Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France.
Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France.
Ann Phys Rehabil Med. 2020 Mar;63(2):99-105. doi: 10.1016/j.rehab.2020.01.002. Epub 2020 Jan 31.
Urgency urinary incontinence is one of the major disabling urinary symptoms in people with multiple sclerosis (PwMS). The warning time (time from first sensation of urgency to voiding or incontinence) only partially reflects the possibility of continence. Other factors such as mobility, difficulties in transfer or undressing can influence this time.
The aim was to create a specific test for PwMS to assess the global time required to be ready to perform micturition and to assess its reliability.
The Time to be Ready to Void (TRV) was based on 2 timed steps: "mobility" stage, including standing up and walking 6m to the toilet, and the "settled" stage, starting as soon as the individual opens the toilet door until readiness for micturition. All participants performed the TRV twice. Reliability were assessed by the intraclass correlation coefficient (ICC) and convergent validity by Spearman correlation coefficient.
We included 71 PwMS (mean [SD] age 54.4 [11.7] years). Inter-rater reliability was excellent for the TRV mobility stage (ICC: 0.97), settled stage (ICC: 0.99) and total test (ICC: 0.99). Test-retest reliability was good for the mobility stage (ICC: 0.88) and total test (ICC: 0.81) and moderate for the settled stage (ICC: 0.67). Test-retest reliability assessed by a Likert-type scale was good for each stage (κ 0.75 and 0.88). The mobility stage was correlated with the scores for the Timed Up and Go test, 10-Meter Walk Test, and Tinetti Mobility Test (ρ=0.89; ρ=0.88; ρ=-0.67, respectively; P<0.0001) and the settled stage with scores for the Tinetti Mobility Test, Functional Independence Measure and Nine Hold Peg test (right) (ρ=-0.48; ρ=-0.36; ρ=0.31, respectively; P<0.01). Comprehension, acceptance and relevance were rated good by most participants (97%, 95% and 90%, respectively).
The TRV is a new tool to measure the global time needed to be ready to achieve micturition in PwMS. It seems useful in clinical practice for overactive bladder in addition to the classical warning time because it takes into account all the time needed to accomplish micturition (mobility, undressing, installation).
急迫性尿失禁是多发性硬化症患者（PwMS）主要的致残性尿症状之一。预警时间（从第一次尿急感到排尿或失禁的时间）仅部分反映了控制能力。其他因素，如移动能力、转移或脱衣困难，也会影响这一时间。
旨在为 PwMS 创建一项特定的测试，以评估准备排尿所需的总时间，并评估其可靠性。
“准备排尿时间”（TRV）基于 2 个计时步骤：“移动”阶段，包括站起来并走 6 米到厕所，以及“安定”阶段，从个人打开厕所门开始，直到准备好排尿。所有参与者都进行了两次 TRV 测试。采用组内相关系数（ICC）评估内部一致性，采用 Spearman 相关系数评估收敛效度。
我们纳入了 71 名 PwMS（平均[标准差]年龄 54.4[11.7]岁）。TRV 移动阶段（ICC：0.97）、安定阶段（ICC：0.99）和总测试（ICC：0.99）的观察者间信度均极好。移动阶段（ICC：0.88）和总测试（ICC：0.81）的重测信度较好，安定阶段（ICC：0.67）的重测信度中等。每个阶段的李克特量表评估的重测信度均较好（κ值分别为 0.75 和 0.88）。移动阶段与计时起立行走测试、10 米步行测试和 Tinetti 移动测试的评分呈正相关（ρ=0.89；ρ=0.88；ρ=-0.67，均 P<0.0001），安定阶段与 Tinetti 移动测试、功能独立性评定和 9 钉插棒测试（右侧）的评分呈负相关（ρ=-0.48；ρ=-0.36；ρ=0.31，均 P<0.01）。大多数参与者（分别为 97%、95%和 90%）对理解、接受和相关性的评价较好。
TRV 是一种新的工具，可用于测量 PwMS 准备排尿所需的总时间。除了经典的预警时间外，它在评估膀胱过度活动症时似乎很有用，因为它考虑到了完成排尿所需的所有时间（移动、脱衣、安装）。
