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不同程度踝跖屈肌痉挛的慢性脑卒中患者 Berg 平衡量表、 Fugl-Meyer 评估量表、计时“站起-行走”测试、步态速度和 2 分钟步行测试的最小可检测变化。

Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone.

机构信息

Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Rd, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.

出版信息

Arch Phys Med Rehabil. 2012 Jul;93(7):1201-8. doi: 10.1016/j.apmr.2012.01.014. Epub 2012 Apr 12.

Abstract

OBJECTIVE

To determine test-retest reliability and absolute and relative minimal detectable changes at the 95% confidence level (MDC(95)) of measures to detect postural balance and lower limb movements in individuals with chronic stroke who were able to walk and had differences in ankle plantarflexor tone.

DESIGN

Test-retest study. Data were collected on 2 occasions, about 6 days apart.

SETTING

Outpatient physical therapy clinics.

PARTICIPANTS

Volunteers (N=61) with chronic stroke who were able to walk and had differences in ankle plantarflexor tone: no increase in ankle plantarflexor tone (n=12), a slight increase in ankle plantarflexor tone (n=32), and a marked increase in ankle plantarflexor tone (n=17).

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Reliability and absolute and relative MDC(95) of the Berg Balance Scale (BBS), the lower limb subscale of Fugl-Meyer Assessment (FMA-LE), the Timed "Up & Go" test (TUG), the comfortable gait speed (CGS), the fast gait speed (FGS), and the 2-minute walk test (2MWT).

RESULTS

Excellent reliability of the BBS, FMA-LE, TUG, CGS, FGS, and 2MWT for all the participants combined and for the subgroups was shown. All the participants combined showed the absolute and relative MDC(95) in the BBS of 5 points and 10%, FMA-LE of 4 points and 16%, TUG of 8 seconds and 28%, CGS of 0.2m/s and 34%, FGS of 0.1m/s and 21%, and 2MWT of 13m and 23%. The absolute and relative MDC(95) of the subgroups were varied based on ankle plantarflexor tone.

CONCLUSIONS

The BBS, FMA-LE, TUG, CGS, FGS, and 2MWT are reliable measures to detect postural balance and lower limb movements in individuals with chronic stroke who have differences in ankle plantarflexor tone. The absolute and relative MDC(95) of each measure are dissimilar in those with differences in ankle plantarflexor tone. The relative MDC(95) seems more useful than the absolute MDC(95) because the relative value can be used for a single individual.

摘要

目的

确定在踝关节跖屈肌张力存在差异的慢性脑卒中患者中,用于检测姿势平衡和下肢运动的测量值的重测信度以及在 95%置信水平下的绝对和相对最小可检测变化(MDC(95))。

设计

测试-重测研究。数据在 2 次就诊时收集,间隔约 6 天。

地点

门诊物理治疗诊所。

参与者

能够行走且踝关节跖屈肌张力存在差异的慢性脑卒中志愿者:踝关节跖屈肌张力无增加(n=12)、轻度增加(n=32)和明显增加(n=17)。

干预措施

不适用。

主要观察指标

Berg 平衡量表(BBS)、Fugl-Meyer 评估下肢子量表(FMA-LE)、计时“站起-行走”测试(TUG)、舒适步态速度(CGS)、快速步态速度(FGS)和 2 分钟步行测试(2MWT)的可靠性以及绝对和相对 MDC(95)。

结果

所有参与者和亚组的 BBS、FMA-LE、TUG、CGS、FGS 和 2MWT 均显示出极好的重测信度。所有参与者的 BBS 绝对和相对 MDC(95)为 5 分和 10%,FMA-LE 为 4 分和 16%,TUG 为 8 秒和 28%,CGS 为 0.2m/s 和 34%,FGS 为 0.1m/s 和 21%,2MWT 为 13m 和 23%。基于踝关节跖屈肌张力,亚组的绝对和相对 MDC(95)各不相同。

结论

BBS、FMA-LE、TUG、CGS、FGS 和 2MWT 是用于检测踝关节跖屈肌张力存在差异的慢性脑卒中患者姿势平衡和下肢运动的可靠测量方法。各测量值的绝对和相对 MDC(95)在踝关节跖屈肌张力存在差异的患者中存在差异。相对 MDC(95)似乎比绝对 MDC(95)更有用,因为相对值可用于单个个体。

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