Reliability of self-measured objective functional impairment using the timed up and go test in patients with diseases of the spine

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2024-10-02 DOI:10.1007/s00701-024-06293-7

Melvyn R. Lüssi, Gregor Fischer, Lorenzo Bertulli, Martin N. Stienen, Felix C. Stengel

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引用次数: 0

Abstract

Background

Accurate assessment of a patient's functional status is crucial for determining the need for treatment and evaluating outcomes. Objective functional impairment (OFI) measures, alongside patient-reported outcome measures (PROMs), have been proposed for spine diseases. The Timed-Up and Go (TUG) test, typically administered by healthcare professionals, is a well-studied OFI measure. This study investigates whether patient self-measurement of TUG is similarly reliable.

Methods

In a prospective, observational study, patients with spinal diseases underwent two TUG assessments: one measured by a healthcare professional and one self-measured by the patient. Interrater reliability was assessed using the intraclass correlation coefficient (ICC) with a two-way random-effects model, considered excellent between 0.75 – 1.00. Paired t-tests directly compared both measurements. The impact of variables such as age, sex, disease type, symptom severity (via PROMs), comorbidities, and frailty on reliability was also analysed.

Results

Seventy-four patients were included, with a mean age of 62.9 years (SD 17.8); 29 (39.2%) were female. The majority (64.9%) were treated for degenerative disc disease. The lumbo-sacral region was most affected (71.6%), and 47.3% had previous surgeries. Patient self-measurement reliability was excellent (ICC 0.8740, p < 0.001), and the difference between healthcare professional (19.3 ± 9.4 s) and patient measurements (18.4 ± 9.7 s) was insignificant (p = 0.116). Interrater reliability remained high in patients > 65 years (ICC 0.8584, p < 0.001), patients with ASA grades 3&4 (ICC 0.7066, p < 0.001), patients considered frail (ICC 0.8799, p < 0.001), and in patients not using any walking aid (ICC 0.8012, p < 0.001). High symptom severity still showed strong reliability (ICC 0.8279, p < 0.001 for Oswestry Disability Index > 40; ICC 0.8607, p = 0.011 for Neck Disability Index > 40).

Conclusions

Patients with spine diseases can reliably self-measure OFI using the TUG test. The interrater reliability between self-measurements and those by healthcare professionals was excellent across all conditions. These findings could optimize patient assessments, especially in resource-limited settings.

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脊柱疾病患者使用定时起立行走测试自我测量客观功能障碍的可靠性。

背景：准确评估患者的功能状态对于确定治疗需求和评估疗效至关重要。针对脊柱疾病提出了客观功能障碍（OFI）测量方法以及患者报告结果测量方法（PROMs）。通常由医护人员进行的定时起立行走（TUG）测试是一种经过充分研究的功能障碍测量方法。本研究探讨了患者对 TUG 的自我测量是否同样可靠：在一项前瞻性观察研究中，脊柱疾病患者接受了两次 TUG 评估：一次由医护人员测量，一次由患者自我测量。使用双向随机效应模型的类内相关系数（ICC）评估了互测者之间的可靠性，认为在 0.75 - 1.00 之间的互测者可靠性极佳。配对 t 检验直接比较了两种测量结果。此外，还分析了年龄、性别、疾病类型、症状严重程度（通过 PROMs）、合并症和虚弱等变量对可靠性的影响：共纳入 74 名患者，平均年龄为 62.9 岁（标准差为 17.8），其中 29 名（39.2%）为女性。大多数患者（64.9%）因椎间盘退行性病变接受治疗。腰骶部受影响最大（71.6%），47.3%曾接受过手术。患者自我测量的可靠性非常高（ICC 0.8740，p 65岁；ICC 0.8584，p 40岁；颈部残疾指数大于40，ICC 0.8607，p = 0.011）：结论：脊柱疾病患者可以使用 TUG 测试对 OFI 进行可靠的自我测量。结论：脊柱疾病患者可以使用 TUG 测试对 OFI 进行可靠的自我测量，在所有情况下，自我测量结果与医护人员的测量结果之间的交互可靠性都非常好。这些发现可以优化对患者的评估，尤其是在资源有限的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.