测量引发与运动相关活动的个体焦虑等级：前交叉韧带重建运动活动摄影系列（PHOSA - ACLR）的开发与验证
Measuring individual hierarchy of anxiety invoking sports related activities: development and validation of the Photographic Series of Sports Activities for Anterior Cruciate Ligament Reconstruction (PHOSA-ACLR).
作者信息
van Lankveld Wim, van Melick Nicky, Habets Bas, Roelofsen Eefje, Staal J Bart, van Cingel Robert
机构信息
HAN University of Applied Sciences, Research group Musculoskeletal Rehabilitation Nijmegen, Kapittelweg 33, Nijmegen, The Netherlands.
Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
出版信息
BMC Musculoskelet Disord. 2017 Jul 4;18(1):287. doi: 10.1186/s12891-017-1643-9.
BACKGROUND
Fear of harm (FoH) after Anterior Cruciate Ligament Reconstruction (ACLR) should be addressed in physical therapy as it hampers return to sports. However, there are no instruments assessing FoH specific for ACLR. The objective of this study is to describe the development and measurement properties of the Photograph Series of Sports Activities for ACLR (PHOSA-ACLR) measuring ACL injury related FoH.
METHODS
Based on literature and opinion of physical therapists with extensive experience in ACLR treatment, photographs depicting FoH inducing situations in ACL injury were considered for inclusion in the instrument. For each photograph the patients is asked to report perceived harmfulness. The set of photographs was completed by two samples of patients with ACLR: 1 cross-sectional sample (n = 55), and 1 test-retest reliability sample (n = 58). Internal consistency and structural validity were assessed in 109 patients. In 58 patients criterion validity was assessed by calculating pearson correlations with the Tampa Scale of Kinesiophobia (TSK). Correlations with self-reported knee function (KOOS and Lysholm score), and Knee Self-efficacy Scale (K-SES) were computed for hypothesis testing. Test-retest reliability was determined in a group of 55 patients, assessed twice with 1 week between assessments.
RESULTS
Twelve photographs depicting sports related movements that are likely to invoke FoH after ACLR were selected. Two items were deleted because of lack of discrimination. The remaining 10 items were included in the PHOSA-ACLR, and the scale showed excellent internal consistency (Cronbach's Alpha is .95). Items reflected one dimension, and was strongly correlated with TSK (r = .59). A priori formulated hypotheses are confirmed and test-retest correlation was excellent (ICC = .86).
CONCLUSION
The PHOSA-ACLR showed acceptable measurement properties. The PHOSA-ACLR gives specific information about fear invoking sports situations that are not measured by other kinesophobia measures. Therefore, the PHOSA-ACLR might be a valuable additional tool in rehabilitation of ACLR patients. Additional research is needed to determine responsiveness to change.
背景
前交叉韧带重建（ACLR）后对受伤的恐惧（FoH）应在物理治疗中加以解决，因为它会妨碍患者恢复运动。然而，目前尚无专门评估ACLR相关FoH的工具。本研究的目的是描述用于测量ACLR损伤相关FoH的前交叉韧带重建运动活动照片系列（PHOSA - ACLR）的开发过程及其测量特性。
方法
基于文献以及在ACLR治疗方面具有丰富经验的物理治疗师的意见，筛选出描绘ACLR损伤中引发FoH情况的照片纳入该工具。对于每张照片，要求患者报告其感知到的有害程度。通过两组ACLR患者样本完善照片集：1个横断面样本（n = 55）和1个重测信度样本（n = 58）。在109名患者中评估内部一致性和结构效度。在58名患者中，通过计算与坦帕运动恐惧量表（TSK）的皮尔逊相关性来评估效标效度。为进行假设检验，计算与自我报告的膝关节功能（KOOS和Lysholm评分）以及膝关节自我效能量表（K - SES）的相关性。在一组55名患者中确定重测信度，在两次评估之间间隔1周进行两次评估。
结果
选择了12张描绘ACLR后可能引发FoH的与运动相关动作的照片。由于缺乏区分度，删除了2个条目。其余10个条目被纳入PHOSA - ACLR，该量表显示出出色的内部一致性（克朗巴哈系数为0.95）。条目反映了一个维度，并且与TSK高度相关（r = 0.59）。预先设定的假设得到证实，重测相关性良好（组内相关系数ICC = 0.86）。
结论
PHOSA - ACLR显示出可接受的测量特性。PHOSA - ACLR提供了关于引发恐惧的运动情况的具体信息，而这些信息是其他运动恐惧测量方法所未涉及的。因此，PHOSA - ACLR可能是ACLR患者康复过程中有价值的辅助工具。需要进一步研究以确定其对变化的反应性。
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