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Validação da versão portuguesa da Functional Gait Assessment Scale para a população com Acidente Vascular Cerebral
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| 2.15 MB | Adobe PDF |
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Abstract(s)
Introdução: O AVC causa alterações significativas da marcha e equilíbrio, exigindo medidas de avaliação válidas e fiáveis. A Functional Gait Assessment (FGA) é um instrumento que avalia a estabilidade dinâmica da marcha, demonstrando elevada sensibilidade para detetar alterações subtis do equilíbrio e excelente fiabilidade em populações pós-AVC. Este estudo analisou as propriedades psicométricas da versão portuguesa em pessoas pós-AVC. Objetivo: Avaliar a fiabilidade (intra e interavaliador, teste–reteste), consistência interna, validade de construto, erro de medição e efeito chão/teto da versão portuguesa da FGA em pessoas pós-AVC. Métodos: Estudo transversal realizado com 84 sobreviventes de AVC. A avaliação consistiu num primeiro momento na aplicação da FGA por três fisioterapeutas experientes (com videogravação), complementada por Functional Ambulatory Category, o Ten Meter’s walk test e Sroke Impact Scale para análise da validade de construto. Após uma semana foi reaplicada a FAG para teste-reteste. Critérios de inclusão: diagnóstico de AVC, idade ≥18 anos e capacidade de marcha independente (FAC 3–5), com ou sem auxiliares/ortóteses. Critérios de exclusão: défices cognitivos que impedissem a compreensão ou execução das tarefas, avaliados pelo MMSE. A Fiabilidade foi avaliada por alfa de Cronbach, Kappa, Spearman, Wilcoxon, Kendall W; a validade de construto foi examinada por correlação de Spearman. O software de estatística utilizado foi SPSS. Resultados: A FGA demonstrou boa consistência interna (α = 0,895) e excelente Fiabilidade intra (ICC = 0,982), interavaliador (ICC = 0,910) e teste–reteste (ICC = 0,926). As correlações da FGA com a FAC (ρ = 0,591), SIS (ρ = 0,549) e 10MWT (ρ = −0,846 a −0,814) confirmaram a validade de construto. Não se observaram efeitos de chão ou teto. Conclusão: A versão portuguesa da FGA apresentou excelente Fiabilidade, boa consistência interna e validade de construto, sendo um instrumento sensível e clinicamente útil para monitorizar a recuperação da marcha e do equilíbrio pós-AVC.
Introduction: Stroke causes significant gait and balance impairments, requiring valid and reliable assessment tools. The Functional Gait Assessment (FGA) is an instrument that evaluates dynamic gait stability, demonstrating high sensitivity for detecting subtle balance impairments and excellent reliability in post-stroke populations. This study analysed the psychometric properties of the Portuguese version of the FGA in individuals after stroke. Aim: To evaluate the reliability (intra-rater, inter-rater and test–retest), internal consistency, construct validity, measurement error, and floor/ceiling effects of the Portuguese version of the FGA in people after stroke. Methods: Cross-sectional study conducted with 84 stroke survivors. The assessment involved administering the FGA at baseline by three experienced physiotherapists (with video recording), complemented by the Functional Ambulatory Category, the Ten-Meter Walk Test, and the Stroke Impact Scale for construct validity analysis. After one week, the FGA was reapplied for test–retest reliability. Inclusion criteria: diagnosis of stroke, age ≥18 years, and independent ambulation (FAC 3–5), with or without assistive devices/orthoses. Exclusion criteria: cognitive deficits that interfered with understanding or safely performing the tasks, assessed using the MMSE. Reliability was evaluated through Cronbach’s alpha, Kappa, Spearman, Wilcoxon, and Kendall’s W; construct validity was examined using Spearman correlations. Statistical analyses were performed using SPSS. Results: The FGA demonstrated good internal consistency (α = 0.895) and excellent intra-rater (ICC = 0.982), inter-rater (ICC = 0.910), and test–retest reliability (ICC = 0.926). Correlations with the FAC (ρ = 0.591), SIS (ρ = 0.549), and 10MWT (ρ = −0.846 to −0.814) confirmed construct validity. No floor or ceiling effects were observed. Conclusion: The Portuguese version of the FGA demonstrated excellent reliability, good internal consistency, and construct validity, confirming it as a sensitive and clinically useful instrument for monitoring gait and balance recovery after stroke.
Introduction: Stroke causes significant gait and balance impairments, requiring valid and reliable assessment tools. The Functional Gait Assessment (FGA) is an instrument that evaluates dynamic gait stability, demonstrating high sensitivity for detecting subtle balance impairments and excellent reliability in post-stroke populations. This study analysed the psychometric properties of the Portuguese version of the FGA in individuals after stroke. Aim: To evaluate the reliability (intra-rater, inter-rater and test–retest), internal consistency, construct validity, measurement error, and floor/ceiling effects of the Portuguese version of the FGA in people after stroke. Methods: Cross-sectional study conducted with 84 stroke survivors. The assessment involved administering the FGA at baseline by three experienced physiotherapists (with video recording), complemented by the Functional Ambulatory Category, the Ten-Meter Walk Test, and the Stroke Impact Scale for construct validity analysis. After one week, the FGA was reapplied for test–retest reliability. Inclusion criteria: diagnosis of stroke, age ≥18 years, and independent ambulation (FAC 3–5), with or without assistive devices/orthoses. Exclusion criteria: cognitive deficits that interfered with understanding or safely performing the tasks, assessed using the MMSE. Reliability was evaluated through Cronbach’s alpha, Kappa, Spearman, Wilcoxon, and Kendall’s W; construct validity was examined using Spearman correlations. Statistical analyses were performed using SPSS. Results: The FGA demonstrated good internal consistency (α = 0.895) and excellent intra-rater (ICC = 0.982), inter-rater (ICC = 0.910), and test–retest reliability (ICC = 0.926). Correlations with the FAC (ρ = 0.591), SIS (ρ = 0.549), and 10MWT (ρ = −0.846 to −0.814) confirmed construct validity. No floor or ceiling effects were observed. Conclusion: The Portuguese version of the FGA demonstrated excellent reliability, good internal consistency, and construct validity, confirming it as a sensitive and clinically useful instrument for monitoring gait and balance recovery after stroke.
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Keywords
Acidente Vascular Cerebral Marcha Equilíbrio Fiabilidade Validade Stroke Gait Balance Reliability Validity