Ramp descent performance with the C-Leg and interrater reliability of the Hill Assessment Index
Ramp descent performance with the C-Leg and interrater reliability of the Hill Assessment Index
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C 型腿的坡道下降性能和山地评估指数的测试者间可靠性
DOI：
10.1177/0309364612470482
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发表时间：
2013
影响因子：
1.5
通讯作者：
L. Mengelkoch
中科院分区：
文献类型：
--
作者：
M. J. Highsmith;Jason T. Kahle;Rebecca M Miro;L. Mengelkoch
背景：经股截肢者下坡能力下降。Hill评估指数量化了经股截肢者的斜坡性能，但尚未评估评估者间的可靠性。目的：确定使用C型腿是否改善下坡步态，并评估希尔评估指数的评分者间可靠性。方法：21例经股动脉截肢者使用非微处理器膝关节假体，在计时和录像的情况下斜坡。为受试者安装C型腿并重新测试。测试时间进行了比较，坡道性能进行了独立审查，使用希尔评估指数由两名评分员。在评分员内的膝关节状况之间以及评分员之间比较Hill评估指数评分，以评估Hill评估指数的评分员间可靠性。结果：两名评定者的平均Hill评估指数评分均高于C型腿假体。C型腿导致更快的斜坡下降。非微处理器假体膝关节（组内相关系数= 0.97）和C型腿（组内相关系数= 0.99）的Hill评估指数评分之间存在强相关性。结论：C-Leg改善了Hill评估指数斜坡下降性能和时间。在下降质量方面，C型腿提供了消除辅助设备使用和/或在没有辅助设备的情况下改善步长的可能性。C型腿导致坡道下降期间步态速度增加23%。希尔评估指数有很好的评价者间的信度，但应评估的intrarater信度，最小可检测的变化，和有效性。临床相关性经股动脉截肢患者在坡道上行走困难。虽然C型腿已被证明可以改善斜坡下降，但这尚未得到证实，并且尚未研究希尔评估指数的可靠性。这项研究证实，C型腿提高坡道下降性能和希尔评估指数的评分员间的可靠性。
Background: Transfemoral amputees have decreased ability to descend ramps and hills. The Hill Assessment Index quantifies transfemoral amputee ramp performance, but interrater reliability has not been assessed. Objectives: To determine whether C-Leg use improves hill descent gait and evaluate the Hill Assessment Index’s interrater reliability. Methods: Twenty-one transfemoral amputees descended a ramp while timed and video recorded, using their nonmicroprocessor prosthetic knee. Subjects were fitted and accommodated with a C-Leg and retested. Test times were compared, and ramp performances were independently reviewed using the Hill Assessment Index by two raters. Hill Assessment Index scores were compared between knee conditions within raters for performance and between raters to assess the Hill Assessment Index’s interrater reliability. Results: Mean Hill Assessment Index scores were greater for C-Leg compared to nonmicroprocessor prosthetic knee for both raters. C-Leg resulted in faster ramp descent. Strong correlations resulted between raters on Hill Assessment Index scores for nonmicroprocessor prosthetic knee (intraclass correlation coefficient = 0.97) and C-Leg (intraclass correlation coefficient = 0.99). Conclusions: C-Leg improves Hill Assessment Index ramp descent performance and time. In descent quality, C-Leg offers the possibility of eliminating assistive device use and/or improving step length in the absence of an assistive device. C-Leg resulted in 23% gait speed increase during ramp descent. The Hill Assessment Index had very good interrater reliability but should be assessed for intrarater reliability, minimal detectable change, and validity. Clinical relevance Transfemoral amputees have difficulty ambulating on ramps. While the C-Leg has been shown to improve ramp descent, this has not been confirmed, and the Hill Assessment Index has not been studied for reliability. This study confirms that the C-Leg improves ramp descent performance and the Hill Assessment Index’s interrater reliability.