The Reproducibility and Convergent Validity of the Walking Index for Spinal Cord Injury (WISCI) in Chronic Spinal Cord Injury
The Reproducibility and Convergent Validity of the Walking Index for Spinal Cord Injury (WISCI) in Chronic Spinal Cord Injury
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DOI：
10.1177/1545968310376756
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发表时间：
2011-02-01
影响因子：
4.2
通讯作者：
Ditunno, John F.
中科院分区：
文献类型：
--
作者：
Burns, Anthony S.;Delparte, Jude J.;Ditunno, John F.
背景。脊髓损伤步行指数 II (WISCI II) 是一个分级量表，用于衡量脊髓损伤 (SCI) 后步行的改善情况。 WISCI II 在急性 SCI 后具有良好的表面效度、同时效度和信度；然而，需要确定慢性 SCI 的心理测量特性。因为之前的研究已经证明了下肢运动评分 (LEMS) 和步行之间的关系，所以步行的结果测量应该证明潜在损伤（虚弱）和步行收敛有效性之间的联系。客观的。确定 WISCI II 的收敛有效性和再现性。方法。对 76 名慢性 SCI 患者（34 名截瘫，42 名四肢瘫痪）进行自我选择和最大 WISCI 水平评估；计算了 10 米的步行速度。通过将 WISCI II 水平与 LEMS 和步行速度相关联来评估收敛有效性。使用组内相关系数（ICC）和最小实际差异（SRD）评估再现性。结果。自选和最大 WISCI II 与 LEMS 的收敛效度对于截瘫来说是中等的（rho = 0.479 和 rho = 0.533），对于四肢瘫痪来说是强的（rho = 0.852 和 rho = 0.816）。四肢瘫痪（而非截瘫）证明了 LEMS 在自我选择和最大 WISCI 水平下步行速度的收敛有效性（rho = 0.752 和 rho = 0.813）。 WISCI 重现性非常好（自选 ICC = 0.994；最大 ICC = 0.995），导致 SRD 为 0.785（自选）和 0.597（最大），表明一个 WISCI 水平的变化可以解释为慢性患者的真实变化。结论。结果表明，WISCI II 应该是一种非常有用的结果测量方法，用于检测慢性 SCI 后步行功能的变化。
Background. The Walking Index for Spinal Cord Injury II (WISCI II) is a hierarchical scale that measures improvements in walking following spinal cord injury (SCI). The WISCI II has good face validity, concurrent validity, and reliability following acute SCI; however, psychometric properties need to be determined for chronic SCI. Because prior studies have demonstrated a relationship between lower-extremity motor scores (LEMS) and walking, outcome measures for walking should demonstrate a linkage between the underlying impairment (weakness) and walking-convergent validity. Objective. To determine convergent validity and reproducibility of the WISCI II. Methods. Self-selected and maximum WISCI levels were assessed for 76 patients with chronic SCI (34 paraplegia, 42 tetraplegia); 10-m walking speeds were calculated. Convergent validity was assessed by correlating WISCI II levels to LEMS and walking speed. Reproducibility was assessed with the intraclass correlation coefficient (ICC) and the smallest real difference (SRD). Results. Convergent validity of the self-selected and maximum WISCI II with LEMS was moderate for paraplegia (rho = 0.479 and rho = 0.533) and strong for tetraplegia (rho = 0.852 and rho = 0.816). Tetraplegia, but not paraplegia, demonstrated convergent validity of walking speed at the self-selected and maximum WISCI levels with LEMS (rho = 0.752 and rho = 0.813). WISCI reproducibility was excellent (self-selected ICC = 0.994; maximum ICC = 0.995), resulting in SRDs of 0.785 (self-selected) and 0.597 (maximum), suggesting that a change of one WISCI level can be interpreted as real in a chronic patient. Conclusions. Results suggest that the WISCI II should be a very useful outcome measure for detecting changes in walking function following chronic SCI.