Skip to main content

Advertisement

SpringerLink
Log in

Validity and reliability of the Duruöz Hand Index in patients with psoriatic arthritis

  • Validation Studies
  • Published:
Rheumatology International Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Objective

The Duruöz Hand Index (DHI) is a valuable scale developed for evaluating hand functions of patients with rheumatoid arthritis and subsequently proven to be valid and reliable in various diseases. This study aims to investigate the validity and reliability of the DHI in patients with psoriatic arthritis (PsA).

Methods

Patients diagnosed with PsA according to CASPAR criteria were enrolled. The demographic, clinical, and functional characteristics of patients were evaluated. Functional assessment was performed with DHI, Hand Functional Index, Health Assessment Questionnaire, and VAS-disability scale. C-reactive protein level, patients’ and physicians’ global VAS, swelling and tenderness of the hand joints, gross grip strength and thumb strength, and disease activity assessments were recorded as non-functional parameters related to active disease status. Reliability was assessed by internal consistency (with Cronbach’s-a) and test–retest intraclass correlation coefficient. Face, content, convergent, and divergent validities were applied.

Results

One hundred and forty-four patients (74.3% female) were included in this study. The Cronbach’s alpha coefficient was 0.963, and for the test–retest reliability of the DHI, the intraclass correlation coefficient was 0.904 (p < 0.001). DHI showed good correlations with the functional disability scales (Hand Functional Index, Health Assessment Questionnaire, VAS-disability), indicating its convergent validity and moderate to non-significant correlations with the non-functional parameters supporting its divergent validity.

Conclusions

Despite the occurrence of significant deformities and functional loss in PsA patients, there is a noticeable absence of specific tools tailored for PsA. Considering the intricacies associated with skin, nail, tendon, entheseal involvement, and arthritis, there is a need for straightforward tools in both clinical practice and studies involving patients with PsA. The DHI is a valid and reliable scale to evaluate the functional disability of hands in patients with PsA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Code availability

Not applicable.

References

  1. Ritchlin CT, Colbert RA, Gladman DD (2017) Psoriatic arthritis. N Engl J Med 376(10):957–970. https://doi.org/10.1056/NEJMra1505557

    Article  PubMed  Google Scholar 

  2. Macía-Villa C, Cruz Valenciano A, De Miguel E (2021) Enthesis lesions are associated with X-ray progression in psoriatic arthritis. Int J Rheum Dis 24(6):828–833

    Article  PubMed  Google Scholar 

  3. Gelfand JM, Gladman DD, Mease PJ, Smith N, Margolis DJ, Nijsten T, Stern RS, Feldman SR, Rolstad T (2005) Epidemiology of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 53(4):573. https://doi.org/10.1016/j.jaad.2005.03.046

    Article  PubMed  Google Scholar 

  4. Liphardt AM, Manger E, Liehr S, Bieniek L, Kleyer A, Simon D, Tascilar K, Sticherling M, Rech J, Schett G, Hueber AJ (2020) Similar impact of psoriatic arthritis and rheumatoid arthritis on objective and subjective parameters of hand function. ACR Open Rheumatol 2(12):734–740. https://doi.org/10.1002/acr2.11196

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jadon DR, Shaddick G, Tillett W, Korendowych E, Robinson G, Waldron N, Cavill C, McHugh NJ (2015) Psoriatic arthritis mutilans: characteristics and natural radiographic history. J Rheumatol 42(7):1169–1176. https://doi.org/10.3899/jrheum.150083

    Article  PubMed  Google Scholar 

  6. Duruöz MT, Poiraudeau S, Fermanian J, Menkes CJ, Amor B, Dougados M, Revel M (1996) Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol 23(7):1167–1172

    PubMed  Google Scholar 

  7. Duruöz MT, Cerrahoglu L, Dincer-Turhan Y, Kürsat S (2003) Hand function assessment in patients receiving haemodialysis. Swiss Med Wkly 133(31–32):433–438

    PubMed  Google Scholar 

  8. Brower LM, Poole JL (2004) Reliability and validity of the Duruoz Hand Index in persons with systemic sclerosis (scleroderma). Arthritis Rheum 51(5):805–809. https://doi.org/10.1002/art.20701

    Article  PubMed  Google Scholar 

  9. Sanal-Top C, Karadag-Saygi E, Saçaklıdır R, Duruöz MT (2019) Duruöz Hand Index: Is it valid and reliable in children with unilateral cerebral palsy? Dev Neurorehabil 22(2):75–79. https://doi.org/10.1080/17518423.2017.1326536

    Article  PubMed  Google Scholar 

  10. Feldman SR, Fleischer AB Jr, Reboussin DM, Rapp SR, Exum ML, Clark AR, Nurre L (1996) The self-administered psoriasis area and severity index is valid and reliable. J Invest Dermatol 106(1):183–186. https://doi.org/10.1111/1523-1747.ep12329912

    Article  CAS  PubMed  Google Scholar 

  11. Helliwell PS, FitzGerald O, Fransen J (2014) Composite disease activity and responder indices for psoriatic arthritis: a report from the GRAPPA 2013 meeting on development of cutoffs for both disease activity states and response. J Rheumatol 41(6):1212–1217. https://doi.org/10.3899/jrheum.140172

    Article  PubMed  Google Scholar 

  12. Schoels M, Aletaha D, Funovits J, Kavanaugh A, Baker D, Smolen JS (2010) Application of the DAREA/DAPSA score for assessment of disease activity in psoriatic arthritis. Ann Rheum Dis 69(8):1441–1447. https://doi.org/10.1136/ard.2009.122259

    Article  PubMed  Google Scholar 

  13. Mackin EJ, Callahan AD, Osterman AL, Skirven TM, Schneider L (2002) Hunter, Mackin & Callahan’s rehabilitation of the hand and upper extremity, 5th edn. Mosby, St Louis, pp 263–284

    Google Scholar 

  14. Poole JL (2011) Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT), and Michigan Hand Outcomes Questionnaire (MHQ). Arthritis Care Res (Hoboken) 63(Suppl 11):S189-199. https://doi.org/10.1002/acr.20631

    Article  PubMed  Google Scholar 

  15. Küçükdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A (2004) Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 51(1):14–19. https://doi.org/10.1002/art.20091

    Article  PubMed  Google Scholar 

  16. McKenna SP, Doward LC, Whalley D, Tennant A, Emery P, Veale DJ (2004) Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis. Ann Rheum Dis 63(2):162–169. https://doi.org/10.1136/ard.2003.006296

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291

    CAS  PubMed  Google Scholar 

  18. Duruöz MT, Erdem D, Gencer K, Ulutatar F, Baklacıoğlu H (2018) Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis. Rheumatol Int 38(2):261–265. https://doi.org/10.1007/s00296-017-3911-2

    Article  PubMed  Google Scholar 

  19. Kasman SA, Duruöz M (2019) Pain and hand function. In: MT D (ed) Hand function. Springer International Publishing, pp 57–72

  20. Kalla AA, Smith PR, Brown GM, Meyers OL, Chalton D (1995) Responsiveness of Keitel functional index compared with laboratory measures of disease activity in rheumatoid arthritis. Br J Rheumatol 34(2):141–149. https://doi.org/10.1093/rheumatology/34.2.141

    Article  CAS  PubMed  Google Scholar 

  21. Sezer N, Yavuzer G, Sivrioglu K, Basaran P, Koseoglu BF (2007) Clinimetric properties of the Duruoz hand index in patients with stroke. Arch Phys Med Rehabil 88(3):309–314. https://doi.org/10.1016/j.apmr.2006.12.019

    Article  PubMed  Google Scholar 

  22. Sanal-Top C, Karadag-Saygi E, Saçaklıdır R, Duruöz MT (2019) Duruöz Hand Index: is it valid and reliable in children with unilateral cerebral palsy? Dev Neurorehabil 22(2):75–79. https://doi.org/10.1080/17518423.2017.1326536

    Article  PubMed  Google Scholar 

  23. Erçalik T, Şahin F, Erçalik C, Doğu B, Dalgiç S, Kuran B (2011) Psychometric characteristics of Duruoz Hand Index in patients with traumatic hand flexor tendon injuries. Disabil Rehabil 33(17–18):1521–1527. https://doi.org/10.3109/09638288.2010.533244

    Article  PubMed  Google Scholar 

  24. Erdem Gürsoy D, Gezer HH, Acer Kasman S, Duruöz MT (2022) Validity and psychometric characteristics of the self-administered comorbidity questionnaire in patients with psoriatic arthritis. Rheumatol Int 42(11):2061–2067. https://doi.org/10.1007/s00296-022-05150-z

    Article  PubMed  Google Scholar 

  25. Zeidler HK (2022) Psoriatic spondylitis: a disease manifestation in debate: evidences to know for the clinical rheumatologist. J Clin Rheumatol 28(1):38–43. https://doi.org/10.1097/rhu.0000000000001815

    Article  PubMed  Google Scholar 

  26. Rajendran CP, Ledge SG, Rani KP, Madhavan R (2003) Psoriatic arthritis. J Assoc Physicians India 51:1065–1068

    CAS  PubMed  Google Scholar 

  27. Queiro-Silva R, Torre-Alonso JC, Tinturé-Eguren T, López-Lagunas I (2003) A polyarticular onset predicts erosive and deforming disease in psoriatic arthritis. Ann Rheum Dis 62(1):68–70. https://doi.org/10.1136/ard.62.1.68

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Erol K, Gok K, Cengiz G, Ozgocmen S (2018) Hand functions in systemic sclerosis and rheumatoid arthritis and influence on clinical variables. Int J Rheum Dis 21(1):249–252. https://doi.org/10.1111/1756-185x.13044

    Article  PubMed  Google Scholar 

  29. Gökşenoğlu G, Paker N, Çelik B, Buğdaycı D, Demircioğlu D, Kesiktaş N (2018) Reliability and validity of Duruoz Hand Index in carpal tunnel syndrome. Turk J Phys Med Rehabil 64(3):277–283. https://doi.org/10.5606/tftrd.2018.1685

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wan MT, Walsh JA, Craig ET, Husni ME, Scher JU, Reddy SM, Leung YY, Ogdie A (2021) A comparison of physical function instruments in psoriatic arthritis: HAQ-DI vs MDHAQ vs PROMIS10 global physical health. Rheumatology (Oxford) 60(5):2307–2316. https://doi.org/10.1093/rheumatology/keaa591

    Article  CAS  PubMed  Google Scholar 

  31. Duruöz MT, Gezer HH, Nas K, Kılıç E, Sargın B, Kasman SA, Alkan H, Şahin N, Cengiz G, Cüzdan N, Gezer İA, Keskin D, Mülkoğlu C, Reşorlu H, Ataman Ş, Bal A, Küçükakkaş O, Yurdakul OV, Melikoğlu MA, Baykul M, Ayhan FF, Bodur H, Çalış M, Çapkın E, Devrimsel G, Gök K, Hizmetli S, Kamanlı A, Keskin Y, Ecesoy H, Kutluk Ö, Şen N, Şendur ÖF, Tekeoğlu İ, Tolu S, Toprak M, Tuncer T (2021) Gender-related differences in disease activity and clinical features in patients with peripheral psoriatic arthritis: a multi-center study. Jt Bone Spine 88(4):105177. https://doi.org/10.1016/j.jbspin.2021.105177

    Article  Google Scholar 

  32. Gezer HH, Duruöz MT, Nas K, Kılıç E, Sargın B, Kasman SA, Alkan H, Şahin N, Cengiz G, Cüzdan N, Gezer İA, Keskin D, Mülkoğlu C, Reşorlu H, Sunar İ, Bal A, Küçükakkaş O, Yurdakul OV, Melikoğlu MA, Baykul M, Ayhan FF, Bodur H, Çalış M, Çapkın E, Devrimsel G, Gök K, Hizmetli S, Kamanlı A, Keskin Y, Ecesoy H, Kutluk Ö, Şen N, Şendur ÖF, Tekeoğlu İ, Tolu S, Toprak M, Tuncer T (2022) Inconsistencies of the disease activity assessment tools for psoriatic arthritis: challenges to rheumatologists. Jt Bone Spine 89(3):105296. https://doi.org/10.1016/j.jbspin.2021.105296

    Article  Google Scholar 

  33. Mease P, Strand V, Gladman D (2018) Functional impairment measurement in psoriatic arthritis: importance and challenges. Semin Arthritis Rheum 48(3):436–448. https://doi.org/10.1016/j.semarthrit.2018.05.010

    Article  PubMed  Google Scholar 

  34. Poole JL, Cordova KJ, Brower LM (2006) Reliability and validity of a self-report of hand function in persons with rheumatoid arthritis. J Hand Ther 19(1):12–16. https://doi.org/10.1197/j.jht.2005.10.001. (quiz 17)

    Article  PubMed  Google Scholar 

  35. Holm B, Jacobsen S, Skjodt H, Klarlund M, Jensen T, Hetland ML, Ostergaard M (2008) Keitel Functional Test for patients with rheumatoid arthritis: translation, reliability, validity, and responsiveness. Phys Ther 88(5):664–678. https://doi.org/10.2522/ptj.20070119

    Article  PubMed  Google Scholar 

  36. Birtane M, Kabayel DD, Uzunca K, Unlu E, Tastekin N (2008) The relation of hand functions with radiological damage and disease activity in rheumatoid arthritis. Rheumatol Int 28(5):407–412. https://doi.org/10.1007/s00296-007-0461-z

    Article  PubMed  Google Scholar 

  37. Candiri B, Talu B, Demirtas Karaoba D, Ozaltin GE, Yolbas S (2022) Effect of psoriatic arthritis on the strength, proprioception, skill, coordination, and functional condition of the hand. Int J Rheum Dis 25(1):47–55. https://doi.org/10.1111/1756-185x.14241

    Article  PubMed  Google Scholar 

  38. Tiwari V, Brent LH (2022) Psoriatic arthritis. In: StatPearls. StatPearls Publishing

Download references

Funding

This research received no spesific grant from any funding agency in the public, commerial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Physical Medicine and Rehabilitation Department, Rheumatology Division, Pendik Training and Educational Hospital, Marmara University School of Medicine, Muhsin Yazıcıoğlu Street, No 10, 34899, Istanbul, Türkiye

    Mehmet Tuncay Duruöz, Sevtap Acer Kasman, Nuran Öz & Halise Hande Gezer

  2. Rheumatology and Immunology DivisionPhysical Medicine and Rehabilitation Department, Sakarya University School of Medicine, Sakarya, Türkiye

    Kemal Nas

  3. Physical Medicine and Rehabilitation Department, Sakarya University School of Medicine, Sakarya, Türkiye

    Emre Uzun

Authors
  1. Mehmet Tuncay Duruöz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kemal Nas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sevtap Acer Kasman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nuran Öz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emre Uzun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Halise Hande Gezer
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: MTD, HHG, SAK, KN, NÖ, EU. Methodology: MTD, NÖ, EU, HHG, KN, SAK. Writing—original draft: SAK, HHG and NÖ. Writing—review and editing: MTD, SAK, Gezer HH, NÖ, EU, KN. All the authors have approved the final manuscript and take full responsibility for the integrity of the contents of the final manuscript.

Corresponding author

Correspondence to Nuran Öz.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethics approval

All procedures performed in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was taken from the Marmara University Ethics Committee (approval no:09.2020.845 and date: 24/07/2022).

Consent to participate

Informed consent was obtained from all subjects before enrollment.

Consent for publication

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Duruöz, M.T., Nas, K., Kasman, S.A. et al. Validity and reliability of the Duruöz Hand Index in patients with psoriatic arthritis. Rheumatol Int 44, 535–542 (2024). https://doi.org/10.1007/s00296-023-05517-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-023-05517-w

Keywords

Search

Navigation