Lord S E, Halligan P W, Wade D T
Rivermead Rehabilitation Centre, Oxford, UK.
Clin Rehabil. 1998 Apr;12(2):107-19. doi: 10.1191/026921598666182531.
To develop and evaluate a four-point scale visual gait assessment form, the Rivermead Visual Gait Assessment (RVGA), for clinical use with patients with neurological deficits.
Preliminary clinical testing of reliability, validity and sensitivity to change.
Patients were recruited from the Rivermead Rehabilitation Centre (RRC), a centre specializing in rehabilitation for patients with neurological disease.
Ten inpatients were assessed by up to seven physiotherapists for the main reliability study, and eight different patients were also assessed by two raters one week apart. Twenty outpatients with multiple sclerosis (MS) who were receiving physiotherapy to improve their mobility and 27 inpatients with various neurological conditions were also assessed and the data used to examine validity, re iability and sensitivity to change.
The other comparative measures used were walking time, stride length, step length asymmetry, balance and the Rivermead Mobility Index.
Inter-rater reliability between multiple raters was reasonable both for the global scores from the gait assessment form (Kendall's coefficient of concordance; p < 0.001), and for individual items (complete agreement occurred on 63.8% of all observations). There was a significant correlation between the global RVGA score and the various criterion measures (r = 0.53-0.79; p < 0.001) and between change in the RVGA score and change in walking time in patients who received treatment (r = 0.68; p < 0.01).
The RVGA provides the clinician with a clinical assessment of the quality of gait which may be used in conjunction with other measures to inform and monitor the value of physiotherapy treatment for people with MS and stroke, and possibly other neurological deficits.
开发并评估一种四点量表视觉步态评估表，即瑞米德视觉步态评估（RVGA），用于对有神经功能缺损的患者进行临床评估。
对可靠性、有效性及变化敏感性进行初步临床测试。
患者招募自瑞瑞功能恢复中心（RRC），这是一家专门为神经疾病患者提供康复服务的中心。
10名住院患者接受了多达7名物理治疗师的评估，用于主要的可靠性研究，另有8名不同患者由两名评估者在相隔一周的时间进行评估。还对20名正在接受物理治疗以改善行动能力的多发性硬化症（MS）门诊患者和27名患有各种神经疾病的住院患者进行了评估，并将数据用于检验有效性、可靠性及变化敏感性。
使用的其他比较指标包括步行时间、步幅长度、步长不对称性、平衡能力以及瑞米德运动指数。
多名评估者之间的评分者间信度对于步态评估表的整体评分（肯德尔和谐系数；p < 0.001）以及各个项目而言都是合理的（在所有观察结果中，完全一致的情况占63.8%）。RVGA整体评分与各种标准指标之间存在显著相关性（r = 0.53 - 0.79；p < 0.001），并且在接受治疗的患者中，RVGA评分的变化与步行时间的变化之间也存在显著相关性（r = 0.68；p < 0.01）。
RVGA为临床医生提供了一种步态质量的临床评估方法，可与其他指标结合使用，以了解和监测针对MS患者、中风患者以及可能患有其他神经功能缺损患者的物理治疗效果。
