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功能性步态评估在不完全性脊髓损伤中的可靠性和有效性。

Reliability and Validity of the Functional Gait Assessment in Incomplete Spinal Cord Injury.

机构信息

Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

Top Spinal Cord Inj Rehabil. 2020;26(4):268-274. doi: 10.46292/sci19-00069. Epub 2021 Jan 20.

Abstract

BACKGROUND

There are limited psychometrically sound measures to assess higher level balance in individuals with incomplete spinal cord injury (iSCI).

OBJECTIVES

To evaluate interrater and intrarater reliability and convergent validity of the Functional Gait Assessment (FGA) in individuals with iSCI.

METHODS

Twelve participants (11 male, 1 female) 32 to 73 years old with chronic motor iSCI, American Spinal Injury Association Impairment Scale C ( = 2) or D ( = 10), were included. Participants completed five outcome measures during a single test session including lower extremity motor scores from the International Standards for the Neurological Classification of Spinal Cord Injury, FGA, 10-Meter Walk Test (10MWT), Walking Index for Spinal Cord Injury (WISCI-II), and the Spinal Cord Injury Functional Ambulation Profile (SCI-FAP).

RESULTS

Inter- and intrarater reliability for the FGA were excellent. Interrater reliability was excellent with intraclass correlation coefficient (ICC) scores greater than 0.92 ( < .001). Interrater reliability against an expert was also excellent for all raters, with an ICC greater than or equal to 0.92 ( < .01). Intrarater reliability was excellent with an ICC score of greater than 0.91 ( < .002) for all raters. Validity of the FGA with 10MWT was -0.90 ( = .000), FGA with WISCI-II was 0.74 ( = .006), and FGA with SCI-FAP was -0.83 ( = .001).

CONCLUSION

The FGA is a reliable and valid outcome measure to use when assessing gait and balance in individuals with motor iSCI. The FGA provides clinicians with a single tool to utilize across a variety of neurologic diagnoses.

摘要

背景

目前用于评估不完全性脊髓损伤(iSCI)患者平衡高级别功能的信度和效度良好的测量工具十分有限。

目的

评估功能性步态评估(FGA)在 iSCI 患者中的评定者间信度、评定者内信度和聚合效度。

方法

12 名参与者(11 名男性,1 名女性),年龄 32 至 73 岁,均患有慢性运动性 iSCI,美国脊髓损伤协会损伤分级为 C 级(n = 2)或 D 级(n = 10)。参与者在单次测试中完成了 5 项测试,包括国际脊髓损伤神经分类标准下肢运动评分、FGA、10 米步行测试(10MWT)、脊髓损伤步行指数(WISCI-II)和脊髓损伤功能步行能力评定(SCI-FAP)。

结果

FGA 的评定者间信度和评定者内信度均为优。评定者间信度的组内相关系数(ICC)评分大于 0.92( <.001),表现为极好。所有评定者的专家评定者间信度也极好,ICC 大于或等于 0.92( <.01)。评定者内信度表现为优,所有评定者的 ICC 评分均大于 0.91( <.002)。FGA 与 10MWT 的效度为-0.90( =.000),与 WISCI-II 的效度为 0.74( =.006),与 SCI-FAP 的效度为-0.83( =.001)。

结论

FGA 是评估运动性 iSCI 患者步态和平衡时一种可靠且有效的测量工具。FGA 为临床医生提供了一种可用于多种神经诊断的单一工具。

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