Desenvolvimento e validação de conteúdo de um instrumento de avaliação clínica da subida e descida de escada em indivíduos com hemiparesia / Development and content validation of a clinical assessment instrument of stair ascentand and descent in individuals with hemiparesis

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Functional limitations resulting from stroke affects performance of daily life activities, such as managing stairs. The existing instruments for the assessment of stair ambulation evaluated distinct and isolated characteristics and there were not found any specific instruments which evaluate, in a comprehensive way, the quality of the movement and the strategies adopted for stroke subjects to perform this task. The aim of this study was to develop and validate the contents of a clinical instrument to identify the qualitative, kinematic characteristics and the strategies related to functional performance, adopted by stroke subjects during the tasks of stair ascent and descent. The first step consisted of an extensive review of the scientific literature regarding the biomechanical characteristics of stair ascent and descent with hemiparetic subjects. Seven well-known professionals involved in the areas of neuro-functional rehabilitation and the biomechanics were consulted to provide essential information regarding the functional performance and adopted strategies during stair ambulation. In addition, qualitative, kinematic analyses of ascending and descending four-step stairs at a height of 17 cm and depth of 28 cm, were obtained from 16 hemiparetic subjects,13 men and three women, with a mean age of 56.612.6 years. From the exhaustive analyses of three sources of information, the scientific literature, the opinions of these professionals, and the kinematic analyses of their stair performance, all variables of interest were selected and the differentiation of the characteristics between the score levels for each item, were determined. The first developed version comprised 80 items and each item was evaluated on a three-point ordinal scale, which ranged from zero, best performance, to 2, worse performance. The content validity of the first version of the instrument was investigated by an expert panel, which was composed of eight well-known national and international professionals involved in motor and functional rehabilitation of stroke subjects with significant publications in referred journals. The content validity index (CVI) and the modified Kappa coefficients were employed for statistical analyses. The items which demonstrated CVI≥0.80 and Kappa≥0.75, were considered valid. The content validation was carried out in three stages to reach consensus among the expert professionals. The final version of the clinical instrument for assessment of stair ascent and descent with hemiparetic individuals was established with 38 items divided into descriptive (eight items), domains related to the general characteristics (16 items), and adopted strategies (14 items) during stair ascent and descent. The total scores ranged from zero to 70 and zero to 74, for stair ascent and descent, respectively. Low scores corresponded to better performance, whereas high ones to worse. Despite the satisfactory results obtained during the process of the development and content validation of the clinical instrument for assessment of stair ascent and descent with hemiparetic subjects, other psychometric properties need to be evaluated.

ASSUNTO(S)

evaluation avaliação stroke acidente vascular encefálico biomecânica educacao fisica biomechanics

ACESSO AO ARTIGO

Documentos Relacionados