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뇌졸중 환자의 Four Square Step Test의 신뢰도와 타당도

The Reliability and Validity of the Four Square Step Testin Stroke Patients

안승헌|박창식
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2017.03|특수교육재활과학연구|제56권 제1호|pp. 309-325|DOI 10.23944/isers.2017.03.56.1.13

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키워드

뇌졸중WalkingStroke보행회전TurningDynamic standing balance동적 서기 균형Four Square Stet TestFour Square Step Test
주제분류기타사회과학

초록

본 연구의 목적은 뇌졸중 환자의 Four Square Step Test(FSST)의 측정자간·검사-재검사 신뢰도와 타당도를 알아보고자 하였다. 본 연구에 참여한 만성 뇌졸중 환자 32명을 대상으로 FSST 소요 시간의 측정자간·검사-재검사 신뢰도는 상대적 신뢰도 지수 인(급간내상관계수: Intra Class Coefficient, ICC)를 이용하였다. 또한 절대적 신뢰도 지수인 표준 측정 오차(Standard Error Measurement, SEM)와 최소 감지 변화(Minimal Detectable Change, MDC) 및 Bland and Altman(일치 한계) 분석이 포함되었다. FSST의 동시 타당도는 8자 경로 보행 검사(Figure-Eight Walk Test, F8WT), 10m 보행 속도, 푸글마이어 하지 운동 기능(Fugl Meyer Assessment-Lower/extremity, FMA-L/E), 일어나 걸어가기 검사(Timed Up & Go Test, TUG), 버그 균형 척도(Berg Balance Scale, BBS)간의 스피어만 상관 계수(Spearman Correlation Coefficient)를 이용하였다. FSST 소요 시간의 측정자간, 검사-재검사 신뢰도 ICC=0.93∼0.97(0.86∼0.98), SEM은 각각 0.91, 1.52, MDC는 각각 2.51, 4.21로 신뢰할 수 있는 수준(<15%)인 것으로 확인되었다. FSST 소요시간은 F8WT(r=0.91), 10m 보행 속도(r=-0.83), FMA-L/E(r=-0.81), TUG(r=0.85) ,BBS(r=-0.82)와는 높은 상관관계가 있는 것으로 확인되었다. 만성 뇌졸중 환자들의 FSST 소요 시간은 높은 측정자간·검사-재검사 신뢰도가 있었고, 뇌졸중 특이성 장애인 마비측 하지 운동 기능과 균형 능력 및 직선과 곡선(회전) 보행 검사와 높은 관련성이 있었다. 따라서 임상에서 FSST 소요 시간은 만성 뇌졸중 환자의 동적 균형 능력을 평가하는데 빠르고 쉽게 적용이 가능한 평가 도구가 될 수 있을 것이다.

Abstract

To establish the Interㆍtest-retest reliabilities of the Four Square Step Test(FSST) times and associations with stroke-specific impairments. A total of 32 subjects with chronic stroke participated in this study. A relative reliability index (intraclass correlation coefficient, ICC) was used to examine the level of agreement of inter-raterㆍtest-retest reliability for FSST times. Also Absolute reliability indices, including the standard error of measurement(SEM) and the minimal detectable change(MDC), and limits of agreement by Bland and Altman analysis. The validity was demonstrated by spearman correlation of FSST time with Figure-Eight Walk Test(F8WT), 10m Walk Test(10mWT), Fugl Meyer Assessment- Lower/Extremity(FMA-L/E), Timed Up & Go Test(TUG), Berg Balance Scale(BBS). Excellent Inter-raterㆍtest-retest reliabilities(ICC range 0.93 to 0.97) of FSST times were found. It all showed acceptable SEM(0.91∼1.52) and MDC(2.51, 4.21)respectively(<15%). The FSST times were significantly correlated with F8WT times(r=0.91), 10mWT(r=-0.83), FMA-L/E(r=-0.81), TUG(r=0.85) and BBS(r=-0.82). Conclusions: The FSST times is a reliable measurement tool and significantly associated with stroke-specific impairments and walking tests(straight, curved walking and turning task). The FSST is could be an easy-to-administer clinical test with chronic stroke to assess dynamic standing balance.

참고문헌 (41)

  1. Altman, D. G., "Measurement in medicine : the analysis of method comparison studies", Statistician, 32(3), pp.307~317 (1983)
  2. Beckerman, H., "Smallest real difference, a link between reproducibility and responsiveness", Quality of Life Research, 10(7), pp.571~578 (2001)
  3. Berg, K. O., "Clinical and laboratory measures of postural balance in an elderly population", Archives of Physical Medicine and Rehabilitation, 73(11), pp.1073~1080 (1992)
  4. Bland, J. M., "Statistical methods for assessing agreement between two methods of clinical measurement", Lancet, 1(8476), pp.307~310 (1986)
  5. Blennerhassett, J. M., "Changes in balance and walking from stroke rehabilitation to the community : a follow-up observational study", Archives of Physical Medicine and Rehabilitation, 93(10), pp.1782~1787 (2012)
  6. Blennerhassett, J. M., "The Four Square Step Test is a feasible and valid clinical test of dynamic standing balance for use in ambulant people poststroke", Archives of Physical Medicine and Rehabilitation, 89(11), pp.2156~2161 (2008)
  7. Courtine, G., "Human walking along a curved path. I. Body trajectory, segment orientation and the effect of vision", The European journal of neuroscience, 18(1), pp.177~190 (2003)
  8. Courbon, A., "Relationship between maximal exercise capacity and walking capacity in adult hemiplegic stroke patients", American journal of physical medicine & rehabilitation, 85(5), pp.436~444 (2006)
  9. Curtin, F., "Multiple correlations and Bonferroni’s correction", Biological Psychiatry, 44(8), pp.775~777 (1998)
  10. De Menezes, K. K., "Measurement properties of the lower extremity motor coordination test in individuals with stroke", Journal of Rehabilitation Medicine, 47(6), pp.502~507 (2015)
  11. Dite, W., "Clinical identification of multiple fall risk early after unilateral transtibial amputation", Archives of Physical Medicine and Rehabilitation, 88(1), pp.109~114 (2007)
  12. Dite, W., "A clinical test of stepping and change of direction to identify multiple falling older adults", Archives of Physical Medicine and Rehabilitation, 83(11), pp.1566~1571 (2002)
  13. Duncan, P. W., "Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident", Physical Therapy, 63(10), pp.1606~1610 (1983)
  14. Flansbjer, U. B., "The reproducibility of berg balance scale and the single-leg stance in chronic stroke and the relationship between the two tests", PM & R, the journal of injury, function, and rehabilitation, 4(3), pp.165~170 (2012)
  15. Fugl-Meyer, A. R., "The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance", Scandinavian Journal of Rehabilitation Medicine, 7(1), pp.13~31 (1975)
  16. Gemperline, J. J., "Characteristics of motor unit discharge in subjects with hemiparesis", Muscle & nerve, 18(10), pp.1101~1114 (1995)
  17. Goh, E. Y, "Reliability and Concurrent Validity of Four Square Step Test Scores in Subjects With Chronic Stroke : A Pilot Study", Archives of Physical Medicine and Rehabilitation, 94(7), pp.1306~1311 (2013)
  18. Harris, J. E., "Relationship of balance and mobility to fall incidence in people with chronic stroke", Physical Therapy, 85(2), pp.150~158 (2005)
  19. Hess, R. J., "Walking skill can be assessed in older adults : validity of the Figure-of-8 Walk Test", Physical Therapy, 90(1), pp.89~99 (2010)
  20. Hollands, K. L., "Kinematics of turning 180 degrees during the timed up and go in stroke survivors with and without falls history", Neurorehabilitation and neural repair, 24(4), pp.358~367 (2010)
  21. Hong, S. J., "Reliability and validity of Step Test scores in subjects with chronic stroke", Archives of Physical Medicine and Rehabilitation, 93(6), pp.1065~1071 (2012)
  22. Hyndman, D., "Falls events among people with stroke living in the community : circumstances of falls and characteristics of fallers", Archives of Physical Medicine and Rehabilitation, 83(2), pp.165~170 (2002)
  23. 권미지, "뇌졸중 환자의 낙상 예측을 위한 Four Square Step Test의 활용에 관한 연구", 대한물리치료학회지, 22(4), pp.1~6 (2010), 대한물리치료학회
  24. Lam, T., "Turning capacity in ambulatory individuals poststroke", Archives of Physical Medicine and Rehabilitation, 88(11), pp.873~383 (2009)
  25. Liaw, L. J., "The relative and absolute reliability of two balance performance measures in chronic stroke patients", Disability and Rehabilitation, 30(9), pp.656~661 (2008)
  26. Lu, W. S., "The minimal detectable change of the simplified stroke rehabilitation assessment of movement measure", Journal of Rehabilitation Medicine, 40(8), pp.615~619 (2008)
  27. Mackintosh, S. F., "Falls and injury prevention should be part of every stroke rehabilitation plan", Clinical Rehabilitation, 19(4), pp.441~451 (2005)
  28. Ng, S. S., "The timed up and go test : its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke", Archives of Physical Medicine and Rehabilitation, 86(8), pp.1641~1647 (2005)
  29. Ng, S. S., "Walkway lengths for measuring walking speed in stroke rehabilitation", Journal of Rehabilitation and Medicine, 44(1), pp.43~46 (2012)
  30. Nilsagard, Y., "Predicting accidental falls in people with multiple sclerosis : a longitudinal study", Clinical Rehabilitation, 23(3), pp.259~269 (2009)
  31. Podsiadlo, D., "The timed ‘‘Up & Go’’: a test of basic functional mobility for frail elderly persons", Journal of the American Geriatrics Society, 39(2), pp.142~148 (1991)
  32. Pohl, P. S., "Long J. Influence of stroke related impairments on performance in 6-minute walk test", Journal of Rehabilitation Research and Development, 39(4), pp.439~444 (2002)
  33. Portney, L. G, "Foundations of clinical research: Applications to practice", pp.2~450 (1993), Appleton & Lange
  34. Prince, B., "Research methodology and applied statistics. Part 2 : the literature search", Physiotherapy Canada, 32(4), pp.201~206 (1980)
  35. Said, C. M., "Control of lead and trail limbs during obstacle crossing following stroke", Physical Therapy, 85(5), pp.413~427 (2005)
  36. Said, C. M., "Balance during obstacle crossing following stroke", Gait & posture, 27(1), pp.23~30 (2008)
  37. Salbach, N. M., "Responsiveness and predictability of gait speed and other disability measures in acute stroke", Archives of Physical Medicine and Rehabilitation, 82(9), pp.1204~1212 (2001)
  38. Segal, A. D., "Local dynamic stability in turning and straight-line gait", Journal of biomechanics, 41(7), pp.1486~1493 (2007)
  39. Whitney, S. L., "The reliability and validity of the Four Square Step Test for people with balance deficits secondary to a vestibular disorder", Archives of Physical Medicine and Rehabilitation, 88(1), pp.99~104 (2007)
  40. Wong, S. S., "The Figure-of-Eight Walk Test : reliability and associations with stroke-specific impairments", Disability and Rehabilitation, 35(22), pp.1896~1902 (2013)
  41. Yates, J. S., "Falls in community dwelling stroke survivors : an accumulated impairments model", Journal of Rehabilitation Research and Development, 39(3), pp.385~394 (2002)

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