Service de Médecine Physique et de Réadaptation, CHU de Caen, France.
Université de Versailles St-Quentin en Yvelines, INSERM UMR 1179, Montigny-le-Bretonneux, France.
Arch Phys Med Rehabil. 2019 Sep;100(9):1672-1679. doi: 10.1016/j.apmr.2018.12.034. Epub 2019 Jan 24.
To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors.
Psychometric study.
Ambulatory stroke care.
A total of one hundred and forty-six (N=146) individuals were included in this study. In stage 1, community-living stroke survivors (n=37; 13 women) with low-moderate disability (modified Rankin Score 0-3, stroke >3mo) were included. In stage 2, participants (n=109; 40 women) with same characteristics were included. Nine professionals experienced in PA for poststroke patients formed an expert panel.
In stage 1, semistructured interviews identified perceived barriers to PA, which were then selected by the expert panel and grouped on a Barriers to Physical Activity After Stroke (BAPAS) scale. In stage 2, stroke participants completed a personal information questionnaire and the BAPAS scale.
An item selection process with factor analysis was carried out. The suitability of the data set was analyzed using the Kaiser-Meyer-Olkin coefficient, internal consistency was evaluated by Cronbach α, and concurrent validity was assessed with Spearman correlation coefficients between the BAPAS scale and the modified Rankin Scale. Test-retest repeatability was estimated using 2-way random effects intraclass correlation coefficient model 2,1 at 4-6 day follow-up (n=21).
Factor analysis supported a 14-item BAPAS that explained 62% of total variance (Kaiser-Meyer-Olkin=0.82) and total score calculated higher than 70 (higher scores for higher barriers). Cronbach α was 0.86, Spearman correlation with the modified Rankin Scale was r=0.65 (P<.001), and test-retest intraclass correlation coefficient was 0.91 (95% CI, 0.79-0.97). The BAPAS scores were higher in patients with greater disabilities and in those with a longer time since the stroke event (P<.01).
We developed and validated the BAPAS scale to assess barriers to PA in stroke survivors with low-moderate disability with promising psychometric properties.
开发并验证一种自我报告问卷，用于评估卒中幸存者的身体活动（PA）障碍。
心理测量学研究。
门诊卒中护理。
共有 146 人（N=146）参与了这项研究。在第 1 阶段，纳入了社区居住的卒中幸存者（n=37；13 名女性），残疾程度较低（改良 Rankin 评分为 0-3，卒中>3 个月）。在第 2 阶段，纳入了具有相同特征的 109 名参与者（n=109；40 名女性）。9 位在卒中后患者的 PA 方面有经验的专业人员组成了一个专家小组。
在第 1 阶段，半结构化访谈确定了对 PA 的感知障碍，然后由专家小组选择，并将其分组到卒中后身体活动障碍（BAPAS）量表中。在第 2 阶段，卒中参与者完成了个人信息问卷和 BAPAS 量表。
进行了项目选择过程和因子分析。使用 Kaiser-Meyer-Olkin 系数分析数据集的适用性，用 Cronbach α 评估内部一致性，并用 BAPAS 量表和改良 Rankin 量表之间的 Spearman 相关系数评估同时效度。使用 2 种随机效应的 2 型 1 型组内相关系数模型（2 型 1 型 ICC），在 4-6 天的随访中（n=21）评估测试-重测的重复性。
因子分析支持有 14 个项目的 BAPAS，解释了总方差的 62%（Kaiser-Meyer-Olkin=0.82），总得分超过 70 分（得分越高，障碍越大）。Cronbach α 为 0.86，与改良 Rankin 量表的 Spearman 相关系数为 r=0.65（P<.001），测试-重测的组内相关系数为 0.91（95%CI，0.79-0.97）。在残疾程度较高和卒中事件发生时间较长的患者中，BAPAS 评分较高（P<.01）。
我们开发并验证了 BAPAS 量表，用于评估低中度残疾卒中幸存者的 PA 障碍，具有良好的心理测量学特性。
