Validity of the walking scale for spinal cord injury and other domains of function in a multicenter clinical trial
Validity of the walking scale for spinal cord injury and other domains of function in a multicenter clinical trial
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DOI：
10.1177/1545968307301880
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发表时间：
2007-11-01
影响因子：
4.2
通讯作者：
Chung, Joanie
中科院分区：
文献类型：
--
作者：
Ditunno, John E., Jr.;Barbeau, Hugues;Chung, Joanie
目标。在脊髓损伤运动试验（SCILT）中，论证脊髓损伤步行指数（WISCI）量表和其他步行测量的判定标准（并发性和预测性）并构建其有效性。设计。急性创伤性脊髓损伤（SCI）患者步行干预的前瞻性多中心临床试验。参与者/方法。在146例不完全性脊髓损伤（C4至L3）患者中，体重支持的跑步机训练与地上活动训练进行了比较，这些患者在发病8周内入组，治疗12周。主要结果测量是功能独立性测量（FIM）， 50英尺步行速度（50FW-S）和6分钟步行距离（6MW-D），在入组后3、6和12个月进行测试。次要测量是下肢运动评分（LEMS）、Berg平衡量表（BBS）、WISCI和FIM运动评分（LFIM），由盲法观察者在6个中心进行评估。由于没有发现结果的显著差异，因此将两个组的数据合并。结果。6个月时，BBS （r = 0.90）、LEMS （r = 0.85）、LFIM （r = 0.89）、FIM （r = 0.77）、50FW-S （r = 0.85）和6MW-D （r = 0.79）与WISCI的相关性显著；3个月和12个月时也有类似的相关性。WISCI基线变化得分与LEMS/BBS/LFIM基线变化得分的相关性显著。12个月时基线LEMS与WISCI相关性最显著（r = 0.73）。基线LEMS的R-2解释了3个月时WISCI水平57%的变异性。结论。在3个月、6个月和12个月时，WISCI量表的并发效度与所有测量值显著相关。变化得分的相关性支持预测效度。基线LEMS是12个月时WISCI评分的最佳预测因子，解释了大部分方差，支持预测效度和结构效度。LEMS、BBS、WISCI、50FW-S和LFIM的组合似乎包含了对不完全性脊髓损伤行走试验结果的足够描述符。
Objective. To demonstrate criterion (concurrent and predictive) and construct validity of the Walking Index for Spinal Cord Injury (WISCI) scale and other walking measures in the Spinal Cord Injury Locomotor Trial (SCILT). Design. Prospective multicenter clinical trial of a walking intervention for patients with acute traumatic spinal cord injury (SCI). Participants/Methods. Body weight-supported treadmill training was compared to overground mobility training in 146 patients with incomplete SCI (C4 to L3) enrolled within 8 weeks of onset and treated for 12 weeks. Primary outcome measures were the Functional Independence Measure (FIM), 50-foot walking speed (50FW-S), and 6-minute walking distance (6MW-D), tested 3, 6, and 12 months after entry. Secondary measures were the Lower Extremity Motor Score (LEMS), Berg Balance Scale (BBS), WISCI, and FIM locomotor score (LFIM), assessed at 6 centers by blinded observers. Data for the 2 arms were combined since no significant differences in outcomes had been found. Results. Correlations with WISCI at 6 months were significant with BBS (r = .90), LEMS (r = .85), LFIM (r = .89), FIM (r = .77), 50FW-S (r = .85), and 6MW-D (r = .79); similar correlations occurred at 3 and 12 months. Correlations of change scores from baseline WISCI were significant for change scores from baseline of LEMS/BBS/LFIM. Correlation of baseline LEMS and WISCI at 12 months were most significant (r = .73). The R-2 of baseline LEMS explained 57% of variability of WISCI levels at 3 months. Conclusion. Concurrent validity of the WISCI scale was supported by significant correlations with all measures at 3, 6, and 12 months. Correlation of change scores supports predictive validity. The LEMS at baseline was the best predictor of the WISCI score at 12 months and explained most of the variance, which supported both predictive and construct validity. The combination of the LEMS, BBS, WISCI, 50FW-S, and LFIM appears to encompass adequate descriptors for outcomes of walking trials for incomplete SCI.