Zanesljivost in veljavnost slovenskega prevoda Fugl-Meyerjevega ocenjevanja za zgornji in spodnji ud pri pacientih po možganski kapi : magistrsko delo

Kotnik, Patricija (author), Puh, Urška (mentor), Bizovičar, Nataša (comentor), Kovačič, Tine (reviewer)

Uvod: Fugl-Meyerjevo ocenjevanje za zgornji (angl. Fugl-Meyer assessment of upper extremity – FMA-UE) in spodnji ud (angl. Fugl-Meyer assessment of lower extremity – FMA-LE) je zanesljivo in veljavno orodje za oceno motoričnih funkcij pri pacientih po možganski kapi. Namen: Prevesti izvirnik FMA-UE in FMA-LE v slovenski jezik in pri pacientih po možganski kapi za motorični del FMA preveriti zanesljivost posameznega preiskovalca, zanesljivost med preiskovalci ter povezanost z mišično jakostjo in testi na ravni dejavnosti. Metode dela: V raziskavi je sodelovalo 40 preiskovancev, starih od 19 do 79 let, od 5 do 89,7 tednov po možganski kapi. Prevod smo izvedli po standardnem postopku prevajanja naprej in nazaj. Ocenjevanje je potekalo šest do osem dni po sprejemu ali pred koncem rehabilitacije. Zanesljivost med preiskovalci smo preverjali z dvema preiskovalcema, posameznega preiskovalca pa pri enem. Povezanost FMA-UE smo ugotavljali z jakostjo prijema roke in s testoma funkcije zgornjega uda. Povezanost FMA-LE pa smo ugotavljali z ročno dinamometrijo ekstenzorjev kolena in dorzalnih fleksorjev gležnja ter s testi ravnotežja in premičnosti. Ugotavljali smo tudi povezanost FMA-UE in FMA-LE z lestvico funkcijske neodvisnosti (angl. functional independence measure – FIM). Za oceno zanesljivosti smo izračunali koeficient intraklasne korelacije (angl. intraclass correlation coefficient – ICC). Povezanost smo izračunali s Spearmanovim koeficientom korelacije (rs). Rezultati: Za skupni motorični del FMA-UE in FMA-LE smo ugotovili odlično zanesljivost posameznega preiskovalca (ICC = 0,99–1) ter odlično zanesljivost med preiskovalci (ICC = 0,96–0,99). FMA-UE in FMA-LE sta bili visoko do odlično pozitivno povezani z mišično jakostjo (rs = 0,73–0,91), povezanost FMA-UE s testom devetih zatičev (angl. nine-hole peg test – 9HPT) je bila visoka pozitivna (rs = 0,63), s funkcijsko komponento Wolfovega testa motoričnih funkcij (angl. Wolf motor function test – WMFT) pa odlična pozitivna (rs = 0,91). Pri vzorcu vseh preiskovancev povezanost FMA-UE s časovno komponento WMFT ni bila statistično značilna, medtem ko je bila pri preiskovancih z zmerno okvaro povezanost zmerna negativna (rs = -0,57). Tako pri vseh preiskovancih kot pri stratificiranih vzorcih nismo ugotovili statistično značilne povezanosti FMA-LE z lestvico za oceno uravnavanja drže pri pacientih po možganski kapi (angl. postural assessment scale for stroke patients – PASS) in Bergovo lestvico za oceno ravnotežja (angl. Berg balance scale – BBS). Lestvica FMA-LE je bila nizko negativno povezana s testom petih vstajanj s stola (rs = -0,40) in visoko do zelo visoko pozitivno povezana z lestvico za oceno funkcionalnosti hoje ter testi hoje (rs = 0,72–0,86). Povezanost FMA-UE in FMA-LE s FIM je bila visoka pozitivna (rs = 0,67–0,73). Zaključek: Slovenski prevod FMA za oceno motoričnih funkcij je zanesljivo in veljavno orodje, zato ga priporočamo za uporabo v klinične in raziskovalne namene. Za ugotavljanje povezanosti FMA-UE z 9HPT in WMFT ter FMA-LE s PASS in BBS so potrebne nadaljnje raziskave.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, Fugl-Meyerjevo ocenjevanje, prevod, zgornji ud, spodnji ud, zanesljivost, veljavnost
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [P. Kotnik]
• Year: 2024
• Number of pages: 64 str., [12] str. pril.
• PID: 20.500.12556/RUL-160581
• UDC: 615.8
• COBISS.SI-ID: 206010371
• Publication date in RUL: 31.08.2024

Secondary language

• Language: English
• Title: Reliability and validity of the Slovenian translation of the Fugl-Meyer assessment of upper and lower extremity in stroke patients : master thesis

Abstract

Introduction: The Fugl-Meyer assessment of upper (FMA-UE) and lower extremity (FMA-LE) is a reliable and valid tool for assessment of motor functions after stroke Purpose: To translate the original FMA-UE and FMA-LE into Slovenian and to determine the intra- and inter-rater reliability for the motor part of the FMA and its correlation with muscle strength and activity level tests in patients after stroke. Methods: 40 stroke subjects aged 19 to 79 years, 5 to 89,7 weeks after stroke participated in the study. The translation followed the standard forward-backward translation procedure. Assessment took place six to eight days after admission or before discharge. Inter-rater reliability was assessed with two raters, while intra-rater reliability was assessed with one rater. The correlation of the FMA-UE was calculated with hand grip strength and two upper extremity function tests. The correlation of the FMA-LE was calculated with handheld dynamometry of knee extensors and ankle dorsiflexors, as well as balance and mobility tests. Additionally, correlation of the FMA-UE and FMA-LE was calculated with the functional independence measure (FIM). The intraclass correlation coefficients (ICC) were calculated to assess reliability. Spearman’s correlation coefficient (rs) was calculated. Results: Excellent intra-rater (ICC = 0.99–1) and inter-rater reliability (ICC = 0.96–0.99) were found for the total motor part of the FMA-UE and FMA-LE. The FMA-UE and FMA-LE had a strong to very strong positive correlation with muscle strength (rs = 0.73–0.91), FMA-UE had a strong positive correlation with the nine-hole peg test (9HPT) (rs = 0.63), and very strong positive correlation with the functional component of the Wolf motor function test (WMFT) (rs = 0.91). In the sample of all subjects, the correlation of the FMA-UE with the time component of the WMFT was not statistically significant, whereas a moderate negative correlation (rs = -0.57) was found in patients with moderate impairment. For both, the sample of all subjects and in stratified samples, we did not find a statistically significant association of FMA-LE with the postural assessment scale for stroke patients (PASS) and the Berg balance scale (BBS). The FMA-LE had a weak negative correlation with the five times sit to stand test (rs = -0.40) and a strong to very strong positive correlation with the functional gait assessment and the walking tests (rs = 0.72 –0.86). The FMA-UE and FMA-LE were strongly positively correlated with FIM (rs = 0.67–0.73). Conclusion: The Slovenian translation of the motor part of FMA is a reliable and valid tool and is therefore recommended for clinical and research use. Further research is needed to determine the correlation of the FMA-UE with the 9HPT and WMFT and the FMA-LE with the PASS and BBS.

• Keywords: master's theses, physiotherapy, Fugl-Meyer assessment, translation, upper extremity, lower extremity, reliability, validity