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Changes over Time and Responsiveness of the Cochin Hand Function Scale and Mouth Handicap in Systemic Sclerosis Scale
Christelle Nguyen1, Alice Bérezné, Caroline Mestre-Stanislas
1From the Université Paris Descartes, PRES Sorbonne Paris Cité, (CN, AB, CM-S, M-ML-C, FR, LG, LM, SP); Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (CN, M-ML-C, FR, SP); INSERM UMR-S 1124, and Laboratoire de Pharmacologie, Toxicologie et Signalisation Cellulaire, UFR Biomédicale des Saints Pères (CN, FR); Service de Médecine Interne, Hôpital Cochin, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Assistance Publique-Hôpitaux de Paris (CN, AB, CM-S, LG, LM); INSERM UMR-S 1153 (M-ML-C, SP); and Institut Fédératif de Recherche sur le Handicap (SP), Paris, France.
Objective:
To assess changes over time and responsiveness of the Cochin Hand Function Scale (CHFS) and Mouth Handicap In Systemic Sclerosis (MHISS) scale in patients with systemic sclerosis (SSc).
Design:
This was a prospective longitudinal study.
Participants:
Participants were drawn from a convenience sample of individuals with SSc, who were attending the annual Congress of the Association des Sclérodermiques de France, the French SSc patients' association.
Methods:
Participants were evaluated twice by the CHFS, MHISS scale, Health Assessment Questionnaire, McMaster-Toronto Arthritis Patient Preference Disability Questionnaire, and other outcome measures. Differences in measures over time were evaluated using the Wilcoxon signed rank test. Responsiveness was assessed by the effect size and standardized response mean. Nonparametric Spearman rank correlation (r) was used to assess correlation between outcome measures.
Results:
Forty-nine patients were assessed. The CHFS and MHISS scores worsened over time (mean [SD] differences 2.7 [10.7], P = 0.08, and 3.5 [9.8], P = 0.14, respectively). The CHFS effect size and standardized response mean values were -0.16 and -0.24, respectively, and MHISS values were -0.53 and -0.52, respectively. The correlation between change in the CHFS score and change in Health Assessment Questionnaire and McMaster-Toronto Arthritis Patient Preference Disability Questionnaire scores was fair to moderate, whereas changes in MHISS score were poorly or not correlated to other measures. For patients considering their state deteriorated, the MHISS scale was the most responsive instrument.
Conclusions:
The CHFS and MHISS scores may be useful in detecting changes in location-specific limitations in activity for SSc patients.
