Lee Kyoung Min, Chung Chin Youb, Park Moon Seok, Lee Sang Hyeong, Choi In Ho, Cho Tae-Joon, Yoo Won Joon
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Bundang-Gu, Sungnam, Kyungki, Korea.
J Pediatr Orthop. 2010 Jun;30(4):396-402. doi: 10.1097/BPO.0b013e3181da855f.
This study was performed to determine changes in Pediatric Outcomes Data Collection Instrument (PODCI) scores after single-event multilevel surgery (SEMS), and to evaluate the relationship between the improvements of PODCI scores and parental satisfaction after SEMS.
Demographic data, preoperative and postoperative PODCI, functional assessment questionnaire (FAQ) walking scales, and self-reported parental satisfaction with SEMS were obtained from 61 parents of ambulatory patients with cerebral palsy [40 male, 21 female, mean age 10 y 2 mo (SD 3 y 8 mo), mean follow-up 2 y 2 mo]. Postoperative improvements in each subscale of PODCI and FAQ were analyzed, and multiple regression analysis was performed to identify the factors that contributed significantly to postoperative parental satisfaction. Rasch analysis was performed for the PODCI subscale that was clinically relevant.
FAQ, transfers/basic mobility, sports/physical activity, and global function subscales of PODCI significantly improved after SEMS. Age, gross motor function classification system level, and the amount of improvement in sports/physical activity subscale were found to affect parental satisfaction to SEMS significantly. However, the subscale showed insufficient item responses, and ceiling and floor effects.
Although changes in sports/physical activity subscale were relatively small, they were found to affect parental satisfaction with SEMS significantly. These indicate that clinicians and researchers should pay attention to sports and physical activities in patients with cerebral palsy.
Diagnostic level I.
本研究旨在确定单节段多平面手术(SEMS)后儿童结局数据收集工具(PODCI)评分的变化,并评估SEMS后PODCI评分改善与家长满意度之间的关系。
从61名门诊脑瘫患者的家长处获取人口统计学数据、术前和术后PODCI、功能评估问卷(FAQ)步行量表以及家长对SEMS的自我报告满意度[40名男性,21名女性,平均年龄10岁2个月(标准差3岁8个月),平均随访2年2个月]。分析PODCI和FAQ各子量表术后的改善情况,并进行多元回归分析以确定对术后家长满意度有显著影响的因素。对具有临床相关性的PODCI子量表进行Rasch分析。
SEMS后,FAQ、PODCI的转移/基本活动能力、运动/体育活动和整体功能子量表有显著改善。发现年龄、粗大运动功能分类系统水平以及运动/体育活动子量表的改善程度对家长对SEMS的满意度有显著影响。然而,该子量表显示项目反应不足,存在天花板效应和地板效应。
尽管运动/体育活动子量表的变化相对较小,但发现它们对家长对SEMS的满意度有显著影响。这表明临床医生和研究人员应关注脑瘫患者的运动和体育活动。
诊断性I级。