뇌졸중 환자들의 축소형 Fugl-Meyer평가 척도의 상대ㆍ절대적 신뢰도와 타당도
The Reliability and Validity of Short Form of the Fugl-Meyer Assessment Scale in Patients with Stroke
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초록
본 연구의 목적은 축소형 퓨글 마이어 평가 척도(Short Form-Fugl Meyer assessment scale: SF-FMA)의 임상적용에 필요한 상대ㆍ절대적 신뢰도와 타당도를 조사하기 위함이다. 본 연구는 만성기 뇌졸중 환자 44명을 대상으로 축소형 FM-평가 척도의 검사-재검사 신뢰도(Test retest reliability)는 급간내상관계수(Intra class coefficient, ICC)를 측정 오차의 정량화를 위해 표준오차 측정(Standard Error Measurement, SEM)과 최저 실제 차이(Smallest real difference, SRD)이용하였다. 축소형 FM-평가 척도와 원본 FM-평가 척도, 10m 보행 속도 검사, 앉고 일어서기 검사(Sit to Stand test, STS), 바델 지수(Barthel Index, BI), 버그 균형 척도(Berg Balance Scale, BBS)의 관련성은 스피어만 계수(Spearman coefficient)로 표기하였다. 연구 결과 축소형 FM-상ㆍ하지, 총점의 검사 재검사 신뢰도 ICC는 .94~.97(95% 신뢰도 수준 ≥.95)로 높았고, SEM(평균 점수의 10% 미만; 0.53~0.76점)과 SRD(최고 획득 점수의 20% 미만; 1.19점~2.11점)의 측정 오류 수준은 수용할 만 하였다. 축소형 FM-평가 척도의 상ㆍ하지, 총합의 동시타당도는 원본 FM-평가와 매우 높은 관련성이 있었고(r=.73~.86), 수렴 타당도는 10m 보행 속도(r=.57~.69), STS(r= -.52~-.70), BI(r=.65~.72), BBS(r=.68~.76)와 중등도 이상의 높은 관련성이 있는 것으로 나타났다. 따라서 축소형 FM-평가 척도는 뇌졸중 환자의 마비측 운동 기능을 평가하는데 적합하다고 할 수 있으며 추후 유병 기간에 따른 축소형 FM-평가 척도의 임상적 유용성에 관한 연구가 필요할 것이다.
Abstract
The purpose of this study was to examine the test-retest reliability and validity of the Short Form-Fugl Meyer assessment scale(SF-FM) for people with stroke. A consecutive sample of 44 participants, the study examined test-retest reliability and Standard Error Measurement(SEM), Smallest real difference(SRD). The validity was tested by correlating results to the Original of FM Scale, 10m Walking Test (10m WT), Sit to Stand test(STS), Barthel Index(BI), Berg Balance Scale(BBS). It was shows that test-retest reliabilities were high for the UE and LE subscales and total scores of the SF-FM scales(all ICCs .94~.97 and lower limits of 95% CI≥.95). The SEM(less 10% of mean score) and SRD(20% of their corresponding highest score) of the UE and LE subscales and total scores of the SF-FM scales representing were 0.53~0.76score and 1.19~2.11score, respectively, indicating acceptable levels of measurement error. The SF-FM subscale and total motor score were demonstrated high concurrent validity with Original of FM Scale(r=.73~.86), and convergent validity with the 10m WT(r=.57~.69), STS(r=-.52~-.70), BI(r= .65~.72), & BBS score(r=.68~.76, p<.01). The SF-FM scale was a valid and reliable measure for assessing the affected motor function of chronic stroke patients. Further studies to recruit patients with characteristics different from those enrolled in this study(eg, acute patients or chronic patients) are necessary to promote the clinical utility.
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