慢性腰背痛患者的 12 项世界卫生组织残疾评估表 (WHODAS) 2.0 的最小重要差异。

IF 2 4区 医学 Q2 REHABILITATION
Jessica J Wong, Sheilah Hogg-Johnson, Wouter De Groote, Agnieszka Ćwirlej-Sozańska, Olatz Garin, Montse Ferrer, Àngels Pont Acuña, Pierre Côté
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引用次数: 0

摘要

背景:世界卫生组织残疾评估表 2.0 12 项调查(WHODAS-12)是由世界卫生组织开发的一份问卷,用于测量不同健康状况、文化和环境下的功能。WHODAS-12 由 WHODAS-2.0 36 项调查表中 36 个项目的子集组成。关于慢性腰背痛(LBP)患者 WHODAS-12 的最小重要差异(MID)知之甚少,而最小重要差异将有助于确定康复治疗是否能在一定程度上改善患者的功能。我们的目标是估算慢性腰背痛患者 WHODAS-12 问卷的锚点 MID:我们分析了在欧洲进行的两项队列研究(在我们之前的系统综述中确定)的数据,这些研究使用 WHODAS-36 测量了慢性腰椎间盘突出症成人患者的功能。符合条件的参与者是患有慢性椎管内疼痛的成年人,他们在基线和随访(研究1:治疗后3个月;研究2:出院后1个月)时,以另一项测量指标的得分作为锚点,表示参与者的功能随时间发生了微小但重要的变化[短表-36身体功能(SF36-PF)或Oswestry残疾指数(ODI)]。WHODAS-12得分是12个项目(0-4分)的总和,可能得分范围为0-48分。我们计算了随访时在 SF36-PF 或 ODI 方面取得微小但有意义改善的参与者的 WHODAS-12 平均得分。有意义的改善是指 ODI 的 MID 为 4-16 或 SF36-PF 的 MID 为 5-16:在研究 1 的 70 名符合条件的参与者(平均年龄 = 54.1 岁,SD = 14.7;69% 为女性)中,有 18 人在 SF-36 PF 方面取得了有意义的微小改善。相应的 WHODAS-12 平均变化分数为-3.22/48(95% CI -4.79至-1.64)。在研究 2 的 89 名符合条件的参与者(平均年龄 = 65.5 岁,SD = 11.5;61% 为女性)中,有 50 人的 ODI 得到了有意义的改善。相应的WHODAS-12平均变化分数为-5.99/48(95% CI - 7.20至-4.79):采用基于锚点的方法,WHODAS-12的MID值估计为-3.22(95% CI -4.79至-1.64)或-5.99(95% CI -7.20至-4.79)。这些MID值说明了WHODAS-12在测量功能方面的实用性,以确定康复或其他医疗服务是否实现了对慢性腰椎间盘突出症患者有意义的最小差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Minimal important difference of the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in persons with chronic low back pain.

Background: The World Health Organization Disability Assessment Schedule 2.0 12-item survey (WHODAS-12) is a questionnaire developed by the WHO to measure functioning across health conditions, cultures, and settings. WHODAS-12 consists of a subset of the 36 items of WHODAS-2.0 36-item questionnaire. Little is known about the minimal important difference (MID) of WHODAS-12 in persons with chronic low back pain (LBP), which would be useful to determine whether rehabilitation improves functioning to an extent that is meaningful for people experiencing the condition. Our objective was to estimate an anchor-based MID for WHODAS-12 questionnaire in persons with chronic LBP.

Methods: We analyzed data from two cohort studies (identified in our previous systematic review) conducted in Europe that measured functioning using the WHODAS-36 in adults with chronic LBP. Eligible participants were adults with chronic LBP with scores on another measure as an anchor to indicate participants with small but important changes in functioning over time [Short-form-36 Physical Functioning (SF36-PF) or Oswestry Disability Index (ODI)] at baseline and follow-up (study 1: 3-months post-treatment; study 2: 1-month post-discharge from hospital). WHODAS-12 scores were constructed as sums of the 12 items (scored 0-4), with possible scores ranging from 0 to 48. We calculated the mean WHODAS-12 score in participants who achieved a small but meaningful improvement on SF36-PF or ODI at follow-up. A meaningful improvement was an MID of 4-16 on ODI or 5-16 on SF36-PF.

Results: Of 70 eligible participants in study 1 (mean age = 54.1 years, SD = 14.7; 69% female), 18 achieved a small meaningful improvement based on SF-36 PF. Corresponding mean WHODAS-12 change score was - 3.22/48 (95% CI -4.79 to -1.64). Of 89 eligible participants in study 2 (mean age = 65.5 years, SD = 11.5; 61% female), 50 achieved a small meaningful improvement based on ODI. Corresponding mean WHODAS-12 change score was - 5.99/48 (95% CI - 7.20 to -4.79).

Conclusions: Using an anchor-based approach, the MID of WHODAS-12 is estimated at -3.22 (95% CI -4.79 to -1.64) or -5.99 (95% CI - 7.20 to -4.79) in adults with chronic LBP. These MID values inform the utility of WHODAS-12 in measuring functioning to determine whether rehabilitation or other health services achieve a minimal difference that is meaningful to patients with chronic LBP.

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来源期刊
Chiropractic & Manual Therapies
Chiropractic & Manual Therapies Medicine-Complementary and Alternative Medicine
CiteScore
3.20
自引率
15.80%
发文量
48
审稿时长
20 weeks
期刊介绍: Chiropractic & Manual Therapies publishes manuscripts on all aspects of evidence-based information that is clinically relevant to chiropractors, manual therapists and related health care professionals. Chiropractic & Manual Therapies is an open access journal that aims to provide chiropractors, manual therapists and related health professionals with clinically relevant, evidence-based information. Chiropractic and other manual therapies share a relatively broad diagnostic practice and treatment scope, emphasizing the structure and function of the body''s musculoskeletal framework (especially the spine). The practices of chiropractic and manual therapies are closely associated with treatments including manipulation, which is a key intervention. The range of services provided can also include massage, mobilisation, physical therapies, dry needling, lifestyle and dietary counselling, plus a variety of other associated therapeutic and rehabilitation approaches. Chiropractic & Manual Therapies continues to serve as a critical resource in this field, and as an open access publication, is more readily available to practitioners, researchers and clinicians worldwide.
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