Andreopoulou Georgia, Mercer Thomas H, van der Linden Marietta L
Centre for Health Activity and Rehabilitation Research,Queen Margaret University, Edinburgh, EH21 6UU, Scotland, UK.
Gait Posture. 2018 Mar;61:55-66. doi: 10.1016/j.gaitpost.2017.12.021. Epub 2017 Dec 25.
Foot drop in people with multiple sclerosis (pwMS) often managed with assistive technologies, such as functional electrical stimulation and ankle foot orthoses. No evidence synthesis exists for the psychometric properties of outcomes used to evaluate the efficacy of these interventions.
This systematic review aimed to identify the outcome measures reported to assess the benefits of assistive technology for pwMS and then synthesize the psychometric evidence in pwMS for a subset of these measures.
Two searches in eight databases were conducted up to May 2017. Methodological quality was rated using the COSMIN guidelines. Overall level of evidence was scored according to the Cochrane criteria.
The first search identified 27 measures, with the 10 m walk test, gait kinematics and Physiological Cost Index (PCI) most frequently used. The second search resulted in 41 studies evaluating 10 measures related to walking performance. Strong levels of evidence were found for the internal consistency and test-retest reliability of the Multiple Sclerosis Walking Scale-12 and for the construct validity for Timed 25 Foot Walk. No psychometric studies were identified for gait kinematics and PCI in pwMS. There was a lack of evidence for measurement error and responsiveness.
Although a strong level of evidence exists for some measures included in this review, there was an absence of psychometric studies on commonly used measures such as gait kinematics. Future psychometric studies should evaluate a wider range of walking related measures used to assess the efficacy of interventions to treat foot drop in pwMS.
多发性硬化症患者（pwMS）的足下垂通常采用功能性电刺激和踝足矫形器等辅助技术进行治疗。目前尚无用于评估这些干预措施疗效的结局指标的心理测量学特性的证据综合分析。
本系统评价旨在确定报告的用于评估辅助技术对pwMS益处的结局指标，然后综合分析pwMS中这些指标子集的心理测量学证据。
截至2017年5月，在8个数据库中进行了两次检索。使用COSMIN指南对方法学质量进行评分。根据Cochrane标准对总体证据水平进行评分。
第一次检索确定了27项指标，其中10米步行试验、步态运动学和生理成本指数（PCI）使用最为频繁。第二次检索产生了41项研究，评估了10项与步行性能相关的指标。发现多发性硬化症步行量表-12的内部一致性和重测信度以及定时25英尺步行的结构效度有强有力的证据水平。未发现关于pwMS中步态运动学和PCI的心理测量学研究。缺乏测量误差和反应性的证据。
尽管本评价中纳入的一些指标有强有力的证据水平，但对于步态运动学等常用指标缺乏心理测量学研究。未来的心理测量学研究应评估更广泛的与步行相关的指标，以评估治疗pwMS足下垂干预措施的疗效。
