Ogawa Takahisa, Hayashi Hiroto, Kishimoto Toshiki, Mashimo Shota, Kusumoto Yasuaki, Nakamura Keisuke, Aoki Takuya, Moross Janelle, Kristensen Morten Tange, Ishibashi Hideaki
Harvard T.H. Chan School of Public Health, Boston, USA.
Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Prog Rehabil Med. 2020 Dec 2;5:20200030. doi: 10.2490/prm.20200030. eCollection 2020.
The aim of this study was to translate the Cumulated Ambulation Score (CAS) from English into Japanese in cooperation with different types of healthcare providers and to investigate its inter-rater reliability and internal consistency.
Two physical therapists at each of three general hospitals in Japan measured the mobility of 50 consecutive post-operative hip fracture patients on two occasions between 2 and 6 days after surgery using the Japanese version of the CAS (CAS-JP). We analyzed the inter-rater reliability and agreement using both the linear weighted kappa and the interclass correlation coefficient; we also analyzed the internal consistency using Cronbach's alpha coefficient.
The mean age of patients was 81 (SD: 11.6) years and 82% were women. Approximately half of the patients had severe cognitive impairment. Kappa was ≥ 0.93 for the three mobility activities and for the total CAS-JP score, the percentage agreement was ≥ 0.98, the ICC was ≥ 0.95, and Cronbach's alpha coefficient was 0.85.
We found that the CAS-JP possessed good inter-rater reliability, agreement, and internal consistency. The CAS-JP is a reliable and easy-to-use evaluation tool suitable for daily clinical practice across different healthcare providers to monitor mobility in older hip fracture patients in Japan. We suggest that CAS-JP be evaluated in future studies for use in younger patients and in other patient groups with mobility problems.
本研究旨在与不同类型的医疗服务提供者合作，将累积步行评分（CAS）从英文翻译成日文，并调查其评分者间信度和内部一致性。
日本三家综合医院的两名物理治疗师，在术后2至6天内，使用日文版的CAS（CAS-JP），对50例连续的髋部骨折术后患者的活动能力进行了两次测量。我们使用线性加权kappa系数和组内相关系数分析评分者间信度和一致性；还使用Cronbach's alpha系数分析内部一致性。
患者的平均年龄为81岁（标准差：11.6），82%为女性。约一半患者有严重认知障碍。三项活动能力及CAS-JP总分的kappa系数≥0.93，一致性百分比≥0.98，组内相关系数≥0.95，Cronbach's alpha系数为0.85。
我们发现CAS-JP具有良好的评分者间信度、一致性和内部一致性。CAS-JP是一种可靠且易于使用的评估工具，适用于不同医疗服务提供者的日常临床实践，以监测日本老年髋部骨折患者的活动能力。我们建议在未来的研究中对CAS-JP在年轻患者和其他有活动能力问题的患者群体中的应用进行评估。
