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儿童孤独症谱系障碍患者计时起立行走测试的信度和一致性。

Reliability and agreement of the timed up and go test in children and teenagers with autism spectrum disorder.

机构信息

International PhD School, Rey Juan Carlos University, 28008, Madrid, Spain.

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.

出版信息

Eur J Pediatr. 2023 Aug;182(8):3577-3585. doi: 10.1007/s00431-023-05027-8. Epub 2023 May 25.

Abstract

ASD patients include a variety of motor deficits; however, these issues have received less scientific attention than other ASD symptoms. Due to understanding and behavioral difficulties, it might be difficult to administer motor assessment measures to children and adolescents with ASD. To evaluate motor challenges in this population, including gait and dynamic balance issues, the timed up and go test (TUG) may be a simple, easy to apply, quick, and inexpensive tool. This test measures in seconds the time it takes for an individual to get up from a standard chair walk 3 m, turn around, walk back to the chair, and sit down again. The study purpose was to evaluate the inter- and intra-rater reliability of TUG test in children and teenagers with ASD. A total of 50 children and teenagers with ASD (43 boys and 7 girls) between 6 and 18 years were included. Reliability was verified by the intraclass correlation coefficient, standard error of measurement, and minimum detectable change. The agreement was analyzed by the Bland-Altman method. A good intra-rater reliability (ICC = 0.88; 95% CI = 0.79-0.93) and an excellent inter-rater reliability (ICC = 0,99; 95% CI = 0.98 to 0.99) were observed. Additionally, Bland-Altman plots demonstrated that there was no evidence of bias in either the replicates or between examiners. Furthermore, the limits of agreement (LOAs) between the testers and test replicates were close, indicating that there was little variation between measurements.       Conclusions: The test TUG showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition in children and teenagers with ASD. These results could be clinically useful for assessing balance and the risk of falls in children and teenagers with ASD. However, the present study is not free of limitations, such as the use of a non-probabilistic sampling. What is Known: • People with ASD have a variety of motor deficits that have a prevalence rate almost as common as intellectual disability. In our knowledge, there are no studies that provide data on the reliability of the use of scales or assessment tests in children and adolescents with ASD to measure motor difficulties, such as gait and dynamic balance, in children and teenagers with ASD. • Timed up and go test (TUG) could be a possible tool to measure this motor skills. What is New: • The reliability and agreement of the Timed up and go test in 50 children and teenagers with autism spectrum disorder showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition.

摘要

ASD 患者存在多种运动障碍;然而,这些问题受到的科学关注不如其他 ASD 症状多。由于理解和行为方面的困难,对 ASD 儿童和青少年进行运动评估可能具有挑战性。为了评估该人群的运动挑战,包括步态和动态平衡问题,计时起身行走测试(TUG)可能是一种简单、易于应用、快速且廉价的工具。该测试以秒为单位测量个体从标准椅子上起身、走 3 米、转身、走回椅子并再次坐下所需的时间。本研究旨在评估 TUG 测试在 ASD 儿童和青少年中的组内和组间可靠性。共有 50 名 6 至 18 岁的 ASD 儿童和青少年(43 名男孩和 7 名女孩)参与了研究。可靠性通过组内相关系数、测量误差的标准误差和最小可检测变化来验证。通过 Bland-Altman 方法分析一致性。观察到良好的组内可靠性(ICC=0.88;95%CI=0.79-0.93)和极好的组间可靠性(ICC=0.99;95%CI=0.98 至 0.99)。此外,Bland-Altman 图表明,无论是在重复测试还是在测试员之间,都没有证据表明存在偏倚。此外,测试员和测试重复之间的界限协议(LOAs)接近,表明测量之间的差异很小。

结论

在 ASD 儿童和青少年中,TUG 测试表现出较强的组内和组间可靠性值、较低的测量误差比例和基于测试重复的无显著偏倚。这些结果可能对评估 ASD 儿童和青少年的平衡和跌倒风险具有临床意义。然而,本研究并非没有局限性,例如使用非概率抽样。

已知内容

  • ASD 患者存在多种运动障碍,其患病率几乎与智力残疾一样常见。据我们所知,尚无研究提供有关在 ASD 儿童和青少年中使用量表或评估测试来测量运动困难(如步态和动态平衡)的可靠性数据。

  • 计时起身行走测试(TUG)可能是衡量这一运动技能的一种可行工具。

新内容

  • 在 50 名自闭症谱系障碍儿童和青少年中,计时起身行走测试的可靠性和一致性显示出较强的组内和组间可靠性值、较低的测量误差比例和基于测试重复的无显著偏倚。
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42ce/10460318/baaf9394b857/431_2023_5027_Fig1_HTML.jpg

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