Anita M Klukowska, Olga Ciobanu-Caraus, Menno R Germans, W Peter Vandertop, Marc L Schröder, Victor E Staartjes
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引用次数: 0
Abstract
Background context: There has been no recent updated comprehensive review of measurement properties focused on the 5-repetition sit-to-stand test (5R-STS) in patients with lumbar degenerative disorders (LDD) that could aid in better understanding of its clinical and research applicability.
Purpose: The aim of this systematic review was to summarize evidence on measurement properties of the 5R-STS in patients with LDD according to COnsensus Based Standards for the Selection of Health Measurement INstruments (COSMIN) guidelines.
Design: Systematic review and meta-analysis.
Patient sample: In Step 1 and 2, 3,363 and 1,287 adult patients with suspected or diagnosed either clinically and/or radiologically LDD were included, respectively. Step 2 involved screening studies from Step 1 that passed the full text-stage and including only those that assessed at least 1 COSMIN measurement property.
Outcome measures: Functional Measures (5R-STS, Timed Up and Go Test). Self-report Measures (including Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire, pain scores eg, Visual Analogue Scale) and health-care quality of life questionnaires (eg, EQ-5D-3L)).
Methods: In December 2022 Embase, PubMed/Medline, Web of Science and Scopus were searched for studies of 5R-STS of patients with LDD (PROSPERO: CRD42022383095). Quality of evidence was assessed using GRADE and COSMIN Checklist. Results for measurement error were pooled using the weighted mean method. Random effect meta-analysis was performed for studies on reliability and criterion validity.
Results: Thirty-eight full-text articles were included in Step 1 and 19 in Step 2. The overall intraclass correlation coefficient (ICC) of test-retest reliability and inter-rater reliability of the 5R-STS was 0.93 (95% CI 0.37-1.00) and 0.99 (95% CI 0.83-1.00), respectively. The weighted standard error of measurement (SEM) mean value was 2.8s. Estimated r of 5R-STS and ODI, reflecting insufficient criterion validity (since r <0.70), was 0.53 (95% CI 0.17-0.88). Hypothesis testing for construct validity was confirmed for 40% of predefined hypothesis (graded as insufficient since overall, not >70% hypothesis confirmed). Accounting for limited evidence, responsiveness of the test was adequate.
Conclusion: This COSMIN systematic review summarizes 5R-STS measurement properties in patients with LDD, including pooled estimates of ICC for reliability, SEM, and correlation between 5R-STS and ODI. The 5R-STS is a reliable and responsive instrument reflecting a new dimension of functional impairment in patients with LDD.
背景：目前还没有针对腰椎退行性疾病（LDD）患者的5次重复坐立试验（5R-STS）测量特性的最新综合综述，这有助于更好地理解其临床和研究适用性。目的：本系统综述的目的是根据基于共识的健康测量仪器选择标准（COSMIN）指南，总结LDD患者5R-STS测量特性的证据。设计：系统回顾和荟萃分析。患者样本：在步骤1和步骤2中，分别纳入3363例和1287例临床和/或放射学上疑似或诊断为LDD的成年患者。步骤2涉及筛选步骤1中通过全文阶段的研究，并且只包括那些评估了至少一个COSMIN测量特性的研究。结果测量：功能测量（5R-STS, Timed Up and Go Test）。自我报告测量（包括Oswestry残疾指数（ODI）、Roland Morris残疾问卷、疼痛评分（如视觉模拟量表）和医疗保健生活质量问卷（如EQ-5D-3L））。方法：于2022年12月检索Embase、PubMed/Medline、Web of Science和Scopus，检索LDD患者5R-STS的相关研究（PROSPERO: CRD42022383095）。使用GRADE和COSMIN检查表评估证据质量。测量误差结果采用加权平均法进行汇总。对信度和效度的研究进行随机效应荟萃分析。结果：步骤1共纳入38篇全文文章，步骤2共纳入19篇全文文章。5R-STS的重测信度和评估间信度总体类内相关系数（ICC）分别为0.93 （95%CI 0.37 ~ 1.00）和0.99 （95%CI 0.83 ~ 1.00）。加权标准误差（SEM）均值为2.8s。估计5R-STS和ODI的r，反映了标准效度不足（因为r 70%的假设得到证实）。考虑到有限的证据，测试的反应性是足够的。结论：这篇COSMIN系统综述总结了LDD患者的5R-STS测量特性，包括ICC的可靠性、SEM和5R-STS与ODI之间的相关性的汇总估计。5R-STS是一种可靠且反应灵敏的仪器，反映了LDD患者功能损害的新层面。
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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