German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich, Marchioninistraße 15, 81377 Munich, Germany; Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany.
Schoen Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany; Chair of Human Movement Science, Department of Sports and Health Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992 Munich, Germany.
Ann Phys Rehabil Med. 2022 Mar;65(2):101537. doi: 10.1016/j.rehab.2021.101537. Epub 2021 Nov 18.
Retropulsion is an impairment of body orientation against gravity in the sagittal plane. In a Delphi study, the Scale for Retropulsion (SRP) was developed with a high level of expert agreement.
To assess the clinimetric properties of the German SRP in patients with neurological disorders.
The SRP was applied to 70 hospitalized patients with neurological disorders (stroke, critical illness neuropathy and/or myopathy, Parkinson syndromes). Internal consistency was determined with the Cronbach ɑ. Test-retest and interrater reliabilities were evaluated with the weighted kappa, intraclass correlation coefficient (ICC), and Bland-Altman plots. The construct validity was evaluated with Spearman correlation.
The median (interquartile range) SRP score was 5 (3-8) and ranged from 0 to 22 (total scale range: 0 to 24). The SRP had excellent internal consistency (Cronbach ɑ=0.875) and good to excellent test-retest reliability (weighted kappa=0.957, ICC=0.957) and interrater reliability (weighted kappa=0.837, ICC=0.837). Analysis of construct validity resulted in good correlations with other clinical balance scales (r>0.80), and fair to moderate correlations with posturographic measures (r=0.27-0.56) and the subjective postural vertical error in the sagittal plane (r=-0.325, P=0.012) as well as the range in the frontal plane (r=0.359, P=0.007). The SRP discriminated between patients classified with and without retropulsion by an independent clinical expert (P<0.001).
The SRP provides a valid and reliable bedside test to quantify retropulsion in individuals with neurological disorders.
后退障碍是矢状面中身体对重力的定向障碍。在一项德尔菲研究中，使用高度专家共识开发了后退障碍量表（SRP）。
评估德国 SRP 在神经障碍患者中的临床计量学特性。
对 70 名患有神经障碍的住院患者（中风、危重病性神经病和/或肌病、帕金森综合征）应用 SRP。使用 Cronbach α 评估内部一致性。使用加权 Kappa、组内相关系数（ICC）和 Bland-Altman 图评估测试-再测试和组内可靠性。使用 Spearman 相关评估结构效度。
SRP 的中位数（四分位距）为 5（3-8），范围为 0 至 22（总量表范围：0 至 24）。SRP 具有极好的内部一致性（Cronbach α=0.875）和良好到极好的测试-再测试可靠性（加权 Kappa=0.957，ICC=0.957）和组内可靠性（加权 Kappa=0.837，ICC=0.837）。结构效度分析得出与其他临床平衡量表的相关性良好（r＞0.80），与姿势描记法测量值的相关性为中等至弱（r=0.27-0.56），与矢状面主观姿势垂直误差的相关性为弱（r=-0.325，P=0.012），与额状面的相关性为弱（r=0.359，P=0.007）。SRP 能够区分独立临床专家分类为有后退障碍和无后退障碍的患者（P＜0.001）。
SRP 提供了一种有效的、可靠的床边测试，用于量化神经障碍患者的后退障碍。
