正常人动态平衡能力测试的信度及效度分析

目的　对正常人平衡功能进行动态姿势图重复检测 ,分析各参数间的内在一致性、重测信度及不同测试者间的信度 ;并与Berg平衡量表、功能性前伸测量、起立行走计时测定结果比较 ,检验其效标效度。方法　 2名测试者应用BiodexBalanceSystem (BBS)分别对 40名正常受试者 ( 18～ 67岁 )进行 2次 8级平台稳定性动态姿势图测试及稳定性测试 ;同时还应用Berg平衡量表、功能性前伸距离及起立行走计时等方法进行检测。结果　研究结果发现年龄因素对所有检测参数均有影响 ,体重指数对稳定指数及平均方向控制能力有影响。各参数间内部存在一致性 (r =0 .2 2～ 0 .93 ,均P <0 .0 1) ,其重测信度 (r =0 .70～ 0 .99)及不同测试者间信度 (r =0 .71～ 0 .98)较佳 (ICC =0 .88～ 0 .99)。在测试过程中 ,发现不同跌下次数的受试者其年龄差异和测试结果间差异显著相关 (P <0 .0 0 1)。BBS测试数据与Berg平衡量表、功能性前伸测量、起立行走计时测评结果有较高的相关性 (r =0 .72～ 0 .86)。结论　BBS能反映受试者平衡能力的年龄变化趋势 ,具有较高的内在一致性、重测信度及不同测试者间的信度 ,与Berg平衡量表、起立行走计时及功能性前伸测量结果具有一致性 ,可用于平衡功能的定量评定。

Reliability and validity of data obtained from normal adults by dynamic posturography

Objective To evaluate the internal consistency, the test-retest and inter-rater reliability of dynamic posturography, and the concurrent validity with the Berg Balance Scale, the Functional Reach and the Timed Up and Go tests. MethodsForty normal adults, aged from 18 to 67 years, were administered with measurements of posturography and limits-of-stability(LOS) by using Biodex Balance System (BBS) at 8th level of the plate stability by 2 raters twice, 3 days apart, and were assessed by using the Berg Balance Scale, the Functional Reach and the Timed Up and Go tests. All the participants'' demographic data were collected for statistical analysis. ResultsAge of the subjects correlated significantly with all the parameters, and the Body Mass Index (BMI) correlated with the stability index (SI) and the direction control (DC). The outcomes between all the parameters presented moderate to high correlation(r=0.22~0.93, P<0.001). Intraclass correlation coefficients (ICCs=0.88~0.99) indicated that there existed high test-retest and the inter-rater reliability(r=0.70~0.99, 0.71~0.98, respectively).The significant difference (P<0.001) between the groups divided according to times of failure in the test procedure showed the discriminating validity of BBS. The concurrent validity of the BBS data was also established for SI, LOS-time and DC, which correlated with the Berg Balance Scale, the Functional Reach and the Timed Up and Go tests (r=0.72~0.86). ConclusionThe BBS is sensitive and reliable to show the difference of balance performance among the subjects of different ages, and in concurrent with the Berg balance scale, the Functional reach and the Timed Up and Go tests, and thus, may be an useful tool for quantitative assessment of equilibrium performance.