Wong Jennifer S, Jasani Hardika, Poon Vivien, Inness Elizabeth L, McIlroy William E, Mansfield Avril
University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada.
Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada; University of Waterloo, Waterloo, ON, Canada.
Gait Posture. 2014;40(1):259-61. doi: 10.1016/j.gaitpost.2014.02.007. Epub 2014 Feb 26.
Technology-based assessment tools with semi-automated processing, such as pressure-sensitive mats used for gait assessment, may be considered to be objective; therefore it may be assumed that rater reliability is not a concern. However, user input is often required and rater reliability must be determined. The purpose of this study was to assess the inter- and intra-rater reliability of spatial and temporal characteristics of gait in stroke patients using the GAITRite system. Forty-six individuals with stroke attending in-patient rehabilitation walked across the pressure-sensitive mat 2-4 times at preferred walking speeds, with or without a gait aid. Five raters independently processed gait data. Three raters re-processed the data after a delay of at least one month. The intraclass correlation coefficients (ICC) and 95% confidence intervals of the ICC were determined for velocity, step time, step length, and step width. Inter-rater reliability for velocity, step time, and step length were high (ICC>0.90). Intra-rater reliability was generally greater than inter-rater reliability (from 0.81 to >0.99 for inter-rater versus 0.77 to >0.99 for intra-rater reliability). Overall, this study suggests that GAITRite is a reliable assessment tool; however, there still remains subjectivity in processing the data, resulting in no patients with perfect agreement between raters. Additional logic checking within the processing software or standardization of training could help to reduce potential errors in processing.
基于技术的评估工具，如用于步态评估的压敏垫，具有半自动处理功能，可能被认为是客观的；因此，可以假设评分者信度不是问题。然而，通常需要用户输入，并且必须确定评分者信度。本研究的目的是使用GAITRite系统评估中风患者步态的空间和时间特征的评分者间信度和评分者内信度。46名住院康复的中风患者以首选步行速度在压敏垫上行走2至4次，有无步态辅助工具均可。五名评分者独立处理步态数据。三名评分者在至少一个月的延迟后重新处理数据。确定了速度、步幅时间、步幅长度和步幅宽度的组内相关系数（ICC）以及ICC的95%置信区间。速度、步幅时间和步幅长度的评分者间信度较高（ICC>0.90）。评分者内信度通常大于评分者间信度（评分者间信度为0.81至>0.99，评分者内信度为0.77至>0.99）。总体而言，本研究表明GAITRite是一种可靠的评估工具；然而，在处理数据时仍然存在主观性，导致评分者之间没有患者完全一致。处理软件内的额外逻辑检查或培训标准化有助于减少处理中的潜在错误。
