Saensook Wilairat, Poncumhak Puttipong, Saengsuwan Jiamjit, Mato Lugkana, Kamruecha Worawan, Amatachaya Sugalya
J Spinal Cord Med. 2014 Mar;37(2):212-7. doi: 10.1179/2045772313Y.0000000139. Epub 2013 Nov 26.
BACKGROUND/OBJECTIVES: Many persons with spinal cord injury (SCI) require an ambulatory assistive device (AAD). An effective monitoring method enables the use of an appropriate AAD and promotes levels of independence for patients. This study investigated the discriminative ability of the three-functional tools relating to walking ability, including the 10-meter walk test (10MWT), the five times sit-to-stand test (FTSST), and the timed up and go test (TUGT), in independent ambulatory persons with SCI who walked with walker, crutches, cane, and non-AAD.
Eighty-five persons with SCI who could perform sit-to-stand and walk independently at least 50 m were cross-sectionally assessed for their functional ability using the 10MWT, FTSST, and TUGT.
The findings for persons not using AADs were significantly better than the other groups for every test (P < 0.001). In addition, persons who walked with cane were significantly different from those who used walkers (P < 0.001) but there were no significant differences between persons who used walker and crutches for every test (P > 0.05).
The findings supported the discriminative validity of the tools, allowing them to indicate functional changes in persons with SCI who walk with different AADs. However, the non-significant differences between subjects who used a walker and crutches may relate to the method of subject arrangement and inclusion criteria that recruit subjects with rather good walking capability and lower limb function. The findings may also suggest the use of the sit-to-stand maneuver as a simple screening tool for walking advancement of walker users, pending further investigation.
背景/目的:许多脊髓损伤(SCI)患者需要使用移动辅助设备(AAD)。一种有效的监测方法能够确保患者使用合适的AAD,并提高其独立水平。本研究调查了与步行能力相关的三种功能测试工具,即10米步行测试(10MWT)、五次坐立测试(FTSST)和计时起立行走测试(TUGT),对使用步行器、拐杖、手杖和不使用AAD独立行走的SCI患者的区分能力。
对85名能够独立完成坐立和至少行走50米的SCI患者,采用10MWT、FTSST和TUGT进行横断面功能能力评估。
在每项测试中,不使用AAD的患者的测试结果均显著优于其他组(P < 0.001)。此外,使用手杖行走的患者与使用步行器的患者之间存在显著差异(P < 0.001),但在每项测试中,使用步行器和拐杖的患者之间没有显著差异(P > 0.05)。
研究结果支持了这些测试工具的区分效度,使其能够表明使用不同AAD行走的SCI患者的功能变化。然而,使用步行器和拐杖的受试者之间无显著差异,这可能与受试者的安排方法和纳入标准有关,这些标准招募的受试者具有较好的步行能力和下肢功能。这些结果也可能表明,在进一步研究之前,坐立动作可作为步行器使用者步行进展的一种简单筛查工具。