周历活动规划中文版在社区中老年人执行功能评测中的信度和效度

目的 探究周历活动规划中文版(WCPA-C)在社区中老年人执行功能评测中的重测信度和区分效度.方法 2020年7月至8月,共招募55例41～89岁的社区中老年人.使用WCPA-C对其中30例受试者进行3次评估,首次评估使用版本A,在间隔2周和4周后分别使用版本B和版本A进行重测,计算3次评估间的组内相关系数(ICC值)...     

脑卒中后失能综合评估量表的汉化与信效度检验

目的 对脑卒中后失能综合评估量表进行汉化及信效度检验,探索该量表在国内的临床适用性。方法 采用Brislin双人直译-回译法、专家评议、预调查对量表进行文化调适,便利抽取203名脑卒中患者进行调查,对中文版量表进行项目分析,并验证其重测信度、评定者间信度、内容效度、效标关联效度。结果 脑卒中后失能综合评估量表重测信度相关性分析结果显示相关系数为0.988;评定者间信度Kappa系数为0.846（95%置信区间为0.793~0.899）,P<0.001;各条目内容效度指数均在0.833~1.000之间,量表内容效度指数为0.935;以改良Rankin量表为标准,效标关联效度系数为0.896。结论 中文版脑卒中后失能综合评估量表具有良好的信效度,可作为我国临床脑卒中失能评估工具。     

情绪抑制量表的汉化及信效度检验

目的 汉化、修订情绪抑制量表,并检验其信度和效度。方法 基于Brislin翻译模型,采用专家咨询法进行跨文化调适,形成中文版情绪抑制量表,并对广州市某三级甲等医院302名癌症患者进行问卷调查以评估其信效度。结果 中文版情绪抑制量表包含14个条目,量表的内容效度指数为0.915。探索性因子分析提取了4个公因子,累计方差贡献率为65.58%,并通过验证性因子分析进行了验证。总量表的Cronbach α系数为0.717,各因子的Cronbach α系数范围为0.602~0.882,量表重测信度ICC值为0.855。结论 中文版情绪抑制量表具有良好的信度和效度,可以作为评估情绪抑制水平和情绪表达干预效果的有效量表。     

Berg平衡量表应用于帕金森病患者的信度分析

目的对Berg平衡量表(BBS)在帕金森病患者中进行信度检验。方法 2011年3~12月帕金森病住院患者121例,由2名治疗师同时对患者采用BBS进行评定,评定过程记录为视频资料;4周后其中1名治疗师观看视频再次进行BBS评定。计算不同评定者间和同一评定者两次测试间的组内相关系数(ICC)及Kappa系数。结果 BBS总分的评定者间ICC为1.00,各单项κ=0.66~0.93;BBS总分的重测ICC为0.99,各单项κ=0.69~0.99。结论 BBS用于评定帕金森病患者的平衡功能有良好的评定者间信度和重测信度。     

护理人员安宁疗护知识问卷的编制及信效度检验

目的 编制护理人员安宁疗护知识问卷,并评估其信度、效度。方法 参考安宁疗护指南、相关文献、护理专家讨论及德尔菲2轮专家咨询法,形成最初版护理人员安宁疗护知识问卷。采取便利抽样法选取青海省人民医院600名护理人员进行调查,评估问卷信度和效度,形成正式问卷。结果 共删除28个条目,保留18个条目。分别为心理护理（3个条目）、心灵关怀与死亡教育（3个条目）、症状护理（7个条目）、基本知识（5个条目）。问卷总内容效度指数0.910,各条目内容效度指数为在0.820~1.000;探索性因子分析共提取4个公因子,公因子解释变量的累积方差贡献率为 52.600%,验证性因子分析显示模型适配度较好。问卷总Cronbach α系数为0.864,4个维度的Cronbach α系数为0.777~0.826。间隔2周后,总问卷重测信度结果为0.852,4个维度的重测信度为0.781~0.862。结论 本研究编制的护理人员安宁疗护知识问卷具有较好的信度、效度,可用于评估护理人员安宁疗护知识的掌握情况。     

足姿指数评价足部位置的信效度研究

目的 探究足姿指数(FPI)评分系统对我国足部姿势评价的信度和效度。 方法 2019年9月至10月,2名评定者(评定者1、评定者2)学习FPI-6评分系统,熟练后对15例20~40岁成年人双下肢的足部姿势进行评估,2名评定者同一天先后对所有受试者进行第1次测试;2周内,再由评定者1对受试者进行第2次测试。计算组内相关系数(ICC)进行重测信度和测试者间信度评价,采用MedCalc进行Bland-Altman绘图。采用Spearman相关系数评价量表的内容效度,采用因子分析评价量表的结构效度。 结果 FPI各项及总分的重测信度和测试者间信度的ICC均> 0.75。测试者间FPI评分的平均差值为-0.133,一致性限度为(-1.82, 1.55)。FPI各条目与总分均相关(P < 0.05);提取到3个公因子,累计贡献率达80%以上。 结论 FPI-6评分系统具有较好的信度和效度,可应用于中国人的足姿评估,对减少运动损伤、疾病预防及康复治疗有重要的指导意义。     

中文版早产儿非营养性吸吮功能评估量表的信效度分析

目的 翻译中文版早产儿非营养性吸吮功能评估量表并进行信效度检验。方法 按照翻译程序将英文版早产儿非营养性吸吮功能评估量表编译成中文,对180例早产儿进行测试,评价量表的信度和效度。结果 量表全体一致内容效度指数为0.893,平均内容效度指数为0.937。探索性因子分析提取2个公因子包括协调因素、非协调因素,累积方差贡献率为68.475%,所有条目在其公因子上的因子载荷均>0.4;2个因子与总量表的相关系数分别为0.979、0.449,均有统计学意义（P<0.01）;集合效度0.460~0.932,区分效度0.004~0.389。总量表的Cronbach α系数为0.896,折半信度为0.873,重测信度为0.798。结论 中文版早产儿非营养性吸吮功能评估量表具有较好的信度和效度,对评价我国早产儿口腔运动功能具有一定的应用价值。     

Groningen骨科社会支持量表汉化及其应用于髋膝关节置换术后患者中的信效度研究

目的 汉化Groningen骨科社会支持量表,在髋膝关节置换术后患者中对该中文版量表进行信、效度的评价。方法 对Groningen骨科社会支持量表进行汉化和跨文化调适,在280例髋关节或膝关节置换术后患者中进行问卷调查,对结果进行信度和效度分析。结果 中文版Groningen骨科社会支持量表各个条目之间的相关系数为0.651~0.733（P<0.01,各条目得分与总分之间的相关系数为0.671~0.824（P<0.01;量表的内容效度指数为0.930;量表总得分和社会支持评定量表得分呈正相关（r=0.653,P<0.01;探索性因子分析提取2个公因子,累计方差贡献率63.215%;验证性因子分析显示模型结构拟合良好;总量表的Cronbach α系数为0.863,重测信度为0.895。结论 中文版Groningen骨科社会支持量表具有较好的信度和效度,可用于评估髋关节或膝关节置换术后患者社会支持情况。     

脊髓损伤痉挛评估量表的信度及各量表间的相关性分析

目的 探讨分析脊髓损伤痉挛状态评估工具(SCI-SET)量表、改良Penn痉挛频率(MPSFS)量表、脊髓痉挛性反应评估工具(SCATS)量表和目测类比法量表(VAS)评估脊髓损伤患者肌肉痉挛的信度及各量表间相关性。 方法 2位治疗师分别应用上述4个量表对35例脊髓损伤患者的痉挛情况进行评估。首先,第一位物理治疗师应用上述4个量表对患者的肌肉痉挛情况进行第1次评估,另一位物理治疗师在第一位物理治疗师评估结束约半个小时后对患者再进行1次评估。3d后,由第一位物理治疗师在相同时间段和环境下对所有患者进行第2次重复评估。计算各量表重复评估及不同测试者间评估的组内相关系数（ICC）及其相应的测量标准误（SEM）、最小可测得差异值（MDD95）,分析第一位治疗师首次评估结果各量表间的相关性。 结果 SCI-SET量表的重测信度和不同测试者间的信度均为优秀（ICC=0.969和0.989）;MPSFS量表的重测信度为优秀（ICC=0.940）,不同测试者间的信度为好（ICC=0.898）;SCATS量表的重测信度和不同测试者间的信度均为优秀（ICC=0.948和0.939）;VAS量表评估痉挛的重测信度和不同测试者间的信度均为优秀（ICC=0.962和0.974）。SCI-SET、MPSFS、SCATS以及VAS等脊髓损伤痉挛评估量表的相关性分析结果显示,各痉挛量表间均有显著相关性（P<0.05）,其中SCI-SET与其它量表间呈负相关,而其余各量表间均呈正相关。SCI-SET与MPSFS间（r=-0.421）、SCI-SET与SCATS间（r=-0.457）以及MPSFS与SCATS间（r=0.498）呈中等相关性,而其它量表两两之间相关性较高（r=0.548～0.938）,且差异均有统计学意义（P<0.05）。 结论 MPSFS、SCATS、VAS 和SCI-SET量表具有良好的重测信度和测试者间信度,适用于脊髓损伤后痉挛的评估。     

四种上肢功能评定量表用于脑卒中患者的信度研究

目的探讨脑卒中偏瘫患者Fugl-Meyer量表上肢运动功能测试部分(U-FMA)、Wolf运动功能测试量表(WMFT)、组块测试(BBT)及九孔柱测试 (NHPT)间不同评定次数的重测信度和不同评价者间的组间信度。 方法选取18例脑卒中患者,2 h内应用上述4种量表对每例患者进行2次评定,每次评定均由2名受过专业训练的评定员分别进行。 结果U-FMA的重测信度组内相关系数（ICC）为0.988,组间信度ICC为0.959;WMFT的计时均数和计时中位数重测信度ICC分别为0.996和0.393,组间信度ICC均为1.000;WMFT的动作质量等级评分均数重测信度ICC为0.989,组间信度ICC为0.977;BBT患手计数及患手与健手差值的重测信度ICC分别为0.975和0.982;NHPT患手计时及患手与健手计时差值的重测信度ICC分别为0.937和0.936,组间信度ICC均为1.000。 结论U-FMA、WMFT、BBT及九孔柱测试均具有良好的重测信度和组间信度,适用于脑卒中患者手部功能的临床评价。     

功能性步态评价应用于帕金森病患者的信度分析

目的:验证功能性步态评价(FGA)在帕金森病(PD)患者中的组间信度、重测信度、内部一致性及分半信度,为临床提供评价工具.方法:121例住院帕金森病患者(平均年龄61.9岁)入选.两名评价者同时评定PD患者的FGA表现,进行组间信度分析.评价过程同时记录为视频资料,4周后其中一名评定者对视频资料进行二次评价,进行重测信度分析.内部一致性信度采用克朗巴赫α系数来评价.分半信度:将FGA各单项以奇数项、偶数项分为两半,计算其分半信度.结果:FGA总分的组间信度和重测信度均为0.99,各单项组间信度波动于0.49-0.98之间,重测信度波动于0.91-0.99之间.FGA内部一致性Cronbach α为0.94,分半信度为0.97.结论:FGA用于评价PD患者的平衡及步态障碍,其组间信度、重测信度、内部一致性及分半信度极佳.     

Interrater and Intrarater Reliability and Minimum Detectable Change of Ultrasound for Active Myofascial Trigger Points in Upper Trapezius Muscle in Individuals With Shoulder Pain

ObjectiveWe sought to investigate the interrater and intrarater reliability of ultrasound and the minimum detectable change (MDC) for the trigger points (TrPs) active in the upper trapezius (UT) muscle in individuals with shoulder pain.MethodsForty individuals with shoulder pain were investigated for the presence of active TrPs in the UT muscle by means of ultrasound for the parameters of gray scale, muscle thickness of UT muscle at rest, and contraction and area of TrPs. The intrarater reliability was performed on 2 days, and interrater reliability on the same day. For the gray scale, the reliability was evaluated using the kappa coefficient (κ), while the other parameters were measured by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and MDC.ResultsFor the gray scale, the intrarater agreement was almost perfect (κ = 1.00) and the interrater agreement was substantial (κ = 0.75). The intrarater and interrater reliability were excellent for most of the parameters, except for the area of TrPs (intrarater: ICC = 0.71, substantial; interrater: ICC = 0.52, substantial). The MDC for intrarater reliability varied between 0.04 and 0.05 (SEM% between 2.4% and 38.87%), and that for interrater reliability ranged from 0.05 to 0.07 (SEM% between 3.18% and 55.10%), with a higher value for area.ConclusionParameters such as gray scale, resting muscle thickness, and muscle contraction of the UT muscle, obtained through ultrasound, showed excellent intrarater and interrater reliability with low SEM%. The intrarater and interrater reliability for the area deserves a caveat regarding their use.     

Intra- and interrater reliability and agreement of the Danish version of the Dynamic Gait Index in older people with balance impairments

Jønsson LR, Kristensen MT, Tibaek S, Andersen CW, Juhl C. Intra- and interrater reliability and agreement of the Danish version of the Dynamic Gait Index in older people with balance impairments.

Objectives

To examine the intrarater and interrater reliability and agreement of the Danish version of the Dynamic Gait Index (DGI) in hospitalized and community-dwelling older people with balance impairments.

Design

Reliability study.

Setting

University hospital and outpatient rehabilitation.

Participants

A convenience sample of older people (≥65y); 24 subjects from a hospital and 24 from an outpatient rehabilitation center. All subjects had either 1 or more falls within the last year or balance impairments evaluated by a physical therapist.

Interventions

Not applicable.

Main Outcome Measures

All subjects carried out the DGI twice with a 1.5-hour interval. Each subject was rated by 3 physical therapists in the first attempt (1 for intrarater and 2 for interrater comparison) and by the intrarater in the second attempt, in both settings. The reliability was calculated using the intraclass correlation coefficient (ICC, 2.1), while agreement was calculated as the smallest real difference (SRD).

Results

The ICC for intrarater and interrater reliability of the total DGI was .90 and .92 at the hospital, while the SRD was 2.72 and 2.58 points, respectively. Correspondingly, the ICC for intrarater and interrater reliability of the total DGI at the rehabilitation center was .89 and .82, while the SRD was 3.49 and 3.99 points, respectively.

Conclusions

The intrarater and interrater reliability of the total DGI ranged from good to excellent in hospitalized and community-dwelling older people. Improvements of 3 and 4 DGI points for hospitalized and community-dwelling older people, respectively, should be regarded as a real change (with a 95% certainty).     

Interrater and intrarater reliability of ultrasonographic measurements of acromion-greater tuberosity distance in healthy people

Acromion-greater tuberosity (AGT) distance could potentially be used to assess rotator cuff tears and shoulder subluxation in patients with poststroke hemiplegia. The aim of this study was to assess the interrater and intrarater reliability of ultrasonographic measurements of AGT distance in healthy people prior to testing on patient populations. Twenty healthy individuals (9 male, 11 female) with a mean age of 21 years (SD±2) were recruited. Three final year physiotherapy students (mean age 23 years) recorded the ultrasonographic measurements of AGT distance by using a standardised protocol. Reliability was assessed by intraclass correlation coefficients (ICC) and standard error of measurements (SEM). The mean AGT distances, as measured by rater one, two, and three were 2.24±0.45?cm, 2.27±0.37?cm, and 2.21±0.31, respectively. The interrater reliability coefficient was ICC=0.79, and the intrarater reliability coefficients were 0.88, 0.84, and 0.91 for each rater. The SEM for the AGT distance measurements was ≤0.15?cm for all three raters. Ultrasonographic measurements of AGT distance demonstrate good intrarater and interrater reliability in healthy individuals even when measured by three relatively inexperienced raters. It has potential to provide quantitative measurements for the clinical management of pathologies such as poststroke shoulder subluxation and rotator cuff tears.     

Reliability of the attraction method for measuring lumbar spine backward bending

The distraction method is one method used to measure forward bending of the spine. Although this technique, which requires the use of a tape measure held over the spine and the location of anatomical landmarks, appears to be highly practical, previous studies have not examined its use for measuring backward bending. The purpose of our study was to determine the reliability of a similar technique, the attraction method, for measuring backward bending of the lumbar spine and to examine whether subjects with low back pain (LBP) could perform similar motion as subjects without LBP. Two groups composed of 100 subjects each, one with "significant" limiting low back pain (SLBP) and the other without "significant" limiting low back pain (NSLBP), were evaluated twice by a physical therapist to assess intrarater reliability. To assess interrater reliability, 11 subjects from the NSLBP Group were evaluated by a second therapist. For the total sample of 200 subjects, the intraclass correlation coefficient (ICC) for intrarater reliability was .95; for the SLBP Group, the ICC was .93; and for the NSLBP Group, the ICC was .90. For the sample of 11 NSLBP Group subjects examined for interrater reliability, the ICC was .94. Using a Kolmogorov-Smirnov test, we found the distribution for backward bending of the two groups to be significantly different. The attraction method, thus, appears to be a reliable method for measuring backward bending of the lumbar spine.     

Muscle thickness and echo intensity measurements of the rectus femoris muscle of healthy subjects: Intra and interrater reliability of transducer tilt during ultrasound

This study aimed to assess the intra and interrater reliability of transducer tilt during the ultrasound (US) measurements of the muscle thickness and the echo intensity of the rectus femoris muscle (RF). Fourteen healthy male subjects (20.8 ± 0.8 years) participated in this study. The transducer tilt was measured using a digital angle gauge (°) during US. Two experimenters took two images to measure the muscle thickness (mm) and the echo intensity (a.u.: arbitrary unit). The intra and interclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were also calculated. These measurements were immediately repeated. The ICC for the intrarater reliability for the transducer tilt, muscle thickness, and echo intensity were 0.96 (SEM: 0.9°, MDC: 2.6°), 0.99 (SEM: 0.4 mm, MDC: 0.1 mm), and 0.97 (SEM: 0.6 a.u., MDC: 1.7 a.u.), respectively. The ICC for the interrater reliability for the transducer tilt, muscle thickness, and echo intensity were 0.40 (SEM: 4.0°, MDC: 11.1°), 0.96 (SEM: 0.7 mm, MDC: 2.0 mm), and 0.95 (SEM: 0.9 a.u., MDC: 2.4 a.u.), respectively. The intrarater reliability of the transducer tilt was reliable, but the interrater reliability was questionable. Meanwhile, both the intra- and interrater reliability of the muscle thickness and the echo intensity were reliable.     

Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test

Our objectives were to examine interrater reliability for inclinometer and goniometric measurements of hip extension flexibility and the intra- and interrater reliability between instruments when measuring hip extension flexibility with the modified Thomas test. The modified Thomas test is frequently used by clinicians to assess hip extension flexibility. Studies examining the reliability of measures of the modified Thomas test are limited. This study included 42 healthy subjects. The modified Thomas test was performed on each subject to quantify hip extension flexibility by using an inclinometer and a goniometer. High interrater reliability was determined for each instrument (r = 0.91-0.93; ICC = 0.89-0.92). High intrarater parallel-forms reliability was found for each examiner between the instruments (r = 0.089-0.92; ICC = 0.91-0.93). High interrater parallel-forms reliability also was found between instruments (r = 0.86-0.93; ICC = 0.86-0.92). The high correlations obtained in this study suggest that the inclinometer and the goniometer are reliable instruments for measuring hip extension flexibility. The results also indicate that the two instruments can be used interchangeably for measuring hip extension flexibility.     

Test of Intrarater and Interrater Reliability for the Star Excursion Balance Test

[Purpose] The aim of this study was to examine the intrarater and interrater reliability of the Star Excursion Balance Test (SEBT), thereby increasing understanding of its efficient utilization. [Subjects and Methods] There were 67 subjects (49 female; 18 male). For the SEBT, eight lines were made using tape at 45-degree angles from the center of a circle. The experiment was conducted in the following order: the anterior, anterior-medial, medial, posterior-medial, posterior, posterior-lateral, lateral, and anterior-lateral directions. Intraclass correlation coefficients (ICC) (3,1) were used to evaluate the intrarater and interrater reliability (2,1) for each reach distance, while the standard error of measurement (SEM) and smallest detectable distance (SDD) were employed to assess absolute reliability. [Results] For intraratar reliability, the ICC values for all directions ranged from 0.88 to 0.96, SEM values ranged from 2.41 to 3.30, and SDD values ranged from 6.68 to 9.15. For interrater reliability, the ICC values for all directions ranged from 0.83 to 0.93, SEM values ranged from 3.19 to 4.26, and SDD values ranged from 8.85 to 11.82 [Conclusion] The SEBT is a highly reliable tool for measuring dynamic balance. Measurements for intrarater reliability are more reliable than measurements for interrater reliability. When measurement for eight directions was difficult, the SEBT was used. While the anterior, posteromedial, and posterolateral directions employed in the Y Balance Test Kit^TM can be utilized, this study recommends using the reverse Y Balance Test Kit^TM method with the posterior direction, not the anterior direction.Key words: Star excursion balance test (SEBT), Dynamic balance, Reliability     

Inter- and intrarater reliability of a back range of motion instrument

OBJECTIVE: To examine the interrater and intrarater reliability of a back range of motion (BROM) instrument when measuring lumbar spine active planar motions and pelvic inclination. DESIGN: Single-group repeated measures for inter- and intrarater reliability. SETTING: Academic institution. PARTICIPANTS: Ninety-one participants (61 women, 30 men; mean age, 28 y) without a current complaint of low back pain volunteered. INTERVENTION: Two examiners measured pelvic inclination and all lumbar motions by using the BROM device. Subjects alternated between examiners for 4 complete trials; examiners remained blinded to the measurements. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) were used to determine intrarater and interrater reliability. Regression analysis was performed to determine the role palpation played in sagittal plane measurement error. RESULTS: Intrarater reliability for side bending was good (ICC range, .85-.83), lumbar forward flexion and pelvic inclination was good to fair (ICC range, .84-.79), and extension and rotation was fair to poor (ICC range, .76-.58). Interrater reliability was fair to poor for all lumbar motions and for pelvic inclination (ICC range, .79-.55). Less than 2% of the variation in sagittal plane measurements was explained by consistency of palpation for device placement. CONCLUSIONS: The BROM provides a reliable means of measuring lumbar forward flexion, side bending, and pelvic inclination when performed by the same examiner in asymptomatic subjects.     

The wheelchair circuit: reliability of a test to assess mobility in persons with spinal cord injuries

OBJECTIVE: To assess the reliability of a 9-task wheelchair circuit. DESIGN: Three test trials per subject were conducted by 2 raters. Inter- and intrarater reliability were examined. SETTING: Eight rehabilitation centers in the Netherlands. PARTICIPANTS: Convenience sample of 27 patients (age, >or=18 y) with spinal cord injury (SCI), all of whom were in the final stage of their inpatient rehabilitation. INTERVENTION: A wheelchair circuit was developed to assess mobility in subjects with SCI. The circuit consisted of 9 tasks: figure-of-8 shape, doorstep crossing, mounting a platform, sprint, walking, driving up treadmill slopes of 3% and 6%, wheelchair driving and transfer. MAIN OUTCOME MEASURE: Task feasibility, task performance time, and peak heart rates. RESULTS: The number of tasks that subjects could perform varied from 3 to 9. Feasibility intrarater reliability was.98, and the interrater reliability intraclass correlation coefficient (ICC) was.97. Performance time ICCs ranged from.70 to.99 (mean,.88) for intrarater reliability and from.76 to.98 (mean,.92) for interrater reliability. Heart rate ICCs ranged from.64 to.96 (mean,.81) for intrarater reliability and from.82 to.99 (mean,.89) for interrater reliability. CONCLUSIONS: The reliability of the wheelchair circuit was good. More research is needed to assess test validity and responsiveness.