Klokkerud M, Dagfinrud H, Uhlig T, Dager T N, Furunes K-A, Klokkeide Å, Larsen M, Nygård S, Nylenna S, Øie L, Kjeken I
a National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
b Norwegian National Unit for Rehabilitation for Rheumatic Patients with Special Needs, Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway.
Scand J Rheumatol. 2018 May;47(3):225-234. doi: 10.1080/03009742.2017.1347959. Epub 2017 Oct 9.
Rehabilitation is important for people with musculoskeletal diseases (MSDs), and evaluating the effect of rehabilitation on both an individual and group level is advocated. A consensus concerning use of outcome measures will improve collaboration between healthcare providers, and increase the possibility of conducting meta-analyses in future research. The aim of this study was to develop a consensus-based core set of outcome measures for rehabilitation in MSDs, and to test the feasibility and responsiveness of the set.
The core set was developed through a stepwise process comprising a Delphi consensus procedure, systematic literature searches, and a pilot study, including 386 patients, to test the feasibility and responsiveness of the set.
The following aspects and outcome measures were selected: pain [numeric rating scale (NRS)], fatigue (NRS), physical fitness (the 30-second Sit to Stand test), mental health (Hopkins Symptom Checklist 5), daily activities (Hannover Functional Questionnaire), goal attainment (Patient-Specific Functional Scale including motivation score for baseline assessment), quality of life (5-level EuroQol 5 Dimensions), social participation (the social participation item from COOP/WONCA) and coping (Effective Musculoskeletal Consumer Scale-17). All tested outcome measures were found to be feasible, with high completion rates and acceptable score distribution. Standard response means varied from 0.3 to 0.9.
A consensus-based core set of patient reported outcome measures is presented for evaluating rehabilitation in MSDs. The core set is feasible and responsive for use in Norway, but needs further testing in other countries.
康复对肌肉骨骼疾病(MSD)患者很重要,提倡在个体和群体层面评估康复效果。就结局指标的使用达成共识将改善医疗服务提供者之间的协作,并增加在未来研究中进行荟萃分析的可能性。本研究的目的是制定一套基于共识的MSD康复核心结局指标集,并测试该指标集的可行性和反应性。
通过包括德尔菲共识程序、系统文献检索和一项试点研究的逐步过程来制定核心指标集,该试点研究纳入了386名患者,以测试该指标集的可行性和反应性。
选择了以下方面和结局指标:疼痛[数字评分量表(NRS)]、疲劳(NRS)、体能(30秒坐立试验)、心理健康(霍普金斯症状清单5)、日常活动(汉诺威功能问卷)、目标达成情况(患者特定功能量表,包括基线评估的动机评分)、生活质量(5级欧洲五维健康量表)、社会参与(COOP/WONCA的社会参与项目)和应对方式(有效肌肉骨骼消费者量表-17)。所有测试的结局指标均被发现是可行的,完成率高且得分分布可接受。标准反应均值从0.3到0.9不等。
提出了一套基于共识的患者报告结局指标核心集,用于评估MSD的康复情况。该核心指标集在挪威使用是可行且有反应性的,但需要在其他国家进一步测试。