P.K. Pardasaney, PT, DPT, ScD, RTI International, 1440 Main St, Suite 337, Waltham, MA 02451 (USA). At the time of the study, Dr Pardasaney was affiliated with the Department of Rehabilitation Sciences, Sargent College of Health & Rehabilitation Sciences, and Health & Disability Research Institute, School of Public Health, Boston University, Boston, Massachusetts.
Phys Ther. 2013 Oct;93(10):1351-68. doi: 10.2522/ptj.20130028. Epub 2013 May 23.
Psychometric limitations of balance measures for community-dwelling elderly may be related to gaps in task and environmental representation.
The purposes of this study were: (1) to conduct item-level content analysis of balance measures for community-dwelling elderly people based on task and environmental factors and (2) to develop profiles of individual measures summarizing their task and environment representation.
A systematic content analysis was conducted.
A literature search was conducted to identify balance measures. Item-level content analysis was based on 7 criteria related to task and environment: (1) task role, (2) environmental variation, (3) object interaction, (4) obstacle negotiation, (5) external forces, (6) dual-tasking, and (7) moving people or objects in the environment.
Twenty-six measures, containing 167 items, were identified. Task role was fairly evenly distributed, with the majority of items examining gait tasks (32.3%), followed by dynamic body stability (29.9%) and static body stability (25.1%). The majority of items involved no environmental variation (58.1%), followed by variation of support surfaces (20.4%), visual conditions (13.2%), and both support and visual conditions (8.4%). Limited task role variability was seen within measures, with 73.1% of measures examining only one task role. Environmental variation was present in 65.3% of measures, primarily during static body stability tasks. Few measures involved object interaction (23.1%), obstacle negotiation (38.5%), external forces (11.5%), dual-tasking (7.7%), or moving people or objects (0%).
The classification framework was not externally validated.
Existing measures focus on single-task assessment in static environments, underrepresenting postural control demands in daily-life situations involving dynamic changing environments, person-environment interactions, and multitasking. New items better reflecting postural control demands in daily-life situations are needed for more ecologically valid balance assessment. Individual balance measure profiles provided can help identify the most appropriate measure for a given purpose.
适用于社区居住老年人的平衡测量方法存在心理计量学上的局限性，这可能与任务和环境表现之间的差距有关。
本研究的目的是：（1）根据任务和环境因素对适用于社区居住老年人的平衡测量方法进行项目水平的内容分析，以及（2）制定个体测量方法的特征分析，总结其任务和环境表现。
系统的内容分析。
进行了文献检索以确定平衡测量方法。基于与任务和环境相关的 7 个标准进行项目水平的内容分析：（1）任务角色，（2）环境变化，（3）物体相互作用，（4）障碍物处理，（5）外力，（6）双重任务，以及（7）在环境中移动人和物体。
确定了 26 种测量方法，包含 167 个项目。任务角色分布相当均匀，多数项目为步态任务（32.3%），其次是动态身体稳定性（29.9%）和静态身体稳定性（25.1%）。多数项目无环境变化（58.1%），其次是支撑表面的变化（20.4%）、视觉条件（13.2%）以及支撑和视觉条件均有的情况（8.4%）。测量方法中的任务角色变化有限，73.1%的测量方法仅检查一个任务角色。65.3%的测量方法存在环境变化，主要是在静态身体稳定性任务中。少数测量方法涉及物体相互作用（23.1%）、障碍物处理（38.5%）、外力（11.5%）、双重任务（7.7%）或移动人和物体（0%）。
分类框架未经外部验证。
现有的测量方法侧重于静态环境下的单一任务评估，在日常生活情况下对涉及动态变化环境、人与环境相互作用和多任务的姿势控制需求代表性不足。需要新的项目来更好地反映日常生活情况下的姿势控制需求，以进行更具生态有效性的平衡评估。提供的个体平衡测量方法特征分析可以帮助确定针对特定目的的最合适的测量方法。
