Development of a patient-reported measure of function of the knee
Development of a patient-reported measure of function of the knee
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DOI：
10.2106/00004623-199808000-00006
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发表时间：
1998-08-01
影响因子：
5.3
通讯作者：
Harner, CD
中科院分区：
文献类型：
--
作者：
Irrgang, JJ;Snyder-Mackler, L;Harner, CD
本研究的目的是证明膝关节结局调查的日常生活活动量表的可靠性、有效性和反应性，该量表是一种患者报告的测量日常生活活动中膝关节病理性疾病和损伤造成的功能限制的方法。男213例，女156例，性别不详28例，平均年龄33.3岁（范围，12至76岁），患者因各种膝关节疾病而接受物理治疗，包括韧带和踝关节损伤，髌股关节疼痛和骨关节病，在八周的时间内施用四次日常生活活动量表：在初始评估时和治疗一周、四周和八周后。同时进行的功能测量包括Lysholm膝关节量表和几种整体功能测量。受试者还提供了功能变化的评估，反应范围从1周、4周和8周时的严重恶化到明显改善。日常生活活动量表被用于另外52名患者的样本（32名男性和20名女性患者，平均年龄31.6岁[范围，14至66岁]）治疗前后，在一天内建立重测信度，因子分析显示两个主导因素：一个反映了症状和功能限制的组合，另一个仅反映症状，日常生活活动量表的内部一致性显著高于Lysholm膝关节量表（系数α，0.92至0.93，与0.60至0.73相比），导致前一量表测量的标准误较小，通过中等强度的相关性证明了有效性，vith功能的并行测量，包括Lysholm膝关节量表（r = 0.78至0.86）和以0至100分的量表测量的总体功能评估（r = 0.66至0.75），重复测量的方差分析显示，在8周的物理治疗期间，日常生活活动量表评分显著改善（F-2，F-236 = 108.13; p < 0.0001）;事后检验表明，8周时评分的变化显著大于4周时的变化，4周时的变化显著大于1周时的变化（两者p < 0.0001），正如假设的那样，膝关节有所改善的患者在四周时的评分变化明显较小（F-1，F-189 = 33.50; p < 0.001）和8周时（F-1，F-156 = 22.48; p <0.001）。重测信度系数（组内相关系数[2，1]）为0，97，这些结果表明日常生活活动量表是一种可靠、有效且反应灵敏的工具，用于评估各种病理性疾病和膝关节损伤导致的功能限制。
The purpose of the present study was to demonstrate the reliability, validity, and responsiveness of the Activities of Daily Living Scale of the Knee Outcome Survey, a patient-reported measure of functional limitations imposed by pathological disorders and impairments of the knee during activities of daily living, The study comprised 397 patients; 213 were male, 156 were female, and the gender was not recorded for the remaining twenty-eight, The mean age of the patients was 33.3 years (range, twelve to seventy-six years), The patients were referred to physical therapy because of a wide variety of disorders of the knee, including ligamentous and meniscal injuries, patellofemoral pain, and osteoarthrosis,The Activities of Daily Living Scale was administered four times during an eight-week period: at the time of the initial evaluation and after one, four, and eight weeks of therapy. Concurrent measures of function included the Lysholm Knee Scale and several global measures of function, The subjects also provided an assessment of the change in function, with responses ranging from greatly worse to greatly better, at one, four, and eight weeks, The Activities of Daily Living Scale was administered to an additional sample of fifty-two patients (thirty-two male and twenty female patients with a mean age of 31.6 years [range, fourteen to sixty-six years]) before and after treatment,within a single day to establish test-retest reliability,Factor analysis revealed two dominant factors: one that reflected a combination of symptoms and functional limitations and the other, only symptoms, The internal consistency of the Activities of Daily Living Scale was substantially higher than that of the Lysholm Knee Scale (coefficient alpha, 0.92 to 0.93 compared with 0.60 to 0,73), resulting in a smaller standard error of measurement for the former scale, Validity was demonstrated by moderately strong correlations,vith concurrent measures of function, including the Lysholm Knee Scale (r = 0.78 to 0.86) and the global assessment of function as measured on a scale ranging from 0 to 100 points (r = 0.66 to 0,75), Analysis of variance with repeated measures revealed significant improvements in the score on the Activities of Daily Living Scale during the eight weeks of physical therapy (F-2,F-236 = 108.13; p < 0.0001); post hoc testing indicated that the change in the score at eight weeks was significantly greater than the change at four weeks and that the change at four weeks was significantly greater than that at one week (p < 0.0001 for both), As had been hypothesized, the patients in whom the knee had somewhat improved had a significantly smaller change in the score, both at four weeks (F-1,F-189 = 33.50; p < 0.001) and at eight weeks (F-1,F-156 = 22.48; p < 0,001), compared with those in whom the knee had greatly improved. The test-retest reliability coefficient (intraclass correlation coefficient[2,1]) was 0,97,These results suggest that the Activities of Daily Living Scale is a reliable, valid, and responsive instrument for the assessment of functional limitations that result from a wide variety of pathological disorders and impairments of the knee.