Background

Ataxia can adversely affect balance and gait and increase the incidence of falls, which puts individuals at greater risk for injury. Thus, interventions focused on balance and gait are integral in rehabilitation training. In order to determine if rehabilitation interventions are effective, we need an outcome measure to detect change. To our knowledge, no activity level outcome measures have been established for balance and gait in cerebellar ataxia.

Objective

The aim of the current study is to determine the reliability and validity of the Dynamic Gait Index (DGI) for ataxia.

Design

Twenty adult participants (23–84 years) with ataxia were evaluated to assess construct validity, inter-rater reliability, and same day test-retest reliability of the DGI.

Methods

Participants completed ataxia-specific impairment level outcome measures, as well as the DGI. In addition to the in-person rater, three additional physical therapists scored video recordings of DGI test and retests. Construct validity was assessed via Spearman’s rank order correlation coefficient (Spearman’s rho) between the impairment measures (Scale for Assessment and Rating of Ataxia (SARA), International Cooperative of Ataxia Rating Scale (ICARS) and the DGI. Reliability was assessed by Spearman’s rho and Intraclass Correlation Coefficient ICC (2,1).

Results

In terms of construct validity, we found significant correlations between the activity level DGI and impairment level outcome measures (-0.81 for SARA; -0.88 with ICARS). The interrater reliability of the DGI applied to participants with ataxia was high (Spearman rho: range 0.71−0.98; ICC (2,1) 0.98) as was test-retest reliability (Spearman rho: 0.95; ICC (2,1) 0.98).

Conclusion

We showed that the DGI is a reliable and valid outcome measure to be used in the clinic for individuals with cerebellar ataxia. The DGI had excellent inter-rater and test-retest reliability for raters with varying years of clinical experience. Therefore, the DGI can be a useful clinical outcome measure for assessing balance and ambulation for individuals with cerebellar ataxia.

中文翻译：

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动态步态指数是衡量小脑性共济失调患者平衡和行走能力的有用结果吗？

背景

共济失调会对平衡和步态产生不利影响，并增加跌倒的发生率，从而使个人面临更大的受伤风险。因此，注重平衡和步态的干预措施是康复训练中不可或缺的一部分。为了确定康复干预措施是否有效，我们需要一种结果衡量标准来检测变化。据我们所知，尚未建立小脑共济失调平衡和步态的活动水平结果测量。

客观的

本研究的目的是确定共济失调动态步态指数 (DGI) 的可靠性和有效性。

设计

对 20 名患有共济失调的成年参与者（23-84 岁）进行了评估，以评估 DGI 的结构有效性、评估者间可靠性和当日重测可靠性。

方法

参与者完成了共济失调特异性损伤水平结果测量以及 DGI。除了现场评分者之外，另外三名物理治疗师还对 DGI 测试和重新测试的视频记录进行评分。通过损伤测量（共济失调评估和评级量表 (SARA)、国际共济失调评定量表 (ICARS) 和 DGI 之间的 Spearman 等级相关系数 (Spearman's rho) 评估结构有效性。可靠性通过 Spearman's rho 和类内相关系数 ICC (2,1)。

结果

在构建有效性方面，我们发现活动水平 DGI 和损伤水平结果测量之间存在显着相关性（SARA 为 -0.81；ICARS 为 -0.88）。适用于共济失调参与者的 DGI 的受试者间可靠性很高（Spearman rho：范围 0.71−0.98；ICC (2,1) 0.98），重测可靠性也很高（Spearman rho：0.95；ICC (2,1) 0.98） 。

结论

我们证明，DGI 是一种可靠且有效的结果测量方法，可用于临床治疗小脑性共济失调患者。对于具有不同年限临床经验的评估者来说，DGI 具有出色的评估者间可靠性和重测可靠性。因此，DGI 可以成为评估小脑性共济失调患者的平衡和行走能力的有用临床结果指标。