Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Postbus 90052, 5600 PD, Eindhoven, The Netherlands.
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health (APH) Research Institute, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):2898-2909. doi: 10.1007/s00167-017-4789-y. Epub 2017 Nov 11.
The Osteoarthritis Research Society International has identified a core set of performance-based tests of physical function for use in people with knee osteoarthritis (OA). The core set consists of the 30-second chair stand test (30-s CST), 4 × 10 m fast-paced walk test (40 m FPWT) and a stair climb test. The aim of this study was to evaluate the reliability, validity and responsiveness of these performance-based measures to assess the ability to measure physical function in knee OA patients.
A prospective cohort study of 85 knee OA patients indicated for total knee arthroplasty (TKA) was performed. Construct validity and responsiveness were assessed by testing of predefined hypotheses. A subgroup (n = 30) underwent test-retest measurements for reliability analysis. The Oxford Knee Score, Knee injury and Osteoarthritis Outcome Score-Physical Function Short Form, pain during activity score and knee extensor strength were used as comparator instruments. Measurements were obtained at baseline and 12 months after TKA.
Appropriate test-retest reliability was found for all three tests. Intraclass correlation coefficient (ICC) for the 30-s CST was 0.90 (95% CI 0.68; 0.96), 40 m FPWT 0.93 (0.85; 0.96) and for the 10-step stair climb test (10-step SCT) 0.94 (0.89; 0.97). Adequate construct validity could not be confirmed for the three tests. For the 30-s CST, 42% of the predefined hypotheses were confirmed; for the 40 m FPWT, 27% and for the 10-step SCT 36% were confirmed. The 40 m FPWT was found to be responsive with 75% of predefined hypothesis confirmed, whereas the responsiveness for the other tests could not be confirmed. For the 30 s CST and 10-step SCT, only 50% of hypotheses were confirmed.
The three performance-based tests had good reliability, but poor construct validity and responsiveness in the assessment of function for the domains sit-to-stand movement, walking short distances and stair negotiation. The findings of the present study do not justify their use for clinical practice.
Level 1. Diagnostic study.
国际骨关节炎研究协会已确定了一套针对膝关节骨关节炎（OA）患者的基本体能表现测试，包括 30 秒起坐测试（30-s CST）、4×10 米快步走测试（40m FPWT）和爬楼梯测试。本研究旨在评估这些体能测试的可靠性、有效性和反应能力，以评估其测量膝关节 OA 患者身体功能的能力。
对 85 名拟行全膝关节置换术（TKA）的膝关节 OA 患者进行前瞻性队列研究。通过检验预设假设来评估结构有效性和反应能力。一个亚组（n=30）进行了测试-再测试测量以进行可靠性分析。牛津膝关节评分、膝关节损伤和骨关节炎结果评分-物理功能简明量表、活动时疼痛评分和膝关节伸肌力量被用作比较工具。在 TKA 前和 12 个月时进行测量。
所有三种测试均具有适当的测试-再测试可靠性。30-s CST 的组内相关系数（ICC）为 0.90（95%CI 0.68；0.96），40m FPWT 为 0.93（0.85；0.96），10 步爬楼梯测试（10-step SCT）为 0.94（0.89；0.97）。无法确认这三种测试具有充分的结构有效性。对于 30-s CST，有 42%的预设假设得到证实；40m FPWT 为 27%，10-step SCT 为 36%。发现 40m FPWT 具有反应性，75%的预设假设得到证实，而其他测试的反应性则无法得到证实。对于 30-s CST 和 10-step SCT，只有 50%的假设得到证实。
在评估坐站运动、短距离行走和楼梯上下能力等功能领域时，三种体能测试均具有良好的可靠性，但结构有效性和反应性较差。本研究的结果不支持将其用于临床实践。
1 级。诊断研究。
