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GNE 肌病患者报告的结局:在罕见病中纳入对身体功能的有效评估。

Patient reported outcomes in GNE myopathy: incorporating a valid assessment of physical function in a rare disease.

机构信息

a Therapeutics for Rare and Neglected Diseases , National Center for Advancing Translational Sciences, National Institutes of Health , Bethesda , MD , USA.

b RTI Health Solutions , NC , USA.

出版信息

Disabil Rehabil. 2018 May;40(10):1206-1213. doi: 10.1080/09638288.2017.1283712. Epub 2017 Feb 7.

Abstract

BACKGROUND

The aim of this analysis was to evaluate the psychometric properties of three patient reported outcome (PRO) measures characterizing physical function in GNE myopathy: the Human Activity Profile, the Inclusion Body Myositis Functional Rating Scale, and the Activities-specific Balance Confidence scale.

METHODS

This analysis used data from 35 GNE myopathy subjects participating in a natural history study. For construct validity, correlational and known-group analyses were between the PROs and physical assessments. Reliability of the PROs between baseline and 6 months was evaluated using the intra-class correlation coefficient model; internal consistency was tested with Cronbach's alpha.

RESULTS

The hypothesized moderate positive correlations for construct validity were supported; the strongest correlation was between the human activity profile adjusted activity score and the adult myopathy assessment endurance subscale score (r = 0.81; p < 0.0001). The PROs were able to discriminate between known high and low functioning groups for the adult myopathy assessment tool. Internal consistency of the PROs was high (α > 0.8) and there was strong reliability (ICC >0.62).

CONCLUSION

The PROs are valid and reliable measures of physical function in GNE myopathy and should be incorporated in investigations to better understand the impact of progressive muscle weakness on physical function in this rare disease population. Implications for Rehabilitation GNE myopathy is a rare muscle disease that results in slow progressive muscle atrophy and weakness, ultimately leading to wheelchair use and dependence on a caregiver. There is limited knowledge on the impact of this disease on the health-related quality of life, specifically physical function, of this rare disease population. Three patient reported outcomes have been shown to be valid and reliable in GNE myopathy subjects and should be incorporated in future investigations to better understand how progressive muscle weakness impacts physical functions in this rare disease population. The patient reported outcome scores of GNE myopathy patients indicate a high risk for falls and impaired physical functioning, so it is important clinicians assess and provide interventions for these subjects to maintain their functional capacity.

摘要

背景

本分析旨在评估三种用于描述 GNE 肌病患者身体功能的患者报告结局(PRO)测量工具的心理测量特性:人体活动概况、包涵体肌炎功能评定量表和活动特异性平衡信心量表。

方法

本分析使用了参加自然史研究的 35 名 GNE 肌病患者的数据。为了进行结构有效性分析,在 PRO 与身体评估之间进行了相关性和已知组分析。使用组内相关系数模型评估 PRO 在基线和 6 个月之间的可靠性;使用 Cronbach's alpha 检验内部一致性。

结果

结构有效性的假设中等正相关得到支持;最强的相关性是人体活动概况调整后的活动评分与成人肌病评估耐力子量表评分之间(r=0.81;p<0.0001)。PRO 能够区分成人肌病评估工具的已知高功能和低功能组。PRO 的内部一致性很高(α>0.8),可靠性很强(ICC>0.62)。

结论

PRO 是 GNE 肌病身体功能的有效且可靠的测量工具,应纳入调查以更好地了解进行性肌肉无力对该罕见疾病人群身体功能的影响。

康复意义

GNE 肌病是一种罕见的肌肉疾病,导致肌肉进行性萎缩和无力,最终导致使用轮椅和依赖护理人员。关于这种疾病对该罕见疾病人群健康相关生活质量,特别是身体功能的影响,了解有限。在 GNE 肌病患者中,三种患者报告结局已被证明是有效且可靠的,应纳入未来的研究中,以更好地了解进行性肌肉无力如何影响该罕见疾病人群的身体功能。GNE 肌病患者的报告结局评分表明跌倒和身体功能受损的风险较高,因此临床医生评估并为这些患者提供干预措施以维持其功能能力非常重要。

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