Severe acute respiratory distress syndrome (SARS) contributed to significant mortality and morbidity worldwide. We aimed to establish the validity, reliability and responsiveness of the functional impairment checklist (FIC) as a measurement tool for physical dysfunction in SARS survivors. One hundred and sixteeen (65 females and 51 males, mean age 45.6) patients who joined the SARS rehabilitation programme were analysed. The factor analysis yielded two latent factors. The mean FIC-symptom and FIC-disability score were 24.12 (SD +/- 20.2) and 26.11 (SD +/- 27.32), respectively. Based on the item-scale correlation coefficients, the Cronbach's alpha coefficients reflecting the internal consistency reliability of scale score were 0.75 for FIC-symptom and 0.86 for FIC-disability. Test-retest reliability in 23 patients showed no statistical significant difference in the FIC scores between tests with intraclass correlation coefficient (ICC) 0.49-0.57. The FIC scales correlated both with 6 munute walking test (6MWT) distance (-0.26 and -0.38) and handgrip strength (HGS) (-0.20 and -0.27). Moreover, the FIC scales correlated with St. George's respiratory questionnaire (SGRQ) (0.19 to 0.52) and short form 36 Hong Kong (SF-36) domains (-0.19 to -0.59). Both FIC scales correlated stronger with physical component summary (PCS) (-0.41 and -0.55) than with mental component summary (MCS) (-0.30 and -0.23). FIC reduced significantly at 6 months while the SF-36 PCS and MCS did not show any change. In conclusion, the study results indicate the FIC is reliable, valid and responsive to change in symptom and disability as a consequence of SARS, suggesting it may provide a means of assessing health related quality of life (HRQOL) outcomes in a longitudinal follow up.
Aim: We conducted a prospective randomized parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with carpal tunnel syndrome (CTS).
Methods:The well-validated and disease-specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included patient satisfaction, the change of an objective finger dexterity test and the side effects.Results: Twenty-five patients in the local steroid group and 25 patients in the wrist splinting group completed the study procedures. At 4 weeks after treatment, there was significant improvement of the BTCQ scores in both the steroid group and splinting group. There was improvement of the finger dexterity test only in the steroid group but not in the splinting group. However, there was no statistically significant difference in the changes of BTCQ scores between the two groups after treatment. Patient satisfaction score was higher in the steroid group. Patients in the steroid group took fewer painkillers after treatment. Four patients developed side effects after splinting and three after local steroid injection, which was not statistically significant.
Conclusion:Although local steroid injection and nocturnal wrist splinting were equally effective in the treatment of patients with CTS, only the former improved objective hand function. Local steroid injection also resulted in better patient satisfaction and less painkiller use without causing more side effects.
BackgroundCarpal tunnel syndrome (CTS) can lead to significant symptoms and loss of hand function. It also has a great socio-economic impact. However, there is no consensus regarding its best treatment up to this moment. Local steroid injection and wrist splinting are among the most popular nonsurgical treatment options. Previous studies have confirmed their respective effectiveness. However, there is no high quality head to head comparative study regarding the two treatments in the literature.ObjectivesTo compare the efficacy of local steroid injection and nocturnal wrist spiniting for CTS.MethodsWe conducted a prospective randomised parallel clinical trial comparing the efficacy of local steroid injection and nocturnal wrist splinting in patients with CTS. The well validated and disease specific Boston Carpal Tunnel Questionnaire (BCTQ) was employed and its score at 4 weeks after treatment was used as the primary outcome measure. Important secondary outcomes included the patient satisfaction, the change of an objective finger dexterity test 9-hole-peg test, and the side effects.ResultsTwenty-five patients in the local steroid group and 25 patients in the wrist splinting group completed the study procedures. The baseline patient and clinical characteristics of the two treatment groups were similar. At 4 weeks after treatment, there was significant improvement of the BTCQ scores in both the steroid group and splinting group. There was improvement of the 9-hole-peg test only in the steroid group but not in the splinting group. However, there was no statistically significant difference in the changes of BTCQ scores between the two groups after treatment. Patient satisfaction score was higher in the steroid group. Patient in the steroid group took less painkillers after treatment. Four patients developed side effects after splinting and 3 after local steroid injection, which was not statistically significant.ConclusionsAlthough local steroid injection and nocturnal wrist splinting were equally effective in the treatment of patients with CTS, only the former improved objective hand function. Local steroid injection also resulted in better patient satisfaction and less painkiller use without causing more side effects.Disclosure of InterestNone declared
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