Sullivan S J, Ornstein A E, Swaine B R
Centre de Recherche, Institut de Réadaptation de Montréal, Québec, Canada.
Brain Inj. 1994 Oct;8(7):613-21. doi: 10.3109/02699059409151014.
Identification of motor co-ordination deficits in persons with a traumatic brain injury (TBI) is a vital part of both assessment and rehabilitation. The purpose of this study was to investigate the agreement of classification decisions based on clinical (subjective) and instrumented (objective) tests for measuring upper-limb co-ordination in persons with a TBI. Twenty-two subjects with TBI performed the 'finger-to-nose' test and a 'lateral reach tapping test' 12 months post-injury. After reduction to categorical form (deficit/no deficit), the data were interpreted using a generalized kappa statistic, to estimate the agreement between the two tests. The kappa values for the right and left upper extremities were 0.625 and 0.360, respectively, while the combined (right and left) value was 0.500, representing only 'moderate' agreement between the two testing protocols. This indicates that motor co-ordination deficits in persons with TBI can be documented using either clinical or instrumented tests. The choice of test does not appear to be based on the subjective/objective nature (dimension) of each test, but rather on more practical factors such as administration time, cost and level of objectivity desired by the clinician.
识别创伤性脑损伤（TBI）患者的运动协调缺陷是评估和康复的重要组成部分。本研究的目的是调查基于临床（主观）和仪器（客观）测试对TBI患者上肢协调性测量的分类决策的一致性。22名TBI患者在受伤12个月后进行了“指鼻试验”和“侧方伸展轻拍试验”。在简化为分类形式（缺陷/无缺陷）后，使用广义kappa统计量对数据进行解释，以估计两种测试之间的一致性。右上肢和左上肢的kappa值分别为0.625和0.360，而双侧（右和左）合并值为0.500，表明两种测试方案之间仅存在“中等”一致性。这表明，可以使用临床或仪器测试记录TBI患者的运动协调缺陷。测试的选择似乎不是基于每种测试的主观/客观性质（维度），而是基于更实际的因素，如测试时间、成本和临床医生期望的客观程度。
