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社区平衡与活动能力量表在多发性硬化症患者中的信度和效度

Reliability and validity of the community balance and mobility scale in individuals with multiple sclerosis.

作者信息

Özbaş Ezgi, Fil Balkan Ayla, Salcı Yeliz, Akyol Betül, Acar Özen Nazire Pınar, Tuncer Meryem Aslı

机构信息

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Institute of Health Sciences, Neurology Physiotherapy Doctorate Program, Hacettepe University, Samanpazari, Ankara, 06230, Turkey.

出版信息

Acta Neurol Belg. 2025 Apr;125(2):385-393. doi: 10.1007/s13760-024-02701-y. Epub 2024 Dec 20.

DOI:10.1007/s13760-024-02701-y
PMID:39704738
Abstract

AIMS

This study aims to evaluate the reliability and validity of the Community Balance and Mobility Scale (CB&M) in people with multiple sclerosis (PwMS).

METHODS

A total of 65 PwMS (Expanded Disability Status Scale (EDSS) ≤ 5.5) were included in the study. Test-retest, internal consistency (item-total score correlation, Cronbach's alpha coefficient) intra-rater, and inter-rater reliability were investigated for the reliability of the CB&M. For intra-rater and inter-rater reliability, CB&M measurements of 34 PwMS were videotaped. The validity of the CB&M was assessed through criterion (predictive and concurrent validity) and construct validity. Construct validity was evaluated using hypothesis testing which included examining correlations with EDSS, Timed Up and Go Test (TUG), and Dynamic Gait Index (DGI).

RESULTS

Test-retest reliability demonstrated a good to excellent correlation (ICC = 0.995, p < 0.001). Cronbach's alpha was 0.971 (p < 0.001). Intra-rater (ICC = 0.993, p < 0.001) and inter-rater reliability (ICC = 0.986, p < 0.001) of the CB&M were also good to excellent. Cohen's kappa range values ​​of the scale vary between 0.958 - 0.665, and the percentage agreement varies between 97% and 75%. For the convergent validity of CB&M, strong correlations were observed with EDSS (r=-0.831, p < 0.001), TUG (r=-0.854, p < 0.001), and DGI (r = 0.865, p < 0.001). Additionally, the CB&M demonstrated an excellent correlation with the BBS (r = 0.907, p < 0.001). The scale exhibited no floor-ceiling effect.

CONCLUSION

CB&M is a reliable and valid tool for assessing balance and mobility in PwMS and offers significant advantages for evaluating balance in PwMS, as it provides comprehensive information about the balance and mobility requirements essential for community living.

摘要

目的

本研究旨在评估社区平衡与移动量表(CB&M)在多发性硬化症患者(PwMS)中的信度和效度。

方法

本研究共纳入65例PwMS(扩展残疾状态量表(EDSS)≤5.5)。对CB&M的信度进行了重测、内部一致性(项目总分相关性、Cronbach's α系数)、评分者内信度和评分者间信度的研究。对于评分者内信度和评分者间信度,对34例PwMS的CB&M测量进行了录像。通过标准效度(预测效度和同时效度)和结构效度评估CB&M的效度。使用假设检验评估结构效度,包括检查与EDSS、定时起立行走测试(TUG)和动态步态指数(DGI)的相关性。

结果

重测信度显示出良好到优秀的相关性(组内相关系数(ICC)=0.995,p<0.001)。Cronbach's α系数为0.971(p<0.001)。CB&M的评分者内信度(ICC=0.993,p<0.001)和评分者间信度(ICC=0.986,p<0.001)也良好到优秀。该量表的Cohen's kappa范围值在0.958 - 0.665之间,百分比一致性在97%和75%之间。对于CB&M的收敛效度,观察到与EDSS(r=-0.831,p<0.001)、TUG(r=-0.854,p<0.001)和DGI(r=0.865,p<0.001)有很强的相关性。此外,CB&M与BBS显示出极好的相关性(r=0.907,p<0.001)。该量表没有地板效应和天花板效应。

结论

CB&M是评估PwMS平衡和移动能力的可靠且有效的工具,在评估PwMS的平衡方面具有显著优势,因为它提供了关于社区生活所需平衡和移动能力要求的全面信息。

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本文引用的文献

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Mult Scler Relat Disord. 2024 Mar;83:105440. doi: 10.1016/j.msard.2024.105440. Epub 2024 Jan 9.
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The effect of balance, walking capacity, and fear of falling on the level of community integration in individuals with Multiple Sclerosis: A cross-sectional study.平衡、行走能力和跌倒恐惧对多发性硬化症患者社区融合水平的影响:一项横断面研究。
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Mobility and balance rehabilitation in multiple sclerosis: A systematic review and dose-response meta-analysis.
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