Pena Fernando, Agel Julie, Coetzee J Chris
Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55454, USA.
Foot Ankle Int. 2007 Jul;28(7):788-93. doi: 10.3113/FAI.2006.0788.
Little information is available on the American Orthopaedic Foot and Ankle Society (AOFAS) outcome tool and its capacity to show changes and improvement in function of patients without a floor or ceiling effect. The purpose of the study was to compare results from the Musculoskeletal Functional Assessment (MFA) and AOFAS outcome tools in a population undergoing a total ankle replacement.
Prospective data was collected on 154 patients preoperatively and at 6, 12, and 24 months after surgery. An analysis was performed between both and within each tool across the time of followup.
No ceiling or floor effect was noticed on the AOFAS outcome tool. Its capacity for discrimination and to observe changes in pain and function are acceptable. No correlation between the AOFAS categories of pain and function and the MFA domain of well being could be found. Both outcome tools presented similar responses.
Though the AOFAS outcome tool seems to have enough sensitivity to analyze pain and function during a postoperative period, the authors strongly recommend the use of an alternative outcome tool to better understand and delineate the patient's level of function and effect of treatment on their quality of life.
These data improve the understanding of and indications for the AOFAS outcome tool. They confirm the AOFAS questionnaire as a tool with enough discriminatory capacity to assess patient improvement and also point out the weaknesses of the questionnaire and the importance of collecting parallel data with other available outcome tools to better understand patient function and quality of life.
关于美国足踝外科协会（AOFAS）疗效评估工具及其在无地板效应或天花板效应情况下显示患者功能变化和改善情况的能力，目前可用信息较少。本研究的目的是比较在接受全踝关节置换术的人群中，肌肉骨骼功能评估（MFA）和AOFAS疗效评估工具的结果。
前瞻性收集了154例患者术前以及术后6个月、12个月和24个月的数据。在随访期间对两种工具之间以及每种工具内部进行了分析。
在AOFAS疗效评估工具上未发现天花板效应或地板效应。其区分能力以及观察疼痛和功能变化的能力是可接受的。未发现AOFAS疼痛和功能类别与MFA幸福领域之间存在相关性。两种疗效评估工具呈现出相似的反应。
尽管AOFAS疗效评估工具似乎具有足够的敏感性来分析术后疼痛和功能，但作者强烈建议使用替代疗效评估工具，以更好地理解和描述患者的功能水平以及治疗对其生活质量的影响。
这些数据增进了对AOFAS疗效评估工具的理解和应用指征。它们证实AOFAS问卷作为一种具有足够区分能力的工具，可用于评估患者的改善情况，同时也指出了该问卷的不足之处，以及收集其他可用疗效评估工具的平行数据以更好地理解患者功能和生活质量的重要性。
