for SSS and 0.831 for FSS.Keywords: Carpal Tunnel Syndrome; Boston Carpal Tunnel Questionnaire; Reliability; ValidityeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1936

scholarly journals Dynamic Ultrasound Assessment of Median Nerve Mobility Changes Following Corticosteroid Injection and Carpal Tunnel Release in Patients With Carpal Tunnel Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
I-Ning Lo ◽  
Po-Cheng Hsu ◽  
Yi-Chao Huang ◽  
Chih-Kuang Yeh ◽  
Yi-Chiang Yang ◽  
...  
Keyword(s):  
Functional Status ◽  
Median Nerve ◽  
Clinical Outcomes ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Symptom Severity Scale ◽  
Dynamic Ultrasound

Decreased median nerve (MN) mobility was found in patients with carpal tunnel syndrome (CTS) and was inversely associated with symptom severity. It is unclear whether MN mobility can be restored with interventions. This study compared the changes in MN mobility and clinical outcomes after interventions. Forty-six patients with CTS received an injection (n = 23) or surgery (n = 23). Clinical outcomes [Visual Analogue Scale; Boston Carpal Tunnel Questionnaire (BCTQ), which includes the Symptom Severity Scale and Functional Status Scale; median nerve cross-sectional area; and dynamic ultrasound MN mobility parameters (amplitude, and R2 value and curvature of the fitted curves of MN transverse sliding)] were assessed at baseline and 12 weeks after the interventions. At baseline, the BCTQ-Functional Status Scale and median nerve cross-sectional area showed significant inter-treatment differences. At 12 weeks, both treatments had significant improvements in BCTQ-Symptom Severity Scale and Visual Analogue Scale scores and median nerve cross-sectional area, but with greater improvements in BCTQ-Functional Status Scale scores observed in those who received surgery than in those who received injections. MN mobility was insignificantly affected by both treatments. The additional application of dynamic ultrasound evaluation may help to discriminate the severity of CTS initially; however, its prognostic value to predict clinical outcomes after interventions in patients with CTS is limited.

Sign in / Sign up

Export Citation Format

Share Document