School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia.
Int Psychogeriatr. 2011 Sep;23(7):1152-9. doi: 10.1017/S1041610211000639. Epub 2011 Apr 14.
To interpret changes of balance and mobility in people with Alzheimer's disease (AD), we require measures of balance and mobility that have demonstrated reliability in this population. The aim of the study was to determine the safety, feasibility and retest reliability of clinical and forceplate balance and mobility measurements in people with AD.
Relative and absolute reliabilities were examined in 14 older people with mild to moderate AD. Relative reliability was calculated using the intraclass correlation coefficient, two-way mixed model (ICC3,1). Absolute reliability was calculated using the standard error of measurement (SEM), the minimum detectable change (MDC) and the coefficient of variation (CV).
All measurements were clinically feasible and could be safely administered. ICC values were excellent and CVs were less than 11% in all clinical balance and mobility measures except the Timed Up & Go test with cognitive or manual task (ICC3,1 = 0.5 and 0.7, and CV = 14% and 10%, respectively). Most balance and mobility measures tested on the Neurocom™ forceplate (modified Clinical Test of Sensory Interaction on Balance, Walk Across (step width, step length parameters), and Sit to Stand (rising index parameter)) had excellent relative reliability (ICC3,1 ranging from 0.75 to 0.91). ICC values were fair to good for the other measures.
Retest reliability of the balance and mobility measures used in this study ranged between fair to good, and good to excellent. Clinicians should consider retest reliability when deciding which balance and mobility measures are used to assess people with AD.
为了解释阿尔茨海默病(AD)患者平衡和移动能力的变化,我们需要使用已在该人群中证明具有可靠性的平衡和移动能力测量方法。本研究的目的是确定 AD 患者临床和测力台平衡及移动能力测量的安全性、可行性和重测信度。
在 14 名轻度至中度 AD 老年人中检查了相对和绝对信度。相对信度使用组内相关系数(ICC3,1)进行计算,采用双向混合模型。绝对信度使用测量标准误差(SEM)、最小可检测变化(MDC)和变异系数(CV)进行计算。
所有测量均具有临床可行性且可安全进行。除了伴有认知或手动任务的计时起立行走测试(ICC3,1=0.5 和 0.7,CV=14%和 10%)之外,所有临床平衡和移动能力测量的 ICC 值均很高,CV 值均小于 11%。在 Neurocom™测力台上测试的大多数平衡和移动能力测量(改良的平衡感觉交互测试、走步测试(步宽、步长参数)和坐站测试(起立指数参数))具有很好的相对信度(ICC3,1 范围为 0.75 至 0.91)。其他测量的 ICC 值为中等到良好。
本研究中使用的平衡和移动能力测量的重测信度范围为中等到良好,良好至优秀。临床医生在决定使用哪些平衡和移动能力测量来评估 AD 患者时,应考虑重测信度。