Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release

Purpose: The objective of this study was to compare the responsiveness (ability to accurately detect change) of 3 self-administered questionnaires to changes produced by carpal tunnel release. Method: The Disabilities of the Arm, Shoulder and Hand (DASH), the Brigham and Women's Carpal Tunnel Questionnaire, and the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36) were completed by 34 subjects before surgery and at 6 and 11 2 Weeks after carpal funnel release. Results: The instrument most sensitive to clinical change at 12 weeks as judged, by.-effect size and standardized response means was the Carpal Tunnel Questionnaire effect size/standardized response means, (1.71/1.66) followed by the DASH (1.01/1.13) and the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain. (0.57/6.52),and role physical (0.39/0.39) subscales. There was good correlation between DASH and Carpal Tunnel Questionnaire change scores (Spearman correlation coefficient 0.87). Conclusions: The Carpal Tunnel Questionnaire is the most sensitive to clinical change, but the DASH is sufficiently responsive for use in outcome studies of car-pal tunnel syndrome done 12 or more weeks after surgery. Copyright (C) 2003 by the American Society for Surgery of the Hand.