Sports Medicine Institute, Hospital for Special Surgery, 541 E 71st St, New York, 10021, USA.
Weill Cornell Medical College, New York, NY, USA.
Knee Surg Sports Traumatol Arthrosc. 2020 Aug;28(8):2619-2625. doi: 10.1007/s00167-020-05895-9. Epub 2020 Feb 19.
The Marx Activity Rating Scale (Marx Scale) is a commonly used activity-related patient-reported outcome which evaluates the highest activity level within the last year, whereas the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) assesses highest activity level within the last month. This study aims to determine whether the different timeframes used for the common items of Marx Scale and HSS Pedi-FABS affect scores, and if so, to determine whether age or injury status affect this difference.
The Marx Scale and four analogous items on the HSS Pedi-FABS were administered in random order to patients being evaluated for knee injuries and in addition to healthy controls to enroll an uninjured comparison group. Responses to each question were scored from 0 to 4 for a maximum overall score of 16. Paired and independent-sample t tests were used to determine mean differences between groups.
The final cohort included 88 participants of which 47% were children (ages 10-17) and 51% had a knee injury. All participants except for healthy adults scored significantly lower on the HSS Pedi-FABS than the Marx Scale (p < 0.05). On the HSS Pedi-FABS activity scale, healthy participants scored significantly higher than injured participants (p < 0.01), but there were no significant differences based on age. Conversely, on the Marx Scale, children scored higher than adults (p ≤ 0.001), but there were no significant differences based on injury.
Physical activity level differs when evaluated with the Marx Scale or the analogue part of HSS Pedi-FABS with timeframe being the only difference between the two. The lower scores on the HSS Pedi-FABS are likely due to seasonal changes in activity which do not affect the Marx Scale. HSS Pedi-FABS analyzes a shorter window and it is more likely to capture changes in physical activity due to a recent injury than the Marx Scale which is better suited for assessing general physical activity level unaffected by seasonality or recent injury. Understating the differences between these physical activity scales can better guide clinicians when using them and interpreting scores.
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马克思活动评分量表（Marx 量表）是一种常用的与活动相关的患者报告结局，用于评估过去一年中的最高活动水平，而特殊外科医院儿童功能活动简要量表（HSS Pedi-FABS）则评估过去一个月中的最高活动水平。本研究旨在确定 Marx 量表和 HSS Pedi-FABS 中常见项目使用的不同时间范围是否会影响评分，如果是，确定年龄或损伤状态是否会影响这种差异。
对接受膝关节损伤评估的患者以及健康对照者进行 Marx 量表和 HSS Pedi-FABS 的四个类似项目的随机排序评估，以招募未受伤的对照组。每个问题的回答从 0 到 4 分，总分为 16 分。采用配对和独立样本 t 检验确定组间平均差异。
最终队列纳入 88 名参与者，其中 47%为儿童（10-17 岁），51%有膝关节损伤。除健康成年人外，所有参与者在 HSS Pedi-FABS 上的得分均明显低于 Marx 量表（p<0.05）。在 HSS Pedi-FABS 活动量表上，健康参与者的得分明显高于受伤参与者（p<0.01），但年龄无显著差异。相反，在 Marx 量表上，儿童的得分高于成人（p≤0.001），但损伤无显著差异。
当使用 Marx 量表或 HSS Pedi-FABS 的类似部分评估时，体力活动水平存在差异，唯一的区别在于时间范围。HSS Pedi-FABS 的得分较低可能是由于活动的季节性变化所致，而这些变化不会影响 Marx 量表。HSS Pedi-FABS 分析的时间窗口较短，更有可能捕捉到因最近受伤而导致的体力活动变化，而 Marx 量表则更适合评估不受季节性或最近受伤影响的一般体力活动水平。了解这些体力活动量表之间的差异可以帮助临床医生在使用和解释评分时更好地指导他们。
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