患者特异性功能量表：在上肢肌肉骨骼问题患者中的有效性、信度和反应度。
The patient-specific functional scale: validity, reliability, and responsiveness in patients with upper extremity musculoskeletal problems.
机构信息
Center for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
出版信息
J Orthop Sports Phys Ther. 2012 Feb;42(2):56-65. doi: 10.2519/jospt.2012.3953. Epub 2012 Feb 1.
STUDY DESIGN
Clinical measurement, longitudinal; multicenter prospective cohort study.
OBJECTIVES
To examine the validity, reliability, and responsiveness of the Patient-Specific Functional Scale (PSFS) in patients with musculoskeletal upper extremity problems being treated in physical therapy.
BACKGROUND
The clinimetric properties of the PSFS have not been established nor compared with region-specific outcome measures in patients with upper extremity problems.
METHODS
Patients completed the PSFS, Upper Extremity Functional Index (UEFI), and numeric pain rating scale (NPRS) at baseline and follow-up, and were categorized as improved, stable, or worsened, using the global rating of change. Construct validity was assessed by comparing the change scores of the stable and improved groups, using independent-samples t tests. Reliability was evaluated using intraclass correlation coefficient (ICC2,1) with 95% confidence intervals. Bland-Altman plots determined limits of agreement. Responsiveness and minimal important difference (MID) were determined with receiver operator characteristic (ROC) curves.
RESULTS
One hundred eighty patients met the inclusion criteria. Construct validity was supported for the PSFS and the UEFI (P<.001). Reliability was moderate to good for the PSFS (ICC2,1 = 0.713) and UEFI (ICC2,1 = 0.848). Reported estimates of reliability may be lower than true values because the group of "stable" patients from this cohort had, on average, a small positive change. Bland-Altman plots indicated good agreement. The area under the ROC curve (AUC) was significantly different from the null value of 0.5 for the PSFS (0.887) and the UEFI (0.877), indicating good accuracy in distinguishing improved patients from stable patients. MID was 1.2 for the PSFS (scale, 0-10) and 8.5 for the UEFI (scale, 0-80).
CONCLUSION
The PSFS is a valid, reliable, and responsive outcome measure for patients with upper extremity problems.
研究设计
临床测量，纵向；多中心前瞻性队列研究。
目的
检验患者特定功能量表（PSFS）在接受物理治疗的肌肉骨骼上肢问题患者中的有效性、可靠性和反应性。
背景
PSFS 的临床计量特性尚未确定，也未与上肢问题患者的特定区域的结果测量进行比较。
方法
患者在基线和随访时完成 PSFS、上肢功能指数（UEFI）和数字疼痛评分量表（NPRS），并使用总体变化评级分为改善、稳定或恶化。使用独立样本 t 检验比较稳定和改善组的变化分数来评估结构有效性。使用 95%置信区间的组内相关系数（ICC2,1）评估可靠性。Bland-Altman 图确定一致性界限。通过接收者操作特征（ROC）曲线确定响应性和最小重要差异（MID）。
结果
180 名患者符合纳入标准。PSFS 和 UEFI 的结构有效性得到支持（P<.001）。PSFS（ICC2,1 = 0.713）和 UEFI（ICC2,1 = 0.848）的可靠性为中等至良好。由于该队列中的“稳定”患者群体平均有较小的正变化，因此报告的可靠性估计值可能低于真实值。Bland-Altman 图表明一致性良好。PSFS（AUC 为 0.887）和 UEFI（AUC 为 0.877）的 ROC 曲线下面积明显不同于 0.5 的零值，表明在区分改善患者和稳定患者方面具有良好的准确性。PSFS 的 MID 为 1.2（量表，0-10），UEFI 的 MID 为 8.5（量表，0-80）。
结论
PSFS 是上肢问题患者的有效、可靠和敏感的结果测量工具。
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