Psychometric Properties of a New Measure of Upper Limb Performance in Post-Stroke Individuals: Trunk-Based Index of Performance.

IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY
Daniele Piscitelli, Melanie C Baniña, Timothy K Lam, Joyce L Chen, Mindy F Levin
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引用次数: 0

Abstract

Background: Several measures of upper limb (UL) motor tasks have been developed to characterize recovery. However, UL performance and movement quality measures in isolation may not provide a true profile of functional recovery.

Objective: To investigate the measurement properties of a new trunk-based Index of Performance (IPt) of the UL combining endpoint performance (accuracy and speed) and movement quality (trunk displacement) in stroke.

Methods: Participants with stroke (n = 25, mean time since stroke: 18.7 ± 17.2 months) performed a reaching task over 3 evaluation sessions. The IPt was computed based on Fitts' Law that incorporated endpoint accuracy and speed corrected by the amount of trunk displacement. Test-retest reliability was analyzed using intraclass correlation coefficient (ICC) and Bland-Altman plots. Standard error of measurement (SEM) and Minimal Detectable Change (MDC) were determined. Validity was investigated through the relationship between IPt, Fugl-Meyer Assessment (FMA-UE), and Action Research Arm Test (ARAT), as well as the ability of IPt to distinguish between levels of UL motor impairment severity.

Results: Test-retest reliability was excellent (ICC = .908, 95% CI: 0.807-0.96). Bland-Altman did not show systematic differences. SEM and MDC95 were 14% and 39%, respectively. Construct validity was satisfactory. The IPt showed low-to-moderate relationships with FMA-UE (R2 ranged from .236 to .428) and ARAT (R2 ranged from .277 to .306). IPt scores distinguished between different levels of UL severity.

Conclusions: The IPt showed evidence of good reliability, and initial validity. The IPt may be a promising tool for research and clinical settings. Further research is warranted to investigate its validity with additional comparator instruments.

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Abstract Image

Abstract Image

脑卒中后上肢表现的一种新测量方法的心理测量特性:基于躯干的表现指数。
背景:上肢(UL)运动任务的几种测量方法已被开发用来表征恢复。然而,单独的UL性能和运动质量测量可能无法提供功能恢复的真实概况。目的:研究一种结合脑卒中终点性能(准确性和速度)和运动质量(躯干位移)的新型脑卒中主干性能指标(IPt)的测量特性。方法:卒中患者(n = 25,卒中后平均时间:18.7±17.2个月)在3个评估阶段完成一项到达任务。IPt是根据Fitts定律计算的,该定律结合了端点精度和速度,并经主干位移量校正。用类内相关系数(ICC)和Bland-Altman图分析重测信度。测定了测量标准误差(SEM)和最小可检测变化(MDC)。通过IPt、Fugl-Meyer评估(FMA-UE)和行动研究臂测试(ARAT)之间的关系以及IPt区分UL运动障碍严重程度水平的能力来调查效度。结果:重测信度极好(ICC =。908, 95% ci: 0.807-0.96)。Bland-Altman没有显示出系统性差异。SEM和MDC95分别为14%和39%。构念效度令人满意。IPt与FMA-UE (R2范围为0.236 ~ 0.428)和ARAT (R2范围为0.277 ~ 0.306)呈低至中度相关。IPt评分可以区分不同程度的UL严重程度。结论:IPt具有良好的信度和初始效度。IPt可能是研究和临床设置的一个有前途的工具。进一步的研究是必要的,以调查其有效性与其他比较仪器。
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来源期刊
CiteScore
8.30
自引率
4.80%
发文量
52
审稿时长
6-12 weeks
期刊介绍: Neurorehabilitation & Neural Repair (NNR) offers innovative and reliable reports relevant to functional recovery from neural injury and long term neurologic care. The journal''s unique focus is evidence-based basic and clinical practice and research. NNR deals with the management and fundamental mechanisms of functional recovery from conditions such as stroke, multiple sclerosis, Alzheimer''s disease, brain and spinal cord injuries, and peripheral nerve injuries.
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