Rasch Analysis Staging Methodology to Classify Upper Extremity Movement Impairment After Stroke
Rasch Analysis Staging Methodology to Classify Upper Extremity Movement Impairment After Stroke
复制标题
DOI：
10.1016/j.apmr.2013.03.007
复制
发表时间：
2013-08-01
影响因子：
4.3
通讯作者：
Duncan, Pamela W.
中科院分区：
文献类型：
--
作者：
Woodbury, Michelle L.;Velozo, Craig A.;Duncan, Pamela W.
目标：定义 Fugl-Meyer 上肢评估 (FMA-UE) 截止分数，以区分 1 级上肢 (UE) 损伤与另一级损伤，并根据预期 FMA-UE 项目表现描述每个类别的运动行为。设计：分析现有 FMA-UE 数据。地点：大学研究实验室。参与者：中风后 0 至 145 天、42 至 42 天内的人员 (N=512) 90岁。干预措施：不适用。主要结果指标：使用项目反应Rasch分析分期方法计算截止分数，其定义为从该样本分析得出的2个标准FMA-UE项目的RaschAndrich阈值。该分析能够将分界分数（以 logit 为单位）转换为针对 30 个 FMA-UE 自愿运动项目评估的 FMA-UE 分数（60 个可能的分数）。结果：严重和中度损伤之间的界限定义为 -1.59 +/-.27 logits 或 19 +/- 2 分；中度和轻度损伤之间的定义为 2.44 +/-.27 logits 或 47 +/- 2 分。对每个损伤级别的预期表现的描述表明，严重损伤患者表现出一些远端运动，而轻度损伤患者在一些近端运动方面有困难。结论：截止分数与患者可以、部分可以和不能执行的特定运动的描述相关联，可能有助于形成异质性患者群体，推进确定特定运动治疗目标的努力，并根据随治疗改变或不改变的特定运动来定义治疗反应。美国康复医学会 2013 年物理医学与康复档案；94:1527-33 (C) 2013
Objectives: To define Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) cutoff scores that demarcate 1 level of upper extremity (UE) impairment from another, and describe motor behaviors for each category in terms of expected FMA-UE item performance.Design: Analysis of existing FMA-UE data.Setting: University research laboratory.Participants: Persons (N=512) 0 to 145 days poststroke, 42 to 90 years of age.Intervention: Not applicable.Main Outcome Measures: An item response Rasch analysis staging method was used to calculate cutoff scores, which were defined as the RaschAndrich threshold values of 2 criterion FMA-UE items derived from an analysis of this sample. The analysis enabled conversion of cutoff scores, in logit units, to FMA-UE points assessed on 30 FMA-UE voluntary movement items (60 possible points).Results: The boundary between severe and moderate impairment was defined as -1.59 +/-.27 logits or 19 +/- 2 points; and between moderate and mild impairment was defined as 2.44 +/-.27 logits or 47 +/- 2 points. A description of expected performance in each impairment level shows that patients with severe impairment exhibited some distal movements, and patients with mild impairment had difficulties with some proximal movements.Conclusions: The cutoff scores, which link to a description of specific movements a patient can, can partially, and cannot perform, may enable formation of heterogeneous patient groups, advance efforts to identify specific movement therapy targets, and define treatment response in terms of specific movement that changed or did not change with therapy. Archives of Physical Medicine and Rehabilitation 2013;94:1527-33 (C) 2013 by the American Congress of Rehabilitation Medicine