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一种用于测量脑瘫儿童躯干控制的临床工具:躯干控制测量量表。

A clinical tool to measure trunk control in children with cerebral palsy: the Trunk Control Measurement Scale.

机构信息

Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium.

出版信息

Res Dev Disabil. 2011 Nov-Dec;32(6):2624-35. doi: 10.1016/j.ridd.2011.06.012. Epub 2011 Jul 14.

Abstract

In this study the psychometric properties of the Trunk Control Measurement Scale (TCMS) in children with cerebral palsy (CP) were examined. Twenty-six children with spastic CP (mean age 11 years 3 months, range 8-15 years; Gross Motor Function Classification System level I n = 11, level II n = 5, level III n = 10) were included in this study. To determine the discriminant ability of the TCMS, 30 typically developing (TD) children (mean age 10 years 6 months, range 8-15 years) were also included. For inter-rater reliability, two testers scored all children simultaneously. To determine test-retest reliability, participants were reassessed on a second test occasion. For construct validity, the Gross Motor Function Measure (GMFM) was administered. Intraclass correlation coefficients (ICC) ranged from 0.91 to 0.99 for inter-rater and test-retest reliability. Kappa and weighted kappa values ranged for all but one item from 0.45 to 1. The standard error of measurement was 2.9% and 3.4%, and the smallest detectable difference for repeated measurements was 8% and 9.43% between raters and test-retest, respectively. Cronbach's alpha coefficients ranged from 0.82 to 0.94. Spearman rank correlation with the GMFM was 0.88 and increasing coefficients were found from dimension B to E. Subscale and total TCMS scores showed significant differences between children with CP and TD children (p < 0.0001). The results support the reliability and validity of the TCMS in children with spastic CP. The scale gives insight into the strengths and weaknesses of the child's trunk performance and therefore can have valuable clinical use.

摘要

本研究旨在检验脑瘫儿童躯干控制测量量表(TCMS)的心理测量特性。本研究纳入了 26 名痉挛型脑瘫儿童(平均年龄 11 岁 3 个月,范围 8-15 岁;粗大运动功能分级系统 1 级 11 名,2 级 5 名,3 级 10 名)。为了确定 TCMS 的判别能力,还纳入了 30 名正常发育(TD)儿童(平均年龄 10 岁 6 个月,范围 8-15 岁)。为了评估观察者间信度,两位测试者同时对所有儿童进行评分。为了确定测试-重测信度,参与者在第二次测试时接受重新评估。为了评估结构效度,使用粗大运动功能测量(GMFM)进行评估。观察者间和测试-重测信度的组内相关系数(ICC)范围分别为 0.91 至 0.99。除了一个项目外,kappa 和加权 kappa 值均在 0.45 至 1 之间。测量误差的标准误差分别为 2.9%和 3.4%,观察者间和测试-重测的最小可检测差异分别为 8%和 9.43%。克朗巴赫的 alpha 系数范围分别为 0.82 至 0.94。与 GMFM 的斯皮尔曼等级相关系数为 0.88,且从维度 B 到 E 呈递增趋势。TCMS 子量表和总评分在脑瘫儿童和 TD 儿童之间存在显著差异(p < 0.0001)。研究结果支持痉挛型脑瘫儿童 TCMS 的可靠性和有效性。该量表可深入了解儿童躯干表现的优势和劣势,因此具有重要的临床应用价值。

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