Introduction: The Patient Evaluation Measure (PEM) is a region-specific patient reported outcome measure (PROM) for hand and wrist disorders, first introduced in English for patients with hand surgery in 1995. The purpose of the study was to assess the psychometric properties of the translated and cross-culturally adapted Slovenian version of PEM (PEM-Slo). Methods: The study was designed as a single-centre observational prospective study conducted from July 2020 to March 2021. The psychometric evaluation was performed on fifty-one patients with miscellaneous hand and wrist disorders. Reliability was tested for internal consistency and test-retest reliability. Convergent and divergent validity, responsiveness, floor and ceiling effect, and interpretability with the determination of minimal detectable change (MDC) and minimal clinically important difference (MCID) were assessed. Results: The PEM-Slo has excellent internal consistency (Cronbach’s α 0.932) and good to excellent test-retest reliability (intraclass correlation coefficient=0.874). Convergent validity was proved with high to moderate correlations of PEM-Slo with DASH, grip strength and self-care, usual activities, and pain EQ-5D-5L subscales, whereas no correlation of PEM-Slo with EQ-5D-5L mobility and anxiety/depression subscale confirmed divergent validity. The PEM-Slo responsiveness was high (standardised response mean=1.42, effect size=1.25). MDC was 18.01 and MCID was 17.31. No floor or ceiling effect was found. Conclusion: The PEM-Slo is a reliable, valid and responsive PROM for Slovenian-speaking patients with hand and wrist disorders.
This study aimed to compare outcomes of early active motion (EAM) using the relative motion extension (RME) approach to outcomes of early passive motion (EPM) with a dynamic extension orthosis (DEO) and to evaluate whether the RME-only approach is equivalent to the RME-plus approach. Fifty adults were randomized into one of the three intervention groups receiving the DEO, RME only, or RME plus orthosis. The score of the Jebsen–Taylor hand function test (JTHFT) without writing and QuickDASH at T1, all measures of mobility at T1 and T2, and grip strength were better in the RME-only and RME-plus group compared to the DEO group, whereas the values of Patient Evaluation Measure (PEM) at T1 and T2, as well as QuickDASH score at T2, orthosis adherence, and the patient’s comfort while wearing the orthoses did not statistically significantly differ among the three groups. The RME concept after extensor tendon injuries in zones 4–6 is superior to the DEO protocol in terms of earlier regain of hand function. The DEO and RME protocols were equivalent regarding patients’ adherence and satisfaction with the orthosis. We found no differences in the RME-plus and RME-only protocols, indicating the safe use of the RME-only protocol in single extensor tendon injuries in zones 4–6.
• The PRWHE is widely used PROM for hand and wrist disorders. • The PRWHE-Slo showed excellent internal consistency and test-retest reliability. • The PRWHE-Slo is freely available for use in clinical and research practice.