保存療法中の変形性膝関節症患者に対する歩行異常性の観察評価と三次元歩行解析データとの基準関連妥当性および再検査信頼性の検討

Evaluation of Observable Items of Gait Abnormality in Patients with Knee Osteoarthritis : Criterion-related Validity Using Three-dimensional Gait Analysis and Test-retest Reliability

要旨

目的：変形性膝関節症（膝OA）患者の歩行異常性に関する観察項目の内容妥当性を検討したうえで，それらの項目と三次元歩行解析データとの基準関連妥当性および再検査信頼性を検証することを目的とした．

方法：歩行異常性の項目プールを作成し，評定を三件法とした．内容妥当性は膝OAの有識者4名から意見を得て精査し，3名以上が同意した内容を検討項目とした．各項目の基準関連妥当性は三次元歩行解析装置にて検討し，再検査信頼性は同一対象者を2回評価した際の一致率から検討した．

結果：観察による歩行異常性の項目として11項目の内容妥当性を吟味し得た．そのうち，8項目が三次元歩行解析データと関連する傾向を示した．信頼性の検討では，8項目が0.61を超える結果となった．

結論：観察による歩行異常性評価は三次元歩行解析データとの基準関連妥当性および再検査信頼性を備えることから，膝OAの特異的な歩行動態を評価できる可能性がある．

Objective：We aimed to examine the criterion-related validity of observable items of gait abnormality in patients with knee osteoarthritis (OA) using three-dimensional gait analysis and to assess the test-retest reliability.

Methods：The items of gait abnormality were pooled from a prior study and rated using a 3-point scale. Content validity was examined by four experts in knee OA research and accepted when there was an agreement among at least three experts. Correlation between abnormality rating and three-dimensional gait analysis data was examined. The test-retest reliability of the agreement rate was then assessed in the same subject twice.

Results：Eleven items were pooled, and all met the criterion of content validity. Eight items showed adequate correlation with the three-dimensional gait analysis data and had test-retest reliability exceeding 0.61.

Conclusion：In patients with knee OA, observable items of gait abnormality had good test-retest reliability and criterion-related validity according to the three-dimensional gait analysis data.