坐立试验在社区慢阻肺患者中的测量性能:COSMIN系统综述
本系统综述依据COSMIN指南,纳入30篇文献评估社区慢阻肺患者坐立试验的测量性能,共识别7种版本,其中1分钟、5次重复和30秒坐立试验最常用。1分钟坐立试验的信度和结构效度证据较充分,30秒坐立试验是唯一具有至少中等质量证据支持反应度的试验。
要点
- 1分钟坐立试验在横断面评估中测量性能最稳健。
- 30秒坐立试验对评估变化更稳健。
- 1分钟、5次重复和30秒坐立试验的信度均充分。
核心结论
- 1分钟坐立试验在横断面评估中具有最稳健的测量性能,30秒坐立试验对评估变化更稳健。
研究设计与样本
- 采用COSMIN指南的系统综述,检索6个数据库,评估社区慢阻肺患者坐立试验的测量性能,最终纳入30篇文献。
主要发现
- 共识别7种坐立试验版本,最常用为1分钟(n=14,39%)、5次重复(n=10,28%)和30秒(n=8,22%)坐立试验。
- 1分钟、5次重复和30秒坐立试验的信度均充分。
- 仅1分钟坐立试验具有高质量证据支持结构效度充分。
- 30秒坐立试验是唯一具有至少中等质量证据支持反应度充分的试验。
临床怎么用
- 横断面评估社区慢阻肺患者躯体功能时可优先选用1分钟坐立试验。
- 需要评估功能变化时可优先选用30秒坐立试验。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
BACKGROUND: The sit-to-stand (STS) test can assess physical function in people with chronic obstructive pulmonary disease (COPD); however, there are multiple versions. No study has used current guidelines to assess the measurement properties of the STS tests in people with COPD. METHODS: We conducted a systematic review using current COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Full text peer-reviewed publications were included if they assessed the measurement properties (validity, reliability and/or responsiveness) of at least one STS test among community-dwelling people with COPD. We searched six databases and imported results into Covidence where title/abstract screening and full text selection was completed independently and in duplicate. Extraction was conducted independently and in duplicate using the COSMIN extraction file. We assessed study risk of bias (very good, adequate, doubtful or inadequate), measurement property quality (sufficient, indeterminate or insufficient) and overall certainty of evidence (high, moderate, low or very low) using the COSMIN recommended tools. RESULTS: We assessed 2577 titles/abstracts and 102 full texts for inclusion; 30 publications met eligibility. Seven unique STS tests were located with the most common being the 1 min STS test (n=14, 39%), 5-repetition STS test (n=10, 28%) and the 30 s STS test (n=8, 22%). Where assessed, reliability was sufficient for the 1 min, the 5-repetition and the 30 s STS tests. Only the 1 min STS test had high-quality evidence of sufficient construct validity, while the 30 s STS test was the sole test with at least moderate quality evidence of sufficient responsiveness. CONCLUSIONS: The 1 min STS test has the most robust measurement properties for cross-sectional assessments while the 30 s STS test is more robust to assess change.
引用
- Farley C, Newman ANL, Phillips SM, et al. Measurement properties of the sit-to-stand test in community-dwelling people with chronic obstructive pulmonary disease: a COSMIN systematic review. Thorax. 2026. PMID: 41386962. doi:10.1136/thorax-2025-223967
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。