Lue Yi-Jing, Su Chwen-Yng, Yang Rei-Cheng, Su Wei-Lieh, Lu Yen-Mou, Lin Rong-Fong, Chen Shun-Sheng
Faculty of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
Clin Rehabil. 2006 Sep;20(9):804-17. doi: 10.1177/0269215506070809.
To develop a reliable and valid new rating scale for measuring the functional impact of muscular dystrophy.
Prospective and longitudinal investigation.
Three academic medical centres in Taiwan and the Muscular Dystrophy Association of Taiwan.
The Brooke Scale, the Vignos Scale, the Barthel Index, muscular strength, contracture severity, and predicted forced vital capacity (FVC%).
Scale development was in three stages. In stage I, a preliminary pool of 53 items was generated from patient interviews (n = 25), literature review, existing functional rating scales and expert opinion. In stage II, these items were administered to 85 patients with muscular dystrophy. The resulting data were analysed to construct a rating scale (the Muscular Dystrophy Functional Rating Scale, MDFRS) that encompassed four unidimensional constructs: mobility, basic activities of daily living, arm function and impairment. In stage III, the measurement properties of this rating scale were assessed in 121 muscular dystrophy patients different from those examined with the preliminary instrument.
Internal consistency reliability was excellent for all domains of the final 33-item scale, with values of Cronbach's alpha ranging from 0.84 to 0.97. Intraclass correlation coefficients for test-retest and inter-rater reliability were 0.99 for all domains of the MDFRS. The MDFRS showed moderate to high correlations with a range of functional rating scales measuring similar aspects and impairment parameters (Spearman's rho = 0.65-0.91; P < 0.001, each). Confirmatory factor analysis supported a unitary construct of the four-dimensional MDFRS. The MDFRS had small floor and ceiling effects in the study samples. Sensitivity to change was confirmed by large standardized response means for the MDFRS total score.
The MDFRS is a reliable and valid disease-specific measure of functional status for patients with muscular dystrophy.
开发一种可靠且有效的新评定量表，用于测量肌肉萎缩症的功能影响。
前瞻性纵向研究。
台湾的三个学术医学中心以及台湾肌肉萎缩症协会。
布鲁克量表、维格诺斯量表、巴氏指数、肌肉力量、挛缩严重程度以及预计用力肺活量（FVC%）。
量表开发分三个阶段。在第一阶段，通过患者访谈（n = 25）、文献综述、现有的功能评定量表以及专家意见，生成了一个包含53个条目的初步条目池。在第二阶段，将这些条目应用于85例肌肉萎缩症患者。对所得数据进行分析，构建了一个评定量表（肌肉萎缩症功能评定量表，MDFRS），该量表包含四个单维结构：活动能力、日常生活基本活动、手臂功能和损伤。在第三阶段，在121例与初步工具测试对象不同的肌肉萎缩症患者中评估该评定量表的测量特性。
最终的33条目量表所有领域的内部一致性信度都非常好，克朗巴哈α系数值在0.84至0.97之间。MDFRS所有领域的重测信度和评分者间信度的组内相关系数均为0.99。MDFRS与一系列测量相似方面和损伤参数的功能评定量表呈现中度至高相关性（斯皮尔曼等级相关系数ρ = 0.65 - 0.91；每组P < 0.001）。验证性因素分析支持了四维MDFRS的单一结构。MDFRS在研究样本中的地板效应和天花板效应较小。MDFRS总分的标准化反应均值较大，证实了其对变化的敏感性。
MDFRS是一种可靠且有效的针对肌肉萎缩症患者功能状态的疾病特异性测量工具。
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