Jackson Amie B, Carnel Charles T, Ditunno John F, Read Mary Schmidt, Boninger Michael L, Schmeler Mark R, Williams Steve R, Donovan William H
Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL 35213, USA.
J Spinal Cord Med. 2008;31(5):487-99. doi: 10.1080/10790268.2008.11753644.
At the 2006 National Institute on Disability and Rehabilitation Research (NIDRR) sponsored pre-conference on spinal cord injury (SCI) outcomes, several gait and ambulation measures were evaluated for utility in clinical practice, validity, and reliability as research measurement tools. The Conference Subcommittee on Gait and Ambulation chose to review the Walking Index for Spinal Cord Injury II (WISCI II), 50-Foot Walk Test (50FTWT), 6-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), and Functional Independence Measure-Locomotor (FIM-L).
A subcommittee of international experts evaluated each instrument for test construct, administration, population applicability, reliability, sensitivity to change, and validity. Evaluations for each outcome measure were compiled, distributed to the whole committee, and then further reviewed with addition of comments and recommendations for consensus. An audience of experts voted on the validity and usefulness of each measure.
WISCI II and 10MWT were found to be the most valid and clinically useful tests to measure improvement in gait for patients with SCI. FIM-L had little utility and validity for research in SCI. 6MWT and 50FTWT were found to be useful but in need of further validation or changes for the SCI population.
A combination of the 10MWT and WISCI II would provide the most valid measure of improvement in gait and ambulation in as much as objective changes of speed, and functional capacity allow for interval measurement. To provide the most comprehensive battery, however, it will be important to include a measure of endurance such as the 6MWT. Further validation and study should be devoted to WISCI II, 10MWT, and 6MWT as primary outcome measures for gait in SCI.
在2006年美国国家残疾与康复研究所（NIDRR）主办的脊髓损伤（SCI）预后会前会议上，对几种步态和步行测量方法在临床实践中的实用性、作为研究测量工具的有效性和可靠性进行了评估。步态与步行会议小组委员会选择审查脊髓损伤步行指数II（WISCI II）、50英尺步行测试（50FTWT）、6分钟步行测试（6MWT）、10米步行测试（10MWT）和功能独立性测量-运动（FIM-L）。
一个国际专家小组委员会对每种工具的测试结构、实施、人群适用性、可靠性、对变化的敏感性和有效性进行了评估。对每个结果测量的评估进行了汇编，分发给整个委员会，然后进一步审查并添加评论和建议以达成共识。专家听众对每种测量方法的有效性和实用性进行了投票。
发现WISCI II和10MWT是测量SCI患者步态改善最有效且临床有用的测试。FIM-L在SCI研究中的实用性和有效性很小。发现6MWT和50FTWT有用，但需要针对SCI人群进行进一步验证或改进。
10MWT和WISCI II的组合将提供步态和步行改善的最有效测量，因为速度和功能能力的客观变化允许进行间隔测量。然而，为了提供最全面的测试组合，纳入耐力测量方法如6MWT将很重要。应进一步对WISCI II、10MWT和6MWT进行验证和研究，将其作为SCI步态的主要结果测量指标。
