脊髓损伤步行指数（WISCI）在慢性脊髓损伤中的可重复性和聚合效度。

The reproducibility and convergent validity of the walking index for spinal cord injury (WISCI) in chronic spinal cord injury.

机构信息

The Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, ON, Canada.

出版信息

Neurorehabil Neural Repair. 2011 Feb;25(2):149-57. doi: 10.1177/1545968310376756.

DOI:10.1177/1545968310376756

PMID:21239706

Abstract

BACKGROUND

The Walking Index for Spinal Cord Injury II (WISCI II) is a hierarchical scale that measures improvements in walking following spinal cord injury (SCI). The WISCI II has good face validity, concurrent validity, and reliability following acute SCI; however, psychometric properties need to be determined for chronic SCI. Because prior studies have demonstrated a relationship between lower-extremity motor scores (LEMS) and walking, outcome measures for walking should demonstrate a linkage between the underlying impairment (weakness) and walking-convergent validity.

OBJECTIVE

To determine convergent validity and reproducibility of the WISCI II.

METHODS

Self-selected and maximum WISCI levels were assessed for 76 patients with chronic SCI (34 paraplegia, 42 tetraplegia); 10-m walking speeds were calculated. Convergent validity was assessed by correlating WISCI II levels to LEMS and walking speed. Reproducibility was assessed with the intraclass correlation coefficient (ICC) and the smallest real difference (SRD).

RESULTS

Convergent validity of the self-selected and maximum WISCI II with LEMS was moderate for paraplegia (ρ = 0.479 and ρ = 0.533) and strong for tetraplegia (ρ = 0.852 and ρ = 0.816). Tetraplegia, but not paraplegia, demonstrated convergent validity of walking speed at the self-selected and maximum WISCI levels with LEMS (ρ = 0.752 and ρ = 0.813). WISCI reproducibility was excellent (self-selected ICC = 0.994; maximum ICC = 0.995), resulting in SRDs of 0.785 (self-selected) and 0.597 (maximum), suggesting that a change of one WISCI level can be interpreted as real in a chronic patient.

CONCLUSIONS

Results suggest that the WISCI II should be a very useful outcome measure for detecting changes in walking function following chronic SCI.

摘要

背景

脊髓损伤步行指数 II（WISCI II）是一个层次量表，用于测量脊髓损伤后步行能力的改善。WISCI II 在急性脊髓损伤后具有良好的表面效度、同时效度和可靠性；然而，其在慢性脊髓损伤中的心理测量特性尚需确定。因为先前的研究已经证明了下肢运动评分（LEMS）与步行之间的关系，所以步行的结果测量应该表现出与潜在损伤（无力）之间的联系——即步行的收敛有效性。

目的

确定 WISCI II 的收敛有效性和可重复性。

方法

对 76 例慢性脊髓损伤患者（34 例截瘫，42 例四肢瘫）进行自我选择和最大 WISCI 水平评估；计算 10 米步行速度。通过将 WISCI II 水平与 LEMS 和步行速度相关联，评估了收敛有效性。使用组内相关系数（ICC）和最小真实差异（SRD）评估了可重复性。

结果

对于截瘫患者，自我选择和最大 WISCI II 与 LEMS 的相关性为中度（ρ=0.479 和 ρ=0.533），对于四肢瘫患者则为强（ρ=0.852 和 ρ=0.816）。只有四肢瘫患者的自我选择和最大 WISCI 水平与 LEMS 具有步行速度的收敛有效性（ρ=0.752 和 ρ=0.813）。WISCI 的可重复性极好（自我选择 ICC=0.994；最大 ICC=0.995），导致 SRD 分别为 0.785（自我选择）和 0.597（最大），这表明慢性患者的 WISCI 水平变化一个等级可以被认为是真实的。