Document Type: RESEARCH PAPER

Authors

Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: The patient-rated wrist evaluation (PRWE) score is one of the most common clinical instruments used
as an outcome measurement tool for distal radius fractures and other upper extremity conditions. The purpose of this
study was to translate the PRWE into its Persian version and to evaluate its validity and reliability in patients with upper
extremity conditions.
Methods: One hundred and fourthly one adult patients with upper extremity conditions participated in this ethical board
approved study from August 2015 to May 2016. After translating the original version of the PRWE into Persian, all
patients filled out the PRWE in addition to the VAS (Visual analogue scale) and DASH questionnaires. For evaluating
reliability, after three days the researchers called back some of the patients who did not receive treatment or any
changes in symptoms and asked them to complete the PRWE retest (104 patients).
Results: Cronbach’s alpha was calculated as high as 0.934, implying very reliable internal consistency. After each item
deletion, the Cronbach’s alpha was still constant (range: 0.926 to 0.936). Intraclass correlation coefficient was 0.952
and this showed excellent test-retest reliability. The correlation coefficient between the PRWE and DASH scores was
strong. Multivariable analysis showed an association between the PRWE and years educated.
Conclusion: Our study has shown that the Persian version of the PRWE is valid and reliable for patients with upper
extremity conditions.

Keywords

Main Subjects

1. Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR,
Birjandinejad A. Validity and reliability of the persian
version of shortened disabilities of the arm, shoulder
and hand questionnaire (quick-dash).Int J Prev Med.
2015; 8(6):59.
2. Ebrahimzadeh MH, Kachooei AR, Vahedi E, Moradi
A, Mashayekhi Z, Hallaj-Moghaddam M, et al. Validity
and cross-cultural adaptation of the persian version
of the oxford elbow score. Int J Rheumatol. 2014;
2014:381237.
3. Ebrahimzadeh MH, Birjandinejad A, Kachooei AR.
Cross-cultural adaptation, validation, and reliability
of the michigan hand outcomes questionnaire among
persian population. Hand Surg. 2015; 20(1):25-31.
4. Ebrahimzadeh MH, Shojaei BS, golhasani-Keshtan
F, Soltani-Moghaddas SH, Fattahi AS, Mazloumi SM.
Quality of life and the related factors in spouses of
veterans with chronic spinal cord injury. Health Qual
Life Outcomes. 2013; 11(1):48.
5. MacDermid JC, Turgeon T, Richards RS, Beadle M,
Roth JH. Patient rating of wrist pain and disability: a
reliable and valid measurement tool. J Orthop Trauma.
1998; 12(8):577-86.
6. MacDermid JC, Richards RS, Donner A, Bellamy N, Roth
JH. Responsiveness of the short form-36, disability of
the arm, shoulder, and hand questionnaire, patientrated
wrist evaluation, and physical impairment
measurements in evaluating recovery after a distal
radius fracture. J Hand Surg Am. 2000;25(2):330-40.
7. Imaeda T, Uchiyama S, Wada T, Okinaga S, Sawaizumi T,
Omokawa S, et al. Reliability, validity, and responsiveness
of the Japanese version of the Patient-Rated Wrist
Evaluation. J Orthop Sci. 2010; 15(4):509-17.
8. da Silva Rodrigues EK, de Cassia Registro Fonseca M,
MacDermid JC. Brazilian version of the patient rated
wrist evaluation (prwe-br): cross-cultural adaptation,
internal consistency, test-retest reliability and
construct validity. J Hand Ther. 2015; 28(1):69-75.
9. Kachooei AR, Ebrahimzadeh MH, Erfani-Sayyar
R, Salehi M, Salimi E, Razi S. Short form-mcgill
pain questionnaire-2 (sf-mpq-2): a cross-cultural
adaptation and validation study of the persian version
in patients with knee osteoarthritis. Arch Bone Jt Surg.
2015; 3(1):45-50.
10. Ebrahimzadeh MH, Vahedi E, Baradaran A,
Birjandinejad A, Seyyed-Hoseinian SH, Bagheri F, et al.
Psychometric properties of the persian version of the
simple shoulder test (sst) questionnaire. Arch Bone Jt
Surg. 2016; 4(4):387-92.
11. Ebrahimzadeh MH, Birjandinejad A, Golhasani F,
Moradi A, Vahedi E, Kachooei AR. Cross-cultural
adaptation, validation, and reliability testing of the
Shoulder Pain and Disability Index in the Persian
population with shoulder problems. Int J Rehabil Res.
2015; 38(1):84-7.
12. Beaton DE, Bombardier C, Guillemin F, Ferraz MB.
Guidelines for the process of cross-cultural adaptation
of self-report measures. Spine. 2000; 25(24):3186-91.
13. Walenkamp MM, de Muinck Keizer RJ, Goslings JC,
Vos LM, Rosenwasser MP, Schep NW. The minimum
clinically important difference of the patient-rated
wrist evaluation score for patients with distal
radius fractures. Clin Orthop Relat Res. 2015;
473(10):3235-41.
14. Contributors W. Construct validity Wikipedia, The
Free Encyclopedia. Available at: URL:https://
en.wikipedia.org/w/index.php?title=Construct_
validity&oldid=774377796; 2017.
15. Contributors W. Reliability (statistics) Wikipedia,
The Free Encyclopedia. ; . Available at: URL: https://
en.wikipedia.org/w/index.php?title=Reliability_
(statistics)&oldid=776006196; 2017.
16. Christmann A, Van Aelst S. Robust estimation of
Cronbach’s alpha. J Multivar Anal. 2006; 97(7):1660-74.
17. Bravo G, Potvin L. Estimating the reliability of
continuous measures with Cronbach’s alpha or
the intraclass correlation coefficient: toward the
integration of two traditions. J Clin Epidemiol. 1991;
44(4-5):381-90.
18. MacDermid JC, Donner A, Richards RS, Roth JH.
Patient versus injury factors as predictors of pain and
disability six months after a distal radius fracture. J
Clin Epidemiol. 2002; 55(9):849-54.
19. Smith ME, Auchincloss J, Ali M. Causes and
consequences of hand injury. the journal of hand
surgery: british & european volume. J Hand Surg Br.
1985; 10(3):288-92.
20. Nellans KW, Kowalski E, Chung KC. The epidemiology
of distal radius fractures. Hand clinics. 2012;
28(2):113-25.
21. Mehta SP, MacDermid JC, Richardson J, MacIntyre NJ,
Grewal R. A systematic review of the measurement
properties of the patient-rated wrist evaluation. J
Orthop Sports Phys Ther. 2015; 45(4):289-98.
22. Moradi A, Ebrahimzadeh MH, Jupiter JB. Intraarticular
fractures of the distal radius: bridging
external fixation in slight flexion and ulnar deviation
along articular surface instead of radial shaft. Tech
Hand Up Extrem Surg. 2014; 18(1):41-50.
23. Sandelin H, Jalanko T, Huhtala H, Lassila H, Haapala
J, Helkamaa T. Translation and validation of the
finnish version of the patient-rated wrist evaluation
questionnaire (prwe) in patients with acute distal
radius fracture. Scand J Surg. 2016; 105(3):204-10.
24. Schonnemann JO, Hansen TB, Soballe K. Translation
and validation of the danish version of the patient
rated wrist evaluation questionnaire. J Plast Surg
Hand Surg. 2013; 47(6):489-92.
25. Kim JK, Kang JS. Evaluation of the Korean version of
the patient-rated wrist evaluation. J Plast Surg Hand
Surg. 2013; 26(3):238-43.
26. Ozturk O, Sari Z, Ozgul B, Tasyikan L. Validity 

and reliability of the turkish “patient-rated wrist
evaluation” questionnaire. Acta Orthop Traumatol
Turc. 2015; 49(2):120-5.
27. Wilcke MT, Abbaszadegan H, Adolphson PY.
Evaluation of a swedish version of the patientrated
wrist evaluation outcome questionnaire:
good responsiveness, validity, and reliability, in 99
patients recovering from a fracture of the distal
radius. Scand J Plast Reconstr Surg Hand Surg. 2009;
43(2):94-101.
28. Hemelaers L, Angst F, Drerup S, Simmen BR, Wood-
Dauphinee S. Reliability and validity of the German
version of “the Patient-rated Wrist Evaluation
(PRWE)” as an outcome measure of wrist pain and
disability in patients with acute distal radius fractures.
J Hand Ther. 2008; 21(4):366-76.
29. Wah JW, Wang MK, Ping CL. Construct validity of the
chinese version of the patient-rated wrist evaluation
questionnaire (prwe-hong kong version). J Hand Ther.
2006; 19(1):18-26.
30. Mellstrand Navarro C, Ponzer S, Törnkvist H,
Ahrengart L, Bergström G. Measuring outcome after
wrist injury: translation and validation of the swedish
version of the patient-rated wrist evaluation (prweswe).
BMC Musculoskelet Disord. 2011; 12:171.
31. Downie WW, Leatham PA, Rhind VM, Pickup ME,
Wright V. The visual analogue scale in the assessment
of grip strength. Ann Rheum Dis. 1978; 37(4):382-4.
32. Kilinc AS, Ebrahimzadeh MH, Lafosse L. Subacromial
internal spacer for rotator cuff tendon repair: “the
balloon technique”. Arthroscopy. 2009 Aug;25(8):921-4.
33. Moradi A, Ebrahimzadeh MH, Jupiter JB. Radial Tunnel
Syndrome, Diagnostic and Treatment Dilemma. Arch
Bone Jt Surg. 2015 Jul;3(3):156-62.