뇌졸중 환자의 Supine to Stand Test의 상대적･절대적 신뢰도와 동시타당도
The Relative･Absolute Reliability and Concurrent Validity of the Supine to Stand Test in People with Stroke
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초록
본 연구의 목적은 뇌졸중 환자의 누운 자세에서 일어서기 검사(Supine to Stand Test, STST)의 신뢰도와 타당도를 알아보고자 하였다. 뇌졸중 환자 31명을 대상으로 STST소요 시간의 측정자간･검사-재검사 신뢰도는 급간내상관계수(Intra Class Coefficient, ICC2,1)로 구하였고, 측정 오류를 추정하기 위하여 측정 오차(Standard Error of Measurement, SEM)와 최저 식별 변화(Minimal Detectable Change, MDC) 및 Bland and Altman 분석을 이용하였다. STST의 타당도는 활동 특이성 균형 자신감 척도(Activities-specific Balance Confidence scale, ABC-C), 버그 균형 척도(Berg Balance Scale, BBS), 일어나 걸어 가기 검사(Timed Up & Go test, TUG), 네막대 스텝 검사(Four Square Step Test, FSST)와의 관련성을 스피어만 계수로 표기하였다. 본 연구 결과 STST의 측정자 간･검사-재검사 신뢰도 ICC=.932∼.957로 일치율은 높고, STST소요 시간의 측정자 간과 검사 재검사간의 MDC는 각각 2.43, 2.71로 획득 가능한 최고 점수의 20% 미만으로 측정 오차 수준은 신뢰할만하였다. STST의 타당도는 ABC-C(r=-.489), BBS(r=-.410), TUG(r=.462), FSST(r=.439)와 양호한 관련성이 있는 것으로 확인되었다. STST는 뇌졸중 환자의 누운 자세에서 일어서는 능력을 평가할 수 있는 신뢰도와 타당도가 있는 검사 방법이다. STST검사 결과를 측정으로 사용할 때 MDC는 평균 2.5초를 기준값으로 사용할 수 있다.
Abstract
The aim of this study was to investigate the reliability and validity of the Supine to Stand Test (STST) in patients with stroke. In 31 patients with stroke, the inter-rater and test-retest reliability of the STST completion time were calculated using the intraclass correlation coefficient (ICC2,1). Measurement error was estimated using the standard error of measurement (SEM), minimal detectable change (MDC), and Bland and Altman analysis. The validity of the STST was assessed by its correlations with the Activities-specific Balance Confidence scale (ABC-C), Berg Balance Scale(BBS), Timed Up & Go test (TUG), and Four Square Step Test (FSST), presented as Spearman coefficients. The results showed high consistency in the inter-rater and test-retest reliability of the STST, with ICC ranging from .932 to .957. The MDC for the completion time of the STST was 2.43 for inter-rater reliability and 2.71 for test-retest reliability, representing less than 20% of the maximum attainable score, indicating acceptable levels of measurement error. The validity of the STST was confirmed by its significant correlations with ABC-C(r=-.489), BBS (r=-.410), TUG(r=.462), and FSST(r=.439). STST is a reliable and valid assessment method for evaluating supine-to-stand ability in patients with stroke. When using STST results for measurement, an MDC criterion value of approximately 2.5 seconds can be considered.
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