Alyn水中适应性测试量表2的汉化及在脊髓损伤患者中的信度与效度
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摘要
目的翻译Alyn水中适应性测试量表2 (WOTA2),并检验其用于脊髓损伤患者的信度和效度。方法获得授权后,将英文版WOTA2及其培训手册翻译成中文。2018年1月至9月,采用汉化后的WOTA2对137例脊髓损伤患者进行评定。先由两名评定者独立进行WOTA2测试;3 d后,其中一名评定者再次进行测试。计算Cronbachα系数、Spearman-Brown系数、组内相关系数(ICC)和Kappa系数评估信度。利用单项内容效度指数(I-CVI)和量表内容效度指数(S-CVI)评价内容效度,利用因子分析评价结构效度。结果中文版WOTA2全部条目Cronbachα系数为0.947,心理适应条目为0.890,水中技能条目为0.954。奇偶折半法两部分评分之间Pearson相关系数为0.948,折半信度为0.973。重测ICC总分为0.965,百分制总分为0.965,心理适应部分为0.847,水中技能部分为0.970;评定者间ICC总分为0.964,百分制总分为0.965,心理适应部分为0.847,水中技能部分为0.970。27个条目重测Kappa系数为0.528～0.927,评定者间为0.478～0.936。I-CVI为0.8～1.0,S-CVI为0.63。因子分析提取4个公共因子,符合理论预设,累积方差贡献率67%。结论中文版WOTA2应用于脊髓损伤患者有良好的信度和效度,可在国内水中运动疗法临床实践中推广应用。
Objective To translate the Water Orientation Test of Alyn 2(WOTA2) into Chinese, and to study its reliability and validity for patients with spinal cord injury.Methods After authorizing, the English version WOTA2 scale and its training package were translated into Chinese.From January to September, 2018, 137 patients with spinal cord injury were evaluated with the Chinese version WOTA2 by two evaluators independently, and evaluated again three days later by one of the evaluators. The Cronbach's α, Spearman-Brown coefficient, intra-group correlation coefficient(ICC) and Kappa coefficient were calculated to evaluate the reliability. Content Validity Index(CVI) of items(I-CVI) and scale(S-CVI) were used to evaluate the content validity, and factors analysis was used to evaluate the structure validity.Results The Cronbach's α was 0.947 in all items of the scale, 0.890 in mental adjustment items and 0.954 in aquatic skills items. Pearson correlation coefficient of the half scales separated by odd and even items was 0.948, and the Spearman-Brown coefficient was 0.973. The ICC of test-retest was 0.965 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The ICC of inter-testers was0.964 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The Kappa coefficient was 0.528 to 0.927 in test-retest and 0.528 to 0.927 in inter-testers. The I-CVI was 0.8 to 1.0 and S-CVI was 0.63. Factors analysis extracted four factors, which met the theory, and contributed 67% of cumulative variance.Conclusion The Chinese version WOTA2 is good in reliability and validity for patients with spinal cord injury, and can be used in the clinical practice of aquatic therapeutic exercise in China.
Objective To translate the Water Orientation Test of Alyn 2(WOTA2) into Chinese, and to study its reliability and validity for patients with spinal cord injury.Methods After authorizing, the English version WOTA2 scale and its training package were translated into Chinese.From January to September, 2018, 137 patients with spinal cord injury were evaluated with the Chinese version WOTA2 by two evaluators independently, and evaluated again three days later by one of the evaluators. The Cronbach's α, Spearman-Brown coefficient, intra-group correlation coefficient(ICC) and Kappa coefficient were calculated to evaluate the reliability. Content Validity Index(CVI) of items(I-CVI) and scale(S-CVI) were used to evaluate the content validity, and factors analysis was used to evaluate the structure validity.Results The Cronbach's α was 0.947 in all items of the scale, 0.890 in mental adjustment items and 0.954 in aquatic skills items. Pearson correlation coefficient of the half scales separated by odd and even items was 0.948, and the Spearman-Brown coefficient was 0.973. The ICC of test-retest was 0.965 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The ICC of inter-testers was0.964 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The Kappa coefficient was 0.528 to 0.927 in test-retest and 0.528 to 0.927 in inter-testers. The I-CVI was 0.8 to 1.0 and S-CVI was 0.63. Factors analysis extracted four factors, which met the theory, and contributed 67% of cumulative variance.Conclusion The Chinese version WOTA2 is good in reliability and validity for patients with spinal cord injury, and can be used in the clinical practice of aquatic therapeutic exercise in China.
引文
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[19]孙知寒,马洪路,王莲屏.世界卫生组织生活质量-100量表在脊髓损伤人群生活质量评价中的信度和效度[J].中国临床康复, 2005, 9(5):33-35.
[20]Kabacoff RI. R语言实战(第2版)[M].王小宁,刘撷芯,黄俊文,等,译.北京:人民邮电出版社, 2016.
[21]张铁军,陈兴林,刘振球. R语言与医学统计图形[M].北京:人民卫生出版社, 2018.
[22]R Core Team. R:A language and environment for statistical computing. R Foundation for Statistical Computing[DB/OL].(2014-06-16). https://www.R-project.org/.
[23]Gandhi P, Chan K, Verrier MC, et al. Training to improve walking after pediatric spinal cord injury:a systematic review of parameters and walking outcomes[J]. J Neurotraum, 2017,34(9):1713-1725.
[24]Paddison S, Hexter B. Spinal Cord Injury[M]. Phys Manag Neurol Cond E-Book, 2018:171.
[25]Lima LV, Abner TS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena[J]. J Phys, 2017, 595(13):4141-4150.
[26]Parfitt R, Hensman MY, Lucas SJ. Cerebral blood flow responses to aquatic treadmill exercise[J]. Med Sci Sports Exerc, 2017, 49(7):1305-1312.
[27]Rodríguez LS, Gonzalez J, Barrios M, et al. Physiotherapeutic intervention in a patient with spinal cord injury[J]. Indian J Sci Tech, 2017, 10(32):1-7.
[28]Recio A, Kubrova E. Effectiveness of aquatic therapy among spinal cord injury patients with complex medical conditions[J]. Arch Phys Med Rehabil, 2017, 98(10):e60.
[29]Recio AC, Stiens SA, Kubrova E. Aquatic-based therapy in spinal cord injury rehabilitation:effective yet underutilized[J].Cur Phys Med Rehabil Rep, 2017, 5(3):108-112.
[30]Rimmer J, Lai B. Framing new pathways in transformative exercise for individuals with existing and newly acquired disability[J]. Disabil rehabil, 2017, 39(2):173-180.
[2]Li C, Khoo S, Adnan A. Effects of aquatic exercise on physical function and fitness among people with spinal cord injury:a systematic review[J]. Medicine, 2017, 96(11):e6328.
[3]Frontera WR, Jette AM, Carter GT, et al. Delisa康复医学理论与实践(第五版)[M].励建安,毕胜,黄晓琳,译.北京:人民卫生出版社, 2013:1283-1295.
[4]Campion MR. Hydrotherapy:Principles and Practice[M]. 2nd ed. Oxford:Butterworth-Heinemann, 1997.
[5]崔尧,丛芳,金龙. Halliwick理念及其在水疗康复中的应用[J].中国康复理论与实践, 2013, 19(3):239-245.
[6]崔尧,丛芳,金龙. Halliwick理念[M]//黄东峰,李建新,王宁华.综合水疗学.北京:金盾出版社, 2015:62-88.
[7]Becker BE, Cole AJ. Comprehensive Aquatic Therapy[M]. 3rd ed. Pullman WA:Washington State University Publishing,2011.
[8]Garcia M, Cordeiro Joares E, Alves Silva M, et al. The Halliwick Concept, inclusion and participation through aquatic functional activities[J]. Acta Fisiatr, 2012, 19(3):142-150.
[9]Tirosh R, Katz-Leurer M, Getz MD. Halliwick-based aquatic assessments:reliability and validity[J]. Int J Aquatic Res Educ, 2008, 2(3):224-236.
[10]王玉龙.康复功能评定学[M]. 2版.北京:人民卫生出版社,2017.
[11]恽晓平.康复疗法评定学[M]. 2版.北京:华夏出版社, 2014.
[12]金龙,丛芳,崔尧,等. Alyn水中适应性测试量表1的汉化及信度与效度研究[J].中国康复理论与实践, 2015, 21(5):539-543.
[13]丛芳,崔尧,金龙,等.国内水疗康复概况与发展趋势[J].世界康复工程与器械, 2014, 4(2):9-11.
[14]崔尧,李建军,丛芳,等.一种基于浏览器/服务器结构的综合康复信息系统的设计与初步实现[J].中国康复理论与实践,2015, 21(1):114-116.
[15]李建军.脊髓损伤神经学分类国际标准参考手册[M].北京:人民卫生出版社, 2008.
[16]美国脊髓损伤协会.脊髓损伤神经学分类国际标准(2011年修订)[J].李建军,王方永,译.中国康复理论与实践, 2011, 17(10):963-972.
[17]马斌荣.医学科研中的统计方法[M]. 4版.北京:科学出版社, 2012.
[18]王于领,梁崎,黄东锋,等.脊髓独立测量量表Ⅱ中文版的开发及信度和效度研究[J].中国康复医学杂志, 2007, 22(8):714-717.
[19]孙知寒,马洪路,王莲屏.世界卫生组织生活质量-100量表在脊髓损伤人群生活质量评价中的信度和效度[J].中国临床康复, 2005, 9(5):33-35.
[20]Kabacoff RI. R语言实战(第2版)[M].王小宁,刘撷芯,黄俊文,等,译.北京:人民邮电出版社, 2016.
[21]张铁军,陈兴林,刘振球. R语言与医学统计图形[M].北京:人民卫生出版社, 2018.
[22]R Core Team. R:A language and environment for statistical computing. R Foundation for Statistical Computing[DB/OL].(2014-06-16). https://www.R-project.org/.
[23]Gandhi P, Chan K, Verrier MC, et al. Training to improve walking after pediatric spinal cord injury:a systematic review of parameters and walking outcomes[J]. J Neurotraum, 2017,34(9):1713-1725.
[24]Paddison S, Hexter B. Spinal Cord Injury[M]. Phys Manag Neurol Cond E-Book, 2018:171.
[25]Lima LV, Abner TS, Sluka KA. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena[J]. J Phys, 2017, 595(13):4141-4150.
[26]Parfitt R, Hensman MY, Lucas SJ. Cerebral blood flow responses to aquatic treadmill exercise[J]. Med Sci Sports Exerc, 2017, 49(7):1305-1312.
[27]Rodríguez LS, Gonzalez J, Barrios M, et al. Physiotherapeutic intervention in a patient with spinal cord injury[J]. Indian J Sci Tech, 2017, 10(32):1-7.
[28]Recio A, Kubrova E. Effectiveness of aquatic therapy among spinal cord injury patients with complex medical conditions[J]. Arch Phys Med Rehabil, 2017, 98(10):e60.
[29]Recio AC, Stiens SA, Kubrova E. Aquatic-based therapy in spinal cord injury rehabilitation:effective yet underutilized[J].Cur Phys Med Rehabil Rep, 2017, 5(3):108-112.
[30]Rimmer J, Lai B. Framing new pathways in transformative exercise for individuals with existing and newly acquired disability[J]. Disabil rehabil, 2017, 39(2):173-180.