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基于仪器步态分析的步态参数的可靠性:系统评价和荟萃分析。

The reliability of gait parameters captured via instrumented walkways: a systematic review and meta-analysis.

机构信息

Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.

Istituti Clinici Scientifici Maugeri IRCCS, Milan, Italy.

出版信息

Eur J Phys Rehabil Med. 2022 Jun;58(3):363-377. doi: 10.23736/S1973-9087.22.07037-X. Epub 2022 Jan 5.

Abstract

INTRODUCTION

Electronic pressure-sensitive walkways are commonly available solutions to quantitatively assess gait parameters for clinical and research purposes. Many studies have evaluated their measurement properties in different conditions with variable findings. In order to be informed about the current evidence of their reliability for optimal clinical and scientific decision making, this systematic review provided a quantitative synthesis of the test-retest reliability and minimal detectable change of the captured gait parameters across different test conditions (single and cognitive dual-task conditions) and population groups.

EVIDENCE ACQUISITION

A literature search was conducted in PubMed, Embase, and Scopus until November 2021 to identify articles that examined the test-retest reliability properties of the gait parameters captured by pressure-sensitive walkways (gait speed, cadence, stride length and time, double support time, base of support) in adult healthy individuals or patients. The methodological quality was rated using the Consensus-Based Standards for the Selection of Health Measurement Instruments Checklist. Data were meta-analyzed on intraclass correlation coefficient to examine the test-retest relative reliability. Quantitative synthesis was performed for absolute reliability, examined by the weighted average of minimal detectable change values.

EVIDENCE SYNTHESIS

A total of 44 studies were included in this systematic review. The methodological quality was adequate in half of the included studies. The main finding was that pressure-sensitive walkways are reliable tools for objective assessment of spatial and temporal gait parameters both in single-and cognitive dual-task conditions. Despite few exceptions, the review identified intraclass correlation coefficient higher than 0.75 and minimal detectable change lower than 30%, demonstrating satisfactory relative and absolute reliability in all examined populations (healthy adults, elderly, patients with cognitive impairment, spinocerebellar ataxia type 14, Huntington's disease, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, spinal cord injury, stroke or vestibular dysfunction).

CONCLUSIONS

Current evidence suggested that, despite different populations and testing protocols used in the included studies, the test-retest reliability of the examined gait parameters was acceptable under single and cognitive dual-task conditions. Further high-quality studies with powered sample sizes are needed to examine the reliability findings of the currently understudied and unexplored pathologies and test conditions.

摘要

简介

电子压力敏感步道是一种常用的解决方案,可用于临床和研究目的定量评估步态参数。许多研究已经在不同条件下评估了它们的测量性能,结果各不相同。为了了解其在最佳临床和科学决策方面的可靠性的当前证据,本系统评价对不同测试条件(单任务和认知双重任务条件)和人群中捕获的步态参数的测试-重测信度和最小可检测变化进行了定量综合。

证据获取

在 2021 年 11 月之前,在 PubMed、Embase 和 Scopus 上进行了文献检索,以确定检查压力敏感步道(步态速度、步频、步长和时间、双支撑时间、支撑基础)捕获的步态参数的测试-重测可靠性特性的文章在健康成年人或患者中。使用共识标准用于健康测量仪器选择清单来评估方法学质量。使用组内相关系数对数据进行荟萃分析,以检查测试-重测相对可靠性。通过最小可检测变化值的加权平均值进行绝对可靠性的定量综合。

证据综合

本系统评价共纳入 44 项研究。纳入研究中有一半的方法学质量较高。主要发现是,压力敏感步道是在单任务和认知双重任务条件下客观评估空间和时间步态参数的可靠工具。尽管有一些例外,但该综述确定了组内相关系数高于 0.75 和最小可检测变化低于 30%,表明所有检查人群(健康成年人、老年人、认知障碍患者、脊髓小脑共济失调 14 型、亨廷顿病、多发性硬化症、帕金森病、类风湿关节炎、脊髓损伤、中风或前庭功能障碍)的相对和绝对可靠性均令人满意。

结论

尽管纳入研究中使用了不同的人群和测试方案,但目前的证据表明,在单任务和认知双重任务条件下,所检查的步态参数的测试-重测可靠性是可以接受的。需要进一步进行高质量、有充分样本量的研究,以检验目前研究较少且尚未探索的病理学和测试条件的可靠性研究结果。

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