患者特定功能量表测量多发性硬化症患者移动相关目标的可靠性、有效性和反应性。

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis.

机构信息

Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora (M.M.M., C.L.C., M.B.); Department of Neurology, School of Medicine, University of Colorado, Aurora (M.M.M.); Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado (M.M.M., C.L.C., M.B.); Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania (E.T.C.); and Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, and VA Portland Health Care System, Portland, Oregon (M.H.C.).

出版信息

J Neurol Phys Ther. 2023 Jul 1;47(3):139-145. doi: 10.1097/NPT.0000000000000439. Epub 2023 Mar 7.

DOI:10.1097/NPT.0000000000000439

PMID:36897202

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10329992/

Abstract

BACKGROUND AND PURPOSE

This study's purpose was to investigate the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS) for measuring mobility-related goals in people with multiple sclerosis (MS).

METHODS

Data from 32 participants with MS who underwent 8 to 10 weeks of rehabilitation were analyzed (Expanded Disability Status Scale scores 1.0-7.0). For the PSFS, participants identified 3 mobility-related areas where they had difficulty and rated them at baseline, 10 to 14 days later (before starting intervention), and immediately after intervention. Test-retest reliability and response stability of the PSFS were calculated using the intraclass correlation coefficient (ICC 2,1 ) and minimal detectable change (MDC 95 ), respectively. Concurrent validity of the PSFS was determined with the 12-item Multiple Sclerosis Walking Scale (MSWS-12) and the Timed 25-Foot Walk Test (T25FW). PSFS responsiveness was determined using Cohen's d , and minimal clinically important difference (MCID) was calculated based on patient-reported improvements on a Global Rating of Change (GRoC) scale.

RESULTS

The PSFS total score demonstrated moderate reliability (ICC 2,1 = 0.70, 95% CI: 0.46 to 0.84) and the MDC was 2.1 points. At baseline, the PSFS was fairly and significantly correlated with the MSWS-12 ( r = -0.46, P = 0.008) but not with the T25FW. Changes in the PSFS were moderately and significantly correlated with the GRoC scale (ρ = 0.63, P < 0.001), but not with MSWS-12 or T25FW changes. The PSFS was responsive ( d = 1.7), and the MCID was 2.5 points or more to identify patient-perceived improvements based on the GRoC scale (sensitivity = 0.85, specificity = 0.76).

DISCUSSION AND CONCLUSIONS

This study supports the use of the PSFS as an outcome measure in people with MS to assess mobility-related goals.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A423 ).

摘要

背景与目的

本研究旨在探讨患者特定功能量表（PSFS）用于评估多发性硬化症（MS）患者与移动相关目标的可靠性、有效性和反应性。

方法

对 32 名接受 8 至 10 周康复治疗的 MS 患者的数据进行了分析（扩展残疾状态量表评分 1.0-7.0）。对于 PSFS，参与者确定了 3 个与移动相关的困难领域，并在基线时、10 至 14 天后（开始干预前）以及干预后立即进行了评估。使用组内相关系数（ICC 2,1 ）和最小可检测变化（MDC 95 ）分别计算 PSFS 的重测信度和反应稳定性。使用 12 项多发性硬化步行量表（MSWS-12）和定时 25 英尺步行测试（T25FW）确定 PSFS 的同时效度。使用 Cohen 的 d 确定 PSFS 的反应性，并根据患者对总体变化评级（GRoC）量表的改善情况计算最小临床重要差异（MCID）。

结果

PSFS 总分显示出中等的可靠性（ICC 2,1 = 0.70，95%置信区间：0.46 至 0.84），MDC 为 2.1 分。在基线时，PSFS 与 MSWS-12 呈中度显著相关（r = -0.46，P = 0.008），但与 T25FW 无关。PSFS 的变化与 GRoC 量表呈中度显著相关（ρ=0.63，P<0.001），但与 MSWS-12 或 T25FW 的变化无关。PSFS 具有反应性（d=1.7），根据 GRoC 量表，MCID 为 2.5 分或更高，以识别患者感知到的改善（敏感性=0.85，特异性=0.76）。