星状伸展平衡测试评定脑卒中患者动态平衡的信度和效度

doi:10.3969/j.issn.1006-9771.2021.05.014

摘要/Abstract

摘要： 目的

探讨星状伸展平衡测试(SEBT)对脑卒中患者动态平衡功能评定的价值。

方法

2018年9月至2019年11月，Brunnstrom IV期及以上能独立步行的恢复期脑卒中偏瘫住院患者38例，由两名测试者评定患侧下肢支撑下SEBT前、后内、后外侧伸展距离标准化值；其中一名测试者间隔1 d再次测量。计算组内相关系数(ICC)。第三位测试者采用EAB-100平衡检测仪(EAB)评定患者前、后内、后外、外侧稳定极限值，进行计时起立-行走测试(TUGT)，评定结果与SEBT结果行Pearson相关性分析。

结果

3个方向测试者间ICC = 0.892~0.951；重测ICC = 0.888~0.963；SEBT三个方向与EAB前、外侧稳定极限值呈正相关(r = 0.479~0.671, P < 0.05)，与TUGT呈负相关(r = -0.557~-0.633, P < 0.05)。

结论

SEBT评定Brunnstrom IV期及以上可独立步行脑卒中患者的立位动态平衡功能有较高的信、效度。

关键词: 脑卒中, 星状伸展平衡测试, 平衡, 康复评定

Abstract: Objective

To apply Star Excursion Balance Test (SEBT) in evaluating dynamic balance function in stroke patients.

Methods

From September, 2018 to November, 2019, 38 stroke hemiplegic patients of Brunnstrom IV and above who could walk independently were included. They completed SEBT by two testers; the anterior, posteromedial and posterolateral extension standardized distance of the affected leg support were recorded. One of the testers measured SEBT again the day after the next day. The intraclass correlation coefficient (ICC) was calculated. The limits of stability on different directions were measured with active balancer EAB-100 (EAB) and tested with Timed 'Up & Go' Test (TUGT) by the third tester. The correlation of SEBT to EAB and TUGT was analyzed with Pearson correlation coefficient.

Results

ICCs of three directions was 0.892 to 0.951 between testers, and 0.888 to 0.963 of test-retest. The standardized distance of three directions of SEBT correlated with the anterior and lateral stability limits of EAB (r = 0.479 to 0.671, P < 0.05), as well as TUGT (r = -0.557~-0.633， P < 0.05).

Conclusion

SEBT is valid and reliable for evaluation of the dynamic balance for stroke patients of Brunnstrom IV and above who can walk independently.

Key words: stroke, Star Excursion Balance Test, balance, rehabilitation assessment

中图分类号:

R743.3

王亚囡,张通,刘元旻,朱晓敏,杜雪晶. 星状伸展平衡测试评定脑卒中患者动态平衡的信度和效度[J]. 《中国康复理论与实践》, 2021, 27(5): 604-608.

Ya-nan WANG,Tong ZHANG,Yuan-min LIU,Xiao-min ZHU,Xue-jin DU. Validity and Reliability of Star Excursion Balance Test for Dynamic Balance Assessment in Stroke Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 604-608.

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项目	数值
性别(男/女, n)	22/16
年龄(岁)	41.79±10.33
身高(cm)	171.32±6.88
体质量(kg)	73.16±8.85
BMI (kg/m²)	24.89±2.27
下肢长(cm)	83.32±5.94
疾病种类(脑梗死/脑出血, n)	18/20
偏瘫侧(左/右, n)	17/21

方向	测试者A第一次	测试者A第二次	测试者B	ICC^a	95%CI^a	ICC^b	95%CI^b
前	47.53±12.74	48.02±13.26	47.47±11.24	0.888	0.794~0.940	0.951	0.909~0.974
后内	70.45±13.37	68.62±13.10	72.56±13.37	0.963	0.900~0.984	0.892	0.794~0.944
后外	54.82±16.69	55.62±14.71	54.14±15.32	0.953	0.912~0.975	0.905	0.825~0.949

TUGT (s)	EAB (mm)
TUGT (s)	前	后内	后外	外
19.53±9.26	58.21±16.06	68.20±14.62	52.98±21.46	63.72±18.35
r	-0.535	-0.116	-0.208	-0.532
P值	0.001	0.488	0.209	0.001

测量			SEBT
测量			前	后内	后外
EAB (mm)	前	r	0.531	0.479	0.559
		P值	0.001	0.002	< 0.001
	后内	r	0.099	0.060	0.128
	后内	P值	0.553	0.722	0.445
	后外	r	0.147	0.163	0.138
	后外	P值	0.378	0.328	0.375
	外	r	0.653	0.587	0.671
	外	P值	< 0.001	< 0.001	< 0.001
TUGT(s)		r	-0.557	-0.641	-0.633
		P值	< 0.001	< 0.001	< 0.001

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