适用于膝骨关节炎膝关节置换术围手术期ICF核心分类组合简明版临床评定工具的信度与效度

doi:10.3969/j.issn.1006-9771.2024.09.008

Abstract

Abstract:

Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period (ICSAKOPP).
Methods From May, 2022 to April, 2023, 320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital, China-Japan Friendship Hospital, Peking University First Hospital and Chinese PLA General Hospital. Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty, three days (±one day) after arthroplasty, three weeks (±one week) after arthroplasty, and three months (±one month) after arthroplasty. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded at the same time. Five professionals were asked to score all the items of Brief ICSAKOPP, and the content validity index (CVI) was caculated.
Results A total of 64 cases were dropped down. CVI of all the items of the Brief ICSAKOPP were above 0.8, with a average CVI of the scale of 0.938. The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813. There was a moderate correlation (r = 0.681, P < 0.001) between the overall Brief ICSAKOPP and WOMAC scores, as well as body functional dimension score (r = 0.668, P < 0.001) and activities and participation dimension score (r = 0.657, P < 0.001).
Conclusion Brief ICSAKOPP is good in content validity, internal consistency reliability and criterion validity.

Key words: knee osteoarthritis, arthroplasty, International Classification of Functioning, Disability, and Health, core set, assessment, reliability, validity

CLC Number:

R684.3

YU Boyang, YANG Yanyan, MA Ao, LI Tao, LIU Xiaoxie, LI Zhengyang, DUAN Yajing, LIU Jiaqi, XIE Yuxiao, WANG Cui, HUANG Zhen, ZHANG Lining, LIU Xinyi, JIA Zishan, ZHOU Mouwang. Reliability and validity of assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(9): 1053-1059.

Figures/Tables 6

Table 1

Brief ICSAKOPP"

维度	编码	类目名称	描述
身体功能	b260	本体感受功能	感受身体各部分相对位置的感觉功能包括：静觉和动觉功能不包括：前庭功能(b235)；与肌肉和运动功能有关的感觉(b780)
	b280	痛觉	对预示身体某处受到潜在或实际损害而感到不舒服的感觉包括：在身体一处或多处的全身性或局部性疼痛、皮肤疼痛、刺疼、灼疼、钝疼、疼痛；如肌疼、痛觉缺失和痛觉过敏的损伤
	b710	关节活动功能	关节活动的幅度和灵活性的功能包括：单个或多个关节的活动，椎、肩、肘、腕、髋、膝、踝、手及足部小关节的功能；全身关节活动能力；如关节过度活动、冻关节、冻肩、关节炎的损伤不包括：关节稳定功能(b715)；随意运动控制功能(b760)
	b715	关节稳定功能	维持关节结构完整的功能包括：单关节、多关节和全身关节稳定的功能；如不稳定的肩关节、关节脱位、肩和髋关节脱位的损伤不包括：关节活动功能(b710)
	b730	肌肉力量功能	与肌肉或肌群收缩产生力量有关的功能包括：与特定肌肉和肌群、单肢体肌肉、单侧身体肌肉、下半身肌肉、四肢肌肉、躯干和全身肌肉力量相关的功能；如足和手小肌肉的力量减弱、肌肉轻瘫、肌肉麻痹、单瘫、偏瘫、截瘫、四肢瘫和运动性失语的损伤不包括：眼相邻结构的功能(b215)；肌张力功能(b735)；肌肉耐力功能(b740)
	b770	步态功能	与步行、跑步或其他全身运动相关运动类型的功能包括：步行和跑步类型；如痉挛步态、偏瘫步态、截瘫步态、不对称步态、跛行和强直步态的损伤不包括：肌肉力量功能(b730)；肌张力功能(b735)；随意运动控制功能(b760)；不随意运动功能(b765)
身体结构	s750	下肢的结构	下肢的结构
活动和参与	d410	改变身体的基本姿势	摆出或转换身体姿势并从一处移动到另一处，如从椅子上起来躺到床上，摆出或转换跪下或蹲下的姿势包括：从躺下、蹲下或跪下、从坐或站立、从曲身的姿势变换身体姿势并变换身体重心不包括：移动自身(d420)
	d450	步行	靠脚在地面一步步走动，总是一只脚在地面，如漫步、踱步、向前、后或两侧行走包括：短距离或长距离步行；不同地面步行；绕障碍步行不包括：移动自身(d420)，到处移动 (d455)
	d530	入厕	安排和完成人体废弃物(月经、小便和大便)的排泄，然后清洁身体包括：控制大小便和月经护理不包括：盥洗自身 (d510); 护理身体各部 (d520)
环境因素	e115	个人日常生活用的用品和技术	人们日常活动中使用的设备、用品和技术，包括那些适应性或特殊设计的，放在使用者体内、身上或附近的物品包括：供个人使用的普通和辅助用品及技术不包括：个人护理提供者和个人助手(e340)
	e355	卫生专业人员	所有在卫生系统背景中工作的提供服务的人员，如医生、护士、理疗师、职业医疗师、语言医疗师、听觉医疗师、假肢矫形师或医疗社会工作者不包括：其他专业人员(e360)
	e580	卫生的服务、体制和政策	为预防和处理卫生问题，提供医疗康复和促进健康生活方式而提供的服务、体制和政策不包括：全社会支持的服务、体制和政策(e575)

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References 11

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项目	时间	$\bar{x}±s$
NRS评分	术前
	行走时	5.75±1.84
	休息或睡觉时	1.82±1.78
	术后3 d (±1 d)
	行走时	4.56±1.92
	休息或睡觉时	2.26±1.89
	术后3周(±1周)
	行走时	2.59±1.83
	休息或睡觉时	1.50±1.65
	术后3个月(±1个月)
	行走时	1.71±1.80
	休息或睡觉时	0.82±1.31
WOMAC评分	术前
	疼痛	8.02±2.97
	僵硬	2.67±1.83
	功能	24.90±8.94
	总分	35.60±11.98
	术后3 d (±1 d)
	疼痛	8.24±3.36
	僵硬	3.20±1.85
	功能	38.50±11.86
	总分	49.94±14.43
	术后3周(±1周)
	疼痛	4.64±3.01
	僵硬	2.50±1.47
	功能	21.73±11.46
	总分	28.87±14.02
	术后3个月(±1个月)
	疼痛	2.61±2.35
	僵硬	1.66±1.34
	功能	10.61±7.36
	总分	14.89±9.71

类目	专家评分					I-CVI	Pc	Κ^*	SCVI /AVE
类目	A	B	C	D	E	I-CVI	Pc	Κ^*	SCVI /AVE
b260	2	3	4	4	4	0.80	0.156	0.76	0.938
b280	4	4	4	4	4	1.00	0.041	1.00
b710	4	4	4	4	4	1.00	0.041	1.00
b715	3	4	4	4	4	1.00	0.041	1.00
b730	4	4	4	4	4	1.00	0.041	1.00
b770	2	3	4	4	4	0.80	0.156	0.76
s750	3	3	4	4	4	1.00	0.041	1.00
d410	4	4	4	3	4	1.00	0.041	1.00
d450	4	4	4	4	4	1.00	0.041	1.00
d530	4	4	3	3	4	1.00	0.041	1.00
e115	4	4	3	3	3	1.00	0.041	1.00
e355	4	3	3	2	3	1.00	0.156	0.76
e580	3	3	3	2	3	0.80	0.156	0.76

时间	整体	身体功能	身体结构	活动与参与	环境因素
各时期	0.813	0.701	/	0.731	0.803
术前	0.620	0.556	/	0.567	0.740
术后3 d	0.766	0.544	/	0.724	0.893
术后3周	0.789	0.446	/	0.509	0.897
术后3个月	0.508	0.512	/	0.476	0.665

时间	总体	身体功能	活动与参与
各时期	0.681^a	0.668^a	0.657^a
术前	0.512^a	0.563^a	0.605^a
术后3 d	0.398^a	0.088	0.403^a
术后3周	0.419^a	0.243^b	0.213^b
术后3个月	0.475^a	0.632^a	0.579^a

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Reliability and validity of assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period

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