摘要
目的:评估脑卒中患者的移动能力是康复医学重要内容,研究脑卒中患者计时“起立-行走”测试的信度和同时效度,为临床评定提供客观依据。方法:解放军总医院康复医学科收治47例脑卒中偏瘫患者,均符合第四届全国脑血管病会议通过的诊断标准,意识清晰,可接受动作行指令,可独立或在监视下步行20m以上,排除下肢全关节置换术后、严重关节炎而影响步行者以及存在其他限制下肢活动的合并症者。有5位医师参与,其中2位医师评估47例脑卒中偏瘫患者的计时“起立-行走”的测试作为评测者间信度研究,患者在同一时间段内被同一医师再评估1次,以作为评测者内信度研究。由另3位医师共同利用Berg平衡量表(BBS),FIM和最大步行速度测量评估患者的平衡功能、日常生活能力和步行速度作为效标尺度,进行同时效度的研究。结果:在信度方面,在同一评定者的两次评定结果之间高度相关ICC=0.982(95%CI:0.901～0.992);不同评定者的同一次评定结果之间也高度相关ICC=0.984(95%CI:0.889～0.995),同时在效度方面,计时“起立-行走”测试与BBS,FIM和最大步行速度之间有较好的相关性(r=-0.914～-0.646,P<0.001)。结论:计时“起立-行走”测试方法用于评定脑卒中患者的功能性步行能力方面具有良好的信度和效度。
AIM:Evaluation on the physical mobility of stroke patients is important in rehabilitation medicine.This study is to investigate the interrater and intrarater reliability and the concurrent validity of timed “up-go' test(TUGT), so as to provide objective evidence for clinical evaluation. METHODS:Forty-seven hemiplegic patients after stroke were selected from the Department of Rehabilitation Medicine,General Hospital of Chinese PLA.All the patients were in accordance with the diagnostic criteria of the Fourth National Academic Meeting for Cerebrovascular Disease,had consciousness and could act as the instruction,and could walk over 20 m by themselves or under monitoring.The patients,who had received total joint replacement of whole lower limbs,with walking disturbance induced by severe arthritis,and other complications that confined the activities of lower limbs,were excluded.All subjects were randomly examined with the TUGT by two of the five independent evaluators within one day to assess inter-rater reliability,and were reexamined for intra-rater reliability by the same evaluator.The equilibrium function,activities of daily life(ADL) and gait speed,measured with Berg balance scale(BBS),maximal gait speed and FIM,were taken as validity scale for study of concurrent validity. RESULTS:In the aspect of reliability,the TUGT showed good intrarater and interrater reliability in the two evaluation by the same evaluator ICC=0.982(95%CI: 0.901 to 0.992) and the same evaluation by different evaluator ICC=0.984(95%CI: 0.889 to 0.995).In the aspect of concurrent validity,the TUGT was well correlated with BBS,gait speed and FIM(r=-0.914 to -0.646,P< 0.001). CONCLUSION:TUGT is a reliable instrument with adequate concurrent validity to measure the physical mobility in patients with stroke.
出处
《中国临床康复》
CSCD
2004年第31期6819-6821,共3页
Chinese Journal of Clinical Rehabilitation
