国际活动量问卷用于全膝关节置换术后患者活动量评估的信度和效度研究

摘要

Objective:To investigate the reliability and validity of international physical activity questionnaire (IPAQ) for assessing the activity level of total knee replacement(TKR) patients,and provide a reliable and valid instrument for patients to assess the activity level.Method:One hundred and fifty-five TKR patients used IPAQ and pedometer,respectively,to record the activity level for 7 consecutive days.The intraclass correlation coefficient and Kappa coefficient were used to prove reliability and validity of IPAQ.Result:Compared with pedometer,IPAQ had high reliability (P＜0.01),the lowest ICC (0.904; 95％ CI∶0.846-0.940) exited in the low activity,the highest ICC (0.964; 95％ CI∶ 0.942-0.977) exited in total physical activity; The validity of IPAQ was evaluated with Kappa coefficient.The validity in the first group (50-60years old) and the second group (61-70 years old) were relatively higher (Kappa coefficient:0.627,0.892;P＜0.001),in the third group (＞71 years old) was slightly lower (0.241; P=0.067).The ANOVA test showed that the accuracy of classification of IPAQ was affected by body mass index (BMI),education level,number of family members in the third group.Conclusion:The IPAQ showed good reliability and validity for TKR patients with the age of 50-70years old,and it could be a method for assessing the activity level of TKR patients.IPAQ was affected by many factors on assessing the activity level of TKR patients aged above 71years old.So it might need a modification,or to find other methods.%目的:探讨国际活动量问卷(IPAQ)用于全膝关节置换术(TKR)后患者活动量的评估的信度和效度,为TKR术后患者活动量的测量提供一个准确可靠的康复评估工具.方法:TKR术后患者155例,分别用IPAQ和计步器来记录连续7d的活动量,用组内相关系数和Kappa系数分别来证实其信度和效度.结果:与计步器相比,IPAQ的组内相关系数(ICC)的范围0.904-0.964,具有较高的可靠性(P＜ 0.01).低强度活动有最低ICC (0.904; 95％ CI:0.846-0.940),最高的ICC (0.964; 95％CI:0.942-0.977)出现在总的体力活动.通过Kappa系数来判断IPAQ的准确性,在第一组(50-60岁)和第二组(61-70岁)中有比较好的准确性(0.627,0.892;P＜0.001),第三组(＞71岁)准确性稍低(0.241；P=0.067).方差检验发现,第三组IPAQ的分级准确性受到了体质指数、教育程度、家庭成员的影响.结论:IPAQ用于TKR术后患者活动量的评估在50-70岁的人群中,显示了比较好的信度和效度,可用于TKR术后患者活动量的康复评估.在＞71岁的TKR术后患者活动量评估时受到了多种影响.