Test-Retest Reliability and Minimal Detectable Change Scores for the Timed "Up & Go" Test, the Six-Minute Walk Test, and Gait Speed in People With Alzheimer Disease
Test-Retest Reliability and Minimal Detectable Change Scores for the Timed "Up & Go" Test, the Six-Minute Walk Test, and Gait Speed in People With Alzheimer Disease
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DOI：
10.2522/ptj.20080258
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发表时间：
2009-06-01
期刊：
影响因子：
3.2
通讯作者：
Blodgett, Michelle Gagnon
中科院分区：
文献类型：
--
作者：
Ries, Julie D.;Echternach, John L.;Blodgett, Michelle Gagnon
背景随着阿尔茨海默病（Alzheimer disease，AD）发病率的不断上升，确定AD患者结局指标的有效性和可靠性是非常必要的。本研究的目的是评估定时“起身和行走”测试（TUG）、六分钟步行测试（6 MWT）和步态速度数据的重测信度，并计算每个结果测量的最小可检测变化（MDC）评分。轻度至中度AD组和中度至重度AD组之间的表现差异（由功能评估分期[FAST]量表确定）。设计。这是一项前瞻性、非实验性、描述性方法学研究。收集的51例AD患者的背景数据包括：辅助设备的使用、简易精神状态检查评分和FAST量表评分。每名参与者参与2个测试阶段，间隔30至60分钟的休息时间，其中包括2个TUG试验，I 6 MWT试验和2个使用计算机步态评估系统的步态速度试验。一个特定的提示协议之后，以实现最佳的性能在测试会话。所有参与者的TUG、6 MWT和步态速度的重测信度值较高，轻度至中度AD组和中重度至重度AD组分别较高（组内相关系数>= 0.973）;然而，个体表现的变异性也较高。在90%置信区间计算的MDC评分为：TUG=4.09秒，6 MWT =33.5 m（110 ft），步态速度=9.4 cm/s。两组在临床测试的表现上有显著差异，认知受损程度更高的参与者在身体和功能上受到的损害更大。一个单一的研究人员进行数据收集的样本数量有限，并禁止盲痴呆水平。TUG、6 MWT和步态速度是用于AD患者的可靠结局指标，因为认识到个体表现的变异性很高。90%置信区间的最小可检测变化评分可用于评估性能随时间的变化和治疗的影响。
Background. With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability Of Outcome measures for people with this disease is necessary.Objective. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups With mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were Studied.Design. This was a prospective, nonexperimental, descriptive methodological study.Methods. Background data collected for 51 people with AD included: use of an assistive device, Mini-Mental Status Examination scores, and FAST scale scores. Each participant engaged in 2 test sessions, separated by a 30- to 60-minute rest period, which included 2 TUG trials, I 6MWT trial, and 2 gait speed trials using a computerized gait assessment system. A specific cuing protocol was followed to achieve optimal performance during test sessions.Results. Test-retest reliability values for the TUG, the 6MWT, and gait speed were high for all participants together and for the mild to moderate AD and moderately severe to severe AD groups separately (intraclass correlation coefficients >=.973); however, individual variability of performance also was high. Calculated MDC scores at the 90% confidence interval were: TUG=4.09 seconds, 6MWT=33.5 m (110 ft), and gait speed=9.4 cm/s. The 2 groups were significantly different in performance of clinical tests, with the participants who were more cognitively impaired being more physically and functionally impaired.Limitations. A single researcher for data collection limited sample numbers and prohibited blinding to dementia level.Conclusions. The TUG, the 6MWT, and gait speed are reliable outcome measures for use with people with AD, recognizing that individual variability of performance is high. Minimal detectable change scores at the 90% confidence interval can be used to assess change in performance over time and the impact of treatment.