Motorische Funktionen in der postprimären Neurorehabilitation: Der Bereich Mobilität des Assessments der Kliniken Schmieder (AKS/C)

Zusammenfassung

Hintergrund: Die in der Neurorehabilitation am meisten verwendeten Assessments wurden verschiedentlich wegen ihrer ungenügenden Sensitivität kritisiert. Daher wurde in den Kliniken Schmieder in Deutschland das Assessment der Kliniken Schmieder/C (AKS/C) erarbeitet, das bei Patienten in der postprimären Rehabilitation die Motorik, Kognition, Kommunikation und die Fähigkeit zur Selbstversorgung erfasst.

Ziel: Bestimmung von Validität, Reliabilität und Responsivität des Bereichs Mobilität des AKS/C.

Methode: Patienten mit verschiedenen Diagnosen in der postprimären Neurorehabilitation (n = 31 bei Eintritt, n = 24 bei Austritt) wurden getestet. Für die Bestimmung der Validität fand der Vergleich der AKS/C-Daten mit den Mobilitätsitems des FIM statt. Die Bestimmung der Reliabilität erfolgte mittels Intraklassen-Korrelations- (ICC) sowie Cronbach-Alpha-Koeffizient und die Responsivität mittels Standardised Response Mean (SRM).

Ergebnisse: Validität (ICC = 0,93) und Reliabilität (ICC = 0,86 – 0,99; Cronbach Alpha = 0,95) des AKS/C waren gut. Die Responsivität (SRM = 1,3) lag etwas höher als die der FIM-Mobilitätsitems (SRM = 1,2). Die Kombination des AKS/C mit den FIM-Mobilitätsitems erhöhte die Responsivität nicht.

Schlussfolgerung: Der Bereich Mobilität des AKS/C erwies sich als valides, reliables und responsives Assessment zur Erfassung der motorischen Fähigkeiten von Patienten mit verschiedenen Diagnosen in der postprimären Neurorehabilitation.

Abstract

Background: The most used assessments in neuro-rehabilitation were often criticized because of their insufficient sensitivity. For this purpose, the Kliniken Schmieder in Germany have developed the Assessment of the Kliniken Schmieder/C (AKS/C) in order to collect motor function, cognition, communication and self-care competence of post-primary rehabilitation patients.

Objective: To determine validity, reliability and responsiveness of the AKS/C motor domain.

Method: Patients with various neurologic diagnoses in post-primary rehabilitation (n = 31 at admission, n = 24 at discharge) were tested. For concurrent validity determination AKS/C data were compared with those of FIM mobility and locomotor items. For assessing reliability intraclass correlation coefficients (ICC) and Cronbach’s Alpha and for assessing responsiveness standardised response mean (SRM) were calculated.

Results: Validity (ICC = 0.93) and reliability (ICC = 0.86 – 0.99; Cronbach’s Alpha = 0.95) of AKS/C were good. Responsiveness of the AKS/C was slightly higher (SRM = 1.3) than of FIM motor items (SRM = 1.2). Combination of AKS/C and FIM items did not increase responsiveness.

Conclusion: The motor domain of the AKS/C proved to be a valid, reliable and responsive motor function assessment tool for patients in post-primary neuro-rehabilitation.

Schlüsselwörter

Mobilität - Neurorehabilitation - Reliabilität - Responsivität - Validität

Key words

mobility - neuro-rehabilitation - reliability - responsiveness - validity

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