多维度视频定量评估系统在脑卒中患者手功能评估中的信效度研究  

The reliability and validity of multi-dimensional,quantitative video evaluation of the hand function of stroke survivors

作　　者：马红梅 石雨 慕雅婷 贾杰 陆小锋[3] 付江红 储天宇 李冬[1] 朱琳[1] 王宝兰[1] Ma Hongmei;Shi Yu;Mu Yating;Jia Jie;Lu Xiaofeng;Fu Jianghong;Chu Tianyu;Li Dong;Zhu Lin;Wang Baolan(Department of Rehabilitation Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;School of Communications and Information Engineering,Shanghai University,Shanghai 200444,China)

机构地区：[1]新疆医科大学第一附属医院康复医学科,乌鲁木齐830054 [2]复旦大学附属华山医院康复医学科,上海200040 [3]上海大学通信与信息工程学院,上海200444

出　　处：《中华物理医学与康复杂志》2022年第2期116-120,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：新疆维吾尔自治区区域协同创新专项(科技援疆计划)(2019E0283)。

摘　　要：目的检验多维度视频定量评估系统(简称多维系统)在脑卒中手功能障碍患者中的信度和效度,为临床应用提供客观依据。方法对60例单手功能障碍的脑卒中患者,采用多维系统、手主动关节活动度(AROM-H)、Fugl-Meyer上肢功能评定量表(FMA-UE)、上肢运动研究量表(ARAT)进行评估。采取内部一致性、组合信度、分半信度、复本信度、评估者间信度、评估者内信度行信度检验,内容效度、结构效度、收敛效度、校标效度行效度检验。结果①信度检验显示,多维系统Cronbachα系数=0.860,单维度的组合信度=0.939,分半信度系数=0.880,复本信度系数=0.922,各动作评估者间信度ICC=0.965~0.998[95%CI=(0.919,0.999)],评估者内信度ICC值=0.973~0.998(95%CI=(0.937,0.999))。②效度检验显示,内容效度指数I-CVI=1,且各亚项与多维系统总分Pearson相关系数均>0.600(P<0.01);结构效度中KMO值=0.882(P<0.01),成分矩阵中存在一个公因子,累计反映原始变量60.879%的信息量;收敛效度AVE=0.609;标效度中多维系统与FMA-UE和ARAT的Pearson相关系数均>0.700(P<0.01)。结论多维度视频定量评估系统对脑卒中手功能障碍患者的评估具有较高的信效度。Objective To test the reliability and validity of a multi-dimensional,quantitative video evalua-tion system(the Multi-dimensional system)for evaluating hand dysfunction among stroke survivors so as to provide an objective basis for its clinical application.Methods Sixty stroke survivors with single dysfunctional hand were evaluated using the Multi-dimensional system and also using the Fugl-Meyer Upper Extremity Assessment(FMA-UE)and the Action Research Arm Test(ARAT)and in terms of their active range of hand motion(AROM-H).The Multi-dimensional system′s internal consistency,composite reliability,split-half reliability,parallel-forms reliability as well as intra-and inter-observer reliability were quantified.Its validity was tested in terms of content validity,structural validity,convergent validity and criterion validity.Results The system′s Cronbach′sαwas determined to be 0.86.Its one-dimension composite reliability was 0.939,its split-half reliability coefficient was 0.88 and its paral-lel-forms reliability was 0.922.The inter-evaluator reliability was between 0.965 and 0.998[95%CI=(0.919,0.999)],and the single evaluator ICC value was 0.973 to 0.998[95%CI=(0.937,0.999)].The validity test pro-duced a content validity index of 1,and the Pearson correlation coefficients between each sub-item and the total score were all greater than 0.60.The KMO value for structural validity was 0.882,and there was a common factor in the component matrix which reflected 60.9%of the information in the original variables.The system′s convergent validity AVE was 0.609 with Pearson correlation coefficients between the multidimensional system and the FMA-UE and ARAT both>0.70.Conclusion The multi-dimensional quantitative video evaluation system has good reliability and validity in the evaluation of stroke survivors with hand dysfunction.

关 键 词：脑卒中 手功能 多维度视频定量评估系统 信度 效度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]