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Vojnosanitetski pregled
2016, vol. 73, br. 12, str. 1139-1148
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 09/12/2016
doi: 10.2298/VSP150819056V
Creative Commons License 4.0
Dijagnostička tačnost A-testa i tačke preseka za procenu ishoda i planiranje rane i produžene rehabilitacije bolesnika operativno lečenih zbog preloma i osteoartritisa kuka
Vojnomedicinska akademija, Klinika za fizikalnu medicinu i rehabilitaciju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd

e-adresa: aleksandravukomanovic@yahoo.com

Sažetak

Uvod/Cilj. A-test se koristi u svakodnevnoj kliničkoj praksi za praćenje ortopedskih bolesnika tokom rane rehabilitacije. Cilj ove studije bio je da se utvrdi tačnosti A-testa i odrede tačke preseka na kojima A-test odvaja bolesnike od onih bez funkcionalne nesposobnosti na kraju rane rehabilitacije. Takođe, da bi se napravio plan produžene rehabilitacije, cilj nam je bio da utvrdimo da li A-test ima tu diskriminatornu sposobnost (i na kojim tačkama preseka) i tokom prvih dana rane rehabilitacije. Metode. Ova studija usmerena na ispitivanje mernog instrumenta sprovedena je na Ortopedskom odeljenju tokom rane rehabilitacije (1-5. postoperativni dan) na 60 bolesnika nakon artroplastike kuka zbog osteoartritisa i 60 bolesnika nakon operativno lečenog preloma kuka. Za merenja smo koristili A-test i the University of Iowa Level of Assistance Scale (ILAS) kao zlatni standard. Statistička analiza obuhvatala je ROC krivu i površinu ispod krive (AUC) sa 95% intervalom pouzdanosti za rezultate A-testa od 1. do 5. dana rehabilitacije senzitivnost, specifičnost, stopu lažno pozitivne i lažno negatívne greške, pozitivnu i negativnu prediktivnu vrednost, odnos pozitivnog i negativnog odnosa verovatnoće, tačnost, tačku na ROC krivi najbližu (0.1) i Youden index za sve tačke preseka. Rezultati. Vrednosti AUC iznosile su: 0,825 (0,744-0,905) za 1. dan rehabilitacije, 0,922 (0,872-0,972) za 2. dan, 0,980 (0,959-1,000) za 3. dan, 0,989 (0,973-1,004) za 4. dan i 0,999 (0,996-1,001) za 5. dan rehabilitacije. Optimalna tačka preseka za rezultate A­testa bila je: 7/8 za 1. dan, 29/30 za 4. dan i 34/35 za 5. dan rehabilitacije. Drugog i 3. dana rehabilitacije A-test imao je dve tačke preseka, a nižom tačkom se pouzdano odvajaju bolesnici sa funkcionalnom nesposobnošću, dok se višom tačkom odbacuje postojanje funkcionalne nesposobnosti. Drugog dana rehabilitacije tačke preseka bile su 12/13 i 17/18, a 3. dana 13/14 i 18/19. Zaključak. A-test ima karakteristike dijagnostički tačnog testa koji može da odvoji bolesnike sa i bez funkcionalne nesposobnosti u svim fazama rane rehabilitacije bolesnika koji su operativno lečeni zbog oboljenja ili preloma kuka. Na osnovu rezultata A­testa tokom prvih dana rane rehabilitacije moguće je napraviti plan za produženu rehabilitaciju.

Ključne reči

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