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社区居住老年人四步楼梯攀爬功率测试的信度、效度和最小可检测变化

Reliability, Validity, and Minimal Detectable Change of Four-Step Stair Climb Power Test in Community-Dwelling Older Adults.

作者信息

Ni Meng, Brown Lorna G, Lawler Danielle, Bean Jonathan F

机构信息

Spaulding Rehabilitation Hospital, 1575 Cambridge St, Cambridge, MA 02138 (USA), and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.

Spaulding Rehabilitation Hospital.

出版信息

Phys Ther. 2017 Jul 1;97(7):767-773. doi: 10.1093/ptj/pzx039.

Abstract

BACKGROUND

Stair climb power is an important clinical measure of lower-extremity power. The stair climb power test (SCPT) was validated by requiring individuals to climb a full flight of stairs. A 4-step SCPT (4SCPT) would be more clinically feasible and easier to perform, yet its reliability and validity are unknown.

OBJECTIVE

To evaluate reliability, validity, and minimal detectable change of 4SCPT among community-dwelling older adults.

DESIGN

This study is a cross-sectional analysis of baseline data from a clinical trial.

METHODS

Fifty older adults ≥65 years of age, at risk for mobility decline, consented to participate in this ancillary study. Test-retest reliability was derived from 2 measurements within each participant measured by a single assessor. Pearson correlation analyses among leg power measures (4SCPT, SCPT, single leg press power at 40% and 70% of the 1-repetition maximum [SLP40, SLP70]) were performed. Separate multivariate linear regressions were conducted evaluating the associations between each leg power measure and 2 mobility outcomes, the Short Physical Performance Battery (SPPB) and habitual gait speed (HGS). Minimal detectable change was based on a 90% confidence interval (MDC 90 ).

RESULTS

The 4SCPT had excellent test-retest reliability (ICC(2,1) = 0.951), and strong correlation with SCPT, SLP40, and SLP70 ( r = 0.85-0.96). The 4SCPT explained a greater amount of variance in the SPPB (R 2 = 0.31) than other leg power measurements (R 2 = 0.23-0.25). The 4SCPT (R 2 = 0.41) and SCPT (R 2 = 0.42) described equivalent amounts of variance in HGS, and greater than that with SLP40 (R 2 = 0.28) and SLP70 (R 2 = 0.30). The MDC 90 for 4SCPT was 44.0 watts.

LIMITATIONS

This was a cross-sectional analysis within a small, nonrepresentative sample. Interrater reliability was not evaluated.

CONCLUSIONS

The 4SCPT shows scientific promise as a valid and reliable leg power measurement among community-dwelling older adults.

摘要

背景

爬楼梯功率是下肢力量的一项重要临床指标。爬楼梯功率测试(SCPT)通过要求个体攀爬一整段楼梯来进行验证。四步爬楼梯功率测试(4SCPT)在临床上会更可行且更易于实施,但其可靠性和有效性尚不清楚。

目的

评估社区居住的老年人中4SCPT的可靠性、有效性和最小可检测变化。

设计

本研究是对一项临床试验基线数据的横断面分析。

方法

50名年龄≥65岁、有行动能力下降风险的老年人同意参与这项辅助研究。重测信度来自于由单一评估者对每位参与者进行的两次测量。对腿部力量指标(4SCPT、SCPT、一次重复最大值的40%和70%时的单腿推举力量[SLP40、SLP70])进行Pearson相关性分析。进行单独的多元线性回归,评估每个腿部力量指标与两个行动能力结果之间的关联,即简短体能状况量表(SPPB)和习惯性步速(HGS)。最小可检测变化基于90%置信区间(MDC90)。

结果

4SCPT具有出色的重测信度(ICC(2,1)=0.951),并且与SCPT、SLP40和SLP70有很强的相关性(r=0.85 - 0.96)。4SCPT在SPPB中解释的方差量(R²=0.31)比其他腿部力量测量指标(R²=0.23 - 0.25)更多。4SCPT(R²=0.41)和SCPT(R²=0.42)在HGS中解释的方差量相当,且大于SLP40(R²=0.28)和SLP70(R²=0.30)。4SCPT的MDC90为44.0瓦。

局限性

这是在一个小的、不具代表性的样本内进行的横断面分析。未评估评分者间信度。

结论

4SCPT作为社区居住老年人中一种有效且可靠的腿部力量测量方法显示出科学前景。

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