腰痛功能障碍评价量表QBPDS、ODI、RMDQ的比较研究  

Comparative study of scales measuring lumbar disability:QBPDS,ODI and RMDQ

作　　者：梁元文 陈红[1] 陈千吉 李晓泉 兰晓雪 高艺轩 安易 刘长信[1] 訾一路 邵辉 杨晓明[1] 郭俊明[1] 翁志文[1] 章乃文 马敬祎 孙亚男[6] 于长禾[1] LIANG Yuan-wen;CHEN Hong;CHEN Qian-ji;LI Xiao-quan;LAN Xiao-xue;GAO Yi-xuan;AN Yi;LIU Chang-xin;ZI Yi-lu;SHAO Hui;YANG Xiao-ming;GUO Jun-ming;WENG Zhi-wen;ZHANG Nai-wen;MA Jing-yi;SUN Ya-nan;YU Chang-he(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;The first clinical department,Beijing University of Chinese Medicine,Beijing 100700,China;Shenzhen Luohu Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong 518001,China;Department of Rehabilitation,Shenyang Red Cross Central Hospital,Shenyang,Liaoning 110001,China;Aerospace Center Hospital,Beijing 100049,China;Department of Traditional Chinese Medicine,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学第一临床医学院,北京100700 [3]深圳市罗湖区中医院,广东深圳518001 [4]沈阳市红十字会中心医院康复科,辽宁沈阳110001 [5]航天中心医院,北京100049 [6]首都医科大学宣武医院中医科,北京100053

出　　处：《颈腰痛杂志》2024年第6期1040-1046,共7页The Journal of Cervicodynia and Lumbodynia

基　　金：国家自然科学基金青年项目(编号:81803956);首都卫生发展科研专项青年优才项目(编号:首发2020-4-4195)。

摘　　要：目的检验并比较测量腰痛功能障碍的3个量表QBPDS、ODI和RMDQ的测量性能。方法采取横断面和纵向疗效评价的研究设计,将7个量表人工分为2组,组合1包括RMDQ、VAS、SF-12v2,组合2包括ODI、QBPDS、NRS、EQ-5D-5L,然后将2组量表进行随机后纳入腰痛患者填写,最终测评3个量表的结构效度、聚合效度、内部一致性、反应度以及天花板和地板效应。结果QBPDS EFA提取出2个特征值大于1的公因子,根据EFA结果建立模型进行CFA,模型拟合度较差。QBPDS与ODI、EQ-5D-5L UI、EQ-5D-5L VAS呈较高至高相关性,内部一致性高,反应度高。无天花板及地板效应。ODI的CFA显示,其单维度结构模型拟合度尚可。其与EQ-5D-5L UI与EQ-5D-5L VAS呈较高至高相关性。内部一致性高,反应度高。无天花板及地板效应。RMDQ EFA提取出6个特征值大于1的公因子,根据EFA结果删除部分条目建立模型进行CFA,模型拟合度不理想。其与SF-12v2 MCS及PCS部分一般高相关性。内部一致性高,反应度低。无天花板及地板效应。结论综合测量性能结果,认为QBPDS、ODI量表测量中国腰痛人群腰部功能障碍情况的性能更佳。但尚不能形成三个量表应用的推荐意见。Objective To examine and compare the measurement properties of three scales measuring lumbar disability:QBPDS,ODI,and RMDQ.Methods A cross-sectional study and longitudinal evaluation of clinical therapeutic effect study design was adopted.Seven scales were manually divided into two groups.Group 1 included RMDQ,VAS and SF-12v2.Group 2 included ODI,QBPDS,NRS and EQ-5D-5L.Then the two groups of scales were randomized and patients with low back pain were included to fill in the scale combination.Finally,construct validity,aggregation validity,internal consistency,responsiveness,and ceiling and floor effects of the three scales were evaluated.Results QBPDS EFA extracted 2 common factors with eigenvalues greater than 1.A model was built for CFA based on the EFA results,and the model fit was poor.QBPDS showed good to very good correlations with ODI,EQ-5D-5L UI,and EQ-5D-5L VAS with high internal consistency and high responsiveness.No ceiling and floor effects.The CFA of ODI showed a fair fit of its unidimensional structural model.Its correlation with EQ-5D-5L UI and EQ-5D-5L VAS was good to very good.Internal consistency and responsiveness was high.No ceiling and floor effects.RMDQ EFA extracted six common factors with eigenvalues greater than 1.The model was built for CFA by removing some entries based on EFA results,and the model fit was poor.Its correlation with the SF-12v2 MCS and PCS sections was generally high.Internal consistency was high.Responsiveness was small.No ceiling and floor effects.Conclusion Based on the results of measurement properties,it is believed that the measurement properties of QBPDS and ODI for lumbar disability in Chinese people with low back pain are better.However,recommendations for the application of the three scales cannot be formed.

关 键 词：患者报告结局 量表 效度 信度 反应度 腰痛 腰部功能障碍 QBPDS ODI RMDQ 

分 类 号：R493[医药卫生—康复医学] R681.5[医药卫生—临床医学]