İbrahim Taka1, Berat M. Alkan2, Fatma F. Yıldız2

1Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Türkiye
2Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Ankara, Türkiye

Keywords: Duruöz Hand Index, factor analysis, lateral epicondylitis, reliability, validity.


Objectives: This study aims to investigate the validity, reliability and clinimetric features of the Duruöz Hand Index (DHI) in patients with lateral epicondylitis.

Patients and methods: Between October 2019 and January 2020, a total of 78 patients (28 males, 50 females; mean age: 46.4±9.4 years; range, 20 to 65 years) who presented with pain in the forearm and were diagnosed with lateral epicondylitis were included in the study. The patients were evaluated using the Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ), the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEEQ), the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire at Weeks 0, 1 and 4. The DHI reliability (Cronbach alpha, intraclass correlation [ICC]), validity and factor analyses were performed with the data of 70 and 49 patients who attended to follow-up visit at Weeks 1 and 4. The effect size (ES), standard response mean (SRM), and minimum detectable change (MDC) values of the DHI were calculated.

Results: Of the patients, 84.6% were right-handed. The ICC coefficients of DHI were found to be perfect with the test-retest method (ICC; total=0.943). It showed a well-excellent consistency with the internal consistency method (Cronbach alpha; total=0.90). In the structural validity of the DHI, it was very strongly correlated with the DASH (r=0.801; p<0.01), strongly correlated with the PRTEEQ and HAQ total scores (r=0.793; p<0.01; r=0.785; p<0.01), and acceptably correlated with PRTEEQ pain score (r=0.570; p<0.01). The DHI was acceptably correlated with the VAS and grip strength as measured by the hand dynamometer (p<0.05). In our study, three main factors were obtained and MDC and responsiveness sensitivity were found to be moderate (MDC=4.4; SEM=1.61; ES=0.246 p<0.001; SRM=0.538 p<0.001).

Conclusion: Duruöz Hand Index is a reliable, valid, and practical functional assessment scale in patients with lateral epicondylitis.

Citation: Taka İ, Alkan BM, Yıldız FF. Validity and reliability of the Duruöz Hand Index in patients with lateral epicondylitis. Arch Rheumatol 2022;37(3):315-325.

Ethics Committee Approval

The study protocol was approved by the Yildirim Beyazit University Faculty of Medicine Ethics Committee (Date: 09/10/2019; No: 101). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Gathering data, Data analysis, writing the manuscript: ‹.T.; Study plan, data analysis, revising the manuscript: B.M.A.; Gathering data: F.F.Y.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.