Rasch 验证和比较脑卒中患者的 Mini-BESTest 和 S-BESTest。
Rasch Validation and Comparison of the Mini-BESTest and S-BESTest in Individuals With Stroke.
机构信息
Department of Physical Therapy, Ibaraki Prefectural University of Health Science, Ibaraki, Japan.
Department of Rehabilitation, Public Nanokaichi Hospital, Gunma, Japan.
出版信息
Phys Ther. 2022 Apr 1;102(4). doi: 10.1093/ptj/pzab295.
OBJECTIVE
The purpose of this study was to compare the psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) and S-BESTest and to evaluate which is more suitable for use in clinical settings for individuals with stroke.
METHODS
This multicenter retrospective cross-sectional study investigated 115 individuals with stroke (mean age, 70.8 y [SD = 11.2 y]) who were able to stand without physical assistance. All individuals were examined with the BESTest and with the Mini-BESTest and S-BESTest scored based on the BESTest results. The data were analyzed using a Rasch analysis (partial credit model).
RESULTS
The Mini-BESTest results revealed a correctly functioning rating scale, good fit of the data to the model (apart from 1 overfit item), good reliability for both persons and items (6 statistically detectable levels of balance ability), local dependence between 1 item pair, and essential unidimensionality. The S-BESTest results demonstrated disordered rating scale thresholds (1 response option required collapsing), good fit of the data to the model (apart from 1 underfit item), good reliability for both persons and items (5 statistically detectable levels of balance ability), local dependence between 2 item pairs, and essential unidimensionality.
CONCLUSION
The analyses confirmed that the reliability of the S-BESTest was good and unidimensional and that the test provides several improved points, such as item redundancy and local independence of items. Nevertheless, the Mini-BESTest results supported previous findings as a whole and were better than those from the S-BESTest.
IMPACT
Rasch analysis demonstrated that the Mini-BESTest was a better balance assessment scale than the S-BESTest for individuals with stroke based on its psychometric properties. The Mini-BESTest may serve as a useful scale for assessing balance in individuals with stroke, and a keyform plot and strata may help clinical decision-making in terms of interpreting scores and goal setting.
目的
本研究旨在比较 Mini-Balance Evaluation Systems Test（Mini-BESTest）和 S-BESTest 的心理测量特性，并评估哪一种更适合用于中风患者的临床环境。
方法
这是一项多中心回顾性横断面研究，共纳入 115 名能够无辅助站立的中风患者（平均年龄 70.8 岁 [标准差 11.2 岁]）。所有患者均接受 BESTest 和 Mini-BESTest 检查，并根据 BESTest 结果对 Mini-BESTest 和 S-BESTest 进行评分。数据采用 Rasch 分析（部分信用模型）进行分析。
结果
Mini-BESTest 结果显示，评分量表功能正常，数据与模型拟合良好（除 1 项过拟合项目外），个体和项目的可靠性良好（具有 6 个统计学上可检测的平衡能力水平），1 对项目之间存在局部依赖性，具有基本的单维性。S-BESTest 结果表明，评分量表阈值紊乱（需要合并 1 个应答选项），数据与模型拟合良好（除 1 项欠拟合项目外），个体和项目的可靠性良好（具有 5 个统计学上可检测的平衡能力水平），2 对项目之间存在局部依赖性，具有基本的单维性。
结论
分析结果证实，S-BESTest 的可靠性良好且具有单维性，并且该测试具有一些改进点，如项目冗余和项目的局部独立性。然而，Mini-BESTest 的结果总体上支持了先前的研究结果，并且优于 S-BESTest。
影响
Rasch 分析表明，基于心理测量特性，Mini-BESTest 是一种比 S-BESTest 更适合中风患者的平衡评估量表。Mini-BESTest 可作为评估中风患者平衡能力的有用量表，关键形式图和分层可能有助于在解释分数和设定目标方面进行临床决策。
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