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要旨 目的:脊髄損傷者(SCI)は上下肢に加えて,体幹にも重度の機能障害を生じ,臨床場面では重要な視点となる.SCIに特化した体幹機能評価の確立は課題となっているが,近年では,SCIに国際的な体幹機能評価法としてClinical Trunk Control Test(CTCT)が使用され,良好な信頼性や妥当性が示されている.一方で,本邦において脊髄損傷者に特化した体幹機能評価法は数が乏しい.本研究は,日本語版CTCT(Japanese Version CTCT:CTCT-J)を作成し,その信頼性を検証することを目的としている.
方法:CTCT-Jの作成にあたっては,ダブルバックトランスレーションの形式を用いた.評価者間信頼性は,CTCT-Jの合計点と各項目の級内相関係数(intraclass correlation coefficients:ICC)と各サブテストのweighted kappa係数を算出した.内的一貫性の検証は,CTCT-J合計点および各項目のCronbachのα係数を算出した.
結果:対象は回復期,慢性期のSCIの12名.対象者の属性は,頚髄損傷9名,胸髄損傷3名.男性10名,女性2名.平均年齢:51.9±17.8歳.評価者間信頼性の検証について,ICCは,0.995〜1.000(p<0.05)の結果を示した.各サブテストのweighted kappa係数は,0.756〜1.000(p<0.05)となった.内的一貫性の検証では,すべての項目のCronbachのα係数は0.995(p<0.05)となった.
結論:本研究では,ダブルバックトランスレーションによってCTCT-Jを作成し,その信頼性について検証した.結果として,良好な評価者間信頼性,内的一貫性が認められ,本邦における適応可能性が示された.
Abstract Objective:The Clinical Trunk Control Test (CTCT) is used to assess trunk function worldwide, particularly for patients with spinal cord injury (SCI), with good reliability and validity. In Japan, trunk function evaluation methods specialized for patients with SCI are scarce. The aim of the present study was to create a Japanese version of CTCT (CTCT-J) and verify its reliability.
Methods:CTCT-J was created using the double-back translation format. The inter-rater reliability was calculated based on the total CTCT-J score and intraclass correlation coefficient (ICC) for each item. The weighted kappa coefficient was calculated for each subtest. To verify internal consistency, Cronbach's alpha coefficient was calculated for the CTCT-J total score and each item.
Results:We enrolled 12 patients with SCI, including ten men and two women, with an average age of 51.9 ± 17.8 years. Nine and three patients had cervical and thoracic SCI, respectively. The ICC for inter-rater reliability ranged from 0.995 to 1.000 (p <0.05). The weighted kappa coefficient for each subtest ranged from 0.756 to 1.000 (p <0.05). In the internal consistency test, the Cronbach's alpha coefficient for all items was 0.995 (p <0.05).
Conclusion:We created the CTCT-J with double back translation and verified its reliability. Good inter-rater reliability and internal consistency were observed, indicating its applicability in Japan.
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