背景與目的：物理治療對膝骨性關節炎（ knee osteoarthritis ）病患的目標在減輕症狀、減少組織缺損、以及避免功能限制與失能的發生。以往針對關節炎的物理治療，不論評估或治療目標都是僅著重組識缺損層面，評估肌力大小、疼痛多寡、僵硬程度、關節活動度受限情形等，然而研究發現關節活動度、肌力、疼痛度、年齡、影像嚴重度與失能之間相關並不高。基於全人功能的考量，對膝骨性關節炎的患者之治療應強調減少其失能程度。因此如何評估膝骨性關節炎失能程度，瞭解影響失能程度的因子及各因子間的相關性，都是值得探討的議題。本研究的兩大目的即在於（一）探討膝關節炎病患之身體質量指數、關節活動度、疼痛度、肌力、上下樓梯功能、失能等六個臨床測試之間的相關性。（二）探討膝關節炎病患，以身體質量指數、關節活動度、疼痛度、肌力、上下樓梯功能五個臨床測試對失能的預測模式。方法：研究參與者包括 30 位（女性 16 位，男性 14 位；年齡平均為 63 . 8 ± 11 . 9 歲）膝關節炎病患。每位患者均接受下列各項測試：（1）下肢被動關節活動度（雙側平均髖伸直、髖外轉及膝彎曲之總合） ；（2）最大膝申直肌力（雙側平均膝伸直肌在30°/s之等速肌力） ;（3）身體質量指數（體重／身高^2) ;（4）上下樓梯功能（測量上下 11 階樓梯時間） ;（5） Western Ontario and McMaster Universities Osteoarthritis index ( WOMAC ) 之疼痛指數；以及（6）WOMAC失能量表總分。資料分析採皮爾森相關係數分析所有變數之間的相關性；並以逐步迴歸方式分析 WOMAC 失能量表總分之預測因子及其方程式。結果：幾項測試中具顯著中高度相關性之變數包括：下肢被動關節活動度與最大膝伸直肌力（ r = 0 . 41 , p < 0 . 05 ) ，疼痛指數與身體質量指數（ r = 0 . 60 , p < 0 . 01 ) ，疼痛指數與失能程度（ r = 0 . 73 , p < 0 . 01 ) , 身體質量指數與失能程度（ r = 0 . 64 , p < 0 . 01 ) ，上下樓梯功能與失能程度（ r = 0 . 49 , p < 0 . 01 )。變數中只有疼痛指數和上下樓梯時間兩者是對失能程度的重要預測因子，其預測方程式為 WOMAC 失能量表總分 = - 3 . 05 + 0 . 66 × （WOMAC疼痛指數）+ 0 . 35 × （上下 11 階樓梯時間）；此預測模式可以解釋 63 ％的 WOMAC 失能指數變異性。結論：疼痛和上下樓梯時間之臨床測量能預測失能程度。（物理治療：2004 ;29( 4 ) : 233 － 241 )

Background and purposes: Physical therapy is usually aimed at reducing symptoms from musculoskeletal disorders. It is beneficial to predict the extent of disability from clinical measures for a clinician. Studies have shown that many clinical measures demonstrate significantly moderate correlations with disability. They may potentially be predictors of a disability score. The purposes of this study were 1) to investigate the correlation between clinical measures including the passive range of motion, pain, muscle strength, body mass index, stair climbing performance, and disability in patients with knee osteoarthritis, and 2) to develop a predictive equation based on clinical measures for disability in patients with knee osteoarthritis. Methods: Thirty outpatients (16 females, 14 males; aged 63.8± 11.9 years) of knee osteoarthritis volunteered the study and were evaluated using the following clinical measures: passive range of motion of hip extension, hip external rotation and knee flexion from both legs, isokinetic muscle strength of 30% from bilateral knee extension, body mass index, time to go up and down a flight of stairs with 11 steps and the WOMAC disability score. The Pearson correlation coefficients were calculated to investigate the relationships between the 6 clinical measures. The stepwise regression was utilized to identify significant predictors and its predictive model for the disability score. Results: The significant correlation coefficients were between ROM and strength (r=0.41, p<0.0 5), between BMI and pain (r=0.60,p<0.01), between pain and disability (r=0.73,p<0.01), between BMI and disability (r = 0.64, p < 0.01), and between the stair climbing performance and disability (r=0.49, p<0.0l). Pain and the stair climbing performance were the two significant predictors for disability. The equation is: WOMAC total score= -0.30 + 0.66×(pain subscale of WOMAC)+ 0.35 × (time to go up and down a flight of stair with 11 steps). Around 63% of the variance of WOMAC total score was accounted for by the two predictors. Conclusion: Pain and the stair climbing performance are most important predictive clinical measures for disability in subjects with knee osteoarthritis. (FJPT 2004;29(4):233-241)