Validity of Visual Assessment of Sit to Stand After Hip Fracture.
Validity of Visual Assessment of Sit to Stand After Hip Fracture.
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DOI：
10.1519/jpt.0000000000000197
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Houck J
中科院分区：
文献类型：
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作者：
Zablotny C;Hilton T;Riek L;Kneiss J;Tome J;Houck J
在治疗老年人髋部骨折时，物理治疗师通常使用观察性分析来评估坐到站立（STS）任务。研究表明，即使个体可以独立站立，但在STS期间，骨折下肢地面反作用力产生的显著运动不对称性仍然存在。到目前为止，治疗师对STS过程中下肢力量判断的有效性尚未得到解决。本观察性队列研究的目的是确定物理治疗师对STS的观察性评估的准确性，以检测老年人髋部骨折后受累肢体及其对地面反力的贡献。18位家庭健康理疗师评估了10盘由STS引起的老年人髋部骨折的录像带，并判断了受累的侧面和下肢骨折产生的地面反作用力的大小。每盘录像带都与其各自的受力数据同步。在测试视频中表现出广泛的上升不对称性。在做出这些判断之前，治疗师观看了一组单独的训练视频，并接受了使用特定视觉线索来辅助后续判断的指导。治疗师对受累侧的判断正确率为74%。所有治疗师判断地面反作用力输出的平均准确率为39%。力的对称性对力判断的准确性没有显著影响。对力量的不准确判断可能会限制治疗强度，并使发展有利于相关肢体产生力量的运动策略的潜力最小化。利用定量数据加强STS的观察分析有助于优化修复功能。仅凭观察判断STS过程中下肢地面反力输出是无效的，可能需要定量数据的补充。
When treating older adults post hip fracture, physical therapists routinely assess the sit to stand (STS) task using observational analysis. Studies have demonstrated that significant movement asymmetries in ground reaction force production of the fractured lower limb persist during STS, even though individuals may rise independently. To date, the validity of therapist judgments of lower limb force during STS has not been addressed. The purpose of this observational cohort study was to determine the accuracy of physical therapists’ observational assessments of STS for detecting the involved limb and its ground reaction force contribution in older adults post hip fracture. Eighteen home health physical therapists assessed 10 videotapes of older adults post hip fracture rising from STS and judged the side of involvement and the amount of ground reaction force generated by the fractured lower limb. Each videotape was synchronized with its respective force data. A wide spectrum of asymmetry in rising was represented in the test videos. Prior to making these judgments, the therapists viewed a separate set of training videos and received instructions in the use of specific visual cues to assist with subsequent judgments. Therapists judged the involved side correctly 74% of the time. Mean accuracy in judging ground reaction force output was 39% across all therapists. Force symmetry did not significantly influence accuracy of force judgments. Inaccurate judgments of force may limit therapeutic intensity and minimize the potential for developing motor strategies that favor force production of the involved limb. Augmenting observational analysis of STS with quantitative data could assist in optimizing restorative function. Judgments of lower limb ground reaction force output during STS based on observation alone are not valid, and may need to be supplemented with quantitative data.