Givens Deborah L, Eskildsen Scott, Taylor Kaitlyn E, Faldowski Richard A, Del Gaizo Daniel J
Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Arthroplast Today. 2018 Sep 1;4(4):505-509. doi: 10.1016/j.artd.2018.07.010. eCollection 2018 Dec.
The Patient Reported Outcomes Measurement Information System (PROMIS) Computerized Adaptive Test (CAT) physical function rapidly assesses self-reported function capability. The Timed Up and Go (TUG) test is often used in clinical practice, but administration may be impeded by space and patient limitations. PROMIS CAT can potentially address these limitations, but we lack evidence if TUG and health indicators are predictors of PROMIS CAT. This study assessed whether TUG, body mass index (BMI), numeric pain rating scale (NPRS), and smoking status were predictors of PROMIS CAT in total knee arthroplasty (TKA) candidates.
Sixty-five TKA candidates completed the PROMIS CAT physical function test using an iPad application. TUG, NPRS, BMI, and smoking status were obtained at the clinic visit or from medical records. Univariate and multiple regression analyses identified the strongest predictors of PROMIS CAT.
TUG was the best predictor of PROMIS CAT physical function based on simple regression (r = -0.43, 95% CI = -0.62 to -0.20) or multiple regression ( = -0.45, 95% CI = -0.73 to -0.17) analyses. BMI and NPRS did not incrementally help predict the PROMIS score beyond TUG. Smoking status did not contribute to the prediction of the PROMIS CAT score.
The findings suggest that the PROMIS CAT physical function is not a surrogate for the TUG performance-based measure in candidates for TKA. However, TUG was the best predictor of PROMIS physical function compared with BMI, NPRS, and smoking status. Clinicians should consider both patient-reported and performance-based measures when evaluating function for TKA outcomes.
患者报告结局测量信息系统（PROMIS）计算机自适应测试（CAT）身体功能可快速评估自我报告的功能能力。定时起立行走（TUG）测试常用于临床实践，但空间和患者限制可能会妨碍其实施。PROMIS CAT可能可以解决这些限制，但我们缺乏证据表明TUG和健康指标是否为PROMIS CAT的预测因素。本研究评估了TUG、体重指数（BMI）、数字疼痛评分量表（NPRS）和吸烟状况是否为全膝关节置换术（TKA）候选患者PROMIS CAT的预测因素。
65名TKA候选患者使用iPad应用程序完成了PROMIS CAT身体功能测试。在门诊就诊时或从病历中获取TUG、NPRS、BMI和吸烟状况。单因素和多因素回归分析确定了PROMIS CAT的最强预测因素。
基于简单回归（r = -0.43，95%CI = -0.62至-0.20）或多因素回归（ = -0.45，95%CI = -0.73至-0.17）分析，TUG是PROMIS CAT身体功能的最佳预测因素。除TUG外，BMI和NPRS并不能逐步帮助预测PROMIS评分。吸烟状况对PROMIS CAT评分的预测没有贡献。
研究结果表明，对于TKA候选患者，PROMIS CAT身体功能并非基于TUG表现的测量指标的替代指标。然而，与BMI、NPRS和吸烟状况相比，TUG是PROMIS身体功能的最佳预测因素。临床医生在评估TKA结局的功能时应同时考虑患者报告的指标和基于表现的指标。
