van Iersel Marianne B, Olde Rikkert Marcel G M, Mulley Graham P
St James's Hospital, Leeds, UK.
Clin Rehabil. 2003 May;17(3):325-33. doi: 10.1191/0269215502cr628oa.
A decline in mobility may result in problems with the negotiation of stairs, which can potentially be hazardous. In practice, stair negotiation is an important aspect of daily living and therefore needs to be assessed carefully.
We conducted a systematic literature review to identify the way functional assessment scales assess stair negotiation. We evaluated whether stair negotiation could be assessed in a valid and reliable way with these scales.
Forty-three of the 92 identified scales have an item on stair negotiation. In these scales, the definition of 'negotiation of stairs' varies, as does the definition of independence. Important aspects such as safety on stairs are missing from all scales. In contrast to older scales, newer scales consist of items that have been tested for validity and reliability. In none of the scales was the stair negotiation item tested separately for validity. Only two scales examined test-retest reliability and only one measured inter-observer agreement.
In current functional assessment scales stair negotiation is measured with great heterogeneity and insufficient validity. In patients and in studies in which assessment of stair negotiation ability is a key part of functional assessment, an improved, well-validated scale is needed. This scale should include not only the subject's physical ability to negotiate stairs, but also safety and change in ability over time.
行动能力下降可能导致上下楼梯出现问题，这可能存在潜在危险。在实际生活中，上下楼梯是日常生活的一个重要方面，因此需要仔细评估。
我们进行了一项系统的文献综述，以确定功能评估量表评估上下楼梯能力的方式。我们评估了使用这些量表能否以有效且可靠的方式评估上下楼梯能力。
在92个已识别的量表中，有43个包含上下楼梯相关项目。在这些量表中，“上下楼梯”的定义各不相同，“独立性”的定义也是如此。所有量表都缺少诸如楼梯安全性等重要方面。与较旧的量表相比，新量表由经过效度和信度测试的项目组成。在任何一个量表中，上下楼梯项目都未单独进行效度测试。只有两个量表检验了重测信度，只有一个量表测量了观察者间一致性。
在当前的功能评估量表中，上下楼梯能力的测量存在很大异质性且效度不足。在患者以及将上下楼梯能力评估作为功能评估关键部分的研究中，需要一个经过改进且效度良好的量表。这个量表不仅应包括受试者上下楼梯的身体能力，还应包括安全性以及能力随时间的变化。
