Department of Physical Medicine and Rehabilitation, CHU Henri Mondor, Créteil, France.
Arch Phys Med Rehabil. 2010 Mar;91(3):421-8. doi: 10.1016/j.apmr.2009.11.017.
To measure the Tardieu Scale's reliability in children with cerebral palsy (CP) when used by raters with and without experience in using the scale, before and after training.
Single-center, intrarater and interrater reliability study.
Institutional ambulatory care.
Referred children with CP in the pretraining phase (n=5), during training (n=3), and in the posttraining phase (n=15).
The Tardieu Scale involves performing passive muscle stretch at 2 velocities, slow and fast. The rater derives 2 parameters; the Spasticity Angle X is the difference between the angles of arrest at slow speed and of catch-and-release or clonus at fast speed; the Spasticity Grade Y is an ordinal variable that grades the intensity (gain) of the muscle reaction to fast stretch. In phase 1, experienced raters without formalized training in the scale graded elbow, knee, and ankle plantar flexors bilaterally, without and with a goniometer. In phase 2, after training, the experienced and nonexperienced raters graded the same muscles unilaterally.
Intrarater and interrater reliability of the Tardieu Scale.
After training, nonexperienced raters had mean +/- SD intrarater and interrater agreement rates across all joints and parameters of 80%+/-14% and 74%+/-16%, respectively. For experienced raters, intrarater and interrater agreement rates before training were 77%+/-13% and 66%+/-15%, respectively, versus 90%+/-8% and 81%+/-13%, respectively, after training (P<.001 for both). Specific angle measurements at the knee were less reliable for the angles of catch measured at fast speed. Across all joints, agreement rates were similar using visual or goniometric measurements.
Both parameters of the Tardieu Scale have excellent intrarater and interrater reliability when assessed at the elbow and ankle joints of children with CP, with no difference noted between visual and goniometric measurements. Angle measurements were less reliable at the knee joints. Training was associated with a highly significant improvement in reliability.
测量脑瘫（CP）患儿在有经验和无经验的评估者使用时，在使用量表前后的 Tardieu 量表的可靠性。
单中心、内部和外部评估者的可靠性研究。
机构门诊。
在培训前阶段（n=5）、培训中（n=3）和培训后阶段（n=15）转诊的 CP 患儿。
Tardieu 量表涉及以 2 种速度（慢和快）进行被动肌肉拉伸。评估者得出 2 个参数；痉挛角度 X 是慢速时的阻滞角度与快速时的捕捉和释放或阵挛角度之间的差异；痉挛等级 Y 是一个序数变量，用于对快速拉伸时肌肉反应的强度（增益）进行分级。在第 1 阶段，没有接受过该量表正式培训的有经验的评估者对双侧肘、膝和踝关节跖屈肌进行分级，有和没有量角器。在第 2 阶段，在培训后，有经验和无经验的评估者对单侧的相同肌肉进行分级。
Tardieu 量表的内部和外部评估者的可靠性。
培训后，所有关节和参数的无经验评估者的内部和外部评估者的平均一致性率分别为 80%+/-14%和 74%+/-16%。对于有经验的评估者，培训前的内部和外部评估者的一致性率分别为 77%+/-13%和 66%+/-15%，而培训后的一致性率分别为 90%+/-8%和 81%+/-13%（均<0.001）。在快速速度下测量的捕捉角度的特定角度测量在膝关节处不太可靠。在所有关节中，使用视觉或量角器测量的一致性率相似。
在 CP 患儿的肘和踝关节处评估时，Tardieu 量表的两个参数均具有极好的内部和外部评估者的可靠性，视觉和量角器测量之间没有差异。在膝关节处，角度测量的可靠性较差。培训与可靠性的显著提高相关。
Zotero 插件