Sorsdahl Anne Brit, Moe-Nilssen Rolf, Strand Liv Inger
Department of Public Health and Primary Health Care, Section for Physiotherapy Science, University of Bergen, Bergen, Norway.
Dev Med Child Neurol. 2008 Feb;50(2):146-51. doi: 10.1111/j.1469-8749.2007.02023.x.
The aim of this study was to examine observer reliability of the Gross Motor Performance Measure (GMPM) and the Quality of Upper Extremity Skills Test (QUEST) based on video clips. The tests were administered to 26 children with cerebral palsy (CP; 14 males, 12 females; range 2-13y, mean 7y 6mo), 24 with spastic CP, and two with dyskinesia. Respectively, five, six, five, four, and six children were classified in Gross Motor Function Classification System Levels I to V; and four, nine, five, five, and three children were classified in Manual Ability Classification System levels I to V. The children's performances were recorded and edited. Two experienced paediatric physical therapists assessed the children from watching the video clips. Intraobserver and interobserver reliability values of the total scores were mostly high, intraclass correlation coefficient (ICC)(1,1) varying from 0.69 to 0.97 with only one coefficient below 0.89. The ICCs of subscores varied from 0.36 to 0.95, finding'Alignment'and'Weight shift'in GMPM and'Protective extension'in QUEST highly reliable. The subscores'Dissociated movements'in GMPM and QUEST, and'Grasp'in QUEST were the least reliable, and recommendations are made to increase reliability of these subscores. Video scoring was time consuming, but was found to offer many advantages; the possibility to review performance, to use special trained observers for scoring and less demanding assessment for the children.
本研究旨在基于视频片段检验粗大运动表现测量（GMPM）和上肢技能质量测试（QUEST）的观察者信度。对26名脑瘫（CP）儿童进行了测试（14名男性，12名女性；年龄范围2 - 13岁，平均7岁6个月），其中24名患有痉挛型CP，2名患有运动障碍型CP。分别有5名、6名、5名、4名和6名儿童被归类为粗大运动功能分类系统的I至V级；4名、9名、5名、5名和3名儿童被归类为手动能力分类系统的I至V级。记录并编辑了儿童的表现。两名经验丰富的儿科物理治疗师通过观看视频片段对儿童进行评估。总分的观察者内和观察者间信度值大多较高，组内相关系数（ICC）（1,1）在0.69至0.97之间变化，只有一个系数低于0.89。子分数的ICC在0.36至0.95之间变化，发现GMPM中的“对齐”和“重心转移”以及QUEST中的“保护性伸展”信度很高。GMPM和QUEST中的子分数“分离运动”以及QUEST中的“抓握”信度最低，并针对提高这些子分数的信度提出了建议。视频评分耗时，但被发现具有许多优点；可以回顾表现、使用经过专门培训的观察者进行评分以及对儿童的评估要求较低。
