PMID- 27769839 OWN - NLM STAT- MEDLINE DCOM- 20171122 LR - 20171128 IS - 1545-004X (Electronic) IS - 0894-1130 (Linking) VI - 29 IP - 4 DP - 2016 Oct-Dec TI - Responsiveness of the active wrist joint position sense test after distal radius fracture intervention. PG - 474-482 LID - S0894-1130(16)30110-7 [pii] LID - 10.1016/j.jht.2016.06.009 [doi] AB - STUDY DESIGN: Prospective cohort study. INTRODUCTION: The active wrist joint position sense (JPS) test has been determined to be a clinically useful test for assessing wrist sensorimotor (SM) status after distal radius fracture (DRF). Its responsiveness is yet to be determined. PURPOSE OF THE STUDY: Primary study aim was to determine the active wrist JPS test responsiveness to detect change in wrist SM status at 8 and 12 weeks after DRF treatment intervention. Secondary aims were to compare group (nonsurgical, surgical, high, and low pain) test responsiveness; compare pain-level group participants test scores; determine the relationship between test minimal clinically important difference (MCID) value and function; compare functional outcomes across assessment times; and determine the Patient Global Impression of Change Scale intrarater reliability. METHODS: A total of 33 male and female participants were tested at baseline, 8, and 12 weeks after nonsurgical (n = 13) and surgical (n = 20) DRF treatment interventions. Distribution-based analysis encompassed both group- (ie, effect size, standardized response mean) and individual-based (ie, minimum detectable change) statistical indices. Anchor-based analysis determined the MCID value by linking test scores to the Patient Global Impression of Change Scale. RESULTS: The active wrist JPS test is highly responsive based on effect size (8 weeks = 1.53 and 12 weeks = 2.36) and standardized response mean (8 weeks = 1.57 and 12 weeks = 2.14). Statistically significant minimum detectable change values were 4.28 degrees and 4.94 degrees at 8 and 12 weeks, respectively. Clinically meaningful MCID values were 5.00 degrees and 7.09 degrees at 8 and 12 weeks, respectively. Between treatment type and pain-level group responsiveness levels were not significantly different. High-pain participants demonstrated significantly greater JPS deficit. Test MCID values and function were significantly associated. DISCUSSION: This is the first study to determine the active wrist JPS test responsiveness as reflected by its group- and individual-based statistical indices following DRF surgical and non-surgical interventions among low- and high-pain level participants. The statistical analysis approach, which was used to determine the aforementioned variables of the active wrist JPS test, is consistent with current research. This study's strengths included its design, methodology, and statistical approach. The study findings must be interpreted, however, within the content of several methodological limitations. CONCLUSIONS: The active wrist JPS test was determined to be highly responsive to detect wrist SM status change at 8 and 12 weeks regardless of treatment type or pain level. Clinicians can use this test with confidence to measure clinically meaningful SM impairment after DRF treatment. LEVEL OF EVIDENCE: 2b. CI - Copyright A(c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved. FAU - Karagiannopoulos, Christos AU - Karagiannopoulos C AD - Doctor of Physical Therapy Program, DeSales University, Center Valley, PA, USA. Electronic address: karagiannopoulosc@gmail.com. FAU - Sitler, Michael AU - Sitler M AD - Office of the Provost, Temple University, Philadelphia, PA, USA. FAU - Michlovitz, Susan AU - Michlovitz S AD - Department of Rehabilitation and Regenerative Medicine, Program in Physical Therapy, Columbia University, New York, NY, USA. FAU - Tucker, Carole AU - Tucker C AD - Department of Physical Therapy, College of Public Health, Temple University, Philadelphia, PA, USA. FAU - Tierney, Ryan AU - Tierney R AD - Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA. LA - eng PT - Comparative Study PT - Journal Article DEP - 20161018 PL - United States TA - J Hand Ther JT - Journal of hand therapy : official journal of the American Society of Hand Therapists JID - 8806591 SB - IM MH - Adult MH - Aged MH - Casts, Surgical MH - Cohort Studies MH - Female MH - Follow-Up Studies MH - Fracture Fixation, Internal/*methods MH - Humans MH - Injury Severity Score MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Observer Variation MH - Proprioception/*physiology MH - Prospective Studies MH - Radius Fractures/diagnostic imaging/*rehabilitation/*surgery MH - Range of Motion, Articular/*physiology MH - Time Factors MH - Treatment Outcome MH - Wrist Injuries/diagnostic imaging/*rehabilitation/*surgery OTO - NOTNLM OT - Active wrist JPS test OT - Responsiveness OT - Wrist Fractures EDAT- 2016/10/23 06:00 MHDA- 2017/11/29 06:00 CRDT- 2016/10/23 06:00 PHST- 2015/08/13 00:00 [received] PHST- 2016/06/12 00:00 [revised] PHST- 2016/06/17 00:00 [accepted] PHST- 2016/10/23 06:00 [pubmed] PHST- 2017/11/29 06:00 [medline] PHST- 2016/10/23 06:00 [entrez] AID - S0894-1130(16)30110-7 [pii] AID - 10.1016/j.jht.2016.06.009 [doi] PST - ppublish SO - J Hand Ther. 2016 Oct-Dec;29(4):474-482. doi: 10.1016/j.jht.2016.06.009. Epub 2016 Oct 18.