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对一种评估生物力学策略的创新工具的临床测试:用于中风患者的定时“站起和行走”评估生物力学策略(TUG-ABS)。

Clinical testing of an innovative tool for the assessment of biomechanical strategies: the Timed “Up and Go” Assessment of Biomechanical Strategies (TUG-ABS) for individuals with stroke.

机构信息

Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

出版信息

J Rehabil Med. 2013 Mar;45(3):241-7. doi: 10.2340/16501977-1106.

Abstract

OBJECTIVE

To investigate the reliability and construct and criterion- related validities of the Timed “Up and Go” Assessment of Biomechanical Strategies (TUG-ABS), when used with subjects with hemiparesis due to stroke within clinical settings.

DESIGN/METHODS: Construct validity was investigated by the following methods: the known groups, convergence, discriminant analyses, and the opinions of clinical professionals, who used the TUG-ABS with subjects with stroke. The criterion-related validity was investigated by comparing the realtime and video observation scores. Inter-rater reliability was investigated by two independent examiners using both realtime and video observations.

RESULTS

The TUG-ABS differentiated people with stroke from healthy controls (p < 0.001), was correlated with the time spent to perform the TUG (rs = –0.85; p < 0.001), and correctly classified 98% of the subjects with stroke (p < 0.001). In addition, all of the clinicians who used the TUG-ABS in their clinical settings, provided positive evaluations. Agreement was also observed between real-time and video observations (0.27 ≤ kappa ≤ 0.85; p < 0.01). Furthermore, the TUG-ABS was reliable for both real-time (0.24 ≤ kappa ≤ 1.00; p < 0.05) and video observations (0.15 ≤ kappa ≤ 0.94; p < 0.05).

CONCLUSION

The TUG-ABS demonstrated good construct and criterion-related validities, as well as reliability, when applied in subjects with stroke within clinical settings, which supported the theoretical assumptions employed for its development.

摘要

目的

在临床环境中,评估因中风导致偏瘫的受试者时,探究时间“站起和行走”评估生物力学策略(TUG-ABS)的可靠性、结构和效标关联效度。

方法/设计:采用以下方法评估结构效度:已知组、收敛、判别分析,以及临床专业人员对 TUG-ABS 应用于中风患者的看法。通过比较实时观察和视频观察评分,评估效标关联效度。采用实时和视频观察,由两名独立评估员评估组内信度。

结果

TUG-ABS 能够区分中风患者和健康对照组(p < 0.001),与完成 TUG 所用的时间相关(rs = –0.85;p < 0.001),正确分类了 98%的中风患者(p < 0.001)。此外,所有在临床环境中使用 TUG-ABS 的临床医生都提供了积极的评价。实时观察和视频观察之间也存在一致性(0.27 ≤ kappa ≤ 0.85;p < 0.01)。此外,TUG-ABS 对实时(0.24 ≤ kappa ≤ 1.00;p < 0.05)和视频观察(0.15 ≤ kappa ≤ 0.94;p < 0.05)均具有可靠性。

结论

TUG-ABS 在临床环境中应用于中风患者时,具有良好的结构和效标关联效度以及可靠性,支持了其开发所依据的理论假设。

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