Shultz Susan, Olszewski Amanda, Ramsey Olivia, Schmitz Michelle, Wyatt Verrelle, Cook Chad
Walsh University, North Canton, OH, USA.
Int J Sports Phys Ther. 2013 Dec;8(6):838-48.
A variety of self-report and physical performance-based outcome measures are commonly used to assess progress and recovery in the lower leg, ankle, and foot. A requisite attribute of any outcome measure is its ability to detect change in a condition, a construct known as "responsiveness". There is a lack of consistency in how responsiveness is defined in all outcome measures.
The purpose of this study was to review the currently used recovery outcome measures for lower leg, ankle and foot conditions in order to determine and report recommended responsiveness values.
A systematic literature search that included electronic searches of PubMed, CINAHL and SportDiscus as well extensive cross-referencing was performed in January, 2013. Studies were included if each involved: 1) a prospective, longitudinal study of any design; 2) any condition associated with the lower leg, ankle or foot; 3) a measure of responsiveness; and 4) was an acceptable type of outcome measure (eg. self-report, physical performance, or clinician report). The quality of the included articles was assessed by two independent authors using the responsiveness sub-component of the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN).
Sixteen different studies met the inclusion criteria for this systematic review. The most commonly used outcome measures were the Foot and Ankle Ability Measure and the Lower Extremity Functional Scale. Responsiveness was calculated in a variety of methods including effect size, standardized response mean, minimal clinically important difference/importance, minimal detectable change, and minimal important change.
Based on the findings of this systematic review there is a lack of consistency for reporting responsiveness among recovery measures used in the lower leg, ankle or foot studies. It is possible that the variability of conditions that involve the lower leg, ankle and foot contribute to the discrepancies found in reporting responsiveness values. Further research must be conducted in order to standardize reporting measures for responsiveness.
2a.
多种基于自我报告和身体表现的结果测量方法常用于评估小腿、踝关节和足部的进展与恢复情况。任何结果测量方法的一个必要属性是其检测病情变化的能力，即所谓的“反应性”。在所有结果测量方法中，对反应性的定义缺乏一致性。
本研究旨在回顾目前用于评估小腿、踝关节和足部疾病恢复情况的结果测量方法，以确定并报告推荐的反应性值。
2013年1月进行了系统的文献检索，包括对PubMed、CINAHL和SportDiscus进行电子检索以及广泛的交叉引用。纳入的研究需满足以下条件：1）任何设计的前瞻性纵向研究；2）与小腿、踝关节或足部相关的任何疾病；3）反应性测量；4）是可接受的结果测量类型（如自我报告、身体表现或临床医生报告）。两名独立作者使用基于共识的健康测量工具选择标准（COSMIN）中的反应性子成分对纳入文章的质量进行评估。
16项不同的研究符合本系统评价的纳入标准。最常用的结果测量方法是足踝能力测量和下肢功能量表。反应性通过多种方法计算，包括效应量、标准化反应均值、最小临床重要差异/重要性、最小可检测变化和最小重要变化。
基于本系统评价的结果，在小腿、踝关节或足部研究中使用的恢复测量方法报告反应性方面缺乏一致性。涉及小腿、踝关节和足部的疾病的变异性可能导致报告反应性值时出现差异。必须进行进一步的研究，以规范反应性报告测量方法。
2a。
