中重度创伤性脑损伤患者的结局指标：美国物理治疗协会神经物理治疗学会TBI EDGE特别工作组的建议
Outcome Measures for Persons With Moderate to Severe Traumatic Brain Injury: Recommendations From the American Physical Therapy Association Academy of Neurologic Physical Therapy TBI EDGE Task Force.
作者信息
McCulloch Karen L, de Joya Anna Lisa, Hays Kaitlin, Donnelly Erin, Johnson Tammie Keller, Nirider Coby D, Roth Heidi, Saliga Sue, Ward Irene
机构信息
Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine (K.L.M.) and Division of Physical Therapy (K.L.M.), The University of North Carolina at Chapel Hill; TIRR Memorial Hermann, Houston, Texas (A.L.J.); Craig Hospital, Denver, Colorado (K.H.); Kessler Institute for Rehabilitation, Saddle Brook, New Jersey (E.D.); Casa Colina Centers for Rehabilitation, Pomona, California (T.K.J.); Touchstone Neurorecovery Center, Conroe, Texas (C.D.N.); Rehabilitation Institute of Chicago, Chicago, Illinois (H.R.); Oakland University, Rochester, Michigan (S.S.); and Kessler Institute for Rehabilitation, West Orange, New Jersey (I.W.).
出版信息
J Neurol Phys Ther. 2016 Oct;40(4):269-80. doi: 10.1097/NPT.0000000000000145.
BACKGROUND AND PURPOSE
The use of standardized outcome measures (OMs) is essential in assessing the effectiveness of physical therapy (PT) interventions. The purposes of this article are (1) to describe the process used by the TBI EDGE task force to assess the psychometrics and clinical utility of OMs used with individuals with moderate to severe traumatic brain injury (TBI); (2) to describe the consensus recommendations for OM use in clinical practice, research, and professional (entry-level) PT education; and (3) to make recommendations for future work.
METHODS
An 8-member task force used a modified Delphi process to develop recommendations on the selection of OMs for individuals with TBI. A 4-point rating scale was used to make recommendations based on practice setting and level of ambulation. Recommendations for appropriateness for research use and inclusion in entry-level education were also provided.
RESULTS
The TBI EDGE task force reviewed 88 OMs across the International Classification of Functioning, Disability, and Health (ICF) domains: 15 measured body functions/structure only, 21 measured activity only, 23 measured participation only, and 29 OMs covered more than 1 ICF domain.
DISCUSSION AND CONCLUSIONS
Recommendations made by the TBI EDGE task force provide clinicians, researchers, and educators with guidance for the selection of OMs. The use of these recommendations may facilitate identification of appropriate OMs in the population with moderate to severe TBI. TBI EDGE task force recommendations can be used by clinicians, researchers, and educators when selecting OMs for their respective needs. Future efforts to update the recommendations are warranted in order to ensure that recommendations remain current and applicable.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A140).
背景与目的
使用标准化结局指标对于评估物理治疗（PT）干预的有效性至关重要。本文的目的是：（1）描述创伤性脑损伤边缘（TBI EDGE）工作组用于评估中度至重度创伤性脑损伤（TBI）患者所使用结局指标的心理测量学特性和临床实用性的过程；（2）描述在临床实践、研究和专业（入门级）PT教育中使用结局指标的共识性建议；（3）为未来的工作提出建议。
方法
一个由8名成员组成的工作组采用改良的德尔菲法，就为TBI患者选择结局指标制定建议。基于实践环境和步行水平，使用4分制评分量表提出建议。还提供了关于研究用途适宜性和纳入入门级教育的建议。
结果
TBI EDGE工作组在《国际功能、残疾和健康分类》（ICF）各领域中审查了88个结局指标：15个仅测量身体功能/结构，21个仅测量活动，23个仅测量参与，29个结局指标涵盖多个ICF领域。
讨论与结论
TBI EDGE工作组提出的建议为临床医生、研究人员和教育工作者选择结局指标提供了指导。使用这些建议可能有助于在中度至重度TBI人群中识别合适的结局指标。临床医生、研究人员和教育工作者在为各自需求选择结局指标时可使用TBI EDGE工作组的建议。为确保建议与时俱进且适用，有必要在未来努力更新这些建议。视频摘要可获取作者更多见解（见补充数字内容1，http://links.lww.com/JNPT/A140）。
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