Clinical Rheumatology

, Volume 27, Issue 6, pp 743–749 | Cite as

Reliability and validity of the Italian version of the hand functional disability scale in patients with systemic sclerosis

  • Francesca Ingegnoli
  • Valentina Galbiati
  • Patrizia Boracchi
  • Daniela Comi
  • Roberta Gualtierotti
  • Silvana Zeni
  • Flavio Fantini
Original Article

Abstract

The English version of hand functional disability scale is a validated instrument for measuring hand involvement in patients with systemic sclerosis (SSc). Because validation of multiple-language versions of existing validated questionnaires plays a key role in standardizing the outcome measurement and increasing the statistical power of clinical studies, this study aims to validate a translated Italian version of hand functional disability scale which is not available at the moment. The Italian version of hand functional disability scale was tested on 50 patients with SSc. To determine test–retest reliability, 40 SSc patients were asked to complete the questionnaire a second time within 2 weeks of the initial testing session. The test–retest reliability and internal consistency were determined by intra-class correlation coefficient (ICC) and Cronbach's α. External consistency was measured by comparing with an already validated test, the Health Assessment Questionnaire (HAQ), and clinical measurements. To explore the relationships among these variables, multiple correspondence analysis (MCA) was adopted. The statistical analysis of each domain and the total score revealed a good test–retest reliability (ICCs > 0.75) and internal consistency (Cronbach's α > 0.7). Furthermore, a good external consistency was confirmed by evaluating the differences between the distributions of hand functional disability scale score for SSc patients with or without hand involvement (arthralgias, arthritis, flexion contractures, and digital ulcers) and comparing results with those obtained for HAQ. Finally, MCA demonstrates a strong correlation among functional disability scale areas and HAQ scores. The hand functional disability scale is a self-administered questionnaire and it has been specially developed to measure hand impairment in patients with hand disorders. Our data support its validity and reliability in Italian SSc patients.

Keywords

Hand function Outcome measure Systemic sclerosis 

References

  1. 1.
    Clements PJ, Medsger TA Jr (2004) Cutaneous involvement in systemic sclerosis. In: Clements PJ, Furst DE (eds) Systemic sclerosis, 2nd edn. Lippincott Williams & Wilkins, New York, pp 129–150Google Scholar
  2. 2.
    Blocka KLN, Basset LW, Furst DE, Clements PJ, Paulus HE (1981) The arthropathy of advanced progressive systemic sclerosis. A radiographic survey. Arthritis Rheum 24:874–884PubMedCrossRefGoogle Scholar
  3. 3.
    Medsger TA (1979) Progressive systemic sclerosis: skeletal muscle involvement. Clin Rheum Dis 5:103–113Google Scholar
  4. 4.
    Lovell CR, Jayson MIV (1979) Joint involvement in systemic sclerosis. Scand J Rheumatol 8:154–160PubMedCrossRefGoogle Scholar
  5. 5.
    Brower LM, Poole JL (2004) Reliability and validity of the Duruöz Hand Index in persons with systemic sclerosis (scleroderma). Arthritis Rheum 51(5):805–809PubMedCrossRefGoogle Scholar
  6. 6.
    Rannou F, Poiraudeau S, Berezne A, Baubet T, Le-Guern V, Cabane J et al (2007) Assessing disability and quality of life in systemic sclerosis: construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), systemic sclerosis HAQ, and medical outcomes study 36-item short form health survey. Arthritis Rheum 57:94–102PubMedCrossRefGoogle Scholar
  7. 7.
    Sandqvist G, Eklund M (2000) Validity of HAMIS: a test of hand mobility in scleroderma. Arthritis Care Res 13:382–387PubMedCrossRefGoogle Scholar
  8. 8.
    Duruöz MT, Poiraudeau S, Fermanian J, Menkes C, Amor B, Dougados M et al (1996) Development and validation of a rheumatoid Duruöz's Hand Index that assesses functional handicap. J Rheumatol 23:1167–1172PubMedGoogle Scholar
  9. 9.
    Poiraudeau S, Chevalier X, Conrozier T, Flippo RM, Liote F, Noel E et al (2001) Reliability, validity, and sensitivity to change of the Cochin Duruöz's Hand Index in hand osteoarthritis. Osteoarthr Cartil 9:570–577PubMedCrossRefGoogle Scholar
  10. 10.
    Fries JF, Spitz PV, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145PubMedCrossRefGoogle Scholar
  11. 11.
    Poole J, Williams C, Bloch D, Hollak B, Spitz P (1995) Concurrent validity of the Health Assessment Questionnaire disability index in scleroderma. Arthritis Care Res 8:189–193PubMedCrossRefGoogle Scholar
  12. 12.
    Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590CrossRefGoogle Scholar
  13. 13.
    LeRoy EC, Black CM, Fleischmajer R et al (1988) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 15:202–205PubMedGoogle Scholar
  14. 14.
    Ferri C, Valentini G, Cozzi F, Sebastiani M, Michelassi C, La Montagna G et al (2002) Systemic sclerosis: demographic, clinical, and serologic features and survival in 1,012 Italian patients. Medicine (Baltimore) 81:139–153CrossRefGoogle Scholar
  15. 15.
    Clements PJ, Lachenbruch PA, Seibold J et al (1995) Intra and interobserver variability of total skin thickness score (modified Rodnan) in systemic sclerosis (SSc). J Rheumatol 22:1281–1285PubMedGoogle Scholar
  16. 16.
    La Montagna G, Cuomo G, Chiarolanza I, Ruocco L, Valentini G (2006) HAQ-DI Italian version in systemic sclerosis. Reumatismo 58:112–115PubMedGoogle Scholar
  17. 17.
    Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefGoogle Scholar
  18. 18.
    Greenacre MJ (1993) Correspondence analysis in practice, 1st edn. Academic, London, pp 32–37Google Scholar
  19. 19.
    Matucci-Cerinic M, Steen VD, Furst DE, Seibold JR (2007) Clinical trials in systemic sclerosis: lessons learned and outcomes. Arthritis Res Ther 9:S7PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Francesca Ingegnoli
    • 1
  • Valentina Galbiati
    • 1
  • Patrizia Boracchi
    • 2
  • Daniela Comi
    • 1
  • Roberta Gualtierotti
    • 1
  • Silvana Zeni
    • 1
  • Flavio Fantini
    • 1
  1. 1.Department of Rheumatology, Istituto Gaetano PiniUniversity of MilanMilanItaly
  2. 2.Institute of Medical Statistics and BiometryUniversity of MilanMilanItaly

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