Objective

To evaluate test-retest reliability, agreement, and convergent validity of the Lean-and-Release test for the assessment of reactive stepping among individuals with incomplete spinal cord injury or disease (iSCI/D).

Design

Multi-center cross-sectional multiple test design.

Setting

SCI/D rehabilitation hospital and biomechanics laboratory.

Participants

Individuals with motor incomplete SCI/D (iSCI/D).

Interventions

None.

Outcome Measures

Twenty-six participants attended two sessions to complete the Lean-and-Release test and a battery of clinical tests. Behavioral (i.e. one-step, multi-step, loss of balance) and temporal (i.e. timing of foot off, foot contact, swing of reactive step) parameters were measured. Test-retest reliability was determined with intraclass correlation coefficients, and agreement was evaluated with Bland–Altman plots. Convergent validity was assessed through correlations with clinical tests.

Results

The behavioral responses were reliable for the Lean-and-Release test (ICC = 0.76), but foot contact was the only reliable temporal parameter using data from a single site (ICC = 0.79). All variables showed agreement according to the Bland–Altman plots. The behavioral responses correlated with scores of lower extremity strength (0.54, P<0.01) and balance confidence (0.55, P < 0.01). Swing time of reactive stepping correlated with step time (0.73, P < 0.01) and cadence (−0.73 P < 0.01) of over ground walking.

Conclusions

The behavioral response of the Lean-and-Release test is a reliable and valid measure for people with iSCI/D. Our findings support the use of the behavioral responses to evaluate reactive stepping for research and clinical purposes.

Trial registration

ClinicalTrials.gov identifier: NCT02960178.

中文翻译：

---

不完全脊髓损伤或疾病患者的 Lean-and-Release 测试的测量特性

客观的

评估 Lean-and-Release 测试的重测信度、一致性和收敛效度，用于评估脊髓不完全损伤或疾病 (iSCI/D) 个体的反应性踩踏。

设计

多中心横截面多重测试设计。

环境

SCI/D康复医院和生物力学实验室。

参与者

运动不完全 SCI/D (iSCI/D) 的个体。

干预措施

没有任何。

结果测量

26 名参与者参加了两次会议，以完成 Lean-and-Release 测试和一系列临床测试。测量了行为（即单步、多步、失去平衡）和时间（即脚离开的时间、脚接触、反应步的摆动）参数。用组内相关系数确定重测信度，用 Bland-Altman 图评估一致性。通过与临床测试的相关性评估收敛效度。

结果

对于 Lean-and-Release 测试 (ICC = 0.76)，行为反应是可靠的，但使用来自单个站点的数据 (ICC = 0.79)，足部接触是唯一可靠的时间参数。根据 Bland-Altman 图，所有变量均显示一致。行为反应与下肢力量（0.54，P<0.01）和平衡信心（0.55，P<0.01）得分相关。反应性踏步的摆动时间与地面行走的踏步时间（0.73，P < 0.01）和节奏（-0.73 P < 0.01）相关。

结论

Lean-and-Release 测试的行为反应对于 iSCI/D 患者来说是一种可靠且有效的测量方法。我们的研究结果支持使用行为反应来评估用于研究和临床目的的反应性步进。

试用注册

ClinicalTrials.gov 标识符：NCT02960178.