Patient-Rated Wrist Evaluation

Distal Radius Fracture: (Rosales et al., 2017; n = 40; female = 31; Mean Age (SD) = 58 (19) years; Time Post Injury = 1 week, assessed at baseline and 8, 9, 12 and 13 weeks after fracture/treatment (closed reduction and cast); Spanish translation of PWRE)

• SEM for pain (baseline): 2.13
• SEM for function (baseline): 1.56
• SEM for total (baseline): 2.67
• SEM for pain (8 weeks): 3.50
• SEM for function (8 weeks): 2.58
• SEM for total: (8 weeks): 4.37

Scaphoid or Distal Radius Fracture: (Fadavi-Ghaffari et al., 2021; n = 150; Age > 18 years; Mean Age (SD) = 39.30 (12.65) years; Time since injury ≥ 2 months; Persian translation of PRWE)

• SEM PRWE-total: 3.93
• SEM PRWE-P: 2.51
• SEM PRWE-F: 2.25

Distal Radius Fractures: (Walenkamp et al., 2015; n = 102; Mean Age (IQR) = 59 (48-66) years; Time Post Injury ≤ 1 year; MDC expressed as points on PRWE scale)

• MDC for PRWE pain: 6.5
• MDC for PRWE function: 4.5
• MDC for PRWE total: 11.0

Distal Radius Fractures: (Walenkamp et al., 2015; MCID expressed as points on PRWE scale)

• MCID for PRWE pain: 1.5
• MCID for PRWE function: 10
• MCID for PRWE total: 11.5

Osteoarthritis: (Larsson et al., 2022; n = 50; Mean age (SD) = 66 (9) years; male = 40 (80%); validated Swedish translation of PRWE)

• Excellent test-retest reliability for the total score and subscales assessed two weeks apart (Kappa coefficients = 0.93 – 0.94)

Scaphoid or Distal Radius Fracture: (Fadavi-Ghaffari et al., 2021)

• Excellent test-retest reliability for total score (ICC = 0.95)

Distal Radius Fractures: (Rosales et al., 2017)

• Excellent test-retest reliability for total score at 8, 9, 12, and 13 weeks (ICC = 0.94 at 8-9 weeks and 0.96 at 12-13 weeks)

Acute Distal Radius Fractures: (Hemelaers et al., 2008; n = 44; Mean age (SD) = 56.3 (15.3); Mean time post injury = 4 – 6 weeks; test-retest interval = 4-7 days; German translation of PRWS)

• Excellent test-retest reliability for total score (n = 42) (ICC = 0.94) and function subscale (ICC = 0.92)
• Acceptable test-retest reliability for pain subscale (n = 42) (ICC = 0.86) 

Distal Radius Fractures: 

• Excellent internal consistency for total score (Cronbach’s alphas = 0.98* and 0.96*) at baseline and 8 weeks, respectively (Rosales et al., 2017)
• Excellent internal consistency (Cronbach’s alpha = 0.94* -0.97*) (Wilcke et al., 2009; n = 99; Mean Age (SD) = 51 (19) years; tested at 7 weeks and 4 to 6 months following injury; various levels of severity; Swedish translation and validation of PRWE)

Acute Distal Radius Fractures: (Hemelaers et al., 2008)

• Excellent internal consistency (Cronbach’s alpha) for total score (0.89), pain scale (0.81), and function scale (0.85)

*Scores higher than 0.9 may indicate redundancy in scale questions

Concurrent Validity: 

Rheumatoid Arthritis: (Tuna et al., 2019; n = 75; Mean age (SD) = 53.92 (13.4) years; female = 56 (74.7%); Mean disease duration (SD) = 119.92 (84.89) months; validated Turkish translation of PRWE into PRWE-T)

• Excellent correlation with Michigan Hand Outcome Questionnaire (MHOQ) for both dominant and non-dominant hands (ρ = -0.83 and -0.79, respectively)

Distal Radius Fractures: (Wilcke et al., 2009)

• Excellent correlation between the PRWE total scores and the DASH scores at 7 weeks and at 4-6 months (r = 0.85 and r = 0.91, respectively)

Convergent Validity:

Osteoarthritis: (Larsson et al., 2022)

• Excellent correlation between PRWE total score and DASH (ρ = 0.86, p < 0.001)
• Excellent correlation between pain subscale and NRS pain at rest (ρ = 0.84, p < 0.001)

Scaphoid or Distal Radius Fracture: (Fadavi-Ghaffari et al., 2021)

• Excellent correlations between PRWE total score and Quick-DASH total score ( ρ = 0.74)
• Adequate to excellent correlations between the total score and subscores of the PRWE and SF-36 subscales (ρ = 0.36-0.66)

Distal Radius Fractures: (Rosales et al., 2017)

• Excellent correlations between the PRWE-Spanish and the QuickDASH at baseline (r =0.71) and 8 weeks (r = 0.79)
• Adequate correlations between the PRWE-Spanish and the EQ-5D Index at baseline (r = -0.45) and 8 weeks (r = -0.40)

Acute Distal Radius Fractures: (Hemelaers et al., 2008)

• Adequate to excellent  correlations between the German PRWE total score and the DASH (sub- and total scores) with correlations between r = 0.50 and r = 0.62 
• Adequate correlations between German PRWE total score and all the scales on the SF-36 (r = 0.31 – 0.58)

Discriminant Validity:  

Acute Distal Radius Fractures: (Hemelaers et al., 2008)

• Adequate correlation between the German PRWE total score and the SF-36 Mental Component Summary (MCS) (r = 0.45)

(Wilcke et al., 2009; Swedish translation and validation of PRWE)

• Scores normally distributed at 7 weeks
• Completeness of responses was good
• No patient left more than three questions unanswered

(Hemelaers et al., 2008)

• German PRWE assessed by expert committee, those who completed measure in the preclinical testing, and the developer of the original PRWE

Distal Radius Fractures: (Cheema et al., 2020; n = 124; Mean Age (SD) = 64(7) years; female = 107 (86%); Time post injury = 2 weeks, assessed at baseline, 6 months, and 12 months; Mean injury severity score (SD) = 9.0 (0.8))

• Poor ceiling effect at baseline (76.6%)
• Adequate ceiling effects at 6 months (8.1%) and 12 months (16.9%)
• Adequate floor effects at baseline (1.0%), 6 months (9.0%), and 12 months (6.4%)

Scaphoid or Distal Radius Fracture: (Fadavi-Ghaffari et al., 2021)

• Adequate ceiling and floor effects of the PRWE total score (0.67% & 2%, respectively)

Distal Radius Fractures: (Wilcke et al., 2009)

• Large responsiveness and large change between 7 week and 4 to 6 months (SRM = 1.4 -1.7; ES = 1.3) 

Scaphoid or Distal Radius Fracture: (Fadavi-Ghaffari et al., 2021)

• Large responsiveness to differences between two groups, one with wrist pain and one without (ES = 0.94)

Ulnar shortening osteotomy: (Kim & Park, 2013; n = 28; Age ≥ 18 years; Mean Age = 41; Time post-surgery = 12 months; Assessed 1 month before surgery and 12 months post-surgery)

• MDC for PRWE total: 7.7

Open reduction & volar locking plate fixation: (Kim & Kang, 2013; n = 63; Mean age (range) = 56 (19-83) years; Time post-surgery = 3 months (baseline) and 6 months (follow-up); Korean translation and cross-cultural adaption of the PWRE into the K-PWRE)

• MDC for PRWE total: 4.4
• MDC for pain subscale: 2.7 
• MDC for function subscale: 2.5

Ulnar shortening osteotomy: (Kim & Park, 2013)

• MCID for PRWE total: 17

Open reduction & volar locking plate fixation: (Kim & Kang, 2013) 

• Excellent test-retest reliability (n = 60) for the PRWE total score (ICC = 0.96) and subscales of pain (ICC = 0.96) and function (ICC = 0.95)

Various Wrist or Hand Disorders: 

• Excellent test-retest reliability for 67 patients who were assessed twice with a test-retest interval of an average of 8 (3.5) days: (ICC = 0.92) (Imaeda et al., 2010; n = 117; Mean Age (SD) = 50 (18.7) years; Japanese translation of PRWE into PRWE-J)
• Excellent test-retest reliability for total score with chronic impairment group (n  = 60): (ICC = 0.93) (Mellstrand Navarro et al., 2011; n = 124; mean age = 61 years; female >80%; Injury/impairment duration = about 12 months (chronic impairment) and 1 week and 5 weeks after removal of cast (acute injury); Swedish translation of PRWE)

Open reduction & volar locking plate fixation: (Kim & Kang, 2013)

• Excellent internal consistency for PRWE total score (Cronbach’s alpha = 0.94*) and for pain and function subscales (Cronbach’s alphas = 0.93* and 0.95*, respectively)

Various Wrist or Hand Disorders:

• Excellent internal consistency for total score, pain scale, and function scale at baseline (Cronbach’s alphas* = 0.97, 0.93, and 0.97, respectively) (Mellstrand Navarro et al., 2011)
• Excellent internal consistency for total scale and subscales pain and function (Cronbach’s alphas = 0.90 to 0.96*) (Imaeda et al., 2010)

Wrist problems/Injuries: 

• Excellent internal consistency for total PRWE score, and scores of pain and function subscales, Cronbach’s alpha was 0.88, 0.86 and 0.82, respectively (Ozturk et al., 2015; n = 110; Mean Age (SD) = 50.8 (1.53); female = 85 (77.3%); Turkish translation of PRWE into PRWE-T)
• Excellent internal consistency of items in pain and functional subsets (Cronbach’s alpha range from 0.78 to 0.95*) (Wah et al., 2006; n = 47; Mean Age (SD) = 46.4 (15.6) years; Age Range = 20-78 years; Assessed at baseline and 6 weeks; Chinese translation of PRWS)

*Scores higher than 0.9 may indicate redundancy in scale questions

Concurrent Validity:

Wrist problems/Injuries: (Ozturk et al., 2015)

• Excellent correlation between PRWE total score and the DASH (r_s = 0.915, p < 0.01)

Open reduction & volar locking plate fixation: (Kim & Kang, 2013)

• Excellent correlations with the K-DASH for the PWRE total score (ρ = 0.74) and pain and function subscales (ρ = 0.63 and 0.76, respectively)

Various Wrist or Hand Disorders: 

• Excellent correlations between total score of PRWE and the DASH (r_s= 0.81) (Imaeda et al., 2010)
• Poor to adequate correlations between the SF-36 subscales and PRWE pain (r_s = -0.24 to -0.37) and function (r_s = -0.21 to -0.46) (Imaeda et al., 2010)
• Excellent correlation with DASH scores at the first measurement (rho = 0.92) and the second measurement (rho = 0.88) (Mellstrand Navarro et al., 2011)

Convergent Validity:

Open reduction & volar locking plate fixation: (Kim & Kang, 2013)

• Adequate negative correlation between grip strength and PRWE total score (ρ = -0.56, p < 0.01)
• Poor negative correlation between wrist flexion and PRWE total score (ρ = -0.30, p < 0.05)
• Poor negative correlation between wrist extension and PRWE total score (ρ = -0.27, p < 0.05)

Wrist problems/Injuries: (Wah et al., 2006; n  = 47)

• Adequate to excellent correlations between PRWE pain subscale and VAS at first and second assessments (r = 0.57 – 0.83)
• Adequate to excellent correlations between PRWE function subscale and SF-36 physical function subscale at first (r = -0.32) and second assessment (r = - 0.69).

(Wah et al., 2006; Chinese translation of PRWE)

• Questionnaire achieved representativeness and relevance in assessing wrist conditions according to qualitative feedback from pane members 
• Over 60% agreement among panel members

(Mellstrand Navarro et al., 2011; Swedish translation of PRWE)

• Changed expression about “turning a door knob” to “turning a tap or key” to culturally adapt to Swedish norms 
• Content validity was judged by experts and determined to be good 

(Mellstrand Navarro et al., 2011)

• Face validity judged by patients and healthcare workers was good
• No reports of difficulty understanding content
• Some reported that questions were not appropriate when the evaluation involved the non-dominant hand

Ulnar shortening osteotomy: (Kim & Park, 2013)

• Large change in PRWE total score 12 months post-surgery (ES = 1.51; SRM = 1.64) 

Open reduction & volar locking plate fixation: (Kim & Kang, 2013)

• Large responsiveness for PRWE total score (SRM = 0.89; ES = 0.84) and pain subscale (SRM = 0.93; ES =0.86)
• Moderate responsiveness for function subscale (SRM = 0.77; ES = 0.73)

Various Wrist or Hand Disorders: 

• Large responsiveness and changes between preoperative and postoperative total scores (n = 50) (SRM = 1.55; ES = 1.92) (Imaeda et al., 2010)
• Large responsiveness for acute injury patients between the first and second measurements (n = 58) (SRM = 1.29) (Mellstrand Navarro et al., 2011)
• Statistically significant clinical change in total score, pain, and function for patients with acute injury (p < 0.001) (Mellstrand Navarro et al., 2011)