Clinimetric testing of the Persian version of the Patient-Rated Tennis Elbow Evaluation (PRTEE) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires in patients with lateral elbow tendinopathy

Abstract

Purpose To evaluate the longitudinal validity and responsiveness of the Persian version of Patient-Rated Tennis Elbow Evaluation (PRTEE) and the Disabilities of the Arm, Shoulder, and Hand (DASH) in patients with lateral elbow tendinopathy (LET). Methods Sixty-four patients with LET completed the PRTEE, DASH, and Global Rating of Change Scale (GRC) at baseline and six weeks. The external and internal responsiveness, floor and ceiling effects, minimal detectable change (MDC) and minimal clinically important difference (MCID) were calculated. Results No ceiling and floor effects were detected for either the PRTEE or DASH. External responsiveness as an indicator to detect the relationship between change in the measured and external indicator of change was acceptable for both, but higher for the PRTEE (AUC = 0.90; CI: 0.83–0.97) vs. DASH (AUC = 0.80; CI: 69–90). Internal responsiveness to detect intervention related changes indicated slightly superiority in responsiveness for PRTEE. The relative efficiency (1.21), standard effect size (1.14 PRTEE vs. 1.03 DASH), and standard response mean (1.34 PRTEE vs. 1.10 DASH). The MDC were 11 and 12, and MCID were 20 and 18 for the PRTEE and DASH, respectively. Conclusions Both the DASH and PRTEE were responsive in detecting improvement in patients with LET. The PRTEE was shorter, more efficient, and slightly more responsive which supports its use as a core outcome measure in evaluating patients with LET. Implications for Rehabilitation The Patient-Rated Tennis Elbow Evaluation (PRTEE) compared with the Disability of the Arm, Shoulder, and Hand (DASH) is a shorter questionnaire with higher psychometric and clinimetric properties for evaluating the patients with lateral elbow tendinopathy. This supports the use of the PRTEE in evaluating patients with elbow tendinopathy.