RESUMO
OBJECTIVE: To tested the reliability and validity of Aofas in a sample of rheumatoid arthritis patients. METHODS: The scale was applicable to rheumatoid arthritis patients, twice by the interviewer 1 and once by the interviewer 2. The Aofas was subjected to test-retest reliability analysis (with 20 Rheumatoid arthritis subjects). The psychometric properties were investigated using Rasch analysis on 33 Rheumatoid arthritis patients. RESULTS: Intra-Class Correlation Coefficient (ICC) were (0.90Assuntos
Artrite Reumatoide/fisiopatologia
, Ortopedia/normas
, Psicometria
, Inquéritos e Questionários/normas
, Brasil
, Humanos
, Ortopedia/métodos
, Qualidade de Vida
, Reprodutibilidade dos Testes
, Perfil de Impacto da Doença
, Sociedades Médicas
, Estados Unidos
RESUMO
Resumo Objetivo: Testar a confiabilidade e a validade do escore Aofas em uma amostra de pacientes com artrite reumatoide. Métodos: A escala foi aplicada a pacientes com artrite reumatoide, duas vezes pelo entrevistador 1 e uma vez pelo entrevistador 2. O Aofas foi submetido a exame de confiabilidade teste-reteste (com 20 indivíduos com artrite reumatoide). As propriedades psicométricas foram investigadas pela análise Rasch em 33 pacientes com artrite reumatoide. Resultados: O coeficiente de correlação intraclasse (CCI) foi de 0,90 < CCI < 0,95 (p < 0,001) para a confiabilidade intraexaminador e 0,75 < CCI < 0,91 (p < 0,001) para a confiabilidade interexaminador. O índice de separação dos indivíduos foi de 1,9 e 4,75 para os itens. Isso demonstra que os pacientes se dividiam em três níveis de habilidade e os itens foram divididos em seis níveis de dificuldades. A análise Rasch mostrou que oito itens foram satisfatórios. Foi identificado um item errôneo, que mostrou percentuais acima dos 5% permitidos pelo modelo estatístico. Além disso, o modelo Rasch sugeriu a revisão do item 8 original. Conclusões: Os resultados sugerem que a versão brasileira do Aofas apresenta confiabilidade adequada, validade de constructo e estabilidade de resposta. Esses resultados indicam que a escala de tornozelo-retropé Aofas apresenta um potencial significativo de aplicabilidade clínica em indivíduos com artrite reumatoide. Outros estudos em populações com outras características já estão em andamento.
Abstract Objective: To tested the reliability and validity of Aofas in a sample of rheumatoid arthritis patients. Methods: The scale was applicable to rheumatoid arthritis patients, twice by the interviewer 1 and once by the interviewer 2. The Aofas was subjected to test-retest reliability analysis (with 20 Rheumatoid arthritis subjects). The psychometric properties were investigated using Rasch analysis on 33 Rheumatoid arthritis patients. Results: Intra-Class Correlation Coefficient (ICC) were (0.90 < ICC < 0.95; p < 0.001) for intra-observer reliability and (0.75 < ICC < 0.91; p < 0.001) for inter-observer reliability. Subjects separation rates were 1.9 and 4.75 for the items, showing that patients fell into three ability levels, and the items were divided into six difficulties levels. The Rasch analysis showed that eight items was satisfactory. One erroneous item have been identified, showing percentages above the 5% allowed by the statistical model. Further Rasch modeling suggested revising the original item 8. Conclusions: The results suggest that the Brazilian versions of Aofas exhibit adequate reliability, construct validity, response stability. These findings indicate that Aofas Ankle-Hindfoot scale presents a significant potential for clinical applicability in individuals with rheumatoid arthritis. Other studies in populations with other characteristics are now underway.
Assuntos
Humanos , Ortopedia/normas , Artrite Reumatoide/fisiopatologia , Psicometria , Inquéritos e Questionários/normas , Ortopedia/métodos , Qualidade de Vida , Sociedades Médicas , Estados Unidos , Brasil , Reprodutibilidade dos Testes , Perfil de Impacto da DoençaRESUMO
PURPOSE: This meta-analysis examined the effects of foot orthoses (FO) on pain and disability in rheumatoid arthritis (RA) patients. METHODS: MEDLINE, Cochrane Controlled Trials Register, EMBASE, SPORT Scielo, and CINAHL were searched through July 2014 for randomized controlled trials (RCTs) examining the effects of orthoses on pain and disability in RA patients. Two reviewers selected studies independently. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. RESULTS: Three studies, involving 110 patients who received FO and 108 control patients, met the study criteria. Relative to controls, FO had a positive impact on pain (WMD 0.40; 95% CI 0.04-0.57). Between group differences in disability were not statistically significant. CONCLUSIONS: FO may improve pain in RA patients, but their impact on disability remains undetermined. Additional large RCTs are needed to investigate the effects of these devices in RA patients. Implications for Rehabilitation The use of foot orthoses (FO) often part of the conservative treatment of patients with rheumatoid arthritis (RA). However, the indication of these devices is usually empiric. Thus, the results of this meta-analysis can provide guidance to rehabilitation professionals to undertake these devices to therapeutic programs. There is no consensus among rehabilitation professionals regarding the efficacy of FO improved pain and disability in patients with RA. The results of this meta-analysis suggest that the use of the FO improves pain but has no impact on disability. Thus, rehabilitation professionals, from reading this article will make clear to their patients that benefit of the FO is exclusively in pain improvement. Healthcare professionals and organizations should take into account the costs of production of FO during the definition of the therapeutic program. In case of low cost, the effect on improvement of pain in the feet can justify the indication of these devices to a patient with RA.