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Evaluation of the Patient Specific Functional Scale in Hand Fractures
Christine B. Novak, PT, PhD; Marianne Williams, PT, CHT; Kathleen Conaty, BSc
University of Toronto, Toronto, ON, Canada

Purpose: Patient self report questionnaires such as the DASH include standardized items to assess upper extremity disability. The Patient Specific Functional Scale (PSFS) provides the opportunity for the patient to select items that are specifically relevant to each individual. This study evaluated the outcomes related to the PSFS in patients with hand fractures.
Methods: Adult patients with a hand fracture, who completed hand therapy care between January 2012 and January 2013, were eligible for inclusion. At initial and final assessment in hand therapy, each patient was asked to complete the PSFS. This included identification of 3 items that were difficult or unable to perform and the degree of difficulty was ranked on a numeric scale from 0 to 10. We excluded those patients who did not complete the PSFS at baseline and discharge. Statistical analyses were performed to evaluate the relationships the PSFS and the independent variables.
Results: There were 63 patients (37 men, 26 women); 21 of 63 patients underwent surgery for fracture fixation. The mean duration of hand therapy treatment was 2.2 1.4 months. The mean PSFS scores were: initial 3.2 2.2; final 8.1 2.2. There was a significant improvement in PSFS scores from initial to final assessment (p < .001) and the correlation relationship was moderate (r = 0.3, p = 0.02). There was no statistical difference in PSFS scores between men vs women or in patients who had surgery vs. no surgery.
Conclusions: In these patients with hand fractures, the PSFS did indicate significant improvement in function. Using items identified by the patient, the PSFS provides a valuable perspective of outcome and may be used in conjuction with generic disease specific questionnaire for assessment of the upper extremity.


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