McCarthy C J, Oldham J A
Centre for Rehabilitation Science, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Rheumatology (Oxford). 2004 Apr;43(4):514-7. doi: 10.1093/rheumatology/keh081. Epub 2004 Jan 13.
The aggregated locomotor function (ALF) score, a simple measure of observed locomotor function, using timed walking, stairs and transfers, was developed and evaluated for intra-tester reliability, criterion-related validity and responsiveness in a sample of patients with knee osteoarthritis.
Patients with knee osteoarthritis (n = 214) were recruited for inclusion in a randomized controlled trial investigating two methods of exercise provision. Before treatment, patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 36 health survey (SF-36) questionnaires and were timed whilst performing an 8 m walk, ascending and descending a set of gymnasium stairs and completing a test of transferring in and out of a chair. A group of 15 patients also undertook a replicate test-retest reliability study of the above outcome measures. Standardized response means were calculated for the ALF, WOMAC and SF-36 from data from the clinical trial.
The ALF takes 10 min to administer and demonstrated excellent intra-tester reliability, with excellent intra-class correlation coefficient (ICC) statistics (ICC(2,k) 0.99; 95% CI 0.98-0.99), and low standard error of measurement (0.86 s) and smallest detectable difference (9.5%) values. Criterion-related validity with the physical function dimensions of the WOMAC and SF-36 was good, with correlation coefficients of 0.59 and - 0.53 respectively. Standardized response means were higher for the ALF (0.49) than for both the WOMAC (0.39) and the SF-36 (0.12).
This work has demonstrated that the ALF can be used as a measure of physical function status and as a means of quantifying treatment response. The measure offers a simple and convenient outcome in the assessment and treatment of locomotor dysfunction. The ALF score is a reliable, valid and responsive outcome measure over 12 months and can be recommended for use in the evaluation of patients with knee osteoarthritis.
汇总运动功能（ALF）评分是一种通过定时步行、上下楼梯及转移动作来简单衡量观察到的运动功能的方法，本研究对其在膝骨关节炎患者样本中的测试者内信度、效标关联效度及反应度进行了开发和评估。
招募膝骨关节炎患者（n = 214）纳入一项调查两种运动提供方法的随机对照试验。治疗前，患者完成西安大略和麦克马斯特大学骨关节炎指数（WOMAC）及简短健康调查36项量表（SF - 36）问卷，并在进行8米步行、上下一组体育馆楼梯以及完成从椅子上进出的测试时进行计时。一组15名患者还对上述结局指标进行了重复测试 - 再测试信度研究。根据临床试验数据计算ALF、WOMAC和SF - 36的标准化反应均值。
ALF评分的实施耗时10分钟，显示出优异的测试者内信度，具有出色的组内相关系数（ICC）统计数据（ICC(2,k) 0.99；95% CI 0.98 - 0.99），以及较低的测量标准误（0.86秒）和最小可检测差异（9.5%）值。与WOMAC和SF - 36的身体功能维度的效标关联效度良好，相关系数分别为0.59和 - 0.53。ALF的标准化反应均值（0.49）高于WOMAC（0.39）和SF - 36（0.12）。
本研究表明，ALF可作为身体功能状态的一种测量方法以及量化治疗反应的手段。该测量方法在评估和治疗运动功能障碍方面提供了一种简单便捷的结果。ALF评分在12个月内是一种可靠、有效且有反应度的结局指标，可推荐用于评估膝骨关节炎患者。
