《国际功能、残疾和健康分类康复组合》在膝骨关节炎康复应用中的信效度研究OACSTPCD

Objective To explore the reliability and validity of the International Classification of Functioning,Disability and Health Rehabilitation Set(ICF-RS)in assessing the body function,activities and social participation of patients with knee osteoar-thritis(KOA).Methods A total of 60 KOA patients in the Outpatient Department of Orthopedic Rehabilitation in the Fifth Hospi-tal of Xiamen and the Xiangyang Central Hospital from October to December 2022 were recruited.The ICF-RS was used to assess the patients'function;the criterion-related validity between the ICF-RS scale and the commonly used clinical scales for knee joints[visual analogue scale(VAS)for pain,hospital for special surgery(HSS)knee score,modified Barthel index(MBI)and 36-item short form health survey(SF-36)]was used to evaluate the effectiveness of ICF-RS scale in assessing the function and activity per-formance of patients with KOA.Internal consistency and item discriminant validity were used to evaluate reliability and validity of the ICF-RS.Results(1)ICF-RS functional status:about 60%of KOA patients had no or mild functional impairments.The most common moderate to severe impairments in body function domain included b280 sensation of pain(54 cases,90.00%),b455 exer-cise tolerance(44 cases,73.33%),and b134 sleep function(28 cases,46.67%);the most common moderate to severe impairments in activities included d455 moving around(52 cases,86.67%)and d410 changing basic body position(30 cases,50.00%);the most common moderate to severe impairments in participation included d660 assisting others(38 cases,63.33%),d850 remunerative em-ployment(32 cases,53.33%)and d920 recreation and leisure(38 cases,63.33%).(2)Criterion-related validity:the ICF-RS body function score was negatively correlated with HSS score(|r|>0.4,P<0.05),the ICF-RS physical activity score was negatively corre-lated with the MBI,HSS and the bodily pain dimension score of SF-36(|r|>0.6,P<0.05).The ICF-RS participation score was nega-tively correlated with the MBI and HSS scores(|r|>0.6,P<0.05).(3)Reliability and validity analysis:the Cronbach's α for the ICF-RS of KOA patients was 0.932(P<0.05).The Cronbach's α coefficients for the remaining items of the ICF-RS decreased except for deleting b620 urinary function,b730 muscle strength function,d710 basic interpersonal interactions and d850 remunerative employ-ment.70.00%(21/30)of the items showed significantly differences in distinguishing between mild and severe dysfunctions,in which items with|r|>0.8 could effectively distinguish KOA patients with high and low score function,including d420 changing body position,d510 washing oneself,d640 doing household chores and d470 using transportation.Conclusion ICF-RS could be used to assess the functional status of KOA patients with good reliability,validity and criterion-related validity.