Smith Toby O, Donell Simon T, Clark Allan, Chester Rachel, Cross Jane, Kader Deiary F, Arendt Elizabeth A
Queen's Building, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK,
Knee Surg Sports Traumatol Arthrosc. 2014 Feb;22(2):324-35. doi: 10.1007/s00167-012-2359-x. Epub 2013 Jan 11.
No outcome measurements have previously been designed to assess patient-perceived patellar instability. The purposes of this study were to address this limitation and to describe the development and validation of the Norwich Patellar Instability (NPI) scores, a self-administered 19-item questionnaire to assess perceived patellar instability.
A previous study assessed activities that aggravated symptoms in individuals with patellar dislocation and instability symptoms. These reported activities were ranked in order of severity, and a weighting system was calculated. The NPI score was introduced to routine clinical practice in three institutions. One hundred and two people who had experienced a lateral patellar dislocation completed 102 NPI questionnaires. The completed NPI score was correlated with the Knee injury and Osteoarthritis Outcome Score (KOOS) to evaluate divergent validity and with the J-sign, patellar mobility, apprehension test, Beighton score, Kujala Patellofemoral Disorder Score and Lysholm Knee Score to evaluate convergent validity. Internal consistency of the 19 items was also calculated.
The results indicated a moderate correlation between the NPI score and the Kujala Patellofemoral Disorder Score (rho = -0.66; p < 0.01) and Lysholm Knee Score (rho = -0.54; p = 0.03), suggesting good convergent validity. There was a little correlation between the KOOS and NPI score, indicating divergent validity (rho = -0.02 to -0.17; n.s.). There was high internal consistency (Cronbach's alpha = 0.93).
These results indicate the NPI score to be a valid tool to assess patellar instability for individuals following patellar dislocation. Further study is now required in order to assess the reliability and responsiveness of this new outcome measure.
此前尚无用于评估患者感知的髌骨不稳定的结局测量方法。本研究的目的是解决这一局限性，并描述诺维奇髌骨不稳定（NPI）评分的开发与验证过程，这是一份用于评估感知到的髌骨不稳定的19项自填式问卷。
此前一项研究评估了加重髌骨脱位和不稳定症状个体症状的活动。这些报告的活动按严重程度排序，并计算了一个加权系统。NPI评分被引入三个机构的常规临床实践中。102名曾经历过外侧髌骨脱位的人完成了102份NPI问卷。将完成的NPI评分与膝关节损伤和骨关节炎结局评分（KOOS）相关联以评估区分效度，与J征、髌骨活动度、恐惧试验、Beighton评分、库贾拉髌股关节疾病评分和Lysholm膝关节评分相关联以评估聚合效度。还计算了这19个条目的内部一致性。
结果表明，NPI评分与库贾拉髌股关节疾病评分（rho = -0.66；p < 0.01）和Lysholm膝关节评分（rho = -0.54；p = 0.03）之间存在中度相关性，提示良好的聚合效度。KOOS与NPI评分之间存在微弱相关性，表明区分效度（rho = -0.02至-0.17；无统计学意义）。内部一致性较高（Cronbach's alpha = 0.93）。
这些结果表明，NPI评分是评估髌骨脱位后个体髌骨不稳定的有效工具。现在需要进一步研究以评估这一新结局测量方法的可靠性和反应性。
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