Convergent validity and responsiveness of the Canadian Occupational Performance Measure for the evaluation of therapeutic outcomes for patients with carpometacarpal osteoarthritis

• Published in: Journal of hand therapy Vol. 34; no. 3; pp. 439 - 445
• Main Authors: Raquel, Cantero-Tellez, Villafañe, Jorge Hugo, Medina-Porqueres, Ivan, Garcia-Orza, Santiago, Valdes, Kristin
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01.07.2021; Elsevier Limited
• Subjects: Activities of daily living; Arthritis; Biomedical materials; Carpometacarpal osteoarthritis; Chronic illnesses; Convergence; COPM; Fingers & toes; Hand; Osteoarthritis; Outcome measures; Pain; Participation; Patient satisfaction; Patients; Perception; Performance evaluation; Questionnaires; Rehabilitation; Self image; Therapists; Therapy; Thumb pain; Validity; Outcome measures; Thumb pain; COPM; Carpometacarpal osteoarthritis
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2020.03.011

This is a longitudinal, observational, multicenter, cohort study. Thumb carpometacarpal (CMC) osteoarthritis (OA) is associated with more pain and restrictions than other hand OA. The use of patient-identified occupational performance goals to guide hand therapy treatment and to measure clinical outcomes is fundamental for a patient-centered intervention. The COPM enables subjects to identify goals for hand therapy and engage in a subject-specific therapeutic process. The purpose of this study is to evaluate the convergent validity and responsiveness of the COPM to evaluate the relationship between the patient’s self-perception and satisfaction of performance in everyday living and pain intensity, upper limb function, and manual ability. Eligible participants to multiple hand therapy centers were recruited. Outcomes measures (VAS scale, QuickDASH, MAM-36, and the COPM questionnaire) were measured at the baseline and 3 months after. One hundred forty-five (n = 145) consecutive patients for five different hand rehabilitation centers with symptomatic thumb CMC OA were screened for eligibility criteria. COPM-P and COPM-S were the most responsive instruments, with an area under the curve of 0.88 (95% CI 0.79-0.96) and 0.88 (95% CI 0.80-0.96), respectively. Although more investigation in this area is necessary to conclude that the COPM is the best option to evaluate the effectiveness of hand therapy interventions for thumb OA. The COPM focuses on function and occupation and, in comparison with others upper limb scales, does not require the use of another complementary scale for addressing both satisfaction and ADL status. COPM is an instrument with a good convergent validity and responsiveness to evaluate the relationship between the patient’s self-perception and satisfaction in thumb CMC OA. •The major strength of the Canadian Occupational Performance Measure (COPM) as an outcome measure for a subject with carpometacarpal osteoarthritis is its focus on function, occupation, and the integration of individual patient perspectives.•COPM change score provides distinction between improved and unimproved participants and showed a moderate statistically significant relationship with pain intensity and function.•COPM has sensitivity to determine change in health-related functional status compared with conventional methods.•The measure should be incorporated when assessing the outcomes of participants with thumb carpometacarpal osteoarthritis because it can be helpful in structuring a patient's thoughts on the problems.•COPM can be also helpful for setting specific goals for therapy intervention.