Çolak İlker, Mete Emel, Kristensen Morten Tange, Kuru Çolak Tuğba
Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği 34890 Kartal, İstanbul, Türkiye.
Jt Dis Relat Surg. 2020;31(2):346-352. doi: 10.5606/ehc.2020.75526. Epub 2020 Jun 18.
This study aims to translate and investigate the inter- rater reliability, agreement and validity of the Turkish version of the Cumulated Ambulation Score (CAS-TR) in patients with hip fracture.
This study included patients with a hip fracture of the femoral neck between July 2019 and March 2020 at the Dr. Lütfi Kırdar Kartal Training and Education Hospital, Department of Orthopedics and Traumatology, Istanbul. The CAS manual and score-sheet were translated into Turkish. An orthopedician and a physiotherapist independently administered the CAS-TR to 36 patients (12 males, 24 females; mean age 78.7 years; range, 65 to 90 years) at postoperative days one, two, three and 30. Weighted Cohen's kappa coefficient was used to measure inter-rater reliability. Turkish version of modified Barthel Index was used for analysis of validity.
The majority of the patients had type III fracture (72.2%) according to Garden's classification. The kappa value was ≥0.90 for days one-three, the total and 30th day score of CAS-TR. The observed agreement ranged between 91.6% and 100% for all assessments. Validity analysis showed a significantly positive correlation between day two and day 30 CAS-TR and Barthel scores.
We found almost perfect reliability, high percentage agreement and acceptable convergent validity of the CAS-TR. We recommend the CAS to be used as an easily applicable instrument to assess basic mobility status in Turkish patients with hip fracture. Orthopedic and geriatric patients and patients undergoing any type of surgery can be assessed with CAS for early evaluation of mobility status.
本研究旨在翻译并调查土耳其语版累积步行评分（CAS-TR）在髋部骨折患者中的评分者间信度、一致性和效度。
本研究纳入了2019年7月至2020年3月在伊斯坦布尔卢特菲·基尔达尔·卡尔塔尔培训与教育医院骨科与创伤科就诊的股骨颈髋部骨折患者。将CAS手册和评分表翻译成土耳其语。一名骨科医生和一名物理治疗师在术后第1、2、3和30天分别独立对36例患者（12例男性，24例女性；平均年龄78.7岁；范围65至90岁）进行CAS-TR评估。采用加权Cohen's kappa系数测量评分者间信度。使用土耳其语版改良Barthel指数进行效度分析。
根据Garden分类，大多数患者为III型骨折（72.2%）。CAS-TR第1至3天、总分和第30天评分的kappa值≥0.90。所有评估的观察一致性在91.6%至100%之间。效度分析显示，第2天和第30天的CAS-TR与Barthel评分之间存在显著正相关。
我们发现CAS-TR具有几乎完美的信度、高百分比一致性和可接受的收敛效度。我们建议将CAS用作评估土耳其髋部骨折患者基本活动状态的一种易于应用的工具。骨科和老年患者以及接受任何类型手术的患者都可以使用CAS进行活动状态的早期评估。
