腰痛患者身体功能测试的心理测量特征及临床实用性

Psychometric characteristics and clinical usefulness of physical performance tests in patients with low back pain.

作者信息

Simmonds M J, Olson S L, Jones S, Hussein T, Lee C E, Novy D, Radwan H

机构信息

School of Physical Therapy, Texas Woman's University, Houston, USA.

出版信息

Spine (Phila Pa 1976). 1998 Nov 15;23(22):2412-21. doi: 10.1097/00007632-199811150-00011.

DOI:10.1097/00007632-199811150-00011

PMID:9836355

Abstract

STUDY DESIGN

The psychometric properties and clinical use of a battery of physical performance measures were tested on 44 patients with low back pain and 48 healthy, pain-free control subjects.

OBJECTIVES

Reliability, validity, and clinical use of nine physical performance measures were evaluated.

SUMMARY OF BACKGROUND DATA

Although physical performance measures have potential use in evaluation, treatment planning, and determination of treatment outcome, there is sparse systematic investigation of their reliability, validity, and clinical use.

METHODS

Forty-four subjects with low back pain and 48 healthy pain-free subjects participated. The following physical performance measures were tested: distance walked in 5 minutes; 50-foot walk at fastest speed; 50-foot walk at preferred speed; 5 repetitions of a sit-to-stand task; 10 repetitions of a repeated trunk flexion task; timed up-and-go task; unloaded forward reach task; loaded forward reach task; and Sorensen fatigue test. Subjects were assessed twice on 2 days.

RESULTS

All measures had excellent intertester reliability (intraclass correlation coefficient [ICC]1,1 > 0.95). Test-retest (within session) reliability was adequate for all measures (ICC1,1 > 0.83) except repeated trunk flexion (ICC1,1 > 0.45) in the low back pain group. Test-retest (day-to-day) reliability ranged between 0.59 and 0.88 in the low back pain group and between 0.46 and 0.76 in the control group. Day-to-day reliability improved when the averages of two trials of repeated trunk flexion and sit-to-stand were used (0.76-0.91 low back pain group and 0.62-0.89 control group). Results of a multivariate analysis of variance showed a significant effect of group (F10,65 = 3.52, P = 0.001). Results of univariate analyses showed significant group differences on all measures except the 50-foot walk at preferred speed and unloaded forward reach. Self-report of disability was moderately correlated with the performance tasks (r = 0.400 to -0.603).

CONCLUSIONS

The results provide support for the use of these physical performance measures as a complement to patient self-report.

摘要

研究设计

对44例腰痛患者和48例无疼痛的健康对照受试者进行了一系列身体功能测量指标的心理测量特性及临床应用测试。

目的

评估9项身体功能测量指标的信度、效度及临床应用情况。

背景资料概述

尽管身体功能测量指标在评估、治疗计划制定及治疗效果判定方面具有潜在用途，但对其信度、效度及临床应用的系统研究较少。

方法

44例腰痛受试者和48例无疼痛的健康受试者参与研究。测试了以下身体功能测量指标：5分钟步行距离；50英尺最快速度步行；50英尺偏好速度步行；5次坐立任务；10次重复躯干前屈任务；计时起立行走任务；无负重前伸任务；负重前伸任务；以及索伦森疲劳试验。受试者在两天内接受两次评估。

结果

所有测量指标的测试者间信度均极佳（组内相关系数[ICC]1,1>0.95）。除腰痛组的重复躯干前屈（ICC1,1>0.45）外，所有测量指标的重测（日内）信度均足够（ICC1,1>0.83）。腰痛组的重测（日间）信度在0.59至0.88之间，对照组在0.46至0.76之间。当使用重复躯干前屈和坐立两次试验的平均值时，日间信度有所提高（腰痛组为0.76 - 0.91，对照组为0.62 - 0.89）。多因素方差分析结果显示组间有显著效应（F10,65 = 3.52，P = 0.001）。单因素分析结果显示，除50英尺偏好速度步行和无负重前伸外，所有测量指标在组间均有显著差异。残疾自评与功能任务表现呈中度相关（r = 0.400至 - 0.603）。