Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
J Hand Ther. 2019 Jul-Sep;32(3):368-374. doi: 10.1016/j.jht.2017.12.003. Epub 2018 Feb 10.
Reliability study.
Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence.
(1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility.
Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's "acceptability", "demand," and "implementation") was determined by using a questionnaire.
After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were к = 0.54 (confidence interval [CI]: 0.52-0.57) and к = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was к = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program.
It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system.
Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established.
可靠性研究。
量化与工作相关任务期间的代偿运动，可能有助于预防上肢缺失者的肌肉骨骼投诉。
（1）为上肢义肢佩戴者在进行功能性能力评估测试（为单手个体调整）期间，开发一种定性评分系统，以评定代偿性肩部和躯干运动；（2）检验评分系统的组内和组间信度；（3）评估其可行性。
分析了 12 段上肢义肢佩戴者和 20 名对照者的录像。为每个功能性能力评估测试定义了代偿运动，并开发、试点和调整了评分系统。在可靠性测试中，18 名评估者（12 名功能性能力评估专家和 6 名物理治疗师/步态分析师）两次（间隔 2 周）对上肢义肢佩戴者进行 4 项功能性能力评估测试的录像进行评分。一致性用%和 Kappa 值表示。通过问卷确定可行性（关注领域的“可接受性”、“需求”和“实施”）。
经过两轮试点和调整，对第三个版本的可靠性进行了测试。第一次和第二次评分的组间信度分别为к=0.54（置信区间[CI]：0.52-0.57）和к=0.64（CI：0.61-0.66）。组内信度为к=0.77（CI：0.72-0.82）。可行性良好，但可以通过培训计划改进。
使用开发的观察性评分系统，通过观察，似乎可以可靠地识别上肢义肢佩戴者在进行功能性能力评估测试期间的代偿运动。
多数情况下，组间信度令人满意；组内信度良好。可行性已确立。
