Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Arch Phys Med Rehabil. 2011 Aug;92(8):1270-80. doi: 10.1016/j.apmr.2011.03.010.
To assess the test-retest reliability and discriminative validity of a 14-item manual wheelchair circuit adapted from previous research (AMWC).
Two AMWC trials per subject completed within 15 days.
Two clinical research and 3 rehabilitation centers.
Convenience sample of individuals with spinal cord injury (N=50) from centers in the United States (n=38) and the Netherlands (n=12). Mean age ± SD was 46±13 years, and mean injury duration ± SD was 12±11 years. Fifteen had cervical injuries, and 42 were men.
An existing 8-task manual wheelchair circuit was modified to remove the need for a wheelchair treadmill and expanded to 14 tasks to attenuate floor and ceiling effects: 5 original tasks-figure-of-8, .012-m doorstep crossing, .10-m platform, 15-m sprint, and making a level transfer; 3 modified tasks-3% and 6% ramp, and 3-minute overground wheeling; and 6 new tasks-.04-m doorstep crossing, propelling over artificial grass, opening/closing a door, 3% side slope, holding a wheelie for 10 seconds, and propelling in a wheelie.
Reliability of the primary outcomes, sum ability score (sum of all tasks; 0-14 [no.]) and sum performance time (figure-of-8 + sprint + grass; 0-360 [s]), was determined by intraclass correlation coefficients (ICCs) for the whole sample and paraplegia (PP) and tetraplegia (TP) subsets. Independent t tests compared PP and TP trial 1 sum ability score and sum performance time.
Sum ability and sum performance time ICCs exceeded .90 for the full sample and the PP/TP subsets. Sum ability was higher for PP than TP (PP, 12.9±1.2; TP, 9.8±2.8; P<.00), and sum performance times were lower for PP than TP (20.0±4.0s vs 32.0±1.97s, P<.00).
AMWC primary outcomes, sum ability score and sum performance time, are reliable and discriminate between TP and PP.
评估从先前研究中改编的 14 项手动轮椅循环测试（AMWC）的重测信度和区分效度。
每位受试者在 15 天内完成两次 AMWC 测试。
美国和荷兰的两个临床研究和 3 个康复中心。
从美国（n=38）和荷兰（n=12）的中心选择的脊髓损伤患者的方便样本（n=50）。平均年龄±标准差为 46±13 岁，平均损伤时间±标准差为 12±11 年。15 人患有颈椎损伤，42 人为男性。
对现有的 8 项手动轮椅循环进行修改，以去除对轮椅跑步机的需求，并扩展到 14 项任务，以减轻地板和天花板效应：5 项原始任务-8 字形、0.012-m 门槛交叉、0.10-m 平台、15-m 冲刺和进行水平转移；3 项修改任务-3%和 6%斜坡和 3 分钟的地面推车；6 项新任务-0.04-m 门槛交叉、推动人造草皮、开门/关门、3%侧坡、保持 10 秒的前轮平衡和前轮平衡推动。
通过整个样本和截瘫（PP）和四肢瘫痪（TP）亚组的组内相关系数（ICC）确定主要结果，即总和能力得分（所有任务之和；0-14[无]）和总和表现时间（8 字形+冲刺+草皮；0-360[s]）的可靠性。独立 t 检验比较了 PP 和 TP 试验 1 的总和能力得分和总和表现时间。
总和能力和总和表现时间的 ICC 对于整个样本和 PP/TP 亚组均超过 0.90。PP 的总和能力高于 TP（PP，12.9±1.2；TP，9.8±2.8；P<.00），PP 的总和表现时间低于 TP（20.0±4.0s 与 32.0±1.97s，P<.00）。
AMWC 的主要结果，总和能力得分和总和表现时间，是可靠的，并能区分 TP 和 PP。
