Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test
Quantitative Evaluation of Gait Disturbance on an Instrumented Timed Up-and-go Test
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DOI：
10.14336/ad.2018.0426
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发表时间：
2019-02-01
影响因子：
7.4
通讯作者：
Ishikawa, Masatsune
中科院分区：
文献类型：
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作者：
Yamada, Shigeki;Aoyagi, Yukihiko;Ishikawa, Masatsune
虽然3米定时起立行走试验（TUG）对于评估活动性是可靠的，但TUG时间不足以评估轻度步态障碍;因此，我们旨在使用免费的智能手机应用程序研究仪器TUG（iTUG）的其他测量结果。我们在这项研究中的入选标准是参与者可以在没有任何帮助的情况下行走。这项研究包括三个异质性组：接受了抽头测试或分流手术的患者，29名因其他原因住院的住院患者和87名日托用户。在敲击试验后，28例被诊断为敲击阳性的特发性常压脑积水（iNPH），8例被诊断为敲击阴性。此外，18例患者在分流手术前后接受了iTUG评估。在iTUG期间，每0.01 s自动记录一次时间和三维（3D）加速度。计算3D加速度所有图的95%置信度椭球体（95%CE）的体积。此外，iTUG评分定义为（95%CE体积）（0.8）/ 1.9 - 1.9 x（时间）+60。测量的可靠性进行了评估，使用组内相关和Bland-Altman图。轻度步态障碍的参与者在iTUG时间13.5 s内完成，3D加速度的95%CE体积>= 70 m（3）/s（6），iTUG评分>= 50。28例穿刺阳性iNPH患者在穿刺试验后以及18例确诊iNPH患者在分流手术后，平均iTUG时间缩短，平均95%CE体积和iTUG评分增加。相反，8例抽头阴性患者的平均iTUG评分在抽头试验后降低。时间、95%CE体积和iTUG评分的组内相关性分别为0.97、0.80和0.90。不仅iTUG时间，而且95%CE体积对于评估活动度也很重要。因此，由两者组成的新iTUG评分可用于定量评估活动性。
Although the 3-m timed up-and-go test (TUG) is reliable for evaluating mobility, TUG time is insufficient to evaluate mild gait disturbance; we, therefore aimed to investigate other measurements with instrumented TUG (iTUG) using a free smartphone application. Our inclusion criterion in this study is only that participants can walk without any assistance. This study included three heterogeneous groups; patients who underwent a tap test or shunt surgery, 29 inpatients hospitalized for other reasons, and 87 day-care users. After the tap test, 28 were diagnosed with tap-positive idiopathic normal-pressure hydrocephalus (iNPH) and 8 were diagnosed with tap-negative. Additionally, 18 patients were assessed iTUG before and after shunt surgery. During iTUG, time and 3-dimensional (3D) acceleration were automatically recorded every 0.01 s. A volume of the 95% confidence ellipsoid (95%CE) of all plots for 3D acceleration was calculated. Additionally, an iTUG score was defined as (95%CE volume)(0.8) / 1.9 - 1.9 x (time) + 60. The measurement reliability was evaluated using intraclass correlations and Bland-Altman plots. The participants with mild gait disturbance who accomplished within 13.5 s on the iTUG time had the 95%CE volumes for 3D acceleration of >= 70 m(3)/s(6) and iTUG scores of >= 50. The mean iTUG time was shortened and the mean 95%CE volumes and iTUG scores were increased after the tap test among 28 patients with tap-positive iNPH and after shunt surgery among 18 patients with definite iNPH. Conversely, the mean iTUG score among 8 patients with tap-negative was decreased after the tap test. The intraclass correlations for the time, 95%CE volume and iTUG score were 0.97, 0.80 and 0.90, respectively. Not only the iTUG time but also the 95%CE volume was important for evaluating mobility. Therefore, the novel iTUG score consisting both is useful for the quantitative assessment of mobility.