Kristensen Morten Tange, Bloch Mette Linding, Jønsson Line Rokkedal, Jakobsen Thomas Linding
Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.
Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.
Physiother Res Int. 2019 Apr;24(2):e1769. doi: 10.1002/pri.1769. Epub 2019 Jan 18.
The purpose of this study was to determine the interrater reliability and measurement error of the standardized Timed Up and Go (TUG) Test manual using the fastest of the three timed TUG trials in hospitalized and community-dwelling older individuals.
Thirty participants (19 from a hospital and 11 from an outpatient geriatric centre: 20 women, 10 men), 65 years or older, all of whom had been referred to physiotherapy due to a functional decline, were included. All participants performed the TUG Test across two sessions (three trials in each) on the same day, separated by a minimum of 30 min. The two raters were blinded to each other's ratings until the end of the study, and the rater order was randomized.
Participants from the outpatient centre had a higher prereferral functional level when evaluated with the New Mobility Score and performed the TUG Test significantly faster than the hospital group. Accordingly, reliability estimates are reported for each specific group. Interrater reliability was excellent for both groups (intraclass correlation coefficient ≥ 0.93), and no systematic between-rater difference for obtained TUG times was found. The measurement error was acceptable both at the group (standard error of measurement [SEM] = 1.7 s and SEM% = 8 [hospital] vs. 0.7 s and 6 [outpatient]) and the individual (minimal detectable change [MDC ] = 4.6 s and MDC % = 23 [hospital] vs. 1.8 s and 17 [outpatient]) level.
Findings suggest that using the fastest of the three TUG trials is highly reliable between raters and with acceptable measurement error. We, therefore, suggest that the standardized TUG manual with the fastest of the three timed trials be used for the assessment of functional mobility in hospitalized and community-dwelling older individuals.
本研究旨在确定标准化的计时起立行走(TUG)测试手册在住院及社区居住的老年人中,使用三次计时TUG试验中最快的一次时的评分者间信度和测量误差。
纳入30名65岁及以上的参与者(19名来自医院,11名来自门诊老年中心:20名女性,10名男性),他们均因功能下降而被转诊至物理治疗科。所有参与者在同一天分两个时段进行TUG测试(每个时段进行三次试验),两次测试间隔至少30分钟。在研究结束前,两名评分者对彼此的评分均不知情,且评分者顺序是随机的。
用新移动性评分评估时,门诊中心的参与者在转诊前功能水平更高,且进行TUG测试的速度明显快于医院组。因此,针对每个特定组报告了信度估计值。两组的评分者间信度均极佳(组内相关系数≥0.93),且未发现评分者间获得的TUG时间存在系统性差异。在组水平(测量标准误[SEM]=1.7秒,SEM%=8[医院];vs. 0.7秒,6[门诊])和个体水平(最小可检测变化[MDC]=4.6秒,MDC%=23[医院];vs. 1.8秒,17[门诊]),测量误差均可接受。
研究结果表明,使用三次TUG试验中最快的一次在评分者间具有高度可靠性,且测量误差可接受。因此,我们建议使用三次计时试验中最快的那次的标准化TUG手册,用于评估住院及社区居住的老年人的功能移动性。