痉挛性反射脊髓评估工具的可靠性

Reliability of the Spinal Cord Assessment Tool for Spastic Reflexes.

作者信息

Akpinar Pinar, Atici Arzu, Ozkan Feyza U, Aktas Ilknur, Kulcu Duygu G, Kurt Kubra Neslihan

机构信息

Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.

出版信息

Arch Phys Med Rehabil. 2017 Jun;98(6):1113-1118. doi: 10.1016/j.apmr.2016.09.119. Epub 2016 Oct 12.

DOI:10.1016/j.apmr.2016.09.119

PMID:27744026

Abstract

OBJECTIVE

To assess the reliability of the Spinal Cord Assessment Tool for Spastic Reflexes (SCATS).

DESIGN

Observational reliability study of the SCATS.

SETTING

Inpatient rehabilitation unit at an education and research hospital.

PARTICIPANTS

Subjects (N=47) between the ages of 18 and 88 years with spinal cord injury (SCI) and with American Spinal Injury Association Impairment Scale grades from A to D with spasticity, who were at least 6 months postinjury.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Interrater and test-retest reliability of the SCATS.

RESULTS

The SCATS had substantial to almost perfect interrater agreement (κ=.669-1.000) between the 2 physiatrists. Test-retest agreement of the SCATS was also substantial to almost perfect (κ=.614-1.000) as well. There was a significant correlation between the SCATS clonus scores and the Modified Ashworth scores of the hip, knee, and ankle. No correlation was found between SCATS extensor spasm scores and Modified Ashworth scores. The SCATS flexor spasm scores were only correlated significantly with the ankle plantar flexor Modified Ashworth scores (P<.05).

CONCLUSIONS

The SCATS is a reliable tool for assessing spasm activity and spastic hypertonia in patients with SCI.

摘要

目的

评估脊髓痉挛反射评估工具（SCATS）的可靠性。

设计

SCATS的观察性可靠性研究。

地点

一所教育和研究医院的住院康复科。

参与者

47名年龄在18至88岁之间的脊髓损伤（SCI）患者，美国脊髓损伤协会损伤量表分级为A至D级，伴有痉挛，且受伤至少6个月。

干预措施

不适用。

主要观察指标

SCATS的评定者间信度和重测信度。

结果

两位物理治疗师之间，SCATS的评定者间一致性为高度至几乎完全一致（κ=0.669 - 1.000）。SCATS的重测一致性也为高度至几乎完全一致（κ=0.614 - 1.000）。SCATS阵挛评分与髋、膝和踝关节的改良Ashworth评分之间存在显著相关性。未发现SCATS伸展肌痉挛评分与改良Ashworth评分之间存在相关性。SCATS屈肌痉挛评分仅与踝关节跖屈肌改良Ashworth评分显著相关（P<0.05）。