eprintid: 26785
rev_number: 12
eprint_status: archive
userid: 1589
dir: disk0/00/02/67/85
datestamp: 2019-08-12 09:25:21
lastmod: 2019-09-22 11:37:39
status_changed: 2019-08-12 09:25:21
type: article
metadata_visibility: show
creators_name: Nerz, Corinna
creators_name: Schwickert, Lars
creators_name: Schölch, Sabine
creators_name: Gordt, Katharina
creators_name: Nolte, Philip-Christian
creators_name: Kröger, Inga
creators_name: Augat, Peter
creators_name: Becker, Clemens
title: Inter-rater reliability, sensitivity to change and responsiveness of the orthopaedic Wolf-Motor-Function-Test as functional capacity measure before and after rehabilitation in patients with proximal humeral fractures
subjects: ddc-610
divisions: i-851600
keywords: Wolf motor function test, Reliability, Sensitivity to change, Responsiveness, Orthopaedic assessment, Shoulder function, Proximal humeral fracture
abstract: Background: The incidence of proximal humeral fractures (PHF) increased by more than 30% over the last decade, which is accompanied by an increased number of operations. However, the evidence on operative vs. non-operative treatment and post-operative treatments is limited and mostly based on expert opinion. It is mandatory to objectively assess functional capacity to compare different treatments. Clinical tools should be valid, reliable and sensitive to change assessing functional capacity after PHFs. This study aimed to analyse inter-rater reliability of the videotaped Wolf-Motor-Function-Test-Orthopaedic (WMFT-O) and the association between the clinical WMFT-O and the Disability of the Arm, Shoulder and Hand (DASH) and to determine the sensitivity to change of the WMFT-O and the DASH to measure functional capacity before and after rehabilitation in PHF patients.

Methods: Fifty-six patients (61.7 ± 14.7 years) after surgical treatment of PHF were assessed using the WMFT-O at two different time points. To determine inter-rater reliability, the videotaped WMFT-O was evaluated through three blinded raters. Inter-rater agreement was determined by Fleiss’ Kappa statistics. Pearson correlation coefficients were calculated to assess the association between the clinical WMFT-O and the video rating as well as the DASH. Sensitivity to change and responsiveness were analysed for the WMFT-O and the DASH in a subsample of forty patients (53.8 ± 1.4 years) who were assessed before and after a three week robotic-assisted training intervention.

Results: Inter-rater agreement was indicated by Fleiss’ Kappa values ranging from 0.33–0.66 for functional capacity and from 0.27–0.54 for quality of movement. The correlation between the clinical WMFT-O and the video rating was higher than 0.77. The correlation between the clinical WMFT-O and the DASH was weak. Sensitivity to change was high for the WMFT-O and the DASH and responsiveness was given. In comparison to the DASH, the sensitivity to change of the WMFT-O was higher.

Conclusion: The overall results indicate that the WMFT-O is a reliable, sensitive and responsive instrument to measure more objectively functional change over time in rehabilitation after PHF. Furthermore, it has been shown that video assessment is eligible for studies to ensure a full blinding of raters.

Trial registration: Clinicaltrials.gov, NCT03100201. Registered on 28 March 2017. The trial was retrospectively registered.
date: 2019
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1671670078
own_urn: urn:nbn:de:bsz:16-heidok-267851
language: eng
bibsort: NERZCORINNINTERRATER2019
full_text_status: public
publication: Musculoskeletal Disorders
volume: 20
number: 315
place_of_pub: London
pagerange: 1-8
issn: 1471-2474
citation:   Nerz, Corinna ; Schwickert, Lars ; Schölch, Sabine ; Gordt, Katharina ; Nolte, Philip-Christian ; Kröger, Inga ; Augat, Peter ; Becker, Clemens  (2019) Inter-rater reliability, sensitivity to change and responsiveness of the orthopaedic Wolf-Motor-Function-Test as functional capacity measure before and after rehabilitation in patients with proximal humeral fractures.  Musculoskeletal Disorders, 20 (315).  pp. 1-8.  ISSN 1471-2474     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26785/1/12891_2019_Article_2691.pdf