Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.
Arch Phys Med Rehabil. 2013 Sep;94(9):1784-1799.e7. doi: 10.1016/j.apmr.2013.04.012. Epub 2013 Apr 28.
To systematically review the instruments used to assess postural control and fear of falling in people with chronic obstructive pulmonary disease (COPD), and to synthesize and evaluate their breadth of content and measurement properties.
MEDLINE, EMBASE, Web of Science, CINAHL, CENTRAL, PsycINFO, PEDro, and OTSeeker databases searched in September 2012.
Two independent reviewers performed the selection of articles, the ICF linking process and quality assessment. Only quantitative studies were included, irrespective of language or publication date.
This systematic review comprised two phases. Phase 1 aimed to identify the commonly used instruments to assess postural control and fear of falling in the COPD literature. The breadth of content of each instrument was examined based on the International Classification of Functioning, Disability and Health (ICF). In phase 2, a measurement property search filter was adopted and used in four electronic databases to retrieve properties reported in the COPD population. The COSMIN checklist was used to assess the methodological quality of each measurement property reported.
Seventeen out of 401 publications were eligible in phase 1. Seventeen instruments were identified including 15 for postural control and 2 for fear of falling assessment. The Berg Balance Scale, the Short Physical Performance Battery, and the Activities-specific Balance Confidence (ABC) scale were the most frequently used instruments to assess postural control and fear of falling respectively. The ICF categories covered varied considerably among instruments. The Balance Evaluation Systems test and ABC presented the greatest breadth of content. Measurement properties reported included criterion predictive validity (4 instruments), construct validity (11 instruments) and responsiveness (1 instrument), with inconsistent findings based on 'fair' and 'poor' quality studies.
Different instruments with heterogeneous content have been used to assess postural control and fear of falling outcomes. Standardized assessment methods and best evidence on measurement properties is required in the COPD literature.
系统评价用于评估慢性阻塞性肺疾病（COPD）患者姿势控制和跌倒恐惧的工具，并综合评价其内容广度和测量特性。
2012 年 9 月检索 MEDLINE、EMBASE、Web of Science、CINAHL、CENTRAL、PsycINFO、PEDro 和 OTSeeker 数据库。
两名独立评审员进行文章选择、ICF 链接过程和质量评估。仅纳入定量研究，无论语言或出版日期如何。
本系统评价包括两个阶段。第 1 阶段旨在确定 COPD 文献中常用的评估姿势控制和跌倒恐惧的工具。根据国际功能、残疾和健康分类（ICF），检查每个工具的内容广度。在第 2 阶段，采用测量属性搜索过滤器，并在四个电子数据库中检索 COPD 人群中报告的属性。使用 COSMIN 清单评估报告的每个测量属性的方法学质量。
第 1 阶段有 401 篇文献中的 17 篇符合条件。确定了 17 种工具，包括 15 种用于姿势控制评估和 2 种用于跌倒恐惧评估。Berg 平衡量表、简短体能测试和活动特定平衡信心量表（ABC 量表）是评估姿势控制和跌倒恐惧最常用的工具。ICF 类别在仪器之间差异很大。平衡评估系统测试和 ABC 具有最大的内容广度。报告的测量特性包括标准预测效度（4 个工具）、结构效度（11 个工具）和反应度（1 个工具），基于“良好”和“较差”质量研究的结果不一致。
用于评估 COPD 患者姿势控制和跌倒恐惧结果的工具具有不同的内容。COPD 文献中需要标准化的评估方法和最佳测量特性证据。
