简明帕金森病评分量表/帕金森病致残量表评估帕金森病患者运动功能的信度和效度

Reliability and validity of short Parkinson evaluation scale/scales for outcomes in Parkinson disease in evaluating the motor function of patients with Parkinson disease

目的:应用简明帕金森病评分量表/帕金森病致残量表(简称为简明帕金森病评分量表)评价帕金森病患者运动损伤情况,并对其信度和效度进行分析。方法:于2005-07/11选择天津医科大学总医院神经内科门诊68例帕金森病患者,用简明帕金森病评分量表及统一帕金森病评分量表对其进行临床评价。评价均在上午进行,如患者有症状波动,则在“开”期进行。简明帕金森病评分量表分为运动评价、日常生活活动及运动并发症3部分,共21项内容,每个项目的计分值按程度分为0～3分4个等级。采用Cronbachα系数、每个项目得分与剩余项目总分间的相关系数评价量表的内部一致性,采用结构效度评价量表的效度。结果:所有患者全部进入结果分析。①简明帕金森病评分量表各部分Cronbachα系数均在0.85以上,除运动评分部分外,其余部分均高于统一帕金森病评分量表。统一帕金森病评分量表第20项(静止性震颤)与其他项目的相关性最小(相关系数为0.10),其他相关系数低于0.30的还有统一帕金森病评分量表第17项(感觉症状),简明帕金森病评分量表的第1项(静止性震颤)及第10项(吞咽),相关系数分别为0.12、0.25和0.29。②简明帕金森病评分量表各部分与统一帕金森病评分量表各分量表之间均呈正相关,Pearson相关系数在0.47～0.96。③简明帕金森病评分量表各部分与Hoehn&Yahr分期呈正相关(rs=0.89)。单因素方差分析显示,不同Hoehn&Yahr分期帕金森病患者简明帕金森病评分量表评分显著不同。post-hoct检验显示,除Hoehn&Yahr1～1.5期(P=0.17)外,其余各期间差异均存在显著性意义(P<0.05)。结论:简明帕金森病评分量表/帕金森病致残量表具有较高的信度和效度,值得临床推广。

AIM： To assess the sports injury with short Parkinson evaluation scale/ scales for outcomes in Parkinson disease （SPES/SCOPA） in patients with Parkinson disease, analyze its reliability and validity. METHODS： Sixty-eight patients with Parkinson disease were selected from the Department of Neurology, General Hospital of Tianjin Medical University from July to November 2005. The patients were evaluated with SPES/SCOPA and unified Parkinsen disease rating scale （UPDRS） in the morning, and in the ＂on＂ phase, if fluctuating. The SPES/SCOPA scale contains 21 items in 3 sections： motor evaluation, activities of daily living, and motor complications. There are four response options ranging from 0 （normal） to 3 （severe）. Cronbach＇s α coefficient and item-total correlation were adopted to assess the reliability, Construct validity was used to evaluate the validity of the scale. RESULTS： All the subjects were involved in the analysis of results, （1） Cronbach＇s α was above 0.85 for every domain of the SPES/SCOPA scale. The internal consistencies of the SPES/SCOPA sections were higher than those of the UPDRS except for the motor evaluation. Rest tremor in the UPDRS had the lowest item-total correlation （0.10）. Other items with item- total correlation below 0.30 involved sensory symptoms （0.12） in the UPDRS; rest tremor （0.25） and swallowing （0.29） in the SPES/SCOPA. （2） Correlations between the sections of the SPES/SCOPA and the subscores of the UPDRS ranged from 0,47 to 0.96. （3） Correlation between the SPES/ SCOPA and the Hoehn ＆ Yabr scale was 0.89, One-way analysis of variance showed significant differences among patients grouped by their Hoehn ＆ Yahr stage in the SPES/SCOPA. The post-hoc t test showed that except for Hoehn ＆ Yabr scale 1-1.5 stage （P=-0,17）, there were significant differences among the other stages （P 〈 0.05）. CONCLUSION： The SPES/SCOPA is a reliable and valid scale that can adequately be used in clinical practice,