Socorro-Cumplido José Luis, Chaler Joaquim, Almirall Miriam, Sánchez-Raya Judith, Cano Mireia, Roman-Viñas Blanca
Faculty of Psychology, Education and Sports Sciences, Universitat Ramon Llull, Blanquerna, Barcelona, Spain.
Physical Medicine and Rehabilitation Department, Hospital Egarsat, Barcelona, Spain; EUSES University School of Health and Sports, University of Girona - University of Barcelona, L'Hospitalet de Llobregat, Spain.
J Pain. 2025 Apr;29:104749. doi: 10.1016/j.jpain.2024.104749. Epub 2024 Nov 28.
Fibromyalgia (FM) impacts patients' health status, functioning and quality of life. Accurate diagnosis and effective treatment planning require reliable, valid and responsive measures of these domains. This study aimed to assess the psychometric properties of performance based tests (PBTs) in FM and to quantify the availability of reliable, valid and responsive PBTs linked to key International Classification of Functioning, Disability and Health (ICF) categories related to functional impact. A systematic review was conducted following the PRISMA checklist, and four databases (PubMed, EMBASE, Cochrane Library and Web of Science) were searched. Eligible studies contained information on population, intervention (assessment), and outcomes (PBTs and their psychometric properties). The risk of bias and the methodological quality were assessed according to the COSMIN criteria. Twenty-two studies evaluating twenty-six PBTs were included. PBTs were linked to five ICF categories: exercise tolerance, muscle power and muscle endurance and changing basic body position and walking. The psychometric properties assessed were reliability, validity and responsiveness. The 6 min walking test was the most often assessed PBT with moderate quality of evidence for reliability, and very good methodological quality for validity. Overall, the methodological quality for reliability was rated as doubtful with very low to moderate evidence, for validity we found very good methodological quality with low to high evidence. No studies investigated criterion validity, and construct validity and responsiveness were seldom determined. Clinicians assessing FM patients should carefully select PBTs. Future research on PBTs psychometrics in FM should follow COSMIN recommendations, ensuring control of symptom variability. PERSPECTIVE: This review confirms that the current understanding of the psychometric properties of PBTs for FM patients is limited, hindered by heterogeneous tests and insufficient evidence, complicating outcome comparisons across studies. This gap underscores the need for future research to enhance methodological quality and address missing ICF categories related to FM. REGISTERED PROTOCOL AT PROSPERO: Registration number: CRD42022380709.
纤维肌痛（FM）会影响患者的健康状况、功能和生活质量。准确的诊断和有效的治疗计划需要对这些领域进行可靠、有效且具有反应性的测量。本研究旨在评估基于表现的测试（PBTs）在纤维肌痛中的心理测量特性，并量化与功能影响相关的关键国际功能、残疾和健康分类（ICF）类别相关的可靠、有效且具有反应性的PBTs的可用性。按照PRISMA清单进行了系统综述，并检索了四个数据库（PubMed、EMBASE、Cochrane图书馆和科学网）。符合条件的研究包含有关人群、干预（评估）和结果（PBTs及其心理测量特性）的信息。根据COSMIN标准评估偏倚风险和方法学质量。纳入了22项评估26种PBTs的研究。PBTs与五个ICF类别相关：运动耐力、肌肉力量和肌肉耐力以及改变基本身体姿势和行走。评估的心理测量特性包括可靠性、有效性和反应性。6分钟步行测试是评估最频繁的PBT，可靠性证据质量中等，有效性方法学质量非常好。总体而言，可靠性的方法学质量被评为可疑，证据非常低至中等；对于有效性，我们发现方法学质量非常好，证据低至高。没有研究调查效标效度，很少确定结构效度和反应性。评估纤维肌痛患者的临床医生应仔细选择PBTs。未来关于纤维肌痛中PBTs心理测量学的研究应遵循COSMIN建议，确保控制症状变异性。观点：本综述证实，目前对纤维肌痛患者PBTs心理测量特性的理解有限，受到测试异质性和证据不足的阻碍，使得跨研究的结果比较变得复杂。这一差距凸显了未来研究提高方法学质量并解决与纤维肌痛相关的缺失ICF类别的必要性。在PROSPERO注册的方案：注册号：CRD42022380709。
