- 期刊
A Reliability Study of Modilfieci Functional Reach Test
改良式功能性取物測試法的信度評估
摘要
功能性取物測試是一九九○年由鄧肯(Duncan)等人所提出，用來評估老年人平衡能力的方法，但老年人在取物時並非只有往正前方取物的動作，本研究的目的在藉由改變肩關節水平外展的角度，設計改良式功能性取物測試法，並評估此測試法的信度。共有二十三位住在安養院的健康老人接受測試，在四種姿勢下（肩關節先前屈90°，再依水平外展的角度90°,50°,0°及水平內收45°等四種角度設計而成，依序為第一、第二、第三和第四個姿勢），進行取物動作，每位受測者在兩位物理治療師指導下，依照鄧肯等人的測試方法，每種姿勢進行三次測試，一星期後受測者再接受一次測試，以評估再測信度。結果顯示：四種姿勢測試所得差距，依肩關節水平外展角度之遞減而呈有意義的遞增，以水平內收45°最大；施測者間，施測者本人及其再測信度在第一個姿勢下，右手及左手的信度分別是0.70, 0.84, 0.50及0.55, 0.81, 0.44；第二個姿勢下是0.85, 0.93, 0.83及0.86, 0.92, 0.82；第三個姿勢下是0.69, 0.95, 0.83及0.65, 0.91, 0.90；第四個姿勢下是0.64, 0.97, 0.82及0.71, 0.91, 0.85。改良式功能性取物測試除了第一個姿勢下的再測信度較差外，其餘都有很好的信度。物理治療師可利用改良式功能性取物測試，來評估老年人的平衡能力以期發現老年人可能跌倒的原因。至於受測者的年齡、性別、身高、體重、軀幹長度、肩高、上肢長度、足長和前足長度等因素對於改良式功能性取物測試所得距離的影響，經運用逐步迴歸得知：身高是唯一在統計學上具有意義的影響因素。
並列摘要
The Functional Reach Test was developed in 1990 by Duncan et al for assessing balance of the elderly. Reaching for objects, however, does not usually conpined to a single direction. The purpose of this study was to test the reliability of three additional functional reach positions by changing the shoulder horizontal abduction-adduction angle. Twenty-three elderly persons were selected to participate. The four positions of functional reach were defined as follows: Position I: shoulder flexion 90°, abduction 90°; Position II: shoulder flexion 90°, horizontal abduction 45°; Position III: shoulder flexion 90°, horizontal abduction 0°; Position IV: shoulder flexion 90°, horizontal adduction 45°. Each subject performed three trials in each position. The measurements were taken by two physical therapists using the protocol of Duncan et al. All subjects were retested one week later to determine test-retest reliability. Repeated measurement analysis of variance and paired t-tests with Bonferroni adjustment were used to analyze the distance differences among the four positions on both sides. It was found that as the angle of shoulder abduction decreased, the reaching distance increased significantly. Intra-class correlation coefficients (ICCs) was used to determine intra-rater, inter-rater and test-retest reliability for the three trials. Intra-rater, inter-rater and test-retest reliability coefficients of the right and left sides ranged from 0.84 to 0.97, 0.62 to 0.88 and 0.50 to 0.88 respectively. The Modified Functional Reach Test showed high inter-rater, intra-rater and test-retest reliabilities for all four positions except for the test-retest reliabilities of Position I on both sides. Stepwise regression analysis revealed that body height was the only variable significantly related to the reach distance of the four positions except for the left arm in Position I. It is strongly suggested that physical therapists use the Modified Functional Test as a tool to assess the balance ability of the elderly to screen for potential problems that may lead to fall.