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脑卒中患者五次坐站试验的反应性和最小临床重要差异。

Responsiveness and Minimal Clinically Important Difference of the Five Times Sit-to-Stand Test in Patients with Stroke.

机构信息

Department of Physical Therapy, University of Valencia, 46010 Valencia, Spain.

Department of Rehabilitation, Jerez Hospital, 11407 Jerez de la Frontera, Spain.

出版信息

Int J Environ Res Public Health. 2021 Feb 26;18(5):2314. doi: 10.3390/ijerph18052314.

Abstract

This study aimed to analyze the responsiveness of the 5STS test among stroke patients and to estimate the MCIDs (minimal clinically important differences) for different severity levels of community ambulation and stages of recovery. The 5STS and comparator instruments (gait speed and Functional Ambulatory Category (FAC)) were evaluated at baseline. These measures were repeated at 4 (Stage 1) and 8 weeks (Stage 2), together with the Global Rating of Change (GROC). The MCIDs were calculated with two anchor-based methods using the GROC as the external criterion. Responsiveness to change for the 5STS was estimated analyzing the correlation with changes in the two comparator instruments and their capacity to discriminate improvement. For the 5STS test, while the MCIDs of the limited community ambulators were similar in the two stages (around 3 s), those of the household ambulators decreased from 1.9 s to 0.72 s. Spearman's rho coefficients showed an acceptable correlation between changes in 5STS and changes for both the FAC and gait speed changes in both stages of recovery. Our study revealed that the 5STS is responsive to functional changes in patients with stroke and that their degree of severity and stage of recovery influence the MCID values of the 5STS.

摘要

本研究旨在分析脑卒中患者在 5STS 测试中的反应能力,并估计不同社区步行能力严重程度水平和恢复阶段的最小临床重要差异(MCIDs)。5STS 和比较仪器(步态速度和功能性步行分类(FAC))在基线时进行评估。这些措施在第 4 周(第 1 阶段)和第 8 周(第 2 阶段)与整体变化评级(GROC)一起重复测量。使用 GROC 作为外部标准,通过两种基于锚定的方法计算 MCIDs。通过分析与两种比较仪器变化的相关性以及它们区分改善的能力,来估计 5STS 的变化反应性。对于 5STS 测试,虽然有限社区步行者在两个阶段的 MCIDs 相似(约 3 秒),但家庭步行者的 MCIDs 从 1.9 秒降至 0.72 秒。Spearman rho 系数显示在恢复的两个阶段中,5STS 的变化与 FAC 和步态速度变化之间存在可接受的相关性。我们的研究表明,5STS 对脑卒中患者的功能变化具有反应性,其严重程度和恢复阶段会影响 5STS 的 MCID 值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b971/7967692/01ccf54e3991/ijerph-18-02314-g001.jpg

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