Clinimetric Properties of the Duruoz Hand Index in Patients With Stroke
Abstract
Sezer N, Yavuzer G, Sivrioglu K, Basaran P, Koseoglu BF. Clinimetric properties of the Duruoz Hand Index in patients with stroke.
Objective
To investigate the reliability, validity, and responsiveness of the Duruoz Hand Index (DHI) in assessing activity limitation related to hand function in patients with stroke.
Design
Prospective validation study. A consecutive sample of stroke patients was evaluated on 3 occasions: 2 baseline measurements with a 24-hour interval in between, and again 1 month later immediately after a 4-week inpatient rehabilitation program.
Setting
Three different inpatient rehabilitation centers.
Participants
A consecutive sample of 56 patients with stroke (33 men, 23 women) with a mean age 62 years and a mean time since stroke 84 days.
Interventions
Not applicable.
Main Outcome Measures
Brunnstrom stages, Modified Ashworth Scale, sensory status, FIM instrument, and DHI. Test-retest reliability was tested using the intraclass correlation coefficient (ICC) and internal consistency was tested using the Cronbach α coefficient. Indexes of measurement error were calculated by standard error of measurement and minimal detectable change (MDC). Construct validity was assessed by association with the FIM instrument (Spearman ρ correlation coefficient). Responsiveness was assessed by calculation of the effect size and paired t test.
Results
The test-retest reliability and internal consistency of the DHI were excellent, with an ICC of .99 (95% confidence interval, .93−.99) and α of .97. The MDC was 1.4 DHI points. The correlation between the DHI and the FIM self-care items was high (ρ=−.73). The DHI significantly discriminated the patients with dominant side paresis versus nondominant side paresis (P<.01). The DHI score improved significantly after a 4-week inpatient rehabilitation program (P<.05).
Conclusions
The DHI is a time and labor efficient, practical instrument that can be used to assess the hand-related activity level for clinical and research purposes in patients with stroke.
aIVth Physical Medicine & Rehabilitation Clinic, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
bDepartment of Physical Medicine & Rehabilitation, Ankara University Faculty of Medicine, Ankara, Turkey
cDepartment of Physical Medicine & Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey.
Reprint requests to Nebahat Sezer, MD, Turkis Bloklari 154/9, Icaydinlikevler, Ankara 06130, Turkey
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT