确定住院康复环境中中风患者个体物理治疗和职业治疗课程的内容。一份评分清单的制定、验证及评分者间信度。

Defining the content of individual physiotherapy and occupational therapy sessions for stroke patients in an inpatient rehabilitation setting. Development, validation and inter-rater reliability of a scoring list.

作者信息

De Wit L, Kamsteegt H, Yadav B, Verheyden G, Feys H, De Weerdt W

机构信息

Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium.

出版信息

Clin Rehabil. 2007 May;21(5):450-9. doi: 10.1177/0269215507074385.

DOI:10.1177/0269215507074385

PMID:17613566

Abstract

OBJECTIVE

To develop a valid and reliable scoring list to define the content of individual physiotherapy and occupational therapy sessions for stroke patients in inpatient rehabilitation.

DESIGN

A list was developed based on previous lists, neurological textbooks and recorded therapy sessions. Content validity was verified and inter-rater reliability evaluated on videos of treatment sessions. In each of four rehabilitation centres, a researcher recorded and scored five physiotherapy and five occupational therapy sessions. These 40 treatment sessions were also scored by the first author. The scores of the researchers and first author were statistically compared. Settings and subjects : Forty stroke patients in four European rehabilitation centres.

RESULTS

The scoring list consists of 49 subcategories, divided into 12 categories: mobilization; selective movements; lying (balance); sitting (balance); standing (balance); sensory and visual perceptual training and cognition; transfers; ambulatory activities; personal activities of daily living; domestic activities of daily living; leisure- and work-related activities; and miscellaneous. Comparing the frequency of occurrence of the categories resulted in intraclass correlation coefficients, indicating high reliability for eight categories, good for one, and fair for two. One category was not observed. Spearman rank correlation coefficients were high to very high for 24 subcategories and moderate for four. Twenty-one subcategories contained too few observations to enable calculation of Spearman rank correlation coefficients. Average point-to-point percentage of agreement in time of the treatment sessions equalled 76.6 +/- 16.2%.

CONCLUSIONS

The list is a valid and reliable tool for describing the content of physiotherapy and occupational therapy for stroke patients.

摘要

目的

制定一份有效且可靠的评分清单，以界定住院康复中风患者个体物理治疗和职业治疗课程的内容。

设计

基于先前的清单、神经学教科书及录制的治疗课程制定一份清单。通过治疗课程视频验证内容效度并评估评分者间信度。在四个康复中心，每位研究人员记录并评分五个物理治疗课程和五个职业治疗课程。这40个治疗课程也由第一作者评分。对研究人员和第一作者的评分进行统计学比较。背景与研究对象：欧洲四个康复中心的40名中风患者。

结果

评分清单由49个亚类组成，分为12个类别：活动、选择性运动、卧位（平衡）、坐位（平衡）、站立位（平衡）、感觉和视觉感知训练及认知、转移、步行活动、日常生活个人活动、日常生活家务活动、休闲和工作相关活动以及其他。比较各分类的出现频率得出组内相关系数，表明八个分类可靠性高，一个分类良好，两个分类尚可。未观察到一个分类。24个亚类的斯皮尔曼等级相关系数高至极高，四个亚类中等。21个亚类观察次数过少，无法计算斯皮尔曼等级相关系数。治疗课程时间上的平均点对点一致百分比为76.6±16.2%。