Hobbelen Johannes S M, Koopmans Raymond T C M, Verhey Frans R J, Habraken Kitty M, de Bie Rob A
Physiotherapy Research Vitalis WoonZorg Groep, Eindhoven, The Netherlands.
Int Psychogeriatr. 2008 Aug;20(4):840-52. doi: 10.1017/S1041610207006424. Epub 2008 Jan 7.
Paratonia is one of the associated movement disorders characteristic of dementia. The aim of this study was to develop an assessment tool (the Paratonia Assessment Instrument, PAI), based on the new consensus definition of paratonia. An additional aim was to investigate the reliability and validity of the PAI.
A three-phase cross-sectional survey was conducted. In the first two phases, the PAI was developed and validated. In the third phase, the inter-observer reliability and feasibility of the instrument was tested.
The original PAI consisted of five criteria that all needed to be met in order to make the diagnosis. On the basis of a qualitative analysis, one criterion was reformulated and another was removed. Following this, inter-observer reliability between the two assessors resulted in an improvement of Cohen's kappa from 0.532 in the initial phase to 0.677 in the second phase. This improvement was substantiated in the third phase by two independent assessors with Cohen's kappa ranging from 0.625 to 1.
The PAI is a reliable and valid assessment tool for diagnosing paratonia in elderly people with dementia that can be applied easily in daily practice.
抓握反射是痴呆症相关的运动障碍之一。本研究的目的是基于抓握反射的新共识定义开发一种评估工具（抓握反射评估工具，PAI）。另一个目的是研究PAI的可靠性和有效性。
进行了一个三阶段的横断面调查。在前两个阶段，开发并验证了PAI。在第三阶段，测试了该工具的观察者间信度和可行性。
最初的PAI由五个标准组成，为了做出诊断，所有标准都需满足。基于定性分析，重新制定了一个标准并删除了另一个标准。在此之后，两名评估者之间的观察者间信度使科恩kappa系数从初始阶段的0.532提高到了第二阶段的0.677。在第三阶段，两名独立评估者证实了这一提高，科恩kappa系数在0.625至1之间。
PAI是一种可靠且有效的评估工具，用于诊断患有痴呆症的老年人的抓握反射，可轻松应用于日常实践。
