Binkley J M, Stratford P W, Lott S A, Riddle D L
Appalachian Physical Therapy, Dahlonega, GA 30534, USA.
Phys Ther. 1999 Apr;79(4):371-83.
The purpose of this study was to assess the reliability, construct validity, and sensitivity to change of the Lower Extremity Functional Scale (LEFS).
The LEFS was administered to 107 patients with lower-extremity musculoskeletal dysfunction referred to 12 outpatient physical therapy clinics.
The LEFS was administered during the initial assessment, 24 to 48 hours following the initial assessment, and then at weekly intervals for 4 weeks. The SF-36 (acute version) was administered during the initial assessment and at weekly intervals. A type 2,1 intraclass correlation coefficient was used to estimate test-retest reliability. Pearson correlations and one-way analyses of variance were used to examine construct validity. Spearman rank-order correlation coefficients were used to examine the relationship between an independent prognostic rating of change for each patient and change in the LEFS and SF-36 scores.
Test-retest reliability of the LEFS scores was excellent (R = .94 [95% lower limit confidence interval (CI) = .89]). Correlations between the LEFS and the SF-36 physical function subscale and physical component score were r=.80 (95% lower limit CI = .73) and r = .64 (95% lower limit CI = .54), respectively. There was a higher correlation between the prognostic rating of change and the LEFS than between the prognostic rating of change and the SF-36 physical function score. The potential error associated with a score on the LEFS at a given point in time is +/-5.3 scale points (90% CI), the minimal detectable change is 9 scale points (90% CI), and the minimal clinically important difference is 9 scale points (90% CI).
The LEFS is reliable, and construct validity was supported by comparison with the SF-36. The sensitivity to change of the LEFS was superior to that of the SF-36 in this population. The LEFS is efficient to administer and score and is applicable for research purposes and clinical decision making for individual patients.
本研究旨在评估下肢功能量表（LEFS）的信度、结构效度及对变化的敏感性。
将LEFS应用于转至12家门诊物理治疗诊所的107例下肢肌肉骨骼功能障碍患者。
在初次评估时、初次评估后24至48小时以及之后连续4周每周进行一次LEFS评估。在初次评估时及每周进行一次SF - 36（急性版）评估。采用2,1类内相关系数估计重测信度。使用Pearson相关分析和单因素方差分析检验结构效度。采用Spearman等级相关系数检验每位患者独立的预后变化评级与LEFS及SF - 36评分变化之间的关系。
LEFS评分的重测信度极佳（R = 0.94[95%下限置信区间（CI）= 0.89]）。LEFS与SF - 36身体功能分量表及身体成分得分之间的相关性分别为r = 0.80（95%下限CI = 0.73）和r = 0.64（95%下限CI = 0.54）。预后变化评级与LEFS之间的相关性高于其与SF - 36身体功能评分之间的相关性。在特定时间点LEFS评分的潜在误差为±5.3个量表分（90%CI），最小可检测变化为9个量表分（90%CI），最小临床重要差异为9个量表分（90%CI）。
LEFS具有可靠性，与SF - 36比较支持其结构效度。在该人群中，LEFS对变化的敏感性优于SF - 36。LEFS易于实施和评分，适用于个体患者的研究及临床决策。
