远程步态评估和步态辅助器具评估：有效性和评分者间可靠性。
Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability.
机构信息
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Physical Medicine and Rehabilitation Service, Durham VA Health Care System, Durham, North Carolina.
出版信息
Phys Ther. 2020 Apr 17;100(4):708-717. doi: 10.1093/ptj/pzaa005.
BACKGROUND
Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation.
OBJECTIVE
The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment.
DESIGN
This repeated-measures study compared the test performances of in-person, slow motion (SM) review, and normal-speed (NS) video ratings at various fixed frame rates (8, 15, and 30 frames per second) and bandwidth (128, 384, and 768 kB/s) configurations.
METHODS
Overall bias, validity, and interrater reliability were assessed for in-person, SM video, and NS video ratings, with SM video rating as the gold standard, as well as for different frame rate and bandwidth configurations within NS videos.
RESULTS
There was moderate to good interrater reliability for the POMA-G (intraclass correlation coefficient [ICC] = 0.66-0.77 across all configurations) and moderate validity for in-person (β = 0.62; 95% confidence interval [CI] = 0.37-0.87) and NS video (β = 0.74; 95% CI = 0.67-0.80) ratings compared with the SM video rating. For cane height, interrater reliability was good (ICC = 0.66-0.77), although it was significantly lower at the lowest frame rate (8 frames per second) (ICC = 0.66; 95% CI = 0.54-0.76) and bandwidth (128 kB/s) (ICC = 0.69; 95% CI = 0.57-0.78) configurations. Validity for cane height was good for both in-person (β = 0.80; 95% CI = 0.62-0.98) and NS video (β = 0.86; 95% CI = 0.81-0.90) ratings compared with SM video rating.
LIMITATIONS
Some lower frame rate and bandwidth configurations may limit the reliability of remote cane height assessments.
CONCLUSIONS
Teleassessment for POMA-G and cane height using typically available internet and video quality is feasible, valid, and reliable.
背景
步态和移动辅助评估是康复的重要组成部分。鉴于远程医疗越来越多地用于满足康复需求，因此，在远程康复的限制范围内，对这些评估进行可行性研究很重要。
目的
本研究旨在通过不同的视频和传输设置来检验 Tinetti 表现导向的移动评估步态量表（POMA-G）和拐杖高度评估的可靠性和有效性，以证明远程评估的可行性。
设计
这是一项重复测量研究，比较了在不同固定帧率（8、15 和 30 帧/秒）和带宽（128、384 和 768 kB/s）配置下的面对面、慢动作（SM）查看和正常速度（NS）视频评分的测试性能。
方法
使用 SM 视频评分作为金标准，评估面对面、SM 视频和 NS 视频评分的整体偏差、有效性和组内相关性，并评估 NS 视频内不同帧率和带宽配置的结果。
结果
POMA-G 的组内相关性在中等至良好范围内（所有配置的 ICC=0.66-0.77），面对面和 NS 视频评分的有效性适中（与 SM 视频评分相比，β=0.62；95%置信区间[CI]：0.37-0.87；β=0.74；95% CI：0.67-0.80）。与 NS 视频相比，拐杖高度的组内相关性良好（ICC=0.66-0.77），但在最低帧率（8 帧/秒）（ICC=0.66；95% CI：0.54-0.76）和带宽（128 kB/s）（ICC=0.69；95% CI：0.57-0.78）配置下，相关性显著降低。与 SM 视频评分相比，面对面和 NS 视频评分的拐杖高度有效性均良好（与 SM 视频评分相比，β=0.80；95% CI：0.62-0.98；β=0.86；95% CI：0.81-0.90）。
局限性
一些较低的帧率和带宽配置可能会限制远程拐杖高度评估的可靠性。
结论
使用通常可用的互联网和视频质量进行 POMA-G 和拐杖高度的远程评估是可行、有效和可靠的。
Zotero 插件