Archives of Physical Medicine and Rehabilitation, vol.88, no.3, pp.309-314, 2007 (SCI-Expanded)
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. © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.