扩展Barthel指数量表应用于脑卒中患者康复评定的信度研究

目的:研究扩展Barthel指数(EBI)评定脑卒中患者的重测信度及评测者间信度。方法:由第1位评定者应用EBI量表对30例脑卒中患者进行评定,3d内再次对该患者进行评定;第2位评定者在第1位评定者初次评定后2 d内再次对该患者进行评定。对不同评定者间的EBI结果进行等级间相关系数(ICC)分析以检验EBI的重测信度和评定者间信度。结果:第1位评定者两次评定总分的组内相关系数为0. 99(P 0. 01);第1位评定者与第2位评定者评定总分的组内相关系数为0. 98(P 0. 01)。结论:EBI量表应用于脑卒中患者康复评定时具有良好的重测信度及评测者间信度。     

香港版偏瘫上肢功能测试评定脑卒中患者上肢功能的效度和信度研究

目的探讨香港版偏瘫上肢功能测试(FTHUE-HK)评定脑卒中患者上肢功能的效度和信度。 方法采用FTHUE-HK、Fugl-Meyer量表上肢部分(FMA)和改良巴氏指数(MBI)对42例入选脑卒中患者在1周内进行2次评定,分析其FTHUE-HK、FMA和MBI评定结果,并验证FTHUE-HK的效度;分析2次FTHUE-HK的评定结果,验证FTHUE-HK的重测信度和评估者间信度。 结果2次FTHUE-HK评定结果与FMA总分具有高度相关性（r=0.981、0.982,P<0.01）,且与MBI总分高度相关（r=0.892、0.896,P<0.01）。FTHUE-HK的重测结果和组间结果高度相关,其重测组内相关系数ICC=0.983,组间相关系数ICC=0.985。 结论FTHUE-HK量表评定脑卒中后上肢功能状况具有良好的效度和信度。     

足姿指数评价青少年特发性脊柱侧弯患者足部位置的信度北大核心CSCD

目的 探究足姿指数(FPI-6)评价我国青少年特发性脊柱侧弯(AIS)患者足姿的信度。方法 2021年7月至2022年4月,从广东省第二中医院门诊及不定向招募AIS患者35例,两名评定者于同一天采用FPI-6进行足姿评定;1周后,其中一名评定者对35例患者再次进行评定。计算评定者间和重测组内相关系数,绘制Bland-Altman图,各项目评分与总分间行Spearman相关分析。结果 除距骨头触诊和距骨关节区隆起外,其他项目评定者间和重测组内相关系数均> 0.75,足姿分类无显著性差异(χ~2=4.000, P> 0.05)。各项目分与总分间相关系数均> 0.3 (P <0.01)。结论 FPI-6对轻度AIS患者足姿评估有较好信度。     

中文版运动觉－视觉想象问卷在脑卒中患者中的信度

目的对运动觉－视觉想象问卷（KVIQ）-20和KVIQ-10翻译和编制,然后进行评估者内重测信度、评估者间信度和内在信度的测评,建立适合中国人群使用的脑卒中患者运动想象能力评估问卷。 方法先参考国内外推荐的问卷汉化程序,将英文版KVIQ编译成中文,然后由2名有经验的评估者各自独立采用中文版运动觉－视觉想象问卷评估30例脑卒中患者的运动想象能力,其中一名评估者于第一次评估7d后对上述30例患者采用该问卷进行第二次评估。采用Pearson相关法检验分析中文版KVIQ-20和KVIQ-10的评估者内重测信度、评估者间信度和内在信度。 结果中文版KVIQ-20评估者内重测信度相关系数范围为0.879~0.945（P<0.01）,评估者间信度相关系数范围为0.894~0.936（P<0.01）;中文版KVIQ-10评估者内重测信度相关系数范围为0.914~0.953（P<0.01）,评估者间信度相关系数范围为0.852~0.900（P<0.01）;中文版KVIQ-20问卷内在信度Cronbach′s α系数范围为0.867～0.919（P<0.01）,中文版KVIQ-10问卷内在信度Cronbach′s α系数范围为0.827～0.878（P<0.01）。 结论中文版运动觉－视觉想象问卷在脑卒中患者中具有良好的评估者内重测信度、评估者间信度和内在信度,可以作为一项有效的工具评估运动想象能力。     

基于ICF的失能评估工具在临床应用中的信度研究

目的验证基于国际功能、残疾和健康分类(ICF)的功能评定工具在失能评估中的信度。方法选取江苏钟山老年康复医院存在功能障碍的住院患者371例参与本研究,以基于ICF的功能评定工具对患者进行失能评估,以数字化评定量表(0~10分)评估条目失能程度。分析失能评定工具的内在一致性、评估者间信度、评估者内信度。结果基于ICF的失能评定量表的Cronbach′sα系数为0.89,评估者间信度分析显示量表总分的组内相关系数(ICC)为0.85,量表包含的20个条目的ICC在0.78~0.94(P<0.01);评估者内信度分析显示量表的总分ICC为0.95,除b230听力外,量表包含的其它条目ICC在0.72~0.97(P<0.01)。结论基于ICF的失能评定工具与数字评定量表联合在临床失能评估应用中具有良好的内在一致性及评估者间信度和评估者内信度。     

简易平衡评定系统测试的汉化及在脑卒中患者中的信度

目的汉化简易平衡评定系统测试(mini-BESTest),测试中文版的信度。方法遵循翻译、逆向翻译、文化调适、预试验的程序,翻译及修订mini-BESTest。由2 名专业人员对61 例脑卒中患者进行mini-BESTest 测试;在首次评估48 h 后,选取其中30 例进行第二次测试。分别计算评定者间及重测组内相关系数(ICC)。计算量表总分和4 个维度Cronbach's α系数。结果测量者间ICC=0.856~0.978 (P<0.01),重测ICC=0.795~0.951 (P<0.01);量表总分和4 个维度间Cronbach's α=0.794~0.905,4 个维度两两之间的相关系数=0.742~0.827。结论中文版mini-BESTest对脑卒中患者具有较好信度。     

改良Loewenstein认知评定量表的效度及信度研究

目的:检验改良Loewenstein认知评定量表(MLOTCA)的效度及信度,为其在国内临床应用提供客观依据。方法:对74例脑血管意外后的患者进行测试,2周后由同一评定者进行复测。对该量表内容效度和结构效度,以及内部一致性信度、重测信度进行检测。结果:量表21个项目与总分之间的相关系数为0.496—0.841,P<0.01,具有较好的内容效度;提取3个主成分,这3个主成分的累计贡献率为69.032%,各项目在相应因子上的因子载荷均大于0.5,可以认为该量表有较好的结构效度。MLOTCA Cronbachα系数0.9379,量表内部一致性信度较好;MLOTCA重测信度相关系数0.718—0.967,重测信度较好。结论:改良Loewenstein认知评定量表有较好的效度和信度,可用于临床脑血管意外后认知功能的评定。     

上肢功能评定量表对脑卒中偏瘫患者上肢功能评价的信效度研究

目的 探讨上肢功能评定量表评定脑卒中偏瘫患者上肢功能的信度和效度.方法 采用上肢功能评定量表、Fugl-Meyer量表上肢部分和Barthel指数,对35例脑卒中偏瘫患者相隔2周进行2次评定,分析上肢功能评定量表、Fugl-Meyer量表上肢部分、Barthel指数评定结果,并验证上肢功能评定量表的标准效度;采用探索性因子分析方法,验证上肢功能评定量表的结构效度;分析2次上肢功能评定量表的评定结果,验证上肢功能评定量表的重测信度和评价者间信度.结果 上肢功能评定量表的重测结果和组间结果高度相关,其重测组内相关系数在0.884以上,组间相关系数在0.965以上.两位评价者上肢功能评定量表评定结果与Fugl-Meyer量表上肢部分和Barthel指数总分具有高度相关性,r值分别在-0.918和-0.771以上.通过条目筛选和探索性因子分析,共得出4个公因子.结论 上肢功能评定量表具有较好的信度和效度,可以用于脑卒中偏瘫患者上肢功能的评定.     

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。     

脊髓独立性评定量表Ⅲ中文版的适用性研究

目的:评价脊髓独立性评定(SCIM)量表Ⅲ中文版的适用性。方法:利用功能独立性评定量表(FIM)和SCIMⅢ中文版对79例急性和27例慢性脊髓损伤患者的功能能力进行评定,通过内部一致信度、重测信度和评定者间信度评价SCIMⅢ中文版的信度,通过效标效度和结构效度评价SCIMⅢ中文版的效度。结果:①中文版SCIMⅢCronbachα系数为0.816,重测相关系数为0.9,总量表评定者间相关系数为0.92;②SCIMⅢ中文版各维度与FIM相对应维度相关系数均在0.806—0.845;SCIMⅢ中文版各维度间相关系数在0.56—0.714,各维度与总量表相关系数在0.732—0.848(P<0.01)。结论:SCIMⅢ中文版具有良好的信度、效度及可行性,适于中国脊髓损伤患者的功能结局评定;但是,呼吸和一些具体活动项目的记分结构或记分标准需要调整以进一步提高其信度、效度和临床应用。     

Wolf运动功能测试量表的标准效度和评定者内部信度研究

目的：研究脑卒中偏瘫患者上肢运动的Wolf运动功能测试量表（WMFT）的标准效度和评定者内部信度研究。方法：22例脑卒中慢性期患者在2周内由同一测试者进行WMFT的检查，并与Fugl—Meyer评价量表上肢部分进行效度分析。结果：两次WMFT计时组内相关系数（ICC）为0．990，95％置信区间为0．977—0.996；两次WMFT动作质量分级组内相关系数（ICC）为0．988．95％置信区间为0.970—0．995。WM丌计时与WMFT动作质量分级相关系数为-0.971（P〈0．001）。WMFT计时与FMA上肢评分相关系数为-0．732（P〈0．001），WMFT动作质量分级与FMA评分相关系数为0．838（P〈0．001）。结论：WMFT具有好的重测信度和标准效度。     

蒙特利尔认知评估量表在重庆地区应用的初步研究

目的:检验蒙特利尔认知评估量表(MoCA)中文版在重庆地区应用的效度、信度及敏感度。方法:选择病例组22例,对照组30例,分别用MoCA和简易精神状态量表(MMSE)评定2组认知功能,检验MoCA的效度、信度及敏感度。结果:MoCA和MMSE评定结果高度相关(r=0.902,P<0.001),MoCA各项测试2名评定员之间ICC:0.913-1.000;病例组和对照组的MoCA总分差异有显著性意义(P<0.01)。结论:MoCA中文版具有良好的效度、信度和敏感度,可用于重庆地区中重度认知功能障碍的评定。     

INTRA‐ AND INTER‐RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA)

Purpose/Background:

The Selective Functional Movement Assessment (SFMA) is a clinical assessment system designed to identify musculoskeletal dysfunction by evaluation of fundamental movements for limitations or symptom provocation. The purpose of this study was to determine the intra‐ and inter‐rater reliability of the ten fundamental movement patterns of the SFMA in a healthy population using the SFMA categorical and criterion checklist scoring tools.

Methods:

35 healthy subjects (22.9 years +/− 1.9) were recorded with two digital video cameras (1‐frontal view/1‐sagittal view) while they performed the ten fundamental movements patterns that comprise the SFMA. Evaluators with varying experience with the SFMA (rater A, > 100 hours; rater B, 25 hours; and rater C, 16 hours) and not present at the initial data collection evaluated each video using categorical and criterion checklist scoring tools. Evaluators repeated this process at least one week later. The evaluators'' composite results were compared between and within raters using the kappa coefficient and ICC''s for categorical scoring and criterion checklist scoring, respectively.

Results

Substantial to almost perfect intra‐rater reliability of the SFMA (kappa, % agreement) was observed for all raters using the categorical scoring tool (rater A: .83, .91; rater B: .78, .88; and rater C: .72, .85). The criterion checklist scoring tool yielded intra‐rater ICCs (3,1; 95% confidence interval) ranging from good to poor with rater A demonstrating the highest reliability (ICC [SEM]) (.52 [2.36]) and rater C the lowest reliability (.26 [3.42]). Inter‐rater reliability of the categorical scoring tool was slight to substantial (.41‐.61, .69‐.79) while the criterion checklist tool (ICC 2,1) demonstrated unacceptable inter‐rater reliability when assessed in all raters together (.43 [2.7]).

Conclusions

As hypothesized, intra‐and inter‐rater reliability of categorical scoring and criterion checklist scoring of the ten fundamental movements of the SFMA was higher in raters with greater experience.     

Inter-rater reliability of formally trained and self-trained raters using the Edmonton Functional Assessment Tool

The primary objective of this study was to determine the inter-rater reliability of the revised version of the Edmonton Functional Assessment Tool (EFAT-2). A second objective was to determine whether both formally trained and self-trained therapists had an acceptable level of inter-rater reliability. The EFAT-2 was administered to consenting palliative care patients by one of two independent physical therapist rater pairs; one pair self-trained (R1, R2) and the other formally trained (R3, R4). The intraclass correlation [ICC (1,1)] for R1, R2 was 0.97 [95% confidence interval (CI) 0.94-0.99] and for R3, R4 was 0.95 (95% CI 0.90-0.98). The standard error of measurement was 1.09 and 1.44, respectively. The Kappa statistic for the rater pairs on individual EFAT items ranged from 0.17 to 0.96. The results suggest that both formally trained and self-trained therapists obtain an acceptable level of inter-rater reliability when using the EFAT-2.     

The Orpington Prognostic Scale for patients with stroke: Reliability and pilot predictive data for discharge destination and therapeutic services

Purpose.?To determine the inter-rater and test-retest reliability of the Orpington Prognostic Scale (OPS) in patients with stroke. Pilot data were gathered to evaluate its predictive validity for discharge destination and therapeutic services required on discharge.

Method.?Ninety-four consecutive patients, admitted to hospital due to stroke participated. Pairs of physiotherapists (PT) and occupational therapists (OT) assessed patients using the OPS on days 7 and 14 post stroke. For inter-rater reliability, one rater performed the OPS while the other observed, each scoring the scale independently. For test-retest reliability, two different raters tested the subjects separately within the same day. Data were gathered on the discharge destination and the number of follow-up services prescribed.

Results.?The inter-rater reliability as measured by the intraclass correlation coefficient (ICC) was 0.99 (95% CI 0.97 – 0.99). For test-retest reliability, the ICC was 0.95 (95% CI 0.90 – 0.98). The accuracy for predicting discharge to home using OPS ? 5.0 was 65% (95% CI 0.52 – 0.76). OPS scores were not related to number of follow-up services prescribed.

Conclusions.?Despite high inter-rater and test-retest reliability, the OPS has limited predictive accuracy for discharge destination and is a poor predictor of follow-up services.     

复合感觉测试在慢性腰痛人群中的信度研究

目的:评估两点辨别测试(TPD)、点对点测试(PTP)和两点距离估算(TPE)三种测试在正常人和慢性腰痛人群(CLBP)中的重测信度和测试者间信度.方法:筛选30例正常人和30例CLBP患者,由两名物理治疗师分别对60例受试者进行TPD、PTP和TPE三种测试评估,测试者间测试间隔时间为10min,其中一人在24h后重...     

Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke

Abstract

Purpose: The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1–14?d post-stroke. Method: A cohort study with repeated measures within 24?h, on 37 patients, 1–14?d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (κ) statistics and internal consistency with Cronbach’s alpha and intra-class correlation (ICC), 3.k. Results: Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; κ between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; κ 0.59–0.87. The internal consistency was high (α 0.96; ICC 3.k 0.99). Conclusion: The MRMI is a reliable measure of physical mobility in the early post-stroke phase.     

Reliability and minimal detectable change of thoracoabdominal mobility measurements using photogrammetry

The knowledge about measurement errors of the measuring tool is important before its use, as clinical decisions are going to be made based on its results. Here we investigate intrarater and interrater reliability and the minimal detectable change (MDC) of thoracoabdominal mobility measurements using photogrammetry, considering novice and experienced raters. Thoracoabdominal mobility of 17 healthy participants was assessed; photographs during apnea in maximal inspiration and expiration were used to calculate latero-lateral and anteroposterior diameters of the thorax (at axillary and xiphoid level) and abdomen. One novice and one experienced rater measured the same photographs three times. We found good reliability for the experienced rater (average Intraclass Correlation Coefficient (ICC): 0.98; average MDC: 0.3) and for interrater comparison (average ICC: 0.97; average MDC: 0.35) for all measures, with poorer results for latero-lateral mobility of abdomen. The novice rater presented moderate reliability for latero-lateral mobility of the thorax at axillary level and abdomen (ICC: 0.52 and 0.61; MDC: 1.42 and 2.05, respectively) and good reliability for the other measures (average ICC: 0.81; average MDC: 1.52). The photogrammetric analysis of thoracoabdominal mobility presented itself as a reliable method when used by an experienced professional. However, considering that the measurement of latero-lateral mobility is more subjected to errors, it should be used with caution. The MDC presented should be taken into account as a threshold to be certain that the measure is not under the measurement error due to rater variability.