在俄罗斯为脑卒中患者验证以表现为导向的行动能力评估(蒂内蒂测试)量表

E. V. Kostenko, L. G. Petrova, I. V. Pogonchenkova
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Clinical and demographic characteristics of patients in two groups were comparable. The median and interquartile interval of TT were 20 [14; 24] points out of 28 possible. Content validity and intra-rater reliability were assessed by 10 clinicians. The test-retesting method was used to determine the intra-rater reliability. The Berg Balance Scale (BBS), the Stand Up and Go for Time (TUG), and the 10-meter walk test (10MWT) were used for concurrent validation. RESULTS. Two-stage linguistic and cultural adaptation made it possible to construct a Russian-language version of TT that was tested in a pilot study of 30 patients. The subsequent study of the psychometric properties of TT demonstrated high level of content validity and internal consistency of TT (α-Kronbach: 0.74 for TT-Balance and 0.72 for TT-Gait). BBS data significantly correlated with TT-Balance scores (r = 0.73, p = 0.001), TUG showed a negative correlation with TT-Gait (r = −0.69, p = 0.02). Retest reliability ranged from 0.72 to 0.86. The Bland-Altman plot showed the loss of one data point for TT-total beyond 95 % CI. DISCUSSION. The Tinetti test indicates high substantive validity and internal consistency of the scales (the α-Kronbach for the balance and walking sections are 0.74 and 0.72, respectively), which is consistent with the data of foreign authors. CONCLUSION. 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引用次数: 0

摘要

引言。平衡障碍是脑中风(CS)后经常出现的综合征。在实际临床实践中,为康复诊断和个人医疗康复计划提供有效的平衡和行走功能综合评估工具是非常重要的一部分。 目的确定运动活动能力评估量表(Tinetti Test,TT)在测量缺血性脑卒中(IS)患者平衡和行走方面的心理测量特性。 共纳入 200 名患者,其中 100 名处于缺血性脑卒中早期恢复期(ERP),100 名处于晚期恢复期(LRP)。患者的平均年龄为 55 [51; 57] 岁。IS持续时间平均为(99.3 ± 30.9)天(ERP)和(267.7 ± 27.8)天(LRP)。两组患者的临床和人口统计学特征相当。TT的中位数和四分位数间隔为20[14;24]分(满分28分)。内容有效性和评分者内部可靠性由 10 名临床医生进行评估。评分者内部信度采用重测法确定。同时采用 Berg 平衡量表(BBS)、站立行走时间(TUG)和 10 米步行测试(10MWT)进行验证。 结果经过两个阶段的语言和文化适应性调整后,TT 的俄语版本得以构建,并在 30 名患者的试点研究中进行了测试。随后对 TT 心理测量特性的研究表明,TT 具有较高的内容效度和内部一致性(α-Kronbach:TT-Balance 为 0.74,TT-Gait 为 0.72)。BBS 数据与 TT 平衡得分有明显相关性(r = 0.73,p = 0.001),TUG 与 TT-Gait 呈负相关(r = -0.69,p = 0.02)。重测信度介于 0.72 和 0.86 之间。Bland-Altman 图显示,TT-总值超过 95 % CI 时损失了一个数据点。 讨论。Tinetti 测试表明量表具有较高的实质效度和内部一致性(平衡和行走部分的 α-Kronbach 分别为 0.74 和 0.72),这与国外学者的数据一致。 结论对俄文版运动活动能力评估量表进行的语言和文化调整及心理测试表明,该测试作为 IS 患者平衡和行走评估工具具有有效性和可靠性。
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Validation of the Performance Oriented Mobility Assessment (Tinetti Test) Scale in Russia for Stroke Patients
INTRODUCTION. Balance disturbances are frequent syndromes after a cerebral stroke (CS). The availability of a validated tool for balance and walking functions comprehensive assessments is very important part of real clinical practice, for rehabilitation diagnosis and individual medical rehabilitation plan. AIM. To determine the psychometric properties of the Motor Activity Performance Assessment Scale (Tinetti Test, TT) for measuring balance and walking in patients with ischemic stroke (IS). MATERIALS AND METHODS. 200 patients were included, 100 in the early (ERP) and 100 in the late (LRP) recovery periods of IS. The average age of patients was 55 [51; 57] years. The average of IS-duration were 99.3 ± 30.9 days (ERP) and 267.7 ± 27.8 days (LRP). Clinical and demographic characteristics of patients in two groups were comparable. The median and interquartile interval of TT were 20 [14; 24] points out of 28 possible. Content validity and intra-rater reliability were assessed by 10 clinicians. The test-retesting method was used to determine the intra-rater reliability. The Berg Balance Scale (BBS), the Stand Up and Go for Time (TUG), and the 10-meter walk test (10MWT) were used for concurrent validation. RESULTS. Two-stage linguistic and cultural adaptation made it possible to construct a Russian-language version of TT that was tested in a pilot study of 30 patients. The subsequent study of the psychometric properties of TT demonstrated high level of content validity and internal consistency of TT (α-Kronbach: 0.74 for TT-Balance and 0.72 for TT-Gait). BBS data significantly correlated with TT-Balance scores (r = 0.73, p = 0.001), TUG showed a negative correlation with TT-Gait (r = −0.69, p = 0.02). Retest reliability ranged from 0.72 to 0.86. The Bland-Altman plot showed the loss of one data point for TT-total beyond 95 % CI. DISCUSSION. The Tinetti test indicates high substantive validity and internal consistency of the scales (the α-Kronbach for the balance and walking sections are 0.74 and 0.72, respectively), which is consistent with the data of foreign authors. CONCLUSION. The linguistic and cultural adaptation and psychometric testing of the Russian version of the Motor Activity Performance Assessment Scale demonstrated the validity and reliability of this test as a tool for balance and walking assessment in patients with IS.
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