Karimijashni Motahareh, Abtahi Forough, Abbasalipour Shokoofih, Dabbagh Armaghan, Ranjbar Parisa, Westby Marie, Ramsay Tim, Beaulé Paul, Poitras Stéphane
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
J Eval Clin Pract. 2025 Feb;31(1):e14307. doi: 10.1111/jep.14307.
One of the important considerations to select the appropriate outcome measures is determining if the tool is relevant to patients. Despite the availability of various performance-based tests to objectively assess function, it is unknown which performance-based tests best capture important aspects of function after hip or knee arthroplasty.
Our systematic review aimed to identify the existing performance-based tests used in hip or knee arthroplasty and link the activity component of each test to the modified International Classification of Functioning, Disability and Health (ICF) core set for osteoarthritis (OA).
We searched four databases from inception until April 2024. A performance-based test was included if an individual performs one or more activities, evaluated by an assessor and resulted in a numerical value. Two reviewers independently screened and extracted data and assessed the included performance-based tests.
From 449 studies included in this review, we identified 28 performance-based tests which covered 15 categories of OA core set activity and participation. The categories of d4500:walking short distances, d4104:standing and d4103:sitting were the most frequently used, employed in 14, 10 and 10 performance-based tests, respectively. However, 34 categories of activity and participation were not found in any performance-based tests. A-test ('A' like Activity or Assessment) had the widest coverage covering 10 out of 49 core set categories. Four performance tests covered four activity and participation categories, one covered three categories, 10 covered two categories and 12 covered one category.
Our ICF-based content analysis revealed that the existing performance-based tests covered certain OA core set activity and participation categories, but overlooked multiple categories. This analysis can serve as a guide for researchers and clinicians in selecting suitable performance-based tests or a battery of tests to assess function following hip or knee arthroplasty.
选择合适的结局指标时的重要考量之一是确定该工具是否与患者相关。尽管有各种基于表现的测试可用于客观评估功能，但尚不清楚哪些基于表现的测试能最好地捕捉髋或膝关节置换术后功能的重要方面。
我们的系统评价旨在识别髋或膝关节置换术中使用的现有基于表现的测试，并将每个测试的活动部分与骨关节炎（OA）的改良国际功能、残疾和健康分类（ICF）核心集相联系。
我们从数据库创建至2024年4月进行了检索。如果个体执行一项或多项活动，由评估者进行评估并得出数值，则纳入一项基于表现的测试。两名评审员独立筛选和提取数据，并评估纳入的基于表现的测试。
在本评价纳入的449项研究中，我们识别出28项基于表现的测试，这些测试涵盖了OA核心集活动和参与的15个类别。d4500：短距离行走、d4104：站立和d4103：坐这些类别使用最为频繁，分别在14项、10项和10项基于表现的测试中被采用。然而，在任何基于表现的测试中均未发现34个活动和参与类别。A测试（“A”类活动或评估）覆盖范围最广，涵盖了49个核心集类别中的10个。四项表现测试涵盖四个活动和参与类别，一项涵盖三个类别，10项涵盖两个类别，12项涵盖一个类别。
我们基于ICF的内容分析表明，现有的基于表现的测试涵盖了某些OA核心集活动和参与类别，但忽略了多个类别。该分析可为研究人员和临床医生选择合适的基于表现的测试或一组测试以评估髋或膝关节置换术后的功能提供指导。
