Kivlan Benjamin R, Martin RobRoy L, Wukich Dane K
John G. Rangos Sr., School of Health Sciences, Duquesne University, Pittsburgh, PA 15282, USA.
Foot (Edinb). 2011 Jun;21(2):84-7. doi: 10.1016/j.foot.2011.04.004. Epub 2011 May 7.
The impact of diabetes on physical function pose a challenge in assessing clinical outcomes.
The purpose of this study was to provide evidence of responsiveness for the foot and ankle ability measures (FAAM) in individuals with diabetes mellitus.
The two most recent FAAM scores of 155 diabetic patients treated for foot/ankle pathology were analyzed. Based on physical component summary (PCS) scores of the SF-36, subjects were categorized as improved (>7-point positive change), worsened (>7-point negative change), or unchanged (<7-point change). Analyses of the worsened and improved groups were compared to the unchanged group using two-way repeated measures ANOVAs and ROC curve analyses.
The ANOVAs demonstrated a significant difference between groups (P = 0.001). ROC curves analysis for detecting an improvement or decline in status were 0.73 (95% CI 0.62-0.84) and 0.70 (95% CI 0.59-0.81), respectively. An increase in FAAM score of 9 points represented the minimal clinically important difference (MCID) with 0.64 sensitivity and 0.78 specificity. A decrease in FAAM score of 2 points represented a MCID with 0.65 sensitivity and 0.61 specificity.
The FAAM demonstrated responsiveness to change in individuals with orthopedic foot and ankle dysfunction complicated by diabetes and can be used to measure patient outcomes over a 6-month period.
糖尿病对身体功能的影响给临床结果评估带来了挑战。
本研究旨在为糖尿病患者的足踝能力测量（FAAM）提供反应性证据。
分析了155例因足踝病变接受治疗的糖尿病患者最近两次的FAAM评分。根据SF-36的身体成分总结（PCS）评分，将受试者分为改善组（阳性变化>7分）、恶化组（阴性变化>7分）或无变化组（变化<7分）。使用双向重复测量方差分析和ROC曲线分析，将恶化组和改善组与无变化组进行比较。
方差分析显示组间存在显著差异（P = 0.001）。检测状态改善或下降的ROC曲线分析分别为0.73（95%CI 0.62 - 0.84）和0.70（95%CI 0.59 - 0.81）。FAAM评分增加9分代表最小临床重要差异（MCID），敏感性为0.64，特异性为0.78。FAAM评分降低2分代表MCID，敏感性为0.65，特异性为0.61。
FAAM显示出对糖尿病合并足踝功能障碍患者变化的反应性，可用于测量6个月期间的患者结果。
