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The Journal of Bone and Joint Surgery, Vol 75, Issue 11 1585-1592, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome
DW Levine, BP Simmons, MJ Koris, LH Daltroy, GG Hohl, AH Fossel and JN Katz
Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
We developed a self-administered questionnaire for the assessment of
severity of symptoms and functional status in patients who have carpal
tunnel syndrome. The reproducibility, internal consistency, validity, and
responsiveness to clinical change of scales for the measurement of severity
of symptoms and functional status were evaluated in a clinical study. The
scales were highly reproducible (Pearson correlation coefficient, r = 0.91
and 0.93 for severity of symptoms and functional status, respectively) and
internally consistent (Cronbach alpha, 0.89 and 0.91 for severity of
symptoms and functional status, respectively). Both scales had positive,
but modest or weak, correlations with two-point discrimination and
Semmes-Weinstein monofilament testing (Spearman coefficient, r = 0.12 to
0.42). In thirty-eight patients who were operated on in 1990 and were
evaluated a median of fourteen months postoperatively, the mean
symptom-severity score improved from 3.4 points preoperatively to 1.9
points at the latest follow-up examination, while the mean
functional-status score improved from 3 to 2 points (5 points is the worst
score and 1 point is the best score for each scale). Similar improvement
was noted in twenty-six patients who were evaluated before and three months
after the operation. We concluded that the scales for the measurement of
severity of symptoms and functional status are reproducible, internally
consistent, and responsive to clinical change, and that they measure
dimensions of outcomes not captured by traditional measurements of
impairment of the median nerve. These scales should enhance standardization
of measurement of outcomes in studies of treatment for carpal tunnel
syndrome.
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