Psychometric properties of selected tests in patients with lumbar spinal stenosis
Psychometric properties of selected tests in patients with lumbar spinal stenosis
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DOI：
10.1016/j.spinee.2012.05.004
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发表时间：
2012-10-01
期刊：
影响因子：
4.5
通讯作者：
Childs, John D.
中科院分区：
文献类型：
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作者：
Cleland, Joshua A.;Whitman, Julie M.;Childs, John D.
背景：腰椎管狭窄症患者常用的许多结果工具的心理测量特性尚未得到检验。目的：检查腰椎管狭窄症患者队列中几种结果测量的重测可靠性、反应性以及可检测和临床重要差异的最小水平。研究设计/设置：对接受门诊体检的腰椎管狭窄症患者进行的一项随机临床试验的队列二次分析患者样本：55 名患者（平均年龄，69.5 岁；标准差，+/- 7.9 岁；43.1% 女性）因腰椎管狭窄而接受物理治疗。结果指标：改良 Oswestry 残疾指数、改良瑞士椎管狭窄量表 (SSS)、患者特定功能量表和数字疼痛评定量表 (NPRS)。方法：所有患者在基线检查和随访时均完成了 Oswestry 残疾指数、SSS、患者特定功能量表和 NPRS。此外，患者在随访时完成了 15 分的总体变化评级，用于对患者是否经历了有临床意义的变化进行分类。然后使用 Oswestry 残疾指数、SSS、患者特定功能量表和 NPRS 的变化来评估重测可靠性、反应性以及可检测和临床重要差异的最低水平。 结果：Oswestry 残疾指数是唯一表现出优异重测可靠性的结果指标，组内相关系数为 0.86（95% 置信区间，0.63-0.93）。所有其他的都介于公平和中等之间。 Oswestry 残疾指数、SSS 和患者特定功能量表表现出不同水平的反应性，其中每一个都优于 NPRS。 Oswestry 残疾指数的最小临床重要差异为 5 分，症状子量表和功能子量表的 SSS 分别为 0.36 和 0.10，患者特定功能量表为 1.3，对于 NPRS，背部/臀部症状为 1.25，大腿/腿部症状为 1.5。结论：我们的研究结果表明 Oswestry 残疾指数、SSS 和患者特定功能量表量表具有足够的心理测量特性，可用于腰椎管狭窄症患者的结果评估。然而，需要进一步研究以在腰椎管狭窄和非特异性腰痛患者的其他样本中验证这些发现。 (C) 2012 Elsevier Inc. 保留所有权利。
BACKGROUND CONTEXT: The psychometric properties of many outcome tools commonly used with patients with lumbar spinal stenosis have yet to be examined.PURPOSE: Examine the test-retest reliability, responsiveness, and minimum levels of detectable and clinically important differences for several outcome measures in a cohort of patients with lumbar spinal stenosis.STUDY DESIGN/SETTING: Cohort secondary analysis of a randomized clinical trial of patients with lumbar spinal stenosis receiving outpatient physical therapy.PATIENT SAMPLE: Fifty-five patients (mean age, 69.5 years; standard deviation, +/- 7.9 years; 43.1% females) presenting with lumbar spinal stenosis to physical therapy.OUTCOME MEASURES: The Modified Oswestry Disability Index, Modified Swiss Spinal Stenosis Scale (SSS), Patient Specific Functional Scale, and Numeric Pain Rating Scale (NPRS).METHODS: All patients completed the Oswestry Disability Index, SSS, Patient Specific Functional Scale, and NPRS at the baseline examination and at a follow-up. In addition, patients completed a 15-point Global Rating of Change at follow-up, which was used to categorize whether patients experienced clinically meaningful change. Changes in the Oswestry Disability Index, SSS, Patient Specific Functional Scale, and NPRS were then used to assess test-retest reliability, responsiveness, and minimum levels of detectable and clinically important differences.RESULTS: The Oswestry Disability Index was the only outcome measure to exhibit excellent test-retest reliability with an intraclass correlation coefficient of 0.86 (95% confidence interval, 0.63-0.93). All others ranged between fair and moderate. The Oswestry Disability Index, SSS, and Patient Specific Functional Scale exhibited varying levels of responsiveness, each of which was superior to the NPRS. The minimal clinically important difference for the Oswestry Disability Index was five points, the SSS was 0.36 and 0.10 for symptoms subscale and functional subscale, respectively, 1.3 for the Patient Specific Functional Scale, and for the NPRS, 1.25 for back/buttock symptoms and 1.5 for thigh/leg symptoms.CONCLUSIONS: The results of our study indicate that the Oswestry Disability Index, SSS, and Patient Specific Functional Scale possess adequate psychometric properties to be used in the outcome assessment of patients with lumbar spinal stenosis. However, further investigation is needed to validate these findings in other samples of patients with lumbar spinal stenosis and nonspecific low back pain. (C) 2012 Elsevier Inc. All rights reserved.