Katzan Irene L, Li Yadi, McCune Maximos, Lapin Brittany
Center for Outcomes Research & Evaluation, Neurological Institute Cleveland Clinic Cleveland OH USA.
Cerebrovascular Center, Neurological Institute Cleveland Clinic Cleveland OH USA.
J Am Heart Assoc. 2025 May 20;14(10):e039366. doi: 10.1161/JAHA.124.039366. Epub 2025 May 15.
The relationship between self-reported physical function (PF) and objective performance in patients with stroke remains unclear. This study explored how various self-reported health domains influence the correlation between Patient-Reported Outcomes Measurement Information System (PROMIS) PF and the Timed Up and Go (TUG) test.
A retrospective cohort study examined patients with stroke who completed the TUG and PROMIS PF within 90 days post stroke. Correlations between these measures were analyzed, both overall and stratified by performance on other patient-reported outcomes (Quality of Life in Neurological Disorders cognitive function, depression, and the following PROMIS scales: global health, social satisfaction, pain, sleep, and fatigue). Structural equation modeling assessed how these patient-reported outcomes influenced the PROMIS PF-TUG relationship.
There were 432 patients with average age 63.7 (SD 13.5) years. Average TUG and PROMIS PF scores were 16.6 (SD 10.4) seconds and 36.8 (SD 8.5), respectively. TUG and PROMIS PF showed moderate correlation (r=-0.47 [95% CI, -0.54 to -0.40]). Fatigue (r=-0.53 [95% CI, -0.59 to -0.45]) and satisfaction with social roles (r=0.53 [95% CI, 0.45 to 0.60]) had the strongest correlations with PROMIS PF. Both social roles (estimate=0.08, SE=0.02, =0.001) and fatigue (0.06, SE=0.02, =0.001) demonstrated indirect effects on the TUG-PROMIS PF relationship. Although not significant, correlations between PROMIS PF and TUG scores were consistently weaker in patients with poor scores in any patient-reported outcome.
There is only moderate correlation between self-reported PF and the performance measure TUG, which is mediated by fatigue and satisfaction with social roles. These findings highlight the importance of considering these broader dimensions of health in addition to physical capacity when interpreting patient-reported PF scores.
中风患者自我报告的身体功能（PF）与客观表现之间的关系仍不明确。本研究探讨了各种自我报告的健康领域如何影响患者报告结局测量信息系统（PROMIS）PF与定时起立行走（TUG）测试之间的相关性。
一项回顾性队列研究对中风后90天内完成TUG和PROMIS PF的中风患者进行了检查。分析了这些测量指标之间的相关性，包括总体相关性以及按其他患者报告结局（神经疾病生活质量认知功能、抑郁以及以下PROMIS量表：总体健康、社会满意度、疼痛、睡眠和疲劳）的表现进行分层后的相关性。结构方程模型评估了这些患者报告结局如何影响PROMIS PF与TUG之间的关系。
共有432例患者，平均年龄63.7（标准差13.5）岁。TUG和PROMIS PF的平均得分分别为16.6（标准差10.4）秒和36.8（标准差8.5）。TUG和PROMIS PF显示出中度相关性（r = -0.47 [95%可信区间，-0.54至-0.40]）。疲劳（r = -0.53 [95%可信区间，-0.59至-0.45]）和社会角色满意度（r = 0.53 [95%可信区间，0.45至0.60]）与PROMIS PF的相关性最强。社会角色（估计值 = 0.08，标准误 = 0.02，P = 0.001）和疲劳（估计值 = 0.06，标准误 = 0.02，P = 0.001）均对TUG与PROMIS PF之间的关系产生间接影响。尽管不显著，但在任何患者报告结局得分较差的患者中，PROMIS PF与TUG得分之间的相关性始终较弱。
自我报告的PF与表现测量指标TUG之间仅存在中度相关性，这是由疲劳和社会角色满意度介导的。这些发现突出了在解释患者报告的PF得分时，除了身体能力外，考虑这些更广泛健康维度的重要性。
