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中文版动作研究手臂测试在脑梗死患者中的反应性和预测能力。

Responsiveness and Predictive Ability of the Chinese Version of the Action Research Arm Test in People with Cerebral Infarction.

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.

Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China.

出版信息

Biomed Res Int. 2019 Oct 7;2019:8270187. doi: 10.1155/2019/8270187. eCollection 2019.

Abstract

PURPOSE

To detect the responsiveness and predictive ability of the Chinese version Action Research Arm Test (C-ARAT) in participants within the first 3 months after cerebral infarction.

METHODS

Ninety-seven individuals (75 men, mean age 59.87 ± 10.94 years) with a first cerebral infarction were enrolled in this study. The participants were evaluated by two outcome measures: C-ARAT and the Barthel Activities of Daily Living Index (BI) at five time points: 0D, 3W, 3M, 6M and 1Y after enrolment. The standardised response mean (SRM) and the Wilcoxon signed rank test were used to analyse responsiveness. Predictive validity was determined by using Spearman's rank correlation coefficients. The predicted performance of C-ARAT on activities of daily living (ADLs) was measured by linear regression model. Floor and ceiling effects were estimated by counting the proportion of subjects falling outside the 5% lower or upper boundary, respectively.

RESULTS

The C-ARAT showed moderate to large responsiveness in detecting changes over time (SRM = 0.58-0.84). The C-ARAT subscales showed small to large responsiveness (SRM = 0.44-0.90). The C-ARAT at 0D showed moderate to good correlation with the BI scores at 3W, 3M and 6M ( = 0.561-0.624, < 0.001), and exhibited fair correlation with the BI score 1Y after enrolment ( = 0.384, < 0.05). C-ARAT was a good predictor (adjusted  = 0.185-0.249) of BI within 3M follow-up. The C-ARAT total score showed a notable floor effect at 0D and 3W and a notable ceiling effect at 3M, 6M and 1Y.

CONCLUSION

The results of this study support the use of the C-ARAT as a measurement of upper extremity function in individuals with a first cerebral infarction.

摘要

目的

检测中文版动作研究臂测试(C-ARAT)在脑梗死发病后 3 个月内患者的反应性和预测能力。

方法

本研究纳入了 97 名初次脑梗死患者(75 名男性,平均年龄 59.87±10.94 岁)。通过两种结局评估方法对患者进行评估:C-ARAT 和 Barthel 日常生活活动指数(BI),在入组后 5 个时间点进行评估:0D、3W、3M、6M 和 1Y。使用标准化反应均值(SRM)和 Wilcoxon 符号秩检验分析反应性。通过 Spearman 秩相关系数确定预测效度。通过线性回归模型测量 C-ARAT 对日常生活活动(ADL)的预测性能。通过计算分别落在 5%下限或上限以外的受试者比例来估计地板和天花板效应。

结果

C-ARAT 在检测随时间变化方面表现出中等到较大的反应性(SRM=0.58-0.84)。C-ARAT 子量表表现出小到较大的反应性(SRM=0.44-0.90)。C-ARAT 在 0D 时与 3W、3M 和 6M 时的 BI 评分具有中等至良好相关性(r=0.561-0.624,P<0.001),与入组后 1Y 时的 BI 评分呈弱相关性(r=0.384,P<0.05)。C-ARAT 在 3M 随访内是 BI 的良好预测指标(调整后 r=0.185-0.249)。C-ARAT 总分在 0D 和 3W 时出现显著地板效应,在 3M、6M 和 1Y 时出现显著天花板效应。

结论

本研究结果支持使用 C-ARAT 作为脑梗死患者上肢功能的测量工具。

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