Assessment of functional capacity in fibromyalgia. Comparative analysis of construct validity of three functional scales

Esteve-Vives, Joaquim; Rivera, Javier; Vallejo, Miguel A.

doi:10.1016/S2173-5743(10)70032-0

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Abstract

Objective

To compare the construct validity of three functional capacity questionnaires in patients with fibromyalgia.

Patients and methods

Transversal multicentric study of 301 patients from fifteen rheumatology outpatient clinics in Spain. Scores of Health Assessment Questionnaire (HAQ), Fibromyalgia Health Assessment Questionnaire (FHAQ) and the physical function scale of the Fibromyalgia Impact Questionnaire (PF-FIQ) were compared with extreme groups of patients defined by four external indirect measures: 6Min Walk Test, a modified Borg Fatigue Scale, Lumbar Spine Flexion Test and Patient Global Passive Mobility Assessment. Standardized differences were determined and correlation coefficients were calculated between the three questionnaires scores.

Results

All three questionnaires showed good construct validity, but the results obtained with the PF-FIQ were poorer. Correlations between HAQ and FHAQ were very high (0.92), but correlations between these two questionnaires and PF-FIQ were only moderate (0.59).

Conclusions

HAQ and FHAQ are more valid measures of functional capacity than the PF-FIQ. HAQ could be substituted by FHAQ in some settings because of its shorter format (only 8 items).

Keywords:

Fibromyalgia

Outcome assessment

Activities of daily living

Resumen

Objetivo

Comparar la validez de constructo de tres cuestionarios de capacidad funcional en pacientes con fibromialgia.

Pacientes y métodos

Estudio multicéntrico transversal: 301 pacientes procedentes de consultas externas de reumatología de 15 centros en España completaron los cuestionarios Health Assessment Questionnaire (HAQ), Fibromyalgia Health Assessment Questionnaire (FHAQ) y la escala defunción física del Fibromyalgia Impact Questionnaire (FF-FIQ), y se compararon sus puntuaciones en grupos extremos de capacidad funcional definida por las medidas externas: test de 6 minutos marcha, test de fatiga de Borg, test de flexibilidad lumbar y evaluación global de la movilidad del paciente. Se calcularon las correspondientes diferencias estandarizadas. Finalmente, se determinaron coeficientes de correlación entre las puntuaciones de los tres cuestionarios.

Resultados

Los tres cuestionarios mostraron una aceptable validez de constructo, pero los resultados del FF-FIQ fueron inferiores. La correlación entre HAQ y FHAQ fue muy elevada (0,92), y solamente moderada entre estos dos y el FF-FIQ (0,59).

Conclusiones

HAQ y FHAQ miden más adecuadamente la verdadera capacidad funcional de los pacientes que el FF-FIQ. ElFHAQ, por su brevedad (sólo 8 ítems) podría sustituir al HAQ en algunas ocasiones.

Palabras clave:

Fibromialgia

Evaluación de medidas de desenlace

Actividades de la vida diaria

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