뇌졸중 환자의 180 ° 회전 검사의 신뢰도와 수렴 타당도 및 회전 방향이 소요시간과 걸음 수에 미치는 효과

안승헌; 이병권

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자료유형: 학술저널

저자정보: 안승헌 (국립재활원) 이병권 (건양대학교)

저널정보: 대한통합의학회 대한통합의학회지 대한통합의학회지 제12권 제3호

발행연도: 2024.8

수록면: 189 - 199 (11page)

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Purpose : This study aimed to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180 ° turn test in subacute stroke patients. Additionally, it examined the concurrent validity of the 180 ° turn test. Methods : The study included 28 subacute stroke patients. The test-retest reliability of the 180 ° turn test according to the direction of rotation (paretic and non-paretic sides) by comparing the consistency between the initial assessment and a reassessment conducted 7 days later. Concurrent validity was examined by assessing the correlation of the 180 ° turn test with the Fugl-Meyer assessment of lower extremity (FMA-L/E), Berg balance scale (BBS), 10-meter walk test (10 mWT), and timed up and go test (TUG). Results : The ICC for the time taken to turn 180 ° to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps were 0.944 and 0.932, respectively. The MDC for the time taken were 0.33 seconds (affected side) and 0.67 seconds (unaffected side). The MDC for the number of steps were 0.49 (affected side) and 0.63 (unaffected side). The paired t-test showed the limited community ambulator group took significantly longer to turn to the unaffected side (p<.048). Significant correlations were found between the 180 ° turn test and FMA-L/E (r= -0.395 to -0.416), BBS (r= -0.622 to -0.684), 10 mWT (r= 0.720 to 0.730), and TUG (r= 0.684 to 0.790) (p<.05 to .01). Conclusion : The 180 ° turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. MDC values indicated high reliability. Faster walking speeds (≥0.95 ㎧) were unaffected by turning direction, while slower speeds (<0.58 ㎧) showed significant effects. The 180 ° turn test is a simple, sensitive, and reliable tool for evaluating turning ability in subacute stroke patients.

Purpose: The aim of this study was to investigate the test-retest reliability, minimal detectable change (MDC), and the effect of turning direction on the time and number of steps taken during the 180° turn test in subacute stroke patients. Additionally, the study sought to examine the concurrent validity of the 180°turn test. Methods: The study included 28 subacute stroke patients. The test-retest reliability of the 180°turn test was assessed using the Intraclass Correlation Coefficient (ICC2,1) and the MDC. The effect of turning direction on the time and number of steps was analyzed using paired T-tests. Concurrent validity was evaluated by analyzing the correlation between the 180°turn test and other established measures, including the Fugl-Meyer Assessment-Lower Extremity (FMA-L/E), Berg Balance Scale (BBS), 10-Meter Walk Test (10mWT), and the Timed Up and Go test (TUG) using Spearman correlation coefficients. Results: The ICC for the time taken to turn 180°to the affected and unaffected sides were 0.971 and 0.918, respectively, indicating excellent reliability. The ICC for the number of steps to turn 180°to the affected and unaffected sides were 0.944 and 0.932, respectively, also showing excellent reliability. The MDC for the time taken to turn 180°to the affected and unaffected sides were 0.33 seconds and 0.67 seconds, respectively. The MDC for the number of steps were 0.49 and 0.63, respectively, which were less than 20% of the maximum time and steps recorded, indicating high reliability. The paired T-test showed that the limited community ambulator group took significantly longer to turn to the unaffected side compared to the affected side (p<0.048). The community ambulator group turned faster to the affected side, and both groups took fewer steps when turning to the affected side, although the differences were not statistically significant. Significant correlations were found between the time and number of steps for the 180°turn test ( both sides) and the FMA-L/E (r=-0.395 ∼ -0.416), BBS (r=-0.622 ∼ -0.684), 10mWT (r=0.720 ∼ 0.730), and TUG (r=0.684 ∼ 0.790) (p<0.05∼0.01). Conclusion: The 180°turn test demonstrated excellent test-retest reliability and high validity when correlated with other functional measures in subacute stroke patients. The MDC values indicated that the test is reliable. Faster walking speeds (≥0.95 m/s) were not influenced by turning direction, while slower speeds (<0.58 m/s) showed significant effects of turning direction on time. Therefore, the 180°turn test is a simple, sensitive, and reliable clinical tool for evaluating turning ability in subacute stroke patients.

#balance #gait velocity #rotation #step #stroke

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