Razmjou Helen, Bean Andrea, Macdermid Joy C, van Osnabrugge Varda, Travers Niki, Holtby Richard
Helen Razmjou, MSc (PT), PhD(C), Cred. MDT : Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario; Department of Physical Therapy, University of Toronto, Toronto, Ontario.
Physiother Can. 2008 Winter;60(1):72-9. doi: 10.3138/physio/60/1/72. Epub 2008 Apr 15.
Despite the popularity of the Constant-Murley score (CMS), a combined patient-report and objective (health professional administered) shoulder outcome measure, minimal information exists on its reliability or validity. The purpose of this study was to examine (1) internal consistency and convergent validity of the CMS and (2) the degree to which other shoulder measures explain variation in range of motion and strength components of the CMS.
In this cross-sectional study of outcome measures, 45 patients undergoing conservative or surgical treatment for rotator cuff disease participated. Two disease-specific outcome measures, one shoulder-specific measure, and one upper extremity outcome measure were compared to the CMS.
Correlations between competing measures and relative total CMS were moderate (0.56 to 0.75). The American Shoulder & Elbow Score, the Upper Extremity Functional Index, the Western Ontario Rotator Cuff Index, and the Rotator Cuff Quality of Life index explained 38%, 28%, 26%, and 10% of variance of the objective component of the CMS respectively.
The patient-report component of the CMS measures a multidimensional concept. The strength component had moderate correlations with isometric strength measures of the shoulder external rotators and abductors. The total CMS appears to measure a construct that is not totally captured by competing measures. The unexplained variance may be due, in part, to the lack of importance of the patient's physical impairment to symptoms or activity limitations as measured by other instruments.
尽管恒定-默里评分（CMS）很受欢迎，它是一种综合了患者报告和客观（由医疗专业人员实施）的肩部结局测量方法，但关于其可靠性或有效性的信息却很少。本研究的目的是检验：（1）CMS的内部一致性和收敛效度；（2）其他肩部测量方法对CMS的活动范围和力量成分变异的解释程度。
在这项结局测量的横断面研究中，45名因肩袖疾病接受保守或手术治疗的患者参与其中。将两种疾病特异性结局测量方法、一种肩部特异性测量方法和一种上肢结局测量方法与CMS进行比较。
竞争测量方法与相对总CMS之间的相关性为中等（0.56至0.75）。美国肩肘评分、上肢功能指数、西安大略肩袖指数和肩袖生活质量指数分别解释了CMS客观成分变异的38%、28%、26%和10%。
CMS的患者报告部分测量的是一个多维概念。力量成分与肩部外旋肌和外展肌的等长力量测量有中等相关性。总CMS似乎测量的是一个竞争测量方法未完全涵盖的结构。无法解释的变异可能部分归因于患者身体损伤对症状或活动受限的重要性，而这是由其他工具测量的。
