Mayo N E, Sullivan S J, Swaine B
Research Department, Jewish Rehabilitation Hospital, Montreal, Quebec, Canada.
Am J Phys Med Rehabil. 1991 Jun;70(3):118-23. doi: 10.1097/00002060-199106000-00002.
As an early phase in the development of a valid and reliable measure of the neurophysical sequelae after head injury, we carried out assessments of interrater agreement on representative items. The purpose of this study was to determine the degree of agreement among expert raters who independently measured neurophysical signs on patients undergoing physical rehabilitation after brain injury. Agreement was described using the index of crude agreement, expected agreement and Kappa. Therapists showed a high degree of agreement on those items forming part of a routine neurological assessment: prehension, coordination, voluntary movements and tendon reflexes. Crude agreement ranged from 77.8-100%. There was considerable discordance in assessing muscle tonus, equilibrium and protective reactions, spinal reflexes, tremor and dysmetria (crude agreement ranged from 49.7-97.9%). Although, the number of subjects was small, the information generated from this study will be useful in refining our instrument for the assessment of neurophysical signs.
作为开发一种有效且可靠的头部损伤后神经物理后遗症测量方法的早期阶段，我们对代表性项目的评分者间一致性进行了评估。本研究的目的是确定在对脑损伤后接受物理康复治疗的患者独立测量神经物理体征的专家评分者之间的一致程度。使用粗略一致性指数、预期一致性指数和卡帕系数来描述一致性。治疗师们对构成常规神经学评估一部分的项目表现出高度一致性：抓握、协调、自主运动和腱反射。粗略一致性范围为77.8% - 100%。在评估肌肉张力、平衡和保护性反应、脊髓反射、震颤和辨距障碍方面存在相当大的不一致（粗略一致性范围为49.7% - 97.9%）。尽管受试者数量较少，但本研究产生的信息将有助于完善我们评估神经物理体征的工具。
