Fosang Adrienne L, Galea Mary P, McCoy Anne T, Reddihough Dinah S, Story Ian
Department of Physiotherapy, Royal Children's Hospital and Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
Dev Med Child Neurol. 2003 Oct;45(10):664-70. doi: 10.1017/s0012162203001245.
The aim of this study was to determine the reliability and magnitude of error of three lower-limb clinical measures for children with cerebral palsy (CP): the Modified Ashworth Scale of Spasticity (MAS), passive range of movement (PROM) and the modified Tardieu scale (MTS). Six physiotherapists measured 11 females and seven males (mean age 6 years 4 months, SD 2 years 4 months; age range 2 years 4 months to 10 years) on two occasions using a repeated measures design, collecting all data over 6 days. The severity of CP spanned all five levels of the Gross Motor Function Classification System and all children demonstrated varying degrees of spasticity. Exclusion criteria included botulinum toxin injections, inhibitory plasters, and orthopaedic surgery within the 6 months before study entry. For PROM and the MTS interrater reliability was acceptable with an intraclass correlation coefficient of 0.7, but results for MAS were lower. Standard error of measurement for repeated measures of PROM and MTS was about five degrees, but 95% confidence interval ranges were considerably higher. Test-retest results varied widely, particularly for the MAS. These measurement tools should be used with caution when evaluating changes in young children with CP.
本研究的目的是确定针对脑瘫（CP）儿童的三种下肢临床测量方法的可靠性和误差幅度：改良阿什沃思痉挛量表（MAS）、被动活动范围（PROM）和改良塔迪厄量表（MTS）。六位物理治疗师采用重复测量设计，在两个时间点对11名女性和7名男性（平均年龄6岁4个月，标准差2岁4个月；年龄范围2岁4个月至10岁）进行测量，在6天内收集所有数据。CP的严重程度涵盖了粗大运动功能分类系统的所有五个级别，所有儿童均表现出不同程度的痉挛。排除标准包括在研究入组前6个月内接受肉毒杆菌毒素注射、使用抑制性石膏和接受矫形手术。对于PROM和MTS，组间信度可接受，组内相关系数为0.7，但MAS的结果较低。PROM和MTS重复测量的测量标准误差约为5度，但95%置信区间范围要高得多。重测结果差异很大，尤其是MAS。在评估CP幼儿的变化时，应谨慎使用这些测量工具。
