Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
BMC Musculoskelet Disord. 2012 Nov 13;13:220. doi: 10.1186/1471-2474-13-220.
Joint replacement is an effective intervention for people with advanced arthritis, although there is an important minority of patients who do not improve post-operatively. There is a need for robust evidence on outcomes after surgery, but there are a number of measures that assess function after joint replacement, many of which lack any clear theoretical basis. The World Health Organisation has introduced the International Classification of Functioning, Disability and Health (ICF), which divides function into three separate domains: Impairment, activity limitations and participation restrictions. The aim of this study is to compare the properties and responsiveness of a selection of commonly used outcome tools that assess function, examine how well they relate to the ICF concepts, and to explore the changes in the measures over time.
METHODS/DESIGN: Two hundred and sixty three patients listed for lower limb joint replacement at an elective orthopaedic centre have been recruited into this study. Participants attend the hospital for a research appointment prior to surgery and then at 3-months and 1-year after surgery. At each assessment time, function is assessed using a range of measures. Self-report function is assessed using the WOMAC, Aberdeen Impairment, Activity Limitation and Participation Restriction Measure, SF-12 and Measure Yourself Medical Outcome Profile 2. Clinician-administered measures of function include the American Knee Society Score for knee patients and the Harris Hip Score for hip patients. Performance tests include the timed 20-metre walk, timed get up and go, sit-to-stand-to-sit, step tests and single stance balance test. During the performance tests, participants wear an inertial sensor and data from motion analysis are collected. Statistical analysis will include exploring the relationship between measures describing the same ICF concepts, assessing responsiveness, and studying changes in measures over time.
There are a range of tools that can be used to assess function before and after joint replacement, with little information about how these various measures compare in their properties and responsiveness. This study aims to provide this data on a selection of commonly used assessments of function, and explore how they relate to the ICF domains.
关节置换术是治疗晚期关节炎患者的有效方法，但仍有一小部分患者术后效果不佳。因此，需要有强有力的证据来评估手术后的结果，但目前有许多用于评估关节置换术后功能的方法，其中许多方法缺乏明确的理论依据。世界卫生组织引入了国际功能、残疾和健康分类（ICF），该分类将功能分为三个独立的领域：损伤、活动受限和参与受限。本研究旨在比较一些常用的功能评估工具的特性和反应性，考察它们与 ICF 概念的相关性，并探讨这些方法随时间的变化。
方法/设计：本研究共招募了 263 名在择期骨科中心接受下肢关节置换术的患者。参与者在手术前到医院进行研究预约，然后在术后 3 个月和 1 年进行评估。在每次评估时，使用多种方法评估功能。使用 WOMAC、Aberdeen 损伤、活动受限和参与受限量表、SF-12 和自我管理医疗结果测量 2 来评估自我报告的功能。临床医生评估的功能包括膝关节患者的美国膝关节协会评分和髋关节患者的 Harris 髋关节评分。功能测试包括 20 米计时步行、计时起身行走、坐站坐测试、台阶测试和单腿平衡测试。在进行性能测试时，参与者会佩戴惯性传感器并收集运动分析数据。统计分析将包括探索描述相同 ICF 概念的方法之间的关系、评估反应性以及研究方法随时间的变化。
有多种工具可用于评估关节置换前后的功能，但关于这些各种方法在特性和反应性方面的比较信息较少。本研究旨在为一系列常用的功能评估方法提供这些数据，并探讨它们与 ICF 领域的关系。
