뇌졸중 환자의 단순화된 뇌졸중 자세 평가 척도와 버그 균형 척도의 비교 연구

• 영문명: The Comparison of Simplified Postural Assessment Scale for Stroke and Berg Balance Scale Used for Stroke Patients
• 발행기관: 대한작업치료학회
• 저자명: 박창식 최유임 안승헌
• 간행물 정보: 『대한작업치료학회지』제18권 제1호, 65~77쪽, 전체 13쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2010.03.31

국문 초록

목적 : 뇌졸중 환자를 대상으로 4점 척도인 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke: PASS) 와 5점 척도인 버그 균형 척도(Berg Balance Scale, BBS)를 3점 척도로 단순화시켜 원본 PASS, BBS와 특성을 비교하고 신뢰도 및 타당도를 알아보고자 하였다. 연구방법 : 만성뇌졸중 환자 62명을 대상으로 PASS(0-1-2-3)는 PASS-3Level(0-1.5-3)로 BBS( 0-1-2- 3-4)는 BBS-3Level(0-2-4)로 기록하여 비교하였다. PASS-3L과 BBS-3L 평가의 측정자내·측정자간 신 뢰도는 급간내 상관계수를(ICC3,1), 절대적 신뢰도는 표준 오차 측정(Standard Error Measurement: SEM)과 최 저 실제 차이(Small Reference Differences: SRD)를 이용하였고, 내적 일치도를 알아보기 위하여 Cronbach’s α 계수를 구하였다. PASS(PASS-3L), BBS(BBS-3L)의 동시 타당도와 수정된 바델 지수(Modified Barthel Index, MBI)와 퓨글 마이어 운동(Fugl Meyer-Motor: FM-M)과의 수렴 타당도를 알아보기 위하여 피어슨 상관 분석을 하였다. 결과 : PASS-3L과 BBS-3L의 검사 재검사 신뢰도는 각각 ICC = .96, .96, 측정자간 신뢰도는 각각 ICC = .95, .94이었다. PASS-3L과 BBS-3L의 SEM은 각각 .99, 1.55, SRD는 1.74, 4.30, Cronbach's α계수는 .77, .85로 신뢰도가 높게 나타났다. PASS-3L의 동시 타당도는 PASS(r=.93), BBS(r=.75), BBS-3L(r=.80)과 유의한 관 련이 있었고, BBS-3L은 PASS(r=.80)와 BBS(r=.93)와 유의한 상관관계가 있었다(p<.01). PASS-3L의 수렴 타당도는 MBI(r=.60), FM-M(r=.42)과 유의한 관련이 있었고, BBS-3L은 MBI(r=.79), FM-M(r=.48)와 유 의한 상관관계가 있었다(p<.01). 결론 : 2개의 단순화된 PASS-3L과 BBS-3L은 PASS, BBS와 비교하여 매우 높은 신뢰도와 타당도를 보여 뇌졸 중 환자의 균형을 평가하는데 적합하다고 할 수 있다.

영문 초록

Objective : The purpose of this study is to simplify the Postural Assessment Scale for Stroke Patients - 4 Level (PASS-4L), and Berg Balance Scale - 5 Level (BBS-5L), into a 3 Level Assessment Scale. The data obtained from the simplified 3 Level Assessment Scale is then compared with those from both PASS-4L and BBS-5L in order to ascertain their reliability as well as validity characteristics. Methods : This study used data from 62 patients in total. Data recorded in the form of PASS-4L(0-1-2-3) was converted into adjusted PASS-3L (ie, 0-1.5-3) in order to form PASS-3 Levels. Similarly, data recorded in the form of BBS-5L (0-1-2-3-4) was converted into adjusted PASS-3L (ie, 0-2-4). To examine the test-retest reliability, the PASS-3L and BBS-3L were administrated to each participant by rater A in 2 testing sessions 3 days apart. To allow the evaluation of inter-rater reliability, the score was rated simultaneously by raters B (PASS, BBS-3L) and C (BBS, PASS-3L) in the latter testing session. The reliability indexes (intra-class correlation coefficient, ICC3,1) of both simplified PASS-3L & BBS 3L were used for the intra-rater and inter-rater reliability, and Cronbach's αwas obtained. Standard Error Measurement (SEM) and Smallest Real Difference (SRD) methods were used to obtain the reliability index of measurement errors. We also made a correlation assessment using a Pearson's correlation coefficient to figure ou the concurrent validity between PASS (PASS-3L) and BSS (BSS-3L) as well as the convergent validity between Modified Barthel Index (MBI) and Fugl Meyer-Motor (FM-M) Scale. Results : The PASS-3L and BBS-3L showed high intra-rater (ICC3,1 = .96, .96, respectively) and interrater reliabilities (.95, .94, respectively). The absolute reliability of the PASS-3L and BBS-3L released more accurate measurements (SEM = .99, 1.55; SRD = 1.74, 4.30, respectively). The internal consistencies of PASS-3L and BBS-3L are expressed using Cronbach's αcoefficient as .77 and .85, respectively. The PASS-3L and BBS-3L showed high concurrent validity (r=.75-.93, p<.01) and convergent validity with the MBI and FM-M scores (r=.42-.79, p<.01). Conclusion : The PASS-3L BBS-3L showed high reliability and validity, and thus it can be stated that the proposed simplified 3-Level scale will be a useful clinical tool for evaluating balance in stroke patients.

목차

Ⅰ. 서론

Ⅱ. 연구 방법

Ⅲ. 연구 결과

Ⅳ. 고찰

Ⅴ. 결론

참고문헌

키워드

균형 뇌졸중 신뢰도 Berg Balance Scale Postural Assessment Scale for Stroke Balance Berg Balance Scale Postural Assessment Scale for Stroke Reliability Stroke