Gulhane Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gulhane Saglik Bilimleri Fakultesi (Gulhane Kulliyesi), University of Health Sciences, Ankara, Turkey.
Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation,Gazi University, Cankaya, Ankara, Turkey.
Physiother Theory Pract. 2022 Nov;38(13):2905-2919. doi: 10.1080/09593985.2021.1938308. Epub 2021 Jun 17.
Limits of stability (LOS) is a major component of balance dysfunction in people with multiple sclerosis (MS). The functional reach test (FRT) is a clinical LOS assessment; however, its psychometric properties have not been investigated in people with MS yet. : To investigate: (1) the intrarater, interrater, and test-retest reliability of the FRT in people with MS; (2) the minimum detectable change (MDC) in the FRT distances; (3) the concurrent and discriminant validity of the FRT; and (4) the cutoff distance that best discriminates people with MS from healthy people and fallers from non-fallers with MS.
Forty-three people with MS and 36 healthy people participated in this study. The FRT was administered along with the instrumented LOS test, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, and Expanded Disability Status Scale. The FRT was repeated by the same rater after 2 min from the first test session to determine the intrarater reliability and was simultaneously conducted by two independent raters to determine the interrater reliability. The FRT was also repeated after 7-10 days to determine the test-retest reliability. The reliability was quantified using intraclass correlation coefficients (ICC), Bland-Altman plots, and the MDC. The validity was assessed by correlating the FRT distances with the scores of other measures and by comparing the FRT distances between the MS group and healthy people, and between the fallers and non-fallers in the MS group.
The FRT demonstrated good to excellent intrarater, interrater, and test-retest reliability with an ICC (3,1) of 0.80-0.88 ( < .001), an ICC (3,2) of 0.94-0.97 ( < .001), an ICC (2,3) of 0.84-0.86 ( < .001), respectively. Bland-Altman analyses showed no systematic bias between the assessments. The MDC was 8.28 centimeters. The FRT was correlated with the other outcome measures (correlation coefficients ranged from 0.31 to 0.79, < .05 for all). Significant differences in the FRT distances were found between people with MS and healthy people; however, no significant difference was found between the fallers and non-fallers with MS ( < .001 and = .09, respectively). The cutoff distance of 35.5 centimeters best discriminates healthy people from people with MS while of 28.5 centimeters did not discriminate between the fallers and non-fallers with MS.
The FRT is a reliable, valid, and easy-to-administer tool for assessing LOS in people with MS.
平衡障碍的稳定性极限（LOS）是多发性硬化症（MS）患者平衡功能障碍的主要组成部分。功能性伸展测试（FRT）是一种临床 LOS 评估方法；然而，它的心理测量特性尚未在 MS 患者中进行研究。目的：研究：（1）FRT 在 MS 患者中的内部、内部和重测信度；（2）FRT 距离的最小可检测变化（MDC）；（3）FRT 的同时和判别效度；（4）最佳区分 MS 患者与健康人和 MS 跌倒者与非跌倒者的截断距离。
43 名 MS 患者和 36 名健康人参加了这项研究。FRT 与仪器化 LOS 测试、伯格平衡量表、四方步测试、计时起身行走测试和扩展残疾状况量表一起进行。在第一次测试后 2 分钟内，由同一位评估者重复进行 FRT，以确定内部评估者的可靠性，并由两位独立评估者同时进行，以确定内部评估者的可靠性。FRT 也在 7-10 天后重复进行，以确定重测信度。使用组内相关系数（ICC）、Bland-Altman 图和 MDC 来量化可靠性。通过将 FRT 距离与其他测量结果的得分相关联，并通过比较 MS 组中的 FRT 距离与健康人以及 MS 组中的跌倒者与非跌倒者，评估了有效性。
FRT 表现出良好到优秀的内部、内部和重测信度，ICC（3,1）为 0.80-0.88（<0.001），ICC（3,2）为 0.94-0.97（<0.001），ICC（2,3）为 0.84-0.86（<0.001）。Bland-Altman 分析显示评估之间没有系统偏差。MDC 为 8.28 厘米。FRT 与其他结果测量值相关（相关系数范围为 0.31 至 0.79，<0.05 所有）。MS 患者与健康人之间的 FRT 距离存在显著差异；然而，MS 患者中的跌倒者与非跌倒者之间没有显著差异（<0.001 和 =0.09，分别）。35.5 厘米的截断距离可最佳区分健康人与 MS 患者，而 28.5 厘米的截断距离不能区分 MS 患者中的跌倒者与非跌倒者。
FRT 是一种可靠、有效且易于管理的工具，可用于评估 MS 患者的 LOS。
