Taheri Mahdie, Negahban Hossein, Mostafaee Neda, Salehi Reza, Tabesh Hamed
a Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran .
b Department of Physical Therapy, School of Paramedical Sciences , Mashhad University of Medical Sciences , Mashhad , Iran , and.
Disabil Rehabil. 2016;38(5):482-6. doi: 10.3109/09638288.2015.1044622. Epub 2015 May 8.
To evaluate the responsiveness of two outcome measures of participation restriction [as measured by the Community Integration Questionnaire (CIQ)] and quality of life [as measured by the Multiple Sclerosis Quality of Life (MSQOL)] following a physiotherapy intervention in patients with multiple sclerosis (MS).
A sample of 265 patients completed both instruments first at the time of initial visit and then after 4-6 weeks physiotherapy. In addition, patients were asked to complete the 7-point global rating scale as an external criterion of change at the post-intervention time. The responsiveness was evaluated using the receiver operating characteristics (ROC) method and the correlation analysis. Two useful statistics were area under the ROC curve (AUC) and the minimally clinically important difference (MCID). The AUC and correlation coefficient greater than 0.70 were considered as acceptable responsiveness.
The CIQ achieved the acceptable responsiveness with an AUC of 0.81. However, the AUCs of 0.61 and 0.66 were obtained for the MSQOL physical and mental, respectively. Moreover, good correlation coefficient was obtained for the CIQ (Gamma = 0.76) while fair correlations of 0.28 and 0.33 were obtained for the MSQOL physical and mental, respectively. The MCIDs were approximately 0.50, 1.5 and 2.5 points for the CIQ, MSQOL physical and mental, respectively.
In contrast to the MSQOL, the CIQ was responsive outcome measure in detecting changes in participation restriction of patients with MS. Moreover, the MCID values obtained in this study will help the clinicians and researchers to determine if a patient with MS has experienced a true change following physiotherapy intervention.
The results provide valuable information regarding to the ability of two outcome measures (i.e. the CIQ and MSQOL) to detect treatment effects in patients with MS. In contrast to the MSQOL, the CIQ is a responsive measure to changes in participation restriction due to physiotherapy. A patient with MS had to change at least 0.50 point on the CIQ, 1.5 points on the MSQOL physical and 2.5 points on the MSQOL mental to be judged as having clinically changed.
评估在多发性硬化症（MS）患者接受物理治疗干预后，两种参与受限结局测量指标[通过社区融合问卷（CIQ）测量]和生活质量[通过多发性硬化症生活质量量表（MSQOL）测量]的反应性。
265名患者的样本在初次就诊时以及物理治疗4 - 6周后分别完成这两种测量工具。此外，要求患者在干预后完成7分整体评定量表，作为变化的外部标准。使用受试者工作特征（ROC）方法和相关性分析评估反应性。两个有用的统计量是ROC曲线下面积（AUC）和最小临床重要差异（MCID）。AUC和相关系数大于0.70被认为具有可接受的反应性。
CIQ的AUC为0.81，达到了可接受的反应性。然而，MSQOL身体维度和心理维度的AUC分别为0.61和0.66。此外，CIQ获得了良好的相关系数（Gamma = 0.76），而MSQOL身体维度和心理维度分别获得了中等的相关系数0.28和0.33。CIQ、MSQOL身体维度和心理维度的MCID分别约为0.50分、1.5分和2.5分。
与MSQOL相比，CIQ是检测MS患者参与受限变化的反应性结局测量指标。此外，本研究中获得的MCID值将有助于临床医生和研究人员确定MS患者在物理治疗干预后是否经历了真正的变化。
结果提供了关于两种结局测量指标（即CIQ和MSQOL）检测MS患者治疗效果能力的有价值信息。与MSQOL相比，CIQ是对物理治疗引起的参与受限变化有反应的测量指标。MS患者在CIQ上至少变化0.50分、在MSQOL身体维度上变化1.5分、在MSQOL心理维度上变化2.5分才能被判定为有临床变化。
