Xu Ling, Wang Chen, Zhang Chen, Feng Xinzhe, Tong Wenwen
Department of Orthopedics, Shanghai Tianyou Hospital, Shanghai, China.
Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
Clin Rheumatol. 2020 Oct;39(10):3041-3048. doi: 10.1007/s10067-020-05077-5. Epub 2020 Apr 21.
The lower extremity function scale (LEFS) is widely used to investigate patients' functional status due to musculoskeletal dysfunction of the lower extremity. The aims of this study were to translate and cross-culturally adapt the LEFS into simplified Chinese (SC-LEFS) and evaluate the psychometric properties in patients with knee osteoarthritis (OA).
The SC-LEFS was translated and cross-culturally adapted on the basis of guideline. Patients scheduled for knee arthroplasty (108) were invited in this study. The Cronbach's alpha coefficient was employed to assess the internal consistency. The test-retest reliability was determined by intra-class correlation coefficient (ICC). Pearson's correlation coefficient was detected to evaluate the criterion validity between the SC-LEFS and WOMAC/SF-36/range of motion (ROM). Construct validity was assessed by exploratory factorial analysis. Additionally, responsiveness analysis was conducted with effect size (ES) and standardized response mean (SRM).
The results revealed good internal consistency (Cronbach's alpha = 0.975) and good test-retest reliability (ICC = 0.937). Strong correlations were observed between the SC-LEFS and WOMAC pain/function/total, physical component summary of SF-36, and ROM. We confirmed the SC-LEFS as a two-factor structure with factor 1 and factor 2 explaining 73.781% and 5.546% of the variance, respectively. The ES (1.74) and SRM (1.95) indicated a good responsiveness.
The SC-LEFS has been nicely adapted into simplified Chinese. It was proved to be reliable and valid for knee OA patients from China mainland who are undergoing arthroplasty. Furthermore, additional research should be conducted to assess these findings in other dysfunctions of lower extremity in a larger sample size. Key Points • The present study firstly cross-culturally adapted the lower extremity function scale (LEFS) into simplified Chinese and applied for patients with knee osteoarthritis in China mainland. • The psychometric properties including reliability, validity, and responsiveness were evaluated in SC-LEFS. • The SC-LEFS turned out to be a reliable and valid tool for clinical physicians and researchers assessing patients with knee osteoarthritis.
下肢功能量表（LEFS）被广泛用于调查因下肢肌肉骨骼功能障碍导致的患者功能状态。本研究的目的是将LEFS翻译并跨文化改编为简体中文（SC-LEFS），并评估其在膝骨关节炎（OA）患者中的心理测量特性。
根据指南对SC-LEFS进行翻译和跨文化改编。本研究纳入了计划进行膝关节置换术的患者（108例）。采用Cronbach's α系数评估内部一致性。通过组内相关系数（ICC）确定重测信度。检测Pearson相关系数以评估SC-LEFS与WOMAC/SF-36/活动范围（ROM）之间的效标效度。通过探索性因子分析评估结构效度。此外，采用效应量（ES）和标准化反应均值（SRM）进行反应度分析。
结果显示具有良好的内部一致性（Cronbach's α = 0.975）和良好的重测信度（ICC = 0.937）。在SC-LEFS与WOMAC疼痛/功能/总分、SF-36的身体成分总结以及ROM之间观察到强相关性。我们确认SC-LEFS为双因素结构，因素1和因素2分别解释了73.781%和5.546%的方差。ES（1.74）和SRM（1.95）表明具有良好的反应度。
SC-LEFS已很好地改编为简体中文。事实证明，它对于中国大陆正在接受关节置换术的膝OA患者是可靠且有效的。此外，应开展更多研究，以更大样本量评估这些发现在其他下肢功能障碍中的情况。要点 • 本研究首次将下肢功能量表（LEFS）跨文化改编为简体中文，并应用于中国大陆的膝骨关节炎患者。 • 对SC-LEFS的心理测量特性包括信度、效度和反应度进行了评估。 • SC-LEFS被证明是临床医生和研究人员评估膝骨关节炎患者的可靠且有效的工具。
