Pike Alycia, McGuckian Thomas B, Steenbergen Bert, Cole Michael H, Wilson Peter H
Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.
Arch Phys Med Rehabil. 2023 Feb;104(2):302-314. doi: 10.1016/j.apmr.2022.07.014. Epub 2022 Aug 6.
To assess the retest reliability, predictive validity, and concurrent validity of locomotor and cognitive dual-task cost (DTC) metrics derived from locomotor-cognitive dual-task paradigms.
A literature search of electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, and Scopus) was conducted on May 29th, 2021, without time restriction.
For 1559 search results, titles and abstracts were screened by a single reviewer and full text of potentially eligible papers was considered by 2 independent reviewers. 25 studies that evaluated retest reliability, predictive validity, and concurrent validity of locomotor-cognitive DTC in healthy and clinical groups met inclusion criteria.
Study quality was assessed using the Consensus-Based Standards for the Selection of Health Measurement Instrument checklist. Data relating to the retest reliability, predictive validity, and concurrent validity of DTC were extracted.
Meta-analysis showed that locomotor DTC metrics (intraclass correlation coefficient [ICC]=0.61, 95% confidence interval [CI; 0.53.0.70]) had better retest reliability than cognitive DTC metrics (ICC=0.27, 95% CI [0.17.0.36]). Larger retest reliability estimates were found for temporal gait outcomes (ICC=0.67-0.72) compared with spatial (ICC=0.34-0.53). Motor DTC metrics showed weak predictive validity for the incidence of future falls (r=0.14, 95% CI [-0.03.0.31]). Motor DTC metrics had weak concurrent validity with other clinical and performance assessments (r=0.11, 95% CI [0.07.0.16]), as did cognitive DTC metrics (r=0.19, 95% CI [0.08.0.30]).
Gait-related temporal DTC metrics achieve adequate retest reliability, while predictive and concurrent validity of DTC needs to be improved before being used widely in clinical practice and other applied settings. Future research should ensure the reliability and validity of DTC outcomes before being used to assess dual-task interference.
评估源自运动-认知双重任务范式的运动和认知双重任务成本（DTC）指标的重测信度、预测效度和同时效度。
于2021年5月29日对电子数据库（PubMed、PsycINFO、MEDLINE、CINAHL和Scopus）进行文献检索，无时间限制。
对于1559条检索结果，由一名审阅者筛选标题和摘要，2名独立审阅者审议潜在符合条件论文的全文。25项评估健康组和临床组中运动-认知DTC的重测信度、预测效度和同时效度的研究符合纳入标准。
使用基于共识的健康测量工具选择标准清单评估研究质量。提取与DTC的重测信度、预测效度和同时效度相关的数据。
荟萃分析表明，运动DTC指标（组内相关系数[ICC]=0.61，95%置信区间[CI；0.53,0.70]）比重测信度认知DTC指标（ICC=0.27，95%CI[0.17,0.36]）更好。与空间步态结果（ICC=0.34-0.53）相比，时间步态结果的重测信度估计值更大（ICC=0.67-0.72）。运动DTC指标对未来跌倒发生率的预测效度较弱（r=0.14，95%CI[-0.03,0.31]）。运动DTC指标与其他临床和性能评估的同时效度较弱（r=0.11，95%CI[0.07,0.16]），认知DTC指标也是如此（r=0.19，95%CI[0.08,0.30]）。
与步态相关的时间DTC指标具有足够的重测信度，而DTC的预测效度和同时效度在广泛应用于临床实践和其他应用场景之前需要改进。未来的研究在用于评估双重任务干扰之前应确保DTC结果的可靠性和效度。
