急性脊髓损伤中脊髓损伤步行指数II版：可靠性与可重复性

Walking Index for Spinal Cord Injury version II in acute spinal cord injury: reliability and reproducibility.

作者信息

Scivoletto G, Tamburella F, Laurenza L, Torre M, Molinari M, Ditunno J F

机构信息

1] Spinal Cord Unit, IRCCS Fondazione S. Lucia, Roma, Italy [2] Clinical and Research Movement Analysis (CARMA) Laboratory, IRCCS Fondazione S. Lucia, Roma, Italy.

Spinal Cord Unit, IRCCS Fondazione S. Lucia, Roma, Italy.

出版信息

Spinal Cord. 2014 Jan;52(1):65-9. doi: 10.1038/sc.2013.127. Epub 2013 Oct 22.

DOI:10.1038/sc.2013.127

PMID:24145685

Abstract

STUDY DESIGN

Administration of the walking index for SCI (WISCI) II is recommended to assess walking in spinal cord injury (SCI) patients. Determining the reliability and reproducibility of the WISCI II in acute SCI would be invaluable.

OBJECTIVES

The objective of this study is to assess the reliability and reproducibility of the WISCI II in patients with traumatic, acute SCI.

DESIGN

Test-retest analysis and calculation of reliability and smallest real difference (SRD).

SETTING

SCI unit of a rehabilitation hospital.

METHODS

Thirty-three patients, median age 44 years, median time since onset of SCI 40 days. Level: 20 cervical, 8 thoracic, 5 lumbar; ASIA (American Spinal Injury Association) impairment scale (AIS) grade: 32 D/1 C. Assessment of maximum WISCI II levels by two trained, blinded raters to evaluate interrater (IRR) and intrarater reliability.

RESULTS

The intrarater reliability was 0.999 for therapists A and 0.979 for therapists B, for the maximum WISCI II level. The IRR for the maximum WISCI II score was 0.996 on day 1 and 0.975 on day 2. The SRD for the maximum WISCI II score was 1.147 for tetraplegics and 1.682 for paraplegics. These results suggest that a change of two WISCI II levels could be considered real.

CONCLUSIONS

The WISCI II has high IRR and intrarater reliability and good reproducibility in the acute and subacute phase when administered by trained raters.

摘要

研究设计

建议采用脊髓损伤步行指数（WISCI）II来评估脊髓损伤（SCI）患者的步行能力。确定WISCI II在急性SCI中的可靠性和可重复性将非常有价值。

目的

本研究的目的是评估WISCI II在创伤性急性SCI患者中的可靠性和可重复性。

设计

重测分析以及可靠性和最小真实差异（SRD）的计算。

地点

一家康复医院的SCI科室。

方法

33例患者，中位年龄44岁，SCI发病后中位时间40天。损伤平面：20例颈椎损伤，8例胸椎损伤，5例腰椎损伤；美国脊髓损伤协会（ASIA）损伤分级（AIS）：32例D级/1例C级。由两名经过培训的、不知情的评估者评估最大WISCI II水平，以评估评估者间（IRR）和评估者内可靠性。

结果

对于最大WISCI II水平，评估者A的评估者内可靠性为0.999，评估者B为0.979。最大WISCI II评分的IRR在第1天为0.996，第2天为0.975。四肢瘫患者最大WISCI II评分的SRD为1.147，截瘫患者为1.682。这些结果表明，WISCI II水平变化2个单位可被视为有实际意义。