一种可靠且有效的脑卒中后上肢运动质量评估方法：观察性饮液任务评估。
A reliable and valid assessment of upper limb movement quality after stroke: the observational Drinking Task Assessment.
机构信息
University of Gothenburg, Institute of Neuroscience and Physiology, Clinical Neuroscience, Gothenburg, Sweden.
University of Gothenburg, Institute of Neuroscience and Physiology, Clinical Neuroscience, Gothenburg, Sweden; Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg, Institute of Neuroscience and Physiology, Health and Rehabilitation, Gothenburg, Sweden.
出版信息
J Rehabil Med. 2024 Oct 9;56:jrm40362. doi: 10.2340/jrm.v56.40362.
OBJECTIVE
To develop and evaluate the reliability and validity of a new observational Drinking Task Assessment (DTA) designed to assess quality of movement in task performance after stroke.
DESIGN
Reliability and validity.
METHODS
The DTA measures movement time and movement quality (smoothness, trunk, shoulder, elbow, and grasp movements) on a 4-level ordinal scale. Thirty participants with chronic stroke were assessed independently by 2 therapists. Intra-class correlation (ICC), standard error of measurement (SEM) and minimal real difference (MRD), weighted kappa, percentage of agreement, and Svensson method were used for reliability assessment. Motion capture-based kinematics and established clinical scales were used to evaluate validity.
RESULTS
The absolute SEM and MRD for movement time were 0.4 and 1 s (11%), respectively. The ICC (≥ 0.93) and weighted kappa (0.71-1.0) showed good to excellent agreement for intra- and inter-rater reliability. DTA showed strong correlations with Fugl-Meyer Assessment (0.74), Action Research Arm Test (0.93), and kinematic measures of smoothness (0.93), trunk displacement (0.91), elbow extension (0.73), and shoulder movements (0.56), indicating good construct validity.
CONCLUSIONS
The new DTA proved to be a reliable and valid tool for assessment of movement quality during task performance after stroke.
目的
开发和评估一种新的观察性饮酒任务评估（DTA），旨在评估中风后任务表现中运动质量的可靠性和有效性。
设计
可靠性和有效性。
方法
DTA 通过 4 级有序量表测量运动时间和运动质量（流畅性、躯干、肩部、肘部和抓握运动）。30 名慢性中风患者由 2 名治疗师独立评估。使用组内相关系数（ICC）、测量误差（SEM）和最小实际差异（MRD）、加权kappa、一致性百分比和 Svensson 方法进行可靠性评估。运动捕捉的运动学和既定的临床量表用于评估有效性。
结果
运动时间的绝对 SEM 和 MRD 分别为 0.4 和 1 秒（11%）。ICC（≥0.93）和加权 kappa（0.71-1.0）表明内和间评分者的一致性良好至优秀。DTA 与 Fugl-Meyer 评估（0.74）、动作研究臂测试（0.93）以及流畅性、躯干位移、肘部伸展和肩部运动的运动学测量值（0.93）、（0.91）和（0.73））以及（0.56）均具有很强的相关性，表明具有良好的结构有效性。
结论
新的 DTA 被证明是评估中风后任务表现中运动质量的可靠和有效工具。
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