title: Responsiveness of the active wrist joint position sense test after distal radius fracture intervention.
abstract: METHODS
  Prospective cohort study.
  
  
  BACKGROUND
  The active wrist joint position sense (JPS) test has been determined to be a clinically useful test for assessing wrist sensorimotor (SM) status after distal radius fracture (DRF). Its responsiveness is yet to be determined.
  
  
  OBJECTIVE
  Primary study aim was to determine the active wrist JPS test responsiveness to detect change in wrist SM status at 8 and 12 weeks after DRF treatment intervention. Secondary aims were to compare group (nonsurgical, surgical, high, and low pain) test responsiveness; compare pain-level group participants test scores; determine the relationship between test minimal clinically important difference (MCID) value and function; compare functional outcomes across assessment times; and determine the Patient Global Impression of Change Scale intrarater reliability.
  
  
  METHODS
  A total of 33 male and female participants were tested at baseline, 8, and 12 weeks after nonsurgical (n = 13) and surgical (n = 20) DRF treatment interventions. Distribution-based analysis encompassed both group- (ie, effect size, standardized response mean) and individual-based (ie, minimum detectable change) statistical indices. Anchor-based analysis determined the MCID value by linking test scores to the Patient Global Impression of Change Scale.
  
  
  RESULTS
  The active wrist JPS test is highly responsive based on effect size (8 weeks = 1.53 and 12 weeks = 2.36) and standardized response mean (8 weeks = 1.57 and 12 weeks = 2.14). Statistically significant minimum detectable change values were 4.28° and 4.94° at 8 and 12 weeks, respectively. Clinically meaningful MCID values were 5.00° and 7.09° at 8 and 12 weeks, respectively. Between treatment type and pain-level group responsiveness levels were not significantly different. High-pain participants demonstrated significantly greater JPS deficit. Test MCID values and function were significantly associated.
  
  
  CONCLUSIONS
  This is the first study to determine the active wrist JPS test responsiveness as reflected by its group- and individual-based statistical indices following DRF surgical and non-surgical interventions among low- and high-pain level participants. The statistical analysis approach, which was used to determine the aforementioned variables of the active wrist JPS test, is consistent with current research. This study's strengths included its design, methodology, and statistical approach. The study findings must be interpreted, however, within the content of several methodological limitations.
  
  
  CONCLUSIONS
  The active wrist JPS test was determined to be highly responsive to detect wrist SM status change at 8 and 12 weeks regardless of treatment type or pain level. Clinicians can use this test with confidence to measure clinically meaningful SM impairment after DRF treatment.
  
  
  METHODS
  2b.
authors: Doctor of Physical Therapy Program, DeSales University, Center Valley, PA, USA. Electronic address: karagiannopoulosc@gmail.com.
authors: Christos
authors: C
authors: Karagiannopoulos
authors: Office of the Provost, Temple University, Philadelphia, PA, USA.
authors: Michael
authors: M
authors: Sitler
authors: Department of Rehabilitation and Regenerative Medicine, Program in Physical Therapy, Columbia University, New York, NY, USA.
authors: Susan
authors: S
authors: Michlovitz
authors: Department of Physical Therapy, College of Public Health, Temple University, Philadelphia, PA, USA.
authors: Carole
authors: C
authors: Tucker
authors: Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA.
authors: Ryan
authors: R
authors: Tierney
mesh_terms: D000328:Adult; D000368:Aged; D002370:Casts, Surgical; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011434:Proprioception / Q000502:physiology*; D011446:Prospective Studies; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation* / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation* / Q000601:surgery*
keywords: Active wrist JPS test; Responsiveness; Wrist Fractures