下肢假肢已使用者进行基于表现的临床测试的测评者间信度和重测信度。
Interrater and Test-Retest Reliability of Performance-Based Clinical Tests Administered to Established Users of Lower Limb Prostheses.
机构信息
Department of Kinesiology, University of Illinois at Chicago, 1919 W. Taylor Street, Chicago, IL 60612 (USA).
Department of Kinesiology, University of Illinois at Chicago.
出版信息
Phys Ther. 2020 Jul 19;100(7):1206-1216. doi: 10.1093/ptj/pzaa063.
OBJECTIVE
A major barrier to reducing falls among users of lower limb prostheses (LLP) has been an absence of statistical indices required for clinicians to select and interpret scores from performance-based clinical tests. The study aimed to derive estimates of reliability, measurement error, and minimal detectable change values in performance-based clinical tests administered to unilateral LLP users.
METHODS
A total of 60 unilateral LLP users were administered the Narrowing Beam Walking Test, Timed ``Up and Go'' (TUG), Four Square Step Test (FSST), and 10-Meter Walk Test on 2 occasions, 3 to 9 days apart. Intraclass correlation coefficients (ICCs) were calculated to assess interrater and test-retest reliability, while standard error of measurement (SEM) and minimal detectable change (MDC90) were derived to establish estimates of measurement error in individual scores or changes in score for each test.
RESULTS
Interrater reliability ICCs (1,1) were high for all tests (ie, ≥0.98). Test-retest ICCs (2,1) varied by test, ranging from .88 for the TUG to .97 for the FSST. SEM and MDC90 varied between .39 and .96 and between .91 seconds and 2.2 seconds for the time-based tests (FSST, TUG, 10-Meter Walk Test). SEM and MDC90 for the Narrowing Beam Walking Test were .07 and .16, respectively.
CONCLUSION
With the exception of the TUG, studied tests had test-retest ICCs (2,1) that exceeded the minimum required threshold to be considered suitable for group- and individual-level applications (ie, ICC ≥ 0.70 and ≥ 0.90, respectively). Future research on individuals with dysvascular and transfemoral amputations or in specific age categories is required.
IMPACT
Along with published validity indices, these reliability, error, and change indices can help clinicians select balance tests suitable for LLP users. They can also help clinicians interpret test scores to make informed, evidence-based clinical decisions.
目的
减少下肢假肢（LLP）使用者跌倒的一个主要障碍是缺乏临床医生选择和解释基于表现的临床测试得分所需的统计指标。本研究旨在为单侧 LLP 用户进行的基于表现的临床测试中得出可靠性、测量误差和最小可检测变化值的估计。
方法
共有 60 名单侧 LLP 用户在 3 至 9 天内的 2 次就诊中接受了狭窄光束行走测试、计时“站起来”（TUG）、四方步测试（FSST）和 10 米步行测试。计算组内相关系数（ICC）以评估评分者间和测试-重测可靠性，而测量误差的标准误差（SEM）和最小可检测变化（MDC90）则用于确定每个测试的个体评分或评分变化的测量误差估计值。
结果
所有测试的评分者间 ICC（1,1）均较高（即≥0.98）。基于表现的测试的测试-重测 ICC（2,1）因测试而异，范围从 TUG 的 0.88 到 FSST 的 0.97。基于时间的测试（FSST、TUG、10 米步行测试）的 SEM 和 MDC90 在 0.39 和 0.96 之间变化，时间在 0.91 秒至 2.2 秒之间。Narrowing Beam Walking Test 的 SEM 和 MDC90 分别为 0.07 和 0.16。
结论
除 TUG 外，研究中的测试的测试-重测 ICC（2,1）均超过了适合群体和个体应用的最低要求阈值（即 ICC≥0.70 和≥0.90）。需要针对血管功能障碍和股骨截肢或特定年龄组的个体进行进一步的研究。
影响
除了已发表的有效性指标外，这些可靠性、误差和变化指标还可以帮助临床医生选择适合 LLP 用户的平衡测试。它们还可以帮助临床医生解释测试分数，以做出明智、基于证据的临床决策。
Zotero 插件