中文版上肢活动量表在脑卒中上肢痉挛患者应用中的信度和效度研究

关键词：脑卒中  痉挛  信度  效度  上肢功能

Keywords:stroke  spasm  reliability  validity  upper extremity function

摘要：

      摘要 目的：汉化上肢活动量表（arm activity measure，ArmA）并分析其信度和效度，为评估脑卒中患者痉挛后上肢功能障碍提供简单、有效的工具。 方法：对英文版ArmA进行翻译和文化调试，并使用中文版ArmA对50例脑卒中患者进行自我评估，对其结果进行重测信度、内在一致性和效度分析。 结果：试验共入组50例脑卒中患者，平均年龄（52.32±14.83）岁。中文版ArmA量表被动部分与主动部分Cronbach α系数分别为0.718和0.831；重测信度的总分组内相关系数ICC为0.990，各条目的ICC值范围为0.902—1.000；每个条目与其所在维度的相关系数均在0.4以上（P<0.05），且均高于与其他维度的相关系数；结构效度主成分分析的结果共提取4个公因子；通过spearman相关分析发现，中文版ArmA量表主动部分与上肢Fugl-Meyer量表具有一定相关，与改良Ashworth量表（modified Ashworth scale， MAS）相关性无显著性差异（P>0.05）。 结论：中文版ArmA量表在脑卒中患者中具有良好的信度和效度，且评测可操作性高，适用于评估我国脑卒中患者痉挛后上肢的活动功能。

Abstract:

      Abstract Objective： To provide a simple and effective tool for assessing the upper limb dysfunction caused by spaciticity in stroke patients by analyzing the reliability and validity of the Chinese version of the arm activity measure （ArmA）. Method： The English version of ArmA was translated and culturally adjusted. 50 stroke patients were self-assessed using the Chinese version of ArmA， and analyzed its reliability， internal consistency and validity. Result： A total of 50 stroke patients were enrolled， with an average age of 52.32±14.83. The Cronbach's α coefficients of passive and active ArmA scale in Chinese version were 0.718 and 0.831， respectively. The total intra-group correlation coefficient （ICC） of retest reliability was 0.990， and the range of ICC for each item was 0.902—1.000. The correlation coefficient of each item with its dimension was above 0.4（P<0.05），which was higher than that of other dimensions. Six common factors were extracted from principal component analysis of structural validity. Spearman correlation analysis showed that the active part of Chinese ArmA scale was correlated with Fugl-Meyer（upper extremity） scale，but had no difference with the modified Ashworth scale. Conclusion： The Chinese version- ArmA scale has good reliability and validity in stroke patients and high feasibility，which is suitable for assessing the upper limb activity function of Chinese stroke patients with spasticity.