Zhang Yongni, Gao Yuan, Ai Dongmei, Li Weimin, Zhang Xin, Xu Xiongwei, Zhang NanNan, Yi Yixiong, Hu Haoyu, Yang Songbin, Martin RobRoy L, Lian Xiaowen
Duquesne-China Health Institute, Duquesne University, Pittsburgh, PA, USA.
Department of Rehabilitation Medicine, Zibo Traditional Chinese Medicine Hospital, Zibo, Shandong, China.
BMC Musculoskelet Disord. 2025 Sep 1;26(1):825. doi: 10.1186/s12891-025-09092-y.
A single substantial clinical benefit (SCB) value for the Simplified Chinese Lower Extremity Functional Scale (SC-LEFS) that can be applied to those with lower extremity musculoskeletal injuries is available. However, unique SCB values defined by specific body region and symptom duration may enhance the precision of the SC-LEFS in clinical assessments.
This study aim to determine unique SCB values for the SC-LEFS based on symptom duration and body region. Patients aged 18-50 years referred to physical therapy with a non-arthritic musculoskeletal injury to the knee or ankle/foot completed the SC-LEFS at initial assessment and 4-weeks follow-up. Demographic information and duration of symptoms was also obtained. Patients were grouped based on symptom duration (≤ 3 months or > 3 months). To determine the SCB change score, patients were classified into "improved" and "not improved" groups based on self-report after 4-weeks of physical therapy. SCB values were determined to best distinguish between the two groups. Receiver operator characteristic (ROC) curve analysis defined the sensitivity and specificity for these SCB values.
313 patients with a mean age of 33.7 (SD 9.3) years were included in the knee region analysis and 354 patients with a mean age of 32.9 (SD 9.4) years in the ankle/foot region analysis. For those with knee injuries, SCB values of 9.5 and 5.5 were found for patients with symptom duration ≤ 3 months and symptom duration > 3 months, respectively. For those with ankle/foot injuries, SCB values 12.5 and 8.5 were found for patients with symptom duration ≤ 3 months and symptom duration > 3 months, respectively. The sensitivity and specificity for these SCB values ranged from 0.67 to 0.72 and from 0.66 to 0.68, respectively, with area under the cures (AUC) being between 0.67 and 0.72 (95% confidence intervals: 0.57-0.87).
This study determined specific SCB values for the SC-LEFS after four weeks of physical therapy based on region of injury and symptom duration. These unique values may better allow clinicians to distinguish those "improved" from "not improved" in Chinese-speaking patients with non-arthritic musculoskeletal knee, ankle, or foot injuries.
This project was registered with the Chinese Clinical Trial Registry (ChiCTR2100052104) on 2021-10-17.
适用于下肢肌肉骨骼损伤患者的简化中文版下肢功能量表（SC-LEFS）有单一的实质性临床益处（SCB）值。然而，根据特定身体部位和症状持续时间定义的独特SCB值可能会提高SC-LEFS在临床评估中的准确性。
本研究旨在确定基于症状持续时间和身体部位的SC-LEFS独特SCB值。年龄在18至50岁之间、因非关节炎性肌肉骨骼损伤至膝关节或踝/足部而接受物理治疗的患者在初始评估和4周随访时完成SC-LEFS。还获取了人口统计学信息和症状持续时间。患者根据症状持续时间（≤3个月或>3个月）分组。为了确定SCB变化分数，根据物理治疗4周后的自我报告，将患者分为“改善”和“未改善”两组。确定SCB值以最佳区分两组。受试者工作特征（ROC）曲线分析确定了这些SCB值的敏感性和特异性。
膝关节区域分析纳入了313例平均年龄为33.7（标准差9.3）岁的患者，踝/足部区域分析纳入了354例平均年龄为32.9（标准差9.4）岁的患者。对于膝关节损伤患者，症状持续时间≤3个月和症状持续时间>3个月的患者的SCB值分别为9.5和5.5。对于踝/足部损伤患者，症状持续时间≤3个月和症状持续时间>3个月的患者的SCB值分别为12.5和8.5。这些SCB值的敏感性和特异性分别为0.67至0.72和0.66至0.68，曲线下面积（AUC）在0.67至0.72之间（95%置信区间：0.57-0.87）。
本研究确定了物理治疗4周后基于损伤部位和症状持续时间的SC-LEFS特定SCB值。这些独特的值可能更好地帮助临床医生区分非关节炎性肌肉骨骼膝关节、踝关节或足部损伤的华语患者中“改善”和“未改善”的患者。
本项目于2021年10月17日在中国临床试验注册中心（ChiCTR2100052104）注册。
