膝骨性關節炎病患之臨床測試對其失能程度的預測

Background and purposes: Physical therapy is usually aimed at reducing symptoms from musculoskeletal disorders. It is beneficial to predict the extent of disability from clinical measures for a clinician. Studies have shown that many clinical measures demonstrate significantly moderate correlations with disability. They may potentially be predictors of a disability score. The purposes of this study were 1) to investigate the correlation between clinical measures including the passive range of motion, pain, muscle strength, body mass index, stair climbing performance, and disability in patients with knee osteoarthritis, and 2) to develop a predictive equation based on clinical measures for disability in patients with knee osteoarthritis. Methods: Thirty outpatients (16 females, 14 males; aged 63.8± 11.9 years) of knee osteoarthritis volunteered the study and were evaluated using the following clinical measures: passive range of motion of hip extension, hip external rotation and knee flexion from both legs, isokinetic muscle strength of 30% from bilateral knee extension, body mass index, time to go up and down a flight of stairs with 11 steps and the WOMAC disability score. The Pearson correlation coefficients were calculated to investigate the relationships between the 6 clinical measures. The stepwise regression was utilized to identify significant predictors and its predictive model for the disability score. Results: The significant correlation coefficients were between ROM and strength (r=0.41, p＜0.0 5), between BMI and pain (r=0.60,p＜0.01), between pain and disability (r=0.73,p＜0.01), between BMI and disability (r = 0.64, p ＜ 0.01), and between the stair climbing performance and disability (r=0.49, p＜0.0l). Pain and the stair climbing performance were the two significant predictors for disability. The equation is: WOMAC total score= -0.30 + 0.66×(pain subscale of WOMAC)+ 0.35 × (time to go up and down a flight of stair with 11 steps). Around 63% of the variance of WOMAC total score was accounted for by the two predictors. Conclusion: Pain and the stair climbing performance are most important predictive clinical measures for disability in subjects with knee osteoarthritis. (FJPT 2004;29(4):233-241)