功能性步态障碍的表型化:对现有框架的探索性分析
Sara Issak1,2, Richard Kanaan3, Natalie A Fini1
1Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Movement disorders clinical practice
|November 11, 2025
概括
现有的框架很难对功能神经障碍走路表型进行分类,评级者之间很少达成一致. 需要进一步的研究来开发一种可靠的分类系统,以对这种残疾状况进行分类.
科学领域:
- 神经学 神经学
- 临床评估 临床评估
- 运动障碍 运动障碍
背景情况:
- 功能神经障碍 (FND) 呈现出明显的步行障碍.
- 目前对功能性步行障碍 (FGD) 现象型的分类方法缺乏标准化.
- 已经提出了六种表型框架,但它们的有效性尚未被证明.
研究的目的:
- 评估现有框架对分类FGD视频的有用性.
- 为了确定这些分类的评级者之间的可靠性.
- 为了确定当前FGD表型化的局限性.
主要方法:
- 观察性研究设计与评价者之间的可靠性评估.
- 五位评级人员使用六个不同的表型框架评估了34个FGD视频.
- 使用Krippendorf的alpha来量化评审者之间的一致性.
主要成果:
- 在Fung (2016) 和 Baik and Lang (2007) 框架中,分类率最高 (85%和82%).
- 其他框架的视频分类在53-65%之间.
- 在所有框架中观察到一致低的评价者间一致性 (K-alpha:0.287-0.507).
结论:
- 当前的表型框架表明,FGD视频全面分类的能力有限.
- 没有一个单一的框架可以对所有观察到的病例进行分类.
- 低级别之间的可靠性强调了对FGD更强大和标准化的分类系统的需求.
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