Highsmith M Jason, Kahle Jason T, Kaluf Brian, Miro Rebecca M, Mengelkoch Larry J, Klenow Tyler D
School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA; Extremity Trauma & Amputation Center of Excellence (EACE), U.S. Department of Veterans Affairs, Tampa, FL, USA; 319 Minimal Care Detachment, U.S. Army Reserves, Pinellas Park, FL, USA.
OP Solutions, Tampa, FL, USA; Prosthetic Design + Research, Tampa, FL, USA.
Technol Innov. 2016 Sep;18(2-3):193-201. doi: 10.21300/18.2-3.2016.193.
The hill assessment index (HAI) and stair assessment index (SAI) were developed to objectively evaluate ramp and stair gait. This study's purpose was to determine the validity and reliability of these tests in a sample of persons with unilateral transfemoral amputation (TFA) using microprocessor prosthetic knee systems. All subjects were fit with a microprocessor knee system. After accommodation, subjects performed three trials ascending and descending a 5° ramp and a flight of stairs while being recorded on video. Sensitivity and specificity for the HAI was calculated against degree of asymmetry in step length using Dartfish video analysis software. Reliability was assessed using intraclass correlational coefficients calculated using Spearman's Rho (r). significance level was set at ≤ 0.05. Twenty ( = 20) individuals with TFA completed the study protocol. Sensitivity and specificity of the HAI were calculated at 88.0% and 75.0% during ascending conditions and 94.0% and 67.0% during descending conditions, respectively. Significant correlations for the HAI included r = 0.87 and r = 0.73 within raters uphill and downhill, respectively. Corresponding coefficients of r = 0.80 and r = 0.67 were calculated between raters. For the SAI, significant correlations included r = 1.00 for both comparisons within raters and in the comparison between raters in the ascending condition. A correlation of r = 0.89 was calculated for the between-rater comparison in the descending condition. The HAI showed moderate to excellent sensitivity and specificity but good to adequate reliability. The SAI showed excellent to good reliability.
山丘评估指数（HAI）和楼梯评估指数（SAI）旨在客观评估斜坡和楼梯步态。本研究的目的是确定这些测试在使用微处理器假肢膝关节系统的单侧经股骨截肢（TFA）患者样本中的有效性和可靠性。所有受试者均适配了微处理器膝关节系统。适应期过后，受试者在上下5°斜坡和一段楼梯时各进行三次试验，同时进行视频记录。使用Dartfish视频分析软件，根据步长不对称程度计算HAI的敏感性和特异性。使用斯皮尔曼等级相关系数（r）计算组内相关系数来评估可靠性。显著性水平设定为≤0.05。二十名（n = 20）TFA患者完成了研究方案。HAI在上升条件下的敏感性和特异性分别计算为88.0%和75.0%，在下降条件下分别为94.0%和67.0%。HAI的显著相关性包括评估者上坡和下坡时的r = 0.87和r = 0.73。评估者之间的相应系数分别为r = 0.80和r = 0.67。对于SAI，显著相关性包括评估者内部比较以及上升条件下评估者之间比较的r = 1.00。下降条件下评估者之间比较的相关性计算为r = 0.89。HAI显示出中度至优异的敏感性和特异性，但可靠性良好至足够。SAI显示出优异至良好的可靠性。
