Psychometric Comparisons of 4 Measures for Assessing Upper-Extremity Function in People With Stroke
Psychometric Comparisons of 4 Measures for Assessing Upper-Extremity Function in People With Stroke
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DOI：
10.2522/ptj.20080285
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发表时间：
2009-08-01
期刊：
影响因子：
3.2
通讯作者：
Hsieh, Ching-Lin
中科院分区：
文献类型：
--
作者：
Lin, Jau-Hong;Hsu, Miao-Ju;Hsieh, Ching-Lin
背景上肢功能受限在中风患者中很常见。具有良好心理测量特性的上肢测量对于临床和研究用途是必不可少的。本研究的目的是比较评估中风患者上肢运动功能的4种临床指标的心理测量学特性：Fugl-Meyer运动测试（UE-FM）的上肢子量表、中风康复运动评估的上肢子量表、动作研究手臂测试（ARAT）和Wolf运动功能测试。这是一项前瞻性、纵向研究。在4个时间点（中风后14、30、90和180天）对53名中风患者进行了4项测量。35名参与者完成了所有评估。天花板和地板的影响，有效性（同时有效性和预测有效性），和每个措施的反应进行了检查。并对量表的评分者间信度和重测信度进行了检验。除UE-FM外，所有测量在一个或多个时间点均具有显著的下限效应或上限效应。每对4项测量的斯皮尔曼rho相关系数>= 0.81，表明高并发效度。4项指标的预测有效性令人满意（斯皮尔曼rho，>=.51）。在卒中后14至180天，4项指标的反应性为中度（0.52 = 0.97）。只有UE-FM（最高可能得分的8%）和ARAT（6%）的最小可检测变化是可检测的。样本量太小，无法根据卒中类型或严重程度进行数据分析。此外，Wolf运动功能测试的计时部分未用于本研究。所有4项测量在卒中参与者中均显示出足够的有效性、反应性和可靠性。用于评估损伤的UE-FM和用于评估残疾的ARAT具有令人满意的最小可检测变化，支持其在临床环境中的实用性。
Background. Functional limitation of the upper extremities is common in patients with stroke. An upper-extremity measure with sound psychometric properties is indispensable for clinical and research use.Objective. The purpose of this stud), was to compare the psychometric properties of 4 clinical measures for assessing upper-extremity motor function in people with stroke: the upper-extremity subscale of the Fugl-Meyer Motor Test (UE-FM), the upper-extremity subscale of the Stroke Rehabilitation Assessment of Movement, the Action Research Arm Test (ARAT), and the Wolf Motor Function Test.Design. This was a prospective, longitudinal study.Methods. Fifty-three people with stroke were evaluated with the 4 measures at 4 time points (14, 30, 90, and 180 days after stroke). Thirty-five participants completed all of the assessments. The ceiling and floor effects, validity (concurrent validity and predictive validity), and responsiveness of each measure were examined. Interrater reliability and test-retest reliability also were examined.Results. All measures, except for the UE-FM, had significant floor effects or ceiling effects at one or more time points. The Spearman rho correlation coefficient for each pair of the 4 measures was >=.81, indicating high concurrent validity. The predictive validity of the 4 measures was satisfactory (Spearman rho, >=.51). The responsiveness of the 4 measures at 14 to 180 days after stroke was moderate (.52 =.97). Only the minimal detectable changes of the UE-FM (8% of the highest possible score) and the ARAT (6%) were satisfactory.Limitations. The sample size was too small to conduct data analysis according to type or severity of stroke. In addition, the timed component of the Wolf Motor Function Test was not used in this study.Conclusions. All 4 measures showed sufficient validity, responsiveness, and reliability in participants with stroke. The UE-FM for assessing impairment and the ARAT for assessing disability had satisfactory minimal detectable changes, supporting their utility in clinical settings.