Core Set da classificação internacional de funcionalidade, incapacidade e saúde para condições musculoesqueléticas: estudo de desenvolvimento e validação para disfunções de joelho

• Autor(a) principal: Fréz, Andersom Ricardo
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2218
• topic: Classificação Internacional de Funcionalidade, Incapacidade e Saúde - CIF; Avaliação em saúde; Joelho; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Knee dysfunctions represent 40% of all musculoskeletal conditions. However, there is a lack of a generalist instrument that considers the presence and severity of this health problem, in the individual or social aspect, as recommended by the International Classification of Functionality, Disability and Health (ICF). The main objective of this study was to develop and validate a core set that best represents the functionality of patients with knee dysfunction. In the first phase, the aim was to develop a core set for patients with knee dysfunction. We assessed 388 people with clinical diagnosis of pathology and/or pain and/or instability and/or restriction of movement in the knee. We used the comprehensive core sets for acute and post-acute musculoskeletal conditions, the subjective International Knee Documentation Commitees (IKDC) form, the self-report of general health status and functionality, and the general health status and functionality classified by the researcher. Descriptive statistics and regression analyzes were performed. Twenty-four categories were identified to compose the preliminary core set for knee dysfunction. Eleven categories belong to the component body functions, three represent the body structures, seven represent activities and participation, and three environmental factors. In the second phase of the study, the aim was to assess the content validity of the preliminary core set for knee dysfunctions. An international electronic research using the Delphi technique was performed. A panel of 180 experts in knee or ICF experts was invited. Nineteen experts participated in all rounds. Among the 24 categories of the preliminary core set for knee dysfunction, 15 remained in the core set and one category was further detailed into three new categories. Seven new categories were included. Thus, after the experts' opinion, 25 categories became part of the comprehensive core set for knee dysfunctions. Eleven categories belong to the component body functions, three represent body structures, 10 represent activities and participation and one environmental factors. In the third phase of the study, the aim was to assess the construct validity of the comprehensive core set for knee dysfunctions and to propose a brief core set to be used as a tool for measuring functionality. One hundred participants were assessed by a professional who applied the comprehensive core set for knee dysfunctions, the subjective IKDC form, and the self-report of general health status and functionality. The categories of the core set considered valid by Rasch analysis were included in the brief core set for knee dysfunctions and a score was proposed. The score of the brief core set was correlated with the IKDC and the self-report of health and functionality. Twelve categories were consistent with a unidimensional construct, with no difference in response pattern for age, gender, education level, and time of complaint. Correlations with the IKDC and self-report of general health status and functionality were adequate and significant. Thus, the 12 categories of the brief core set for knee dysfunction can be used to measure the functionality of people with any knee dysfunction, with a score varying from 0 (no impairment) to 100 (complete impairment). Thus, after the three phases of the study, the comprehensive and brief core set for knee dysfunction were developed and validated. The comprehensive core set has 25 categories that should be used in a functional assessment and the brief core set has 12 categories that should be used to measure the functionality of people with knee dysfunction.