Development and validation of an elbow score.

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Clinical Assessment

Background:

• Limited validated questionnaires exist for elbow function assessment.
• An ideal elbow score requires consistency, sensitivity, reliability, and specificity.
• Incorporating patient and clinician perspectives is crucial for comprehensive evaluation.

Purpose of the Study:

• To develop and validate a new, reliable, and sensitive elbow-specific functional score.
• To create a tool that integrates both patient-reported outcomes and clinical assessments.
• To establish a gold standard for elbow evaluation in clinical practice.

Main Methods:

• Item generation involved 25 patients and expert opinion, followed by reduction using 25 new patients.
• A nine-item patient questionnaire and a six-item clinical evaluation (strength, motion, ulnar nerve) were developed.
• Validation utilized 63 new patients, with test-retest reliability assessed in 28 patients.

Main Results:

• Excellent test-retest reliability (R2 = 0.93) and internal consistency (Cronbach's alpha = 0.98) were achieved.
• Good convergent validity was shown through correlations with Disabilities of Arm, Shoulder and Hand (DASH) and Nottingham Health Profile (NHP) scores.
• The score demonstrated significant sensitivity to change following treatment, correlating with improvements in DASH and NHP.

Conclusions:

• The developed elbow score is reliable, internally consistent, and correlates well with existing non-elbow specific measures.
• The score is sensitive to therapeutic interventions, providing a valuable tool for assessing elbow function.
• This validated instrument offers a comprehensive approach to elbow assessment, combining patient and clinical perspectives.