动态脊柱支撑机器人评测脊髓损伤患者坐位躯干控制的信度与效度研究

关键词：康复机器人  脊髓损伤  躯干控制  信度  效度

Keywords:rehabilitation robot  spinal cord injury  trunk control  reliability  validity

摘要：

      摘要 目的：探究动态脊柱支撑机器人评测脊髓损伤患者坐位躯干控制功能的重测信度和效标效度。 方法：2022年10—12月，共招募20例不能步行的脊髓损伤患者。所有受试者穿戴动态脊柱支撑机器人完成坐位机器人躯干控制测试，包括静态控制测试和动态控制测试。评测指标为静态控制测试中机器人平台给躯干左右、上下、侧弯、屈伸方向施加的支撑力矩回归斜率即Kx、Ky、Kθ、Kα，以及支撑力矩平均值即Fx、Fy、Mθ、Mα；动态控制测试中躯干的主动前屈、后伸、左侧屈和右侧屈活动角度（ROM）。同时完成躯干控制测试量表（TCT）评估作为效标。间隔1周后，脊髓损伤患者进行第2次机器人躯干控制测试，计算两次测试间的组内相关系数（ICC值）。 结果：共20例患者完成首次机器人测试和TCT评估，13例患者完成两次机器人测试。静态控制测试中4项评测参数的ICC值为0.418—0.742，动态控制测试中所有参数的ICC值为0.633—0.848，均呈中等及以上的重测信度。静态控制测试中Ky、Mθ和Mα（|r|=0.467—0.561，P<0.05）与TCT评估结果具有低到中度相关性；动态控制测试中除右侧屈ROM外所有指标（r=0.559—0.758，P<0.05）均与TCT具有中度到高度的相关性。 结论：动态脊柱支撑机器人在脊髓损伤患者坐位躯干控制的评测中具有可接受的重测信度和效标效度。

Abstract:

      Abstract Objective： To investigate the test-retest reliability and criterion validity of the Robotic Brace for Dynamic Trunk Support System （RoboBDsys） in evaluating seated trunk control function in patients with spinal cord injury （SCI）. Method： From October to December， 2022， 20 patients with spinal cord injury who were unable to walk were recruited. All participants completed RoboBDsys trunk control test including static control test and dynamic control test on the seated platform. The evaluation indexes were the supporting torque regression slope exerted by the robot platform on the direction of x， y， α， and θ， recorded as Kx， Ky， Kθ， Kα; the average supporting torque recorded as Fx， Fy， Mθ， Mα in the static control test；and the the Range of Motion （ROM） of trunk in four directions in the dynamic control test. All the participants completed Trunk Control Test （TCT） as criterion assessment. The test interval was one week， intraclass correlation coefficient（ICC） values were calculated between two RoboBDsys trunk control test. Result： There were 13 participants completed two tests. In the static control test， the ICCs of four indexes were 0.418—0.742 between 2 tests； the ICCs of all indexes in dynamic control test were 0.633—0.848， which all showed moderate to high test-retest reliability. In regards of criterion validity， there was low to moderate correlation between Ky， Mθ， Mα in static control test and TCT （|r|=0.467—0.561， P<0.05）； all indexes except right lateral flection ROM in dynamic control test showed moderate to high correlation with TCT （r=0.559—0.758， P<0.05）. Conclusion： RoboBDsys is a reliable and valid tool for evaluating seated trunk control function in patients with SCI.