理学療法ジャーナル53巻7号

2019年07月発行

報告

人工関節置換術後患者における日本語版Forgotten joint scoreの再現性と妥当性

著者： 古谷英孝¹² 廣幡健二³ 美﨑定也⁴ 相澤純也³ 杉本和隆⁵

所属機関： ¹苑田第三病院リハビリテーション科 ²苑田会東京脊椎脊髄病センター ³東京医科歯科大学スポーツ医歯学診療センター ⁴苑田会人工関節センター病院リハビリテーション科 ⁵苑田会人工関節センター病院整形外科

ページ範囲：P.742 - P.750

要旨　【目的】人工関節置換術後患者の手術した関節への意識の程度を評価できる評価尺度であるForgotten joint score（以下，FJS-12）の日本語版を作成し，再現性と妥当性を検討した．【方法】質問票の異文化適応プロセスガイドラインに準じて日本語版を作成した．再現性は人工膝および股関節置換術患者55名に対する再テスト法にて，級内相関係数とBland-Altman分析を用いて検討した．妥当性は288名を対象に，日本語版FJS-12と身体機能，患者立脚型アウトカムとの関連について単相関分析を用いて検討した．【結果】級内相関係数は0.85以上と高値であり，Bland-Altman分析から系統誤差は確認されなかった．単相関分析の結果，日本語版と身体機能，患者立脚型アウトカムに有意な関連を認めた．床・天井効果は認められなかった．【結論】日本語版FJS-12は再現性と妥当性を兼ね備えた質問票である．

参考文献

1）Jones CA, et al：Health related quality of life outcomes after total hip and knee arthroplasties in a community based population. J Rheumatol 2000；27：1745-1752

2）Hawker G, et al：Health-related quality of life after knee replacement. J Bone Joint Surg Am 1998；80：163-173

3）Bade MJ, et al：Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther 2011；41：932-941

4）Gremeaux V, et al：Low-frequency electric muscle stimulation combined with physical therapy after total hip arthroplasty for hip osteoarthritis in elderly patients：a randomized controlled trial. Arch Phys Med Rehabil 2008；89：2265-2273

5）Janse AJ, et al：Quality of life：patients and doctors don't always agree：a meta-analysis. J Clin Epidemiol 2004；57：653-661

6）Bellamy N, et al：Validation study of WOMAC：a health status instrument for measuring clinically-important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. J Rheumatol 1988；15：95-108

7）Dawson J, et al：Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 1998；80：63-69

8）Dawson J, et al：Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br 1996；78：185-190

9）Marx RG, et al：Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Joint Surg Am 2005；87：1999-2005

10）Loughead JM, et al：Outcome following knee arthroplasty beyond 15 years. Knee 2008；15：85-90

11）Richards CJ, et al：Conversion of hip arthrodesis to total hip arthroplasty：survivorship and clinical outcome. J Arthroplasty 2011；26：409-413

12）Behrend H, et al：The“forgotten joint”as the ultimate goal in joint arthroplasty：validation of a new patient-reported outcome measure. J Arthroplasty 2012；27：430-436

13）Bullens PH, et al：Patient satisfaction after total knee arthroplasty：a comparison between subjective and objective outcome assessments. J Arthroplasty 2001；16：740-747

14）Beaton DE, et al：Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000；25：3186-3191

15）Terwee CB, et al：Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007；60：34-42

16）Landis JR, et al：The measurement of observer agreement for categorical data. Biometrics 1977；33：159-174

17）Ludbrook J：Statistical techniques for compairing measurers and methods of measurement：a critical review. Clin Exp Pharmacol Physiol 2002；29：527-536

18）Bland JM, et al：Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986；1：307-310

19）Hashimoto H, et al：Validation of a Japanese patient-delivered outcome scale for assessing total knee arthroplasty：comparison with Western Ontario and McMaster Universities osteoarthritis index（WOMAC）. J Orthop Sci 2003；8：288-293

20）日本リハビリテーション医学会：関節可動域ならびに測定法．Jpn J Rehabil Med 1974；11：127-132

21）Katoh M, et al：Comparison of reliability of isometric leg muscle strength measurements made using a hand-held dynamometer with and without a restraining belt. J Phys Ther Sci 2009；21：37-42

22）厚生労働省：健康づくりのための運動指針2006—生活習慣病予防のために．pp4-10，2006．https://www.mhlw.go.jp/shingi/2006/07/dl/s0719-3c.pdf（2019年4月12日閲覧）

23）Healy WL, et al：Athletic activity after total joint arthroplasty. J Bone Joint Surg Am 2008；90：2245-2252

24）Thienpont E, et al：Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint score. J Arthroplasty 2014；29：48-51

25）Shadid MB, et al：The Dutch version of the Forgotten Joint Score：test-retesting reliability and validation. Acta Orthop Belg 2016；82：112-118

26）Cao S, et al：Simplified Chinese version of the Forgotten Joint Score（FJS）for patients who underwent joint arthroplasty：cross-cultural adaptation and validation. J Orthop Surg Res 2017；12：6-13

27）内田　理：THA後におけるスポーツ活動の実態と満足度．関節外科2012；31：1314-1321

28）西村明展，他：THA前後のスポーツ活動について—当院の現状．関節外科2012；31：1328-1333

29）馬場智規，他：THA後のスポーツ活動に対する実態調査．関節外科2012；31：1334-1339

30）三浦裕正，他：人工関節置換術後のスポーツ活動．関節外科2006；25：162-165

31）王寺享弘：TKA・UKA後のスポーツ活動と競技種目．関節外科2012；31：1266-1274

32）Huch K, et al：Sports activities 5 years after total knee or hip arthroplasty：the Ulm Osteoarthritis Study. Ann Rheum Dis 2005；64：1715-1720

33）Baumann F, et al：Validation of the German Forgotten Joint Score（G-FJS）according to the COSMIN checklist：does a reduction in joint awareness indicate clinical improvement after arthroplasty of the knee? Arch Orthop Trauma Surg 2016；136：257-264

34）Thomsen MG, et al：Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty. Acta Orthop 2016；87：280-285

35）Thompson SM, et al：Construct validity and test re-test reliability of the forgotten joint score. J Arthroplasty 2015；30：1902-1905

36）Vaz MD, et al：Isometric hip abductor strength following total hip replacement and its relationship to functional assessments. J Orthop Sports Phys Ther 1993；18：526-531

37）Davis KE, et al：The importance of range of motion after total hip arthroplasty. Clin Orthop Relat Res 2007；465：180-184

38）Miner AL, et al：Knee range of motion after total knee arthroplasty：how important is this as an outcome measure? J Arthroplasty 2003；18：286-294

39）Mizner RL, et al：Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol 2005；32：1533-1539

40）Mizner RL, et al：Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res 2005；23：1083-1090