Reliabilität und Validität von Ganganalyse-Skalen

Zusammenfassung

Hintergrund: Innerhalb der Physiotherapie ist die beobachtende Ganganalyse ein häufig eingesetztes Instrumentarium zur Bewertung kinematischer Parameter des Gangbildes.

Ziel: Das Ziel dieser Arbeit bestand darin, einen Überblick über die Reliabilität des Edinburgh Visual Gait Score sowie der Physician Rating Scale und deren Modifikationen und Abkömmlinge zu erhalten. Weiterhin wird die Gültigkeit dieser Skalen aufgezeigt.

Methode: Die Literaturrecherche fand in den Datenbanken Medline, Cinahl und PEDro statt. Die ermittelten Studien wurden nach definierten Kriterien in die Arbeit eingeschlossen, in thematische Gruppen gegliedert und deren Ergebnisse auf ihre Reliabilität sowie Validität hin exzerpiert.

Ergebnisse: Die Ganganalyse-Skalen wiesen im Mittel eine moderate Reliabilität auf (k = 0,26 – 0,77; level of agreement = 60,23 – 66,09 %). Der EVGS zeigte Werte zwischen ausreichender bis guter Zuverlässigkeit, die PRS wies Werte von schlechter bis beachtlicher Wiederholbarkeit auf. Die Observational Gait Scale ergab substantielle Übereinstimmungen, und die Visual Gait Assessment Scale erzielte im Mittel eine moderate Qualität. Der Vergleich dieser Skalen mit dem Goldstandard erreichte ebenfalls eine mittelmäßige Gültigkeit (k = 0,21 – 0,61; level of agreement = 47,3 – 64 %).

Schlussfolgerungen: Die visuelle Bewertung kinematischer Parameter anhand der untersuchten Ganganalyse-Skalen ist subjektiv. Bei ihrer Anwendung gewonnene Ergebnisse müssen kritisch interpretiert und verglichen werden.

Abstract

Background: Visual gait analysis is a commonly used tool to evaluate kinematic parameters in physical therapy.

Objective: The aim of this study was to review the reliability of the Edinburgh Visual Gait Score and the Physician Rating Scale as well as their modifications. In addition, their validity is portrayed.

Method: The Literature research was carried out in the databases Medline, Cinahl and PEDro. The reported studies were included according to defined criteria and allocated to thematic groups. The results were extracted subject to reliability and validity.

Results: In average the scales showed moderate results (k = 0,26 – 0,77; level of agreement = 60,23 – 66,09 %). The Edinburgh Visual Gait Score attained values from fair to good agreement and the modified Physician Rating Scale produced slight to substantial accordance. The Observational Gait Scale showed substantial agreement and the Visual Gait Assessment Scale achieved moderate reliability. Compared to the goldstandard the scales’ results also revealed moderate correlation (k = 0,21 – 0,61; level of agreement = 47,3 – 64 %).

Conclusions: Visual assessment of kinematic parameters on the basis of gait scales is subjective. Clinical practice findings must be compared and critically analysed.

Schlüsselwörter

Reliabilität - Validität - beobachtende Ganganalyse - Physiotherapie - Ganganalyse-Skalen

Key words

reliability - validity - visual gait analysis - physiotherapy - gait assessment scales

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