Gray Vicki L, Ivanova Tanya D, Garland S Jayne
Department of Physical Therapy and Rehabilitation Sciences, University of Maryland, Baltimore, MD 21201, USA.
Department of Physical Therapy, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Gait Posture. 2014;40(1):198-203. doi: 10.1016/j.gaitpost.2014.03.191. Epub 2014 Apr 8.
Knowing the reliability of the center of pressure (COP) is important for interpreting balance deficits post-stroke, especially when the balance deficits can necessitate the use of short duration trials. The novel aspect of this reliability study was to examine the center of pressure measures using two adjacent force platforms between and within sessions in stroke and controls. After stroke, it is important to understand the contribution of the paretic and non-paretic leg to the motor control of standing balance. Because there is a considerable body of knowledge on COP reliability on a single platform, we chose to examine reliability using two adjacent platforms which has not been examined previously in stroke.
Twenty participants post-stroke and 22 controls performed an arm raise, load drop and quiet stance balance task while standing on two adjacent force platforms, on two separate days. Intraclass correlations coefficient (ICC2,1) and percentage standard error of measurement (SEM%) were calculated for COP velocity, ellipse area, anterior-posterior (AP) displacement, and medial-lateral (ML) displacement.
Between sessions, COP velocity was the most reliable with high ICCs and low SEM% across groups and tasks and ellipse area was less reliable with low ICCs across groups and tasks. COP measures were less reliable during the arm raise than load drop post-stroke. Within session reliability was high for COP velocity and ML displacement requiring no more than six trials across tasks.
The COP velocity was the most reliable measure with high ICCs between sessions and the high reliability was achieved with fewer trials in both groups in a single session.
了解压力中心(COP)的可靠性对于解释中风后的平衡缺陷很重要,特别是当平衡缺陷需要使用短时间试验时。这项可靠性研究的新颖之处在于,在中风患者和对照组的不同时段之间以及时段内,使用两个相邻的测力平台来检查压力中心测量值。中风后,了解患侧和非患侧下肢对站立平衡运动控制的贡献很重要。由于关于单个平台上COP可靠性已有相当多的知识,我们选择使用两个相邻平台来检查可靠性,而这在中风患者中尚未进行过研究。
20名中风后参与者和22名对照组在两个不同的日子里,站在两个相邻的测力平台上进行举臂、负重下落和安静站立平衡任务。计算COP速度、椭圆面积、前后(AP)位移和内外侧(ML)位移的组内相关系数(ICC2,1)和测量标准误差百分比(SEM%)。
在不同时段之间,COP速度是最可靠的,在各分组和任务中ICC值高且SEM%低,而椭圆面积在各分组和任务中的ICC值低,可靠性较差。中风后,举臂期间的COP测量比负重下落时的可靠性更低。在同一时段内,COP速度和ML位移的可靠性较高,在各任务中不超过六次试验即可达到。
COP速度是最可靠的测量指标,在不同时段之间ICC值高,且两组在单个时段内通过较少的试验次数即可实现高可靠性。