评估脊髓损伤患者平衡功能的诊断测试：对其有效性和可靠性的系统评价
Diagnostic tests to assess balance in patients with spinal cord injury: a systematic review of their validity and reliability.
作者信息
Arsh Aatik, Darain Haider, Ullah Irfan, Shakil-Ur-Rehman Syed
机构信息
Institute of Physical Medicine and Rehabilitation, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa 25100, Pakistan.
Kabir Medical College, Gandhara University, Peshawar, Khyber Pakhtunkhwa 25000, Pakistan.
出版信息
Asian Biomed (Res Rev News). 2021 Jun 30;15(3):111-118. doi: 10.2478/abm-2021-0014. eCollection 2021 Jun.
BACKGROUND
Sophisticated biomechanical instruments can assess balance in patients with spinal cord injury (SCI) with accuracy and precision; however, they are costly and time consuming to use. Clinical diagnostic tests to assess balance in patients with SCI are less costly and easier to use, but there is limited literature available regarding their reliability and validity.
OBJECTIVES
To review systematically articles reporting the validity and reliability of diagnostic tests used to assess balance function in patients with SCI.
METHODS
We searched for articles in the English language from the earliest record to December 15, 2020, which reported validity or reliability of any clinical instrument or diagnostic test used to assess balance in patients with SCI. Articles assessing balance in paraplegic patients with causes other than SCI were excluded. Databases included MEDLINE, AMED, EMBASE, HMIC, PsycINFO, CINAHL, Scopus, and Google Scholar. The COSMIN Risk of Bias checklist was used to assess the studies included and PRISMA-DTA guidelines were applied.
RESULTS
We included 16 articles that assessed the validity or reliability of 10 diagnostic tests. The Functional Reach Test (FRT), Berg Balance Scale (BBS), and Mini-Balance Evaluation Systems Test (Mini-BESTest) were assessed by more than 1 study, while the remaining 7 diagnostic tests including the Function in Sitting Test, T-Shirt Test, Motor Assessment Scale item 3, Sitting Balance Score, 5 Times Sit-to-Stand Test, Tinetti scale, and Sitting Balance Measure were assessed by 1 study each. The FRT has good-to-excellent test-retest reliability, excellent inter-rater reliability, and good construct, concurrent, and convergent validity. The BBS has excellent inter-rater and intra-rater reliability, high internal consistency, and good concurrent and construct validity. The Mini-BESTest has excellent test-retest reliability, excellent inter-rater reliability, high internal consistency, and good concurrent, convergent, and construct validity.
CONCLUSIONS
The FRT, BBS, and Mini-BESTest appear to be valid and reliable clinical instruments to assess balance function in patients with SCI.
背景
精密的生物力学仪器能够准确且精确地评估脊髓损伤（SCI）患者的平衡能力；然而，这些仪器使用成本高昂且耗时。用于评估SCI患者平衡能力的临床诊断测试成本较低且使用更简便，但关于其可靠性和有效性的文献有限。
目的
系统回顾报告用于评估SCI患者平衡功能的诊断测试的有效性和可靠性的文章。
方法
我们检索了从最早记录到2020年12月15日的英文文章，这些文章报告了用于评估SCI患者平衡能力的任何临床仪器或诊断测试的有效性或可靠性。排除评估除SCI以外其他原因导致的截瘫患者平衡能力的文章。数据库包括MEDLINE、AMED、EMBASE、HMIC、PsycINFO、CINAHL、Scopus和谷歌学术。使用COSMIN偏倚风险清单评估纳入的研究，并应用PRISMA-DTA指南。
结果
我们纳入了16篇评估10种诊断测试的有效性或可靠性的文章。功能伸展测试（FRT）、伯格平衡量表（BBS）和迷你平衡评估系统测试（Mini-BESTest）被不止1项研究评估，而其余7种诊断测试，包括坐姿功能测试、T恤测试、运动评估量表项目3、坐姿平衡评分表、5次坐立试验、Tinetti量表和坐姿平衡测量，每项仅被1项研究评估。FRT具有良好至极优的重测信度、极好的评分者间信度以及良好的结构效度、同时效度和收敛效度。BBS具有极好的评分者间和评分者内信度、高内部一致性以及良好的同时效度和结构效度。Mini-BESTest具有极好的重测信度、极好的评分者间信度、高内部一致性以及良好的同时效度、收敛效度和结构效度。
结论
FRT、BBS和Mini-BESTest似乎是评估SCI患者平衡功能的有效且可靠的临床工具。
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