中風病人兩種手功能測驗的不同測試次數之再測信度

The Test-Retest Reliability of Different Trials in Two Hand Function Tests for Patients with Stroke

陳惠媚(Hui-Mei Chen) ； 黃小玲(Sheau-Ling Huang) ； 謝清麟(Ching-Lin Hsieh) ； 蘇純瑩(Chwen-Yng Su)

《職能治療學會雜誌》 27卷1期 (2009/07) Pp. 1-9

https://doi.org/10.6594/JTOTA.2009.27(1).01

摘要

本研究的主要目的為驗證積木與盒子測驗(Box and Block Test, BBT)與九孔插棒測驗(Nine-Hole Peg Test, NHPT)三種計分方式（測量一次、測量二次的平均值和測量三次的平均值）之再測信度。研究的對象為50名台灣北、中、南六間復健科之中風病人，接受一位治療師於前後間隔3至7天共二回，每回共3次的BBT與NHPT測量。利用組內相關係數(intra-class correlation coefficient, ICC)、測量標準誤(standard error of measurement, SEM)及最小真正差異值(smallest real difference, SRD)，以檢驗BBT與NHPT之再測信度。結果發現BBT和NHPT三種計分方式均具有良好的再測一致性(ICC≧0.83)；SEM值顯示：BBT測量二次與測量三次的平均值之SEM數值一致，皆較測量一次之SEM小。NHPT以測量二次平均值之SEM最小。SRD值顯示，BBT測量二次與三次之計分方式，前、後測分數差異需達5.3塊以上，才能視為真正改變。而NHPT若測量二次，則至少須達到35.7秒以上。研究結果顯示：施測者選擇每回評量二次，BBT與NHPT之一致性高且測量誤差最小。此結果能提供治療師，未來能有效地作為臨床評估與決策之參考。

關鍵字

中風 ； 手指精細度測驗 ； 再測信度

並列摘要

The primary purpose of this study was to determine the test-retest reliability of three methods of testing (one trial and the mean of two and three trials) for the Box and Block Test (BBT) and the Nine-Hole Peg Test (NHPT). Fifty patients with stroke were recruited from the rehabilitation departments at 6 hospitals located in the northern, central, and southern parts of Taiwan. One occupational therapist administered the BBT and NHPT to each patient on two separate occasions 3-7 days apart, using three methods to assess hand function. Intra-class correlation coefficient (ICC), standard error of measurement (SEM), and the smallest real difference (SRD) were used to establish the test-retest reliability. High levels of test–retest reliability (ICC≥0.83) were found for the three methods of testing for both tests. For the BBT, the mean of two and three trials had the smallest SEM, whereas the NHPT showed the smallest SEM in relation to the mean of two trials. The SRD value for the BBT indicated that a test-retest difference score of at least 5.3 blocks would be needed to demonstrate true change for an individual patient. Likewise, the SRD value for the NHPT indicated that a test-retest difference score of at least 35.7 seconds would be required to demonstrate true change. The present data support the use of the mean of two trials when administering the BBT and NHPT as part of clinical evaluation. These findings provide a valuable reference guide to the evaluation and outcome measurement in stroke rehabilitation.

並列關鍵字

stroke ； finger dexterity tests ； test-retest reliability