片麻痺上肢遂行機能検査（APTH）の開発—信頼性と妥当性の検証

Development of Arm Performance Test for Hemiplegia (APTH) : Verification of its reliability and validity

要旨：脳卒中片麻痺者の上肢機能を日本の文化的側面や利き手の違いを考慮し，日常生活における動作遂行の観点から評価する片麻痺上肢遂行機能検査（Arm Performance Test for Hemiplegia；以下，APTH）を開発した．APTHは上肢機能を全20項目，合計得点100点で評価する．片麻痺者33名を対象としたAPTHの信頼性と妥当性の検証では，APTHは初回評価時得点と再評価時得点との間に有意に高い級内相関係数が得られ，Wolf Motor Function TestやMotor Activity Log，Brunnstrom Stageいずれとの間にも有意に高い相関が得られた．これらからAPTHは信頼性が高く，十分な妥当性を有する上肢機能検査であることが示唆された．

　We developed the Arm Performance Test for Hemiplegia (APTH), a test that evaluates daily life arm performance in patients with post-stroke hemiplegia, and in consideration of aspects of Japanese culture and the dominant hand. APTH evaluates arm function based on 20 items with a total score of 100 points. The present study investigated the reliability and validity of APTH in 33 patients with hemiplegia. Reliability was investigated in terms of test-retest reliability, while validity was investigated in terms of criterion-related validity with the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Brunnstrom stage. The results showed a significantly high intraclass correlation coefficient between APTH scores at initial evaluation and at re-evaluation, and significant correlations were observed between APTH scores and WMFT, MAL and Brunnstrom stage. These results indicate that the reliability and validity of APTH as an arm function test are sufficiently high.