扩展Barthel指数量表评定脑卒中ADL能力的效度研究
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摘要
目的:初步研究扩展巴氏指数量表(EBI)评定脑卒中日常生活活动能力(ADL)的效度,为其临床应用提供依据。方法:对30例脑卒中患者进行EBI、巴氏指数(BI)量表、改良巴氏指数(MBI)量表、简易精神状态量表(MMSE)的评估,将EBI运动功能部分、认知功能部分分别与BI、MBI和MMSE进行Spearman相关分析以检验EBI的效度。结果:EBI的运动功能部分与BI、MBI总分及各项之间,认知部分与MMSE总分具有高度相关性,EBI与BI、MBI、 MMSE总分相关系数分别为:0.915,0.949,0.879(P<0.01),具有高度相关性。结论:EBI具有良好的效度,从某种程度上体现了脑卒中运动功能、认知功能状态,可以更全面评定脑卒中的ADL能力。
Objective: To study the validity of the Extended Barthel Index(EBI) to evaluate the activity of daily living activity(ADL) of stroke, and to provide a basis for its clinical application. Methods: Thirty stroke patients were evaluated by EBI, the Barthel index(BI), the modified Barthel index(MBI), and the Mini-Mental State Examination(MMSE). Spearman correlation analysis between EBI and BI, MBI or MMSE was done to test the validity of EBI. Results: The motor function part of EBI was highly correlated with BI and MBI in item and total scores. The cognitive function part of EBI was highly correlated with the total scores of MMSE, and the correlation coefficient of the total score of BI and MBI, MMSE was 0.915, 0.949, 0.879 respectively(P<0.01). Conclusion: EBI has good standard validity, which reflects the motor function and cognitive function of stroke to some extent, and can evaluate the ADL ability of stroke more comprehensively.
Objective: To study the validity of the Extended Barthel Index(EBI) to evaluate the activity of daily living activity(ADL) of stroke, and to provide a basis for its clinical application. Methods: Thirty stroke patients were evaluated by EBI, the Barthel index(BI), the modified Barthel index(MBI), and the Mini-Mental State Examination(MMSE). Spearman correlation analysis between EBI and BI, MBI or MMSE was done to test the validity of EBI. Results: The motor function part of EBI was highly correlated with BI and MBI in item and total scores. The cognitive function part of EBI was highly correlated with the total scores of MMSE, and the correlation coefficient of the total score of BI and MBI, MMSE was 0.915, 0.949, 0.879 respectively(P<0.01). Conclusion: EBI has good standard validity, which reflects the motor function and cognitive function of stroke to some extent, and can evaluate the ADL ability of stroke more comprehensively.
引文
[1] 张通.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012, (4):301-318.
[2] Duffy L,Gajree S,Langhorne P,et al.Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis[J].Stroke,2013,44(2):462-468.
[3] Quinn TJ,Langhorne P,Stott DJ.Barthel index for stroke trials: development, properties,and application[J].Stroke,2011,42(4):1146-1151.
[4] Prodinger B,O'Connor RJ,Stucki G,et al.Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index,utilising the International Classification of Functioning,Disability and Health and Rasch measurement theory.Journal of rehabilitation medicine,2017,49(5):416-422.
[5] Prosiegel M, Bottger S, Schenk T. Der Erwertiertr Barthel Index (EBI)-eine neue Skala zur Erfassung von Fahigkeitsstorungen bei neurologischen patieneten[J].Neurol Rehabil, 1996,1:7-13.
[6] J rger M,Beer S,Kesselring J.Impact of neurorehabilitation on disability in patients with acutely and chronically disabling diseases of the nervous system measured by the Extended Barthel Index[J].Neurorehabilitation and neural repair,2001,15(1):15-22.
[7] 蔡业峰,贾真,李伟峰,等.中文版Barthel指数对多中心测评缺血性卒中患者预后的研究[J].中国脑血管病杂志,2007,4(11):486-490.
[8] 闵瑜,吴媛媛,燕铁斌.改良 Barthel指数 (简体中文版 )量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188.
[9] 李文兵,朱珊珊,邹丽娟,等.简易智能精神状态检查量表在脑卒中患者中的应用[J].中国康复,2010,25(6):454-455.
[10] Folstein MF,Folstein SE,Mchugh PR.“ Mini- mental state”: a practical method for grading the cognitive state of patients for the clinician[J].J Psychiatr Res,1975,12(3):189-198.
[11] 方云华,陈善佳,周小炫,等.MoCA、MMSE、NCSE等6个脑卒中认知康复评价工具的使用现状调查[J].中国康复,2014,29(1):40-42.
[12] Uyttenboogaart M,Stewart RE,Vroomen PC.et al.Optimizing cut off scores for the Barthel index and the modified Rankin scale for defi- ning outcome in acute stroke trials[J].Stroke,2005,36 (9): 1984 -1987.
[13] Shah S,Vanclay F,Cooper B.Improving the sensitivity of the Barthel Index for stroke rehabilitation[J].J Clin Epidemiol. 1989,42(8):703-709.
[14] 侯东哲,张颖,巫嘉陵,等.中文版Barthel指数的信度与效度研究[J].临床荟萃,2012,27(3):219-221.
[15] 巫嘉陵,安中平,王世民,等.脑卒中患者日常生活活动能力量表的信度与效度研究[J].中国现代神经疾病杂志,2009,9(5):464-468.
[16] Marolf MV,Vaney C,Konig N,et al. Evaluation of disability in multiple sclerosis patients: a comparative study of the Functional Independence Measure, the Extended Barthel Index and the Expanded Disability Status Scale[J]. Clinical Rehabilitation,1996,10(4):309-313.
[17] Prosiegel M, Pulsone G. Assessment of disability and hand-icap. In: Ketealaer P, Prosiegel M. A problem-oriented approach to multiple sclerosis[J].Leuven,The Netherlands: Acco,1997:21-34.
[18] Beer S,Aschbacher B,Manoglou D,et al.Robot-assisted gait training in multiple sclerosis: a pilot randomized trial[J].Mult Scler,2008,14 (2): 231-236.
[19] Jansa J,Pogacnik T,Gompertz P.An evaluation of the Extended Barthel Index with acute ischemic stroke patients[J].Neurorehabilitation and Neural Repair,2004,18(1):37-41.
[2] Duffy L,Gajree S,Langhorne P,et al.Reliability (inter-rater agreement) of the Barthel Index for assessment of stroke survivors: systematic review and meta-analysis[J].Stroke,2013,44(2):462-468.
[3] Quinn TJ,Langhorne P,Stott DJ.Barthel index for stroke trials: development, properties,and application[J].Stroke,2011,42(4):1146-1151.
[4] Prodinger B,O'Connor RJ,Stucki G,et al.Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index,utilising the International Classification of Functioning,Disability and Health and Rasch measurement theory.Journal of rehabilitation medicine,2017,49(5):416-422.
[5] Prosiegel M, Bottger S, Schenk T. Der Erwertiertr Barthel Index (EBI)-eine neue Skala zur Erfassung von Fahigkeitsstorungen bei neurologischen patieneten[J].Neurol Rehabil, 1996,1:7-13.
[6] J rger M,Beer S,Kesselring J.Impact of neurorehabilitation on disability in patients with acutely and chronically disabling diseases of the nervous system measured by the Extended Barthel Index[J].Neurorehabilitation and neural repair,2001,15(1):15-22.
[7] 蔡业峰,贾真,李伟峰,等.中文版Barthel指数对多中心测评缺血性卒中患者预后的研究[J].中国脑血管病杂志,2007,4(11):486-490.
[8] 闵瑜,吴媛媛,燕铁斌.改良 Barthel指数 (简体中文版 )量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188.
[9] 李文兵,朱珊珊,邹丽娟,等.简易智能精神状态检查量表在脑卒中患者中的应用[J].中国康复,2010,25(6):454-455.
[10] Folstein MF,Folstein SE,Mchugh PR.“ Mini- mental state”: a practical method for grading the cognitive state of patients for the clinician[J].J Psychiatr Res,1975,12(3):189-198.
[11] 方云华,陈善佳,周小炫,等.MoCA、MMSE、NCSE等6个脑卒中认知康复评价工具的使用现状调查[J].中国康复,2014,29(1):40-42.
[12] Uyttenboogaart M,Stewart RE,Vroomen PC.et al.Optimizing cut off scores for the Barthel index and the modified Rankin scale for defi- ning outcome in acute stroke trials[J].Stroke,2005,36 (9): 1984 -1987.
[13] Shah S,Vanclay F,Cooper B.Improving the sensitivity of the Barthel Index for stroke rehabilitation[J].J Clin Epidemiol. 1989,42(8):703-709.
[14] 侯东哲,张颖,巫嘉陵,等.中文版Barthel指数的信度与效度研究[J].临床荟萃,2012,27(3):219-221.
[15] 巫嘉陵,安中平,王世民,等.脑卒中患者日常生活活动能力量表的信度与效度研究[J].中国现代神经疾病杂志,2009,9(5):464-468.
[16] Marolf MV,Vaney C,Konig N,et al. Evaluation of disability in multiple sclerosis patients: a comparative study of the Functional Independence Measure, the Extended Barthel Index and the Expanded Disability Status Scale[J]. Clinical Rehabilitation,1996,10(4):309-313.
[17] Prosiegel M, Pulsone G. Assessment of disability and hand-icap. In: Ketealaer P, Prosiegel M. A problem-oriented approach to multiple sclerosis[J].Leuven,The Netherlands: Acco,1997:21-34.
[18] Beer S,Aschbacher B,Manoglou D,et al.Robot-assisted gait training in multiple sclerosis: a pilot randomized trial[J].Mult Scler,2008,14 (2): 231-236.
[19] Jansa J,Pogacnik T,Gompertz P.An evaluation of the Extended Barthel Index with acute ischemic stroke patients[J].Neurorehabilitation and Neural Repair,2004,18(1):37-41.