康复学报 (Dec 2024)
Reliability and Validity Study of the <italic>International Classification of Functioning</italic>，<italic>Disability and Health Rehabilitation Set</italic> in Rehabilitation of Knee Osteoarthritis
Abstract
ObjectiveTo 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 osteoarthritis (KOA).MethodsA total of 60 KOA patients in the Outpatient Department of Orthopedic Rehabilitation in the Fifth Hospital 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 performance 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 exercise 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 employment (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 correlated 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 negatively 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 employment. 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.ConclusionICF-RS could be used to assess the functional status of KOA patients with good reliability, validity and criterion-related validity.
