Cleland Joshua A, Fritz Julie M, Whitman Julie M, Palmer Jessica A
Department of Physical Therapy, Franklin Pierce College, Concord, NH 03301, USA.
Spine (Phila Pa 1976). 2006 Mar 1;31(5):598-602. doi: 10.1097/01.brs.0000201241.90914.22.
Cohort study of patients with cervical radiculopathy undergoing physical therapy.
Examine the test-retest reliability, construct validity, and minimum levels of detectable and clinically important change for the Neck Disability Index (NDI) and Patient Specific Functional Scale (PSFS) in cohort of patients with cervical radiculopathy.
To date, no studies have investigated the psychometric properties of the NDI or PSFS in a cohort of patients with cervical radiculopathy.
Thirty-eight patients with cervical radiculopathy undergoing physical therapy completed the NDI and PSFS, and Numerical Pain Rating Scale (NPRS) at the baseline examination and at a follow-up. In addition, at follow-up, patients completed a 15-point global rating of change (GROC), which was used to dichotomize patients as improved or stable. Changes in the NDI and PSFS were then used to assess test-retest reliability, construct validity, and minimal levels of detectable and clinically important change.
Test-retest reliability was moderate for the NDI (intraclass correlation coefficient [ICC] = 0.68; 95% confidence interval [CI], 0.30-0.90) and high for the PSFS (ICC = 0.82; 95% CI, 0.54-0.93). The PSFS was more responsive to change than the NDI. The minimal detectable change for the NDI was 10.2 and for the PSFS 2.1. The minimally clinically important change for the NDI was 7.0 and PSFS 2.0.
Our results suggest that the PSFS exhibits superior reliability, construct validity, and responsiveness in this cohort of patients with cervical radiculopathy compared with the NDI. Further research is needed to examine the ability of these measures to accurately reflect changes in individuals, as well as large samples of patients.
对接受物理治疗的神经根型颈椎病患者进行队列研究。
在神经根型颈椎病患者队列中,检验颈部功能障碍指数(NDI)和患者特定功能量表(PSFS)的重测信度、结构效度以及最小可检测变化水平和临床重要变化水平。
迄今为止,尚无研究调查神经根型颈椎病患者队列中NDI或PSFS的心理测量特性。
38例接受物理治疗的神经根型颈椎病患者在基线检查和随访时完成了NDI、PSFS以及数字疼痛评分量表(NPRS)。此外,在随访时,患者完成了15分的整体变化评分(GROC),该评分用于将患者分为改善或稳定两类。然后使用NDI和PSFS的变化来评估重测信度、结构效度以及最小可检测变化水平和临床重要变化水平。
NDI的重测信度中等(组内相关系数[ICC]=0.68;95%置信区间[CI],0.30 - 0.90),PSFS的重测信度较高(ICC = 0.82;95% CI,0.54 - 0.93)。PSFS对变化的反应比NDI更敏感。NDI的最小可检测变化为10.2,PSFS为2.1。NDI的最小临床重要变化为7.0,PSFS为2.0。
我们的结果表明,在该神经根型颈椎病患者队列中,与NDI相比,PSFS表现出更高的信度、结构效度和反应性。需要进一步研究来检验这些测量方法准确反映个体以及大量患者变化的能力。