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Cultural adaptation, translation and validation of Cochin Hand Function Scale and evaluation of hand dysfunction in systemic sclerosis

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Abstract

Objectives

Hand dysfunction causes significant reduction in quality of life in systemic sclerosis. We assessed the validity and reliability of the culturally adapted Indian version of Cochin Hand Function Scale (I-CHFS). We determined the factors contributing to hand dysfunction and its burden on quality of life.

Method

I-CHFS was formulated by replacing five questions (questions 7, 9, 10, 14 and 15) in CHFS which were determined as unsuitable in an Indian setting. The instrument was assessed for acceptability, reliability, reproducibility and validity measures. A total of 87 patients were assessed for various demographic and disease parameters, hand disability and quality of life.

Results

The median I-CHFS score was 22(5–54) and 04 (0.5–17.5) among diffuse (dcSSc) and limited cutaneous systemic sclerosis (lcSSc). I-CHFS showed good reproducibility (interclass correlation coefficient = 0.92) and a strong correlation with I-HAQ (rs = 0.832), usual activities EQ-5D-5L (rs = 0.744), self-care EQ-5D-5L (rs = 0.734) and anxiety/depression EQ-5D-5L (rs = 0.729). It had moderate correlation with pain/discomfort EQ-5D-5L (rs = 0.661) and hand HAQ (rs = 0.576) and poor correlation with HAQ-DI (rs = 0.396) and modified Rodnan skin score (rs = 0.390). Finger to table distance, finger to palm distance in extension and limited hand modified Rodnan skin score were significantly associated with higher values of I-CHFS.

Conclusions

Hand dysfunction in systemic sclerosis is substantial and contributes significantly to poor quality of life. The culturally adapted I-CHFS is a valid and reliable tool to assess it and correlated well with the overall disease burden.

Key Points

• Hand dysfunction is common among systemic sclerosis patients.

• Hand dysfunction contributes to the poor quality of life and more disease burden.

• Culturally adapted Cochin Hand function Scale helps assess hand dysfunction among Indian scleroderma patients.

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Acknowledgements

Mrs. Kalaichelvi K. and Miss Priyanka B. helped in Tamil translation of the questionnaire. Miss Rubini V. the speciality nurse helped in patient recruitment and the data collection and telephonic follow-up.

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Authors and Affiliations

  1. Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India

    Devender Bairwa, Chengappa G. Kavadichanda, M. B. Adarsh, Aishwarya Gopal & Vir Singh Negi

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  1. Devender Bairwa
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  2. Chengappa G. Kavadichanda
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Contributions

DB: Design of the study, acquisition and interpretation of data and drafting the work

CGK: Design of the study, acquisition, interpretation of data and drafting the work

AMB: Acquisition, interpretation of data and drafting the work

AG: Tamil translation of the questionnaire and data acquisition

VSN: Conception and design of study, interpretation of data and drafting the work

All authors read and approved the final manuscript.

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Correspondence to Vir Singh Negi.

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Bairwa, D., Kavadichanda, C.G., Adarsh, M.B. et al. Cultural adaptation, translation and validation of Cochin Hand Function Scale and evaluation of hand dysfunction in systemic sclerosis. Clin Rheumatol 40, 1913–1922 (2021). https://doi.org/10.1007/s10067-020-05434-4

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