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急性脑卒中患者舒适步行速度下 6 分钟步行试验和 10 米步行试验的组内信度和一致性。

Inter-rater reliability and agreement of 6 Minute Walk Test and 10 Meter Walk Test at comfortable walk speed in patients with acute stroke.

机构信息

The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.

Department of Neurology, Zealand University Hospital, Roskilde, Denmark.

出版信息

Physiother Theory Pract. 2023 May;39(5):1024-1032. doi: 10.1080/09593985.2022.2030830. Epub 2022 Feb 3.

Abstract

PURPOSE

Remediation of gait problems is a key feature of neurological physiotherapy We aimed to investigate the inter-rater reliability and agreement of the Six Minute Walk Test (6MWT) and Ten Meter Walk Test (10MWT), at comfortable walking speed, in hospitalized acute ischemic stroke patients.

METHOD

Forty acute first-time patients with brain stem or hemispheric ischemic stroke aged 67.4 ± 12.5 (SD), able to walk with or without an assistive device, were tested by one of three physiotherapists. Test-retest reliability was evaluated using a one-way random effects single measures model (1,1) absolute agreement-type Interclass Correlation Coefficient (ICC). Agreement was evaluated using the Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC).

RESULTS

Both tests demonstrated good reliability; ICC 0.83 (CI 95% 0.70-0.90) (6MWT) and 0.76 (CI 95% 0.59-0.87) (10MWT). The 6MWT-SEM was 27.2 m (m) and the SDC was 75.4 m. The 10MWT-SEM was 0.36 meters per second (m/s) and the SDC was 1.0 m/s.

CONCLUSION

Both tests demonstrated good inter-rater reliability, confirming their discriminative ability on a group of hospitalized first-time acute ischemic stroke patients. However, the measurement error was large for both tests, which is likely due to spontaneous neurological recovery and stress in the acute phase severely affecting the individual-level agreement estimate.

摘要

目的

步态问题的矫正(康复)是神经物理治疗的一个关键特征。我们旨在调查在舒适步行速度下,六分钟步行测试(6MWT)和十米步行测试(10MWT)在住院急性缺血性脑卒中患者中的组内可信度和一致性。

方法

40 名首次急性脑干或半球性缺血性脑卒中患者(年龄 67.4±12.5 岁),能够使用或不使用辅助设备行走,由 3 名物理治疗师中的 1 名进行测试。使用单因素随机效应模型(1,1)绝对一致性的组内相关系数(ICC)评估测试-再测试可靠性。使用测量标准误差(SEM)和最小可检测变化(SDC)评估一致性。

结果

两项测试均表现出良好的可靠性;ICC 0.83(95%CI 0.70-0.90)(6MWT)和 0.76(95%CI 0.59-0.87)(10MWT)。6MWT-SEM 为 27.2m(米),SDC 为 75.4m。10MWT-SEM 为 0.36 米/秒(m/s),SDC 为 1.0m/s。

结论

两项测试均表现出良好的组内可信度,证实了它们在一组住院急性缺血性脑卒中患者中的区分能力。然而,两项测试的测量误差都较大,这可能是由于自发的神经康复以及急性阶段的压力严重影响了个体水平的一致性估计。

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