Article Text

Validation of Duruöz Hand Index for Diabetic Hand Dysfunction
  1. Yasemin Turan, MD*,
  2. Mehmet Tuncay Duruöz, MD,
  3. Elif Aksakalli, MD,
  4. Alev Gürgan, MD§
  1. From the *Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Adnan Menderes University, Aydin; †Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Celal Bayar University, Manisa; ‡Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dumlupinar University, Kutahya; and §Department of Physical Medicine and Rehabilitation, Atatürk Research and Education Hospital, Izmir, Turkey.
  1. Received May 27, 2009.
  2. Accepted for publication July 1, 2009.
  3. Reprints: Elif Aksakalli, MD, Cumhuriyet Mh Yunus Emre Cd. Çelik Sk,8/6 Kutahya, Turkey. E-mail: elifaksakalli{at}


Objectives Duruöz Hand Index (DHI) is a functional disability scale that can be used successfully to assess the functional disability with different hand arthropathies. The hands are frequently involved in diabetic patients. We aimed to examine the use of DHI for its accuracy and ease in assessing these patients.

Methods Forty patients with diabetes mellitus were recruited in this study. Hand pain was assessed with the visual analog scale. Duruöz Hand Index and Hand Functional Index were applied to assess the disability of hand. We evaluated the grip strength and 3 types of pinch strength (tip pinch, lateral or key pinch, and chuck or 3-finger pinch) for the dominant (D) and nondominant (ND) hands of each patient by 2 different kinds of Jamar dynamometers (JA Preston Corp, Jackson, MI).

Results The Jamar dynamometer scores were as follows (mean [SD]): grip strength-D (21.56 [5.86]), grip strength-ND (16.42 [4.26]), tip strength-D (5.14 [1.50]), tip strength-ND (5.13 [1.42]), lateral strength-D (5.15 [1.52]), lateral strength-ND (5.07 [1.19]), chuck strength-D (5.40 [1.40]), chuck strength-ND (5.33 [1.28]). There was a high correlation between DHI and Hand Functional Index (P < 0.001, ρ = 0.586) showing that DHI has good convergent validity. The DHI had significant correlation with nonfunctional parameters such as visual analog scale-pain (P < 0.001), restricted hand motion (P = 0.020), chuck strength-D (P = 0.006), pins test-D (P < 0.001), pins test-ND (P = 0.013), and assembly test (P = 0.025).

Conclusions The DHI is a practical scale that is efficient in accurate assessment of hand dysfunction in diabetic patients.

Key Words
  • diabetes mellitus
  • hand dysfunction
  • Duruöz Hand Index

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