뇌졸중 환자들의 동적 균형 평가(F8WT, FSST, ST)의 검사-재검사 재현성과 최저 실제 차이
Test-retest Reproducibility and Smallest Real Difference of Dynamic Standing Balance Test(F8WT, FSST, ST) in Patients With Stroke
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초록
본 연구의 목적은 만성 뇌졸중 환자를 대상으로 Figure 8 Walk Test(F8WT), Four Square Step Test(FSST), Step Test(ST)의 검사-재검사 재현성과 최저 실제 차이를 알아보고자 하였다. 뇌졸중 환자 30명을 대상으로 F8WT, FSST, ST의 검사-재검사를 7일 간격으로 재평가하였다. 검사-재검사 신뢰도(test-retest reliability)는 급간내상관계수(Intra Class Coefficient, ICC2,1), 무작위 측정 오차의 크기를 결정하기 위하여 표준 측정 오차(Standard Error of Measurement, SEM)와 최저 실제 차이(Small real difference, SRD) 및 SRD%와 Bland and Altman(일치 한계) 분석을 이용하였다. 연구 결과 F8WT, FSST, 마비측과 비마비측 ST의 검사-재검사 신뢰도의 재현성은 ICC=.951∼ .994(.907 ∼ .994)로 높은 것으로 확인되었다. SF8WT와 FSST의 SEM은 각각 2.21, 2.07, 마비측과 비마비측 ST는 각각 .56, .40으로 평균 점수의 <20%미만, SRD는 F8WT와 FSST에서 각각 5.99, 5.72, 마비측과 비마비측 ST는 각각 1.54, 1.10으로 최고 획득 가능한 점수의 20%미만으로 신뢰할 만한 수준이었다. F8WT, FSST, ST검사 재검사 일치율 ICC는 높고, SEM과 SRD값은 신뢰할 수 있는 수준으로 명확히 재현성이 검증되었다. 따라서 F8WT, FSST, ST는 임상가와 연구가에게 있어 만성 뇌졸중 환자들의 이동성과 동적 균형 능력의 변화를 관찰하거나 평가하는데 유용한 평가 도구가 될 수 있을 것이다.
Abstract
This study aimed to assess the test-retest reproducibility and smallest real difference of the Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), and Step Test (ST) in chronic stroke survivors. The test-retest of F8WT, FSST, and ST was re-evaluated at seven-day intervals for 30 stroke survivors. To evaluate test-retest reliability, Standard Error of Measurement (SEM), Small Real Difference(SRD), SRD%, and a Bland-Altman (limits of agreement) plot were used to determine Intra Class Coefficient (ICC2,1), as well as the magnitude of random measurement error. The study’s results showed that the reproducibility of test-retest reliability of F8WT, FSST, and ST on the paretic and non-paretic side was high with ICC=.951-.994 (.907-.994). The SEM of the SF8WT and FSST were 2.21 and 2.07, respectively, and the ST values of the paretic and non-paretic sides were .56 and .40, respectively, which were below 20% of the average score. SRD values were 5.99 and 5.72 in F8WT and FSST, respectively. STs were 1.54 and 1.10 on the paretic and non-paretic sides, reliable at less than 20% of the highest score possible. The intra-class correlation coefficients (ICC), F8WT, FSST, and ST test-retest agreement rates were high furthermore, SEM and SRD values were verified to be sufficiently reproducible at a reliable level. Therefore, F8WT, FSST, and ST may be helpful evaluation tools for clinicians and researchers to observe or evaluate any changes in mobility and dynamic balance ability in chronic stroke survivors.
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