Development and validation of a short version of the French Hand Function Sort questionnaire in vocational rehabilitation.

BACKGROUND: The Hand Function Sort (HFS) is a pictorial self-administered questionnaire with 62 items. It is a valid and reliable scale focused on the physical function of the upper limbs. It is used to predict the return to work. OBJECTIVES: We aimed to develop and validate a short version of the French version of the HFS (HFS-F) to simplify its use in clinical practice. METHODS: We included patients with upper-limb chronic pain hospitalised for vocational rehabilitation from 2012 to 2019. Vocational rehabilitation aims to improve the autonomy of patients to regain their previous working capacity. The 62 items of the HFS-F were analysed in terms of patient and expert assessments, floor/ceiling effect, item-to-total correlation, principal component analysis, and Rasch analysis. A short HFS-F was developed. Thereafter, we assessed its internal consistency, test-retest reliability, criterion validity with the full-length HFS-F, construct validity with different scales (Disabilities of the Arm, Shoulder, and Hand [DASH]; Brief Pain Inventory [BPI]; Hospital Anxiety and Depression [HAD]), standard error of measurement (SEM), and minimal detectable change (MDC). RESULTS: Six experts were consulted, 34 patients were interviewed, and 629 questionnaires were analysed. Among the items, 25 were selected after the final round with the six experts. The internal consistency and test-retest reliability were excellent (Cronbach α=0.95, intraclass correlation coefficient=0.92, 95% confidence interval [95% CI] 0.87 to 0.95). The correlation coefficient between scores of the short and full-length HFS-F was 0.841 (95% CI: 0.752 to 0.897, P<10-4), and those between the short HFS-F score and the DASH, BPI, HAD-Anxiety, and HAD-Depression scores were -0.816 (95% CI: -0.714 to -0.881, P<10-4), -0.529 (95% CI: -0.338 to -0.674, P<10-4), -0.451 (95% CI: -0.244 to 0.614, P=0.0001), and -0.360 (95% CI: -0.140 to -0.542, P=0.0018), respectively. The SEM and MDC values were estimated at 6/100 and 17/100, respectively. CONCLUSIONS: A short version of the HFS-F was developed and validated. We named this questionnaire the 25 HFS-F.

[Leg pain : differential diagnosis and treatment]. / Douleurs de la jambe : diagnostic différentiel et traitement.

Acute or chronic leg pain is a common reason for consultation. It is not a specific symptom and several potential causes have to be considered. Both functional and vital prognosis can be engaged. The diagnosis is often based on patient history and clinical examination, whereas the overuse of complementary investigations can lead to confusion. A good knowledge of anatomy, as well as the different etiologic entities, is essential to evaluate acute or chronic leg pain and to guide the diagnostic and therapeutic strategies.

Les douleurs aiguës ou chroniques de la jambe sont un motif fréquent de consultation. Il s'agit d'un symptôme souvent peu spécifique et plusieurs étiologies sont à considérer. Le pronostic fonctionnel du membre ainsi que le pronostic vital peuvent être engagés. Le diagnostic repose souvent sur l'anamnèse et l'examen clinique, alors que la multiplication d'examens complémentaires peut augmenter la confusion diagnostique. Une bonne connaissance de l'anatomie de la jambe, ainsi que des différents cadres étiologiques est indispensable à l'évaluation de ces douleurs et permet de guider la démarche diagnostique et thérapeutique.

Determining the minimal clinically important difference of the hand function sort questionnaire in vocational rehabilitation.

OBJECTIVE: To estimate the Minimal Clinically Important Difference (MCID) of the French version of the Hand Function Sort questionnaire (HFS-F). As a comparison, the MCID of the Disabilities of the Arm, Shoulder, and Hand (DASH) was also estimated. MATERIALS AND METHODS: We included French-speaking patients hospitalized in a multidisciplinary rehabilitation program for chronic pain of the upper limb after an accident. HFS-F and DASH scores were collected at admission and discharge; the Patient Global Impression of Change measure (PGIC; 7 levels) was collected at discharge. The MCID was estimated by 2 methods: the anchor-based method (receiver operating characteristic [ROC], delta (Δ) mean of scores) and the objective method based on the distribution of scores (standard error of measurement, SEM). RESULT: We included 225 patients. By the anchor-based method, the MCID for the HFS-F and DASH was +26 (SD 35) (P<10-4) and -13 (SD 13) (P<10-4), respectively, and by the ROC curve, it was +10 to +12 for the Δ-HFS-F and -7.5 to -5 for the Δ-DASH. The area under the ROC curve (AUC) was 0.726 [0.638-0.781] for Δ-HFS-F and 0.768 [0.701-0.83] for Δ-DASH. The correlations between the anchor and delta scores were>0.38 (P<10-4). The SEM was 16.2 for the HFS-F and -4.3 for the DASH. CONCLUSIONS: Values below the SEM must be rejected. Our anchor was significantly correlated with the outcome. Therefore, we propose an MCID for the HFS-F of 26, corresponding to approximately 10% progression of the score.