Assessing activity in joint replacement patients
Assessing activity in joint replacement patients
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DOI：
10.1016/s0883-5403(98)90195-4
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发表时间：
1998-12-01
影响因子：
3.5
通讯作者：
Amstutz, HC
中科院分区：
文献类型：
--
作者：
Zahiri, CA;Schmalzried, TP;Amstutz, HC
下肢关节重建的结果评估应包括对患者活动的评估。全关节假体的体内磨损评估应基于使用测量，而不是原位时间或年龄或性别等代理;然而，临床医生缺乏可靠评估关节置换患者活动的简单方法。现代Pedomter可以成为量化下肢关节使用的令人满意的手段。然而，计步器需要医生或评估者和患者的特别努力。因此，我们比较了100例全关节置换患者步行活动的定量评估，用计步器测量，UCLA活动评分和一个简单的视觉模拟量表，可以很容易地在日常办公室评估。UCLA活动评分（P = .002）和视觉模拟量表评分（P = .00001）与计步器记录的每天平均步数有很强的相关性。然而，对于具有相同UCLA评分的个体患者，每天的平均步数差异高达15倍。患者对自身活动的视觉模拟评分与计步器数据的相关性（P = 0.08）不如患者年龄（P = 0.049）强。出于实际原因，计步器可能最好用于评估极端情况下的活动（缺乏活动）。这项研究表明，加州大学洛杉矶分校的活动评级和调查员视觉模拟量表是有效的日常活动评估在临床设置。调整UCLA活动评分的频率和活动强度，可以与调查员视觉模拟量表，增加活动评级的准确性。
Outcome evaluations of lower extremity joint reconstructions should include an assessment of patient activity. In vivo wear assessments of total joint prostheses should be based on a measure of use, not time in situ or a proxy such as age or gender; however, clinicians lack a simple method to reliably assess the activity of patients with joint replacement. The modern pedomter can be a satisfactory means of quantifying the use of lower extremity joints. The pedometer, however, requires special effort on the part of the physician or evaluator and the patient. Therefore, we compared the quantitative assessment of walking activity of 100 total joint replacement patients, as measured with a pedometer, to the UCLA activity score and a simple visual analog scale that can easily be employed during a routine office evaluation. Both the UCLA activity rating (P = .002) and the visual analog scale rating of the investigator (P = .00001) had a strong correlation with the average steps per day as recorded by the pedometer. There was, however, up to a 15-fold difference in the average steps per day for individual patients with the same UCLA score. The visual analog scale as rated by the patients of their own activity did not have as strong a correlation with the pedometer data (P = .08) as did patient age (P = .049). For practical reasons, the pedometer is probably best reserved for the evaluation of extreme cases of activity (dr inactivity). This study indicates chat both the UCLA activity rating and the investigator visual analog scale are valid for routine activity assessment in a clinical setting. Adjustments of the UCLA activity score for the frequency and intensity of activity, as can be done with the investigator visual analog scale, increase the accuracy of the activity rating.