脊髓损伤站立和行走评估工具的评定者间信度。
Interrater reliability of the Standing and Walking Assessment Tool for spinal cord injury.
机构信息
Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
School of Physical and Occupational Therapy, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
出版信息
Spinal Cord. 2023 Oct;61(10):556-561. doi: 10.1038/s41393-023-00921-2. Epub 2023 Jul 31.
STUDY DESIGN
Psychometric study.
OBJECTIVES
The Standing and Walking Assessment Tool (SWAT) is a standardized approach to the evaluation of standing and walking capacity following traumatic spinal cord injury (tSCI) in Canada. The SWAT classifies individuals with a tSCI into 12 stages of standing and walking capacity that are paired with well-established outcome measures, such as the Berg Balance Scale and 10-m Walk Test. Prior research has demonstrated the validity and responsiveness of the SWAT stages; however, the reliability remains unknown. The objective of this study was to evaluate the interrater reliability of the SWAT stages.
SETTING
Inpatient units of two Canadian rehabilitation hospitals.
METHODS
Adults with sub-acute tSCI were recruited. SWAT stage was evaluated for each participant by two physical therapists separately. The two therapists aimed to complete the evaluations within one day of each other. To evaluate interrater reliability, the percentage agreement between the SWAT stages rated by the two physical therapists was calculated, along with a linear weighted kappa statistic with a 95% CI.
RESULTS
Forty-five individuals with sub-acute tSCI (36 males, 9 females, mean (SD) age of 54.8 (17.9) years) participated. The percentage agreement in SWAT stages between the two physical therapists was 75.6%. A kappa statistic of 0.93 with a 95% CI, 0.81-1.05 was obtained. In cases where therapists disagreed (18% of participants), therapists differed by 1-2 stages only.
CONCLUSIONS
The SWAT stages have high interrater reliability, providing further support for the use of the SWAT in rehabilitation practice in Canada.
研究设计
心理计量研究。
目的
站立和行走评估工具（SWAT）是一种在加拿大评估创伤性脊髓损伤（tSCI）后站立和行走能力的标准化方法。SWAT 将 tSCI 患者分为 12 个站立和行走能力阶段，与经过验证的结果测量方法（如 Berg 平衡量表和 10 米步行测试）相匹配。先前的研究已经证明了 SWAT 阶段的有效性和反应性；然而，其可靠性尚不清楚。本研究的目的是评估 SWAT 阶段的评分者间可靠性。
设置
加拿大两家康复医院的住院病房。
方法
招募亚急性 tSCI 成人。由两位物理治疗师分别对每位参与者进行 SWAT 阶段评估。两位治疗师的目标是在彼此一天内完成评估。为了评估评分者间的可靠性，计算了两位物理治疗师评定的 SWAT 阶段之间的百分比一致性，以及线性加权kappa 统计量（95%CI）。
结果
45 名亚急性 tSCI 患者（36 名男性，9 名女性，平均（SD）年龄为 54.8（17.9）岁）参与了研究。两位物理治疗师评定的 SWAT 阶段之间的百分比一致性为 75.6%。获得了kappa 统计量为 0.93（95%CI，0.81-1.05）。在治疗师存在分歧的情况下（18%的参与者），治疗师仅相差 1-2 个阶段。
结论
SWAT 阶段具有很高的评分者间可靠性，进一步支持了在加拿大康复实践中使用 SWAT。
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