Chester Rachel, Jerosch-Herold Christina, Lewis Jeremy, Shepstone Lee
J Orthop Sports Phys Ther. 2017 Aug;47(8):538-547. doi: 10.2519/jospt.2017.7195. Epub 2017 Jul 6.
Study Design Prospective multicenter longitudinal cohort study. Background A key component of assessing clinical effectiveness is to compare instruments measuring similar outcomes and to select one that is sufficiently responsive. Despite their widespread use in reporting outcomes, the responsiveness of the Shoulder Pain and Disability Index (SPADI) and the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) has not been compared and reported within the same population. Objective To compare the responsiveness of the SPADI and QuickDASH in a single large cohort of patients. Methods Seven hundred sixty-seven patients referred to physical therapy with shoulder pain completed the SPADI and QuickDASH at baseline, 6 weeks, and 6 months. Patients who improved (improvers) and those who did not improve (nonimprovers) were defined using a 7-point global rating of change scale. Internal and external responsiveness was evaluated. Results For improvers, the effect size and standardized response mean were large (greater than 1.00) at 6 weeks for both the SPADI and QuickDASH and further increased for both measures at 6 months. For participants who worsened, negative effect sizes and standardized response means were larger at 6 weeks than at 6 months. The area under the curve was similar for both the SPADI (0.81) and QuickDASH (0.78), increasing to 0.85 for both at 6 months. Conclusion Both instruments are similarly able to discriminate between clinical improvers and nonimprovers at either follow-up point. J Orthop Sports Phys Ther 2017;47(8):538-547. Epub 6 Jul 2017. doi:10.2519/jospt.2017.7195.
前瞻性多中心纵向队列研究。背景：评估临床疗效的一个关键组成部分是比较测量相似结局的工具，并选择一个反应足够灵敏的工具。尽管肩痛和功能障碍指数（SPADI）以及上肢、肩部和手部功能障碍问卷简版（QuickDASH）在报告结局方面被广泛使用，但尚未在同一人群中对它们的反应性进行比较和报告。目的：在一个大型单一队列患者中比较SPADI和QuickDASH的反应性。方法：767例因肩痛接受物理治疗的患者在基线、6周和6个月时完成了SPADI和QuickDASH。使用7分整体变化评定量表定义改善的患者（改善者）和未改善的患者（未改善者）。评估内部和外部反应性。结果：对于改善者，SPADI和QuickDASH在6周时的效应量和标准化反应均值都很大（大于1.00），且这两项指标在6个月时进一步增加。对于病情恶化的参与者，6周时的负效应量和标准化反应均值比6个月时更大。SPADI（0.81）和QuickDASH（0.78）的曲线下面积相似，6个月时两者均增至0.85。结论：在两个随访点，这两种工具在区分临床改善者和未改善者方面同样有效。《骨科与运动物理治疗杂志》2017年；47（8）：538 - 547。2017年7月6日在线发表。doi:10.2519/jospt.2017.7195 。
