Blixt Simon, Mukka Sebastian, Försth Peter, Westin Olof, Gerdhem Paul
Department of Clinical Science Intervention and Technology, Karolinska Institutet, K54, SE 141 86, Stockholm, Sweden.
Department of Reconstructive Orthopaedics, Karolinska University Hospital, K54, SE 141 86, Huddinge, Sweden.
Eur Spine J. 2023 Apr;32(4):1471-1479. doi: 10.1007/s00586-023-07581-z. Epub 2023 Feb 24.
The aim of this study was to validate the use of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with a spine fracture.
Cross-sectional cohort of individuals that had sustained a spine fracture (C1-L5) one year earlier. Patients were asked to fill out SMFA, Oswestry Disability Index (ODI), EQ-5D-3L and EQ-VAS. Spearman's rank correlation coefficient (rho) was used to assess convergent validity for each patient-reported outcome measure (PROM). Bland-Altman plots were used to assess PROM agreement.
82 patients completed all questionnaires. The correlations between SMFA Dysfunction and Bother indices and ODI were 0.89 and 0.86, with EQ-5D-3L index 0.89 and 0.80, and with EQ-VAS 0.80 and 0.73, respectively. The correlation for separate categories of the SMFA dysfunction index (daily activities, emotional status, arm and hand function, mobility) ranged between 0.71-0.87 for ODI, 0.72-0.84 for EQ-5D-3L index, and 0.67-0.77 for EQ-VAS. A selection of the ten items of SMFA that had the highest correlations with ODI resulted in a correlation of 0.91. The agreements between SMFA indices and ODI in Bland-Altman plots were good with small differential biases and minimal proportional biases, but worse for SMFA and EQ-5D-3L index and EQ-VAS.
The SMFA indices are highly correlated with ODI in patients with a spine fracture. The Dysfunction index and Bother index, or selected SMFA items, may be used to assess outcome in patients with spine fractures as an alternative to ODI.
本研究旨在验证短肌肉骨骼功能评估（SMFA）问卷在脊柱骨折患者中的应用。
对一年前发生脊柱骨折（C1-L5）的个体进行横断面队列研究。要求患者填写SMFA、奥斯威斯功能障碍指数（ODI）、EQ-5D-3L和EQ视觉模拟量表（EQ-VAS）。采用斯皮尔曼等级相关系数（rho）评估每个患者报告结局指标（PROM）的收敛效度。使用布兰德-奥特曼图评估PROM的一致性。
82例患者完成了所有问卷。SMFA功能障碍指数与困扰指数和ODI之间的相关性分别为0.89和0.86，与EQ-5D-3L指数分别为0.89和0.80，与EQ-VAS分别为0.80和0.73。SMFA功能障碍指数各单独类别（日常活动、情绪状态、手臂和手部功能、活动能力）与ODI的相关性在0.71-0.87之间，与EQ-5D-3L指数在0.72-0.84之间，与EQ-VAS在0.67-0.77之间。选取与ODI相关性最高的10项SMFA条目，相关性为0.91。在布兰德-奥特曼图中，SMFA指数与ODI之间的一致性良好，差异偏差小且比例偏差最小，但SMFA与EQ-5D-3L指数及EQ-VAS的一致性较差。
SMFA指数与脊柱骨折患者的ODI高度相关。功能障碍指数和困扰指数或选定的SMFA条目可用于评估脊柱骨折患者的结局，作为ODI的替代指标。
