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针对轻度和中度上肢偏瘫患者的改良Wolf运动功能测试的心理测量学特性。

Psychometric properties of a modified Wolf Motor Function test for people with mild and moderate upper-extremity hemiparesis.

作者信息

Whitall Jill, Savin Douglas N, Harris-Love Michelle, Waller Sandra McCombe

机构信息

Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

出版信息

Arch Phys Med Rehabil. 2006 May;87(5):656-60. doi: 10.1016/j.apmr.2006.02.004.

Abstract

OBJECTIVE

To test the necessity of videotaping, test-retest reliability, and item stability and validity of a modified Wolf Motor Function Test (WMFT) for people with mild and moderate chronic upper-extremity (UE) hemiparesis caused by stroke.

DESIGN

Raters of videotape versus direct observation; test-retest reliability over 3 observations, item stability, and criterion validity with upper-extremity Fugl-Meyer Assessment (FMA) in the mildly and moderately impaired groups.

SETTING

Academic research center.

PARTICIPANTS

Sixty-six subjects with chronic UE hemiparesis who participated in a large intervention study. Subjects were classified into mild and moderate groups for additional analyses.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Mean and median times of task completion, functional ability, and strength (weight to box) measures of the WMFT. FMA scores for validity assessment.

RESULTS

In a subgroup of 10 subjects, the intraclass correlation coefficient (ICC) for videotape versus direct observation ranged from .96 to .99. For the whole group, test-retest reliability using ICC2,1 ranged from .97 to .99; stability of the test showed that administration 1 differed from administrations 2 and 3 but administrations 2 and 3 did not differ; item analysis showed that 4 of 17 items changed across time, and validity, using a correlation with UE FMA, ranged from .86 to .89. Separate mild- and moderate-group analyses were similar to whole-group results.

CONCLUSIONS

Videotaping the modified WMFT was not necessary for accurate scoring. The modified WMFT is reliable and valid as an outcome measure for people with chronic moderate and mild UE hemiparesis and is stable, but 1 repeat testing is recommended when practical.

摘要

目的

检验录像的必要性、重测信度、以及改良版Wolf运动功能测试(WMFT)对于轻度和中度慢性上肢(UE)偏瘫中风患者的项目稳定性和效度。

设计

录像评估与直接观察评估;在轻度和中度受损组中进行3次观察的重测信度、项目稳定性、以及与上肢Fugl-Meyer评估(FMA)的效标效度。

设置

学术研究中心。

参与者

66名患有慢性UE偏瘫的受试者,他们参与了一项大型干预研究。受试者被分为轻度和中度组以进行额外分析。

干预措施

不适用。

主要观察指标

WMFT的任务完成平均时间和中位数时间、功能能力、以及力量(搬箱子重量)测量。用于效度评估的FMA分数。

结果

在10名受试者的亚组中,录像评估与直接观察评估的组内相关系数(ICC)范围为0.96至0.99。对于整个组,使用ICC2,1的重测信度范围为0.97至0.99;测试稳定性表明第1次施测与第2次和第3次施测不同,但第2次和第3次施测无差异;项目分析表明17个项目中有4个随时间变化,并且与UE FMA的相关性效度范围为0.86至0.89。轻度和中度组的单独分析结果与整个组的结果相似。

结论

对改良版WMFT进行录像对于准确评分并非必要。改良版WMFT作为慢性中度和轻度UE偏瘫患者的结局指标是可靠且有效的,并且具有稳定性,但实际操作时建议进行1次重复测试。

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