Poitras Stéphane, Wood Kristi S, Savard Jacinthe, Dervin Geoffrey F, Beaulé Paul E
School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
Department of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
BMC Musculoskelet Disord. 2016 Nov 16;17(1):478. doi: 10.1186/s12891-016-1338-7.
Following hip or knee arthroplasty, it is clinically warranted to get patients functional as quickly as possible. However, valid tools to assess function shortly after knee or hip arthroplasty are lacking. The objective was to compare the clinimetric properties of four instruments to assess function shortly after arthroplasty.
One hundred eight patients undergoing hip or knee arthroplasty were assessed preoperatively, 1 and 2 days postoperatively, and 2 and 6 weeks postoperatively with the Timed Up and Go (TUG), Iowa Level of Assistance Scale (ILAS), Postoperative Quality of Recovery Scale (PQRS), and Readiness for Hospital Discharge Scale (RHDS). Descriptive data, floor and ceiling effects, responsiveness, interpretation and construct validity were determined.
Only the ILAS and RHDS support subscale demonstrated floor or ceiling effects. A large deterioration from preoperative to postoperative, followed by large improvements after surgery were seen in the TUG and ILAS scores. The RHDS personal status subscale and the PQRS pain and function dimensions demonstrated large improvements after surgery. Changes in the RHDS global scale and personal status subscale, PQRS pain dimension and TUG were significantly related to patient perceived improvement. Minimal important changes were obtained for the RHDS global (1.1/10) and personal status subscale (2.3/10), and the TUG (43.4 s at 6 weeks). For construct validity, the PQRS function dimension and RHDS were moderately related to the TUG or ILAS. The correlation between TUG and ILAS was high from preoperative to postoperative day 2, but substantially decreased at 2 and 6 weeks.
The TUG and RHDS personal status subscale demonstrated the best clinimetric properties to assess function in the first 6 weeks after hip or knee arthroplasty.
髋关节或膝关节置换术后，临床上需要尽快让患者恢复功能。然而，目前缺乏用于评估膝关节或髋关节置换术后短期内功能的有效工具。本研究的目的是比较四种工具在关节置换术后短期内评估功能的临床测量特性。
对108例行髋关节或膝关节置换术的患者在术前、术后1天和2天以及术后2周和6周使用计时起立行走测试（TUG）、爱荷华辅助水平量表（ILAS）、术后恢复质量量表（PQRS）和出院准备度量表（RHDS）进行评估。确定描述性数据、地板效应和天花板效应、反应性、解释性和结构效度。
只有ILAS和RHDS支持性子量表显示出地板效应或天花板效应。TUG和ILAS评分显示，从术前到术后大幅下降，随后术后大幅改善。RHDS个人状态子量表以及PQRS疼痛和功能维度术后有大幅改善。RHDS总体量表和个人状态子量表、PQRS疼痛维度和TUG的变化与患者感知到的改善显著相关。RHDS总体量表（1.1/10）和个人状态子量表（2.3/10）以及TUG（6周时为43.4秒）获得了最小重要变化。对于结构效度，PQRS功能维度和RHDS与TUG或ILAS中度相关。从术前到术后第2天，TUG和ILAS之间的相关性较高，但在术后第2周和第6周大幅下降。
TUG和RHDS个人状态子量表在评估髋关节或膝关节置换术后前6周的功能方面显示出最佳的临床测量特性。
