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脑瘫儿童的小儿运动活动日志的有效性、反应度、最小可检测变化和最小临床重要变化。

Validity, responsiveness, minimal detectable change, and minimal clinically important change of the Pediatric Motor Activity Log in children with cerebral palsy.

机构信息

School of Occupational Therapy, College of Medicine, National Taiwan University, 17 F4 Xu-Zhou Road, Taipei, Taiwan.

出版信息

Res Dev Disabil. 2012 Mar-Apr;33(2):570-7. doi: 10.1016/j.ridd.2011.10.003. Epub 2011 Nov 24.

Abstract

This study examined criterion-related validity and clinimetric properties of the Pediatric Motor Activity Log (PMAL) in children with cerebral palsy. Study participants were 41 children (age range: 28-113 months) and their parents. Criterion-related validity was evaluated by the associations between the PMAL and criterion measures at baseline and posttreatment, including the self-care, mobility, and cognition subscale, the total performance of the Functional Independence Measure in children (WeeFIM), and the grasping and visual-motor integration of the Peabody Developmental Motor Scales. Pearson correlation coefficients were calculated. Responsiveness was examined using the paired t test and the standardized response mean, the minimal detectable change was captured at the 90% confidence level, and the minimal clinically important change was estimated using anchor-based and distribution-based approaches. The PMAL-QOM showed fair concurrent validity at pretreatment and posttreatment and predictive validity, whereas the PMAL-AOU had fair concurrent validity at posttreatment only. The PMAL-AOU and PMAL-QOM were both markedly responsive to change after treatment. Improvement of at least 0.67 points on the PMAL-AOU and 0.66 points on the PMAL-QOM can be considered as a true change, not measurement error. A mean change has to exceed the range of 0.39-0.94 on the PMAL-AOU and the range of 0.38-0.74 on the PMAL-QOM to be regarded as clinically important change.

摘要

本研究考察了脑瘫儿童的儿科运动活动日志(PMAL)的效标关联效度和临床计量学特性。研究参与者为 41 名儿童(年龄范围:28-113 个月)及其父母。在基线和治疗后,通过 PMAL 与标准测量之间的关联来评估效标关联效度,包括自我护理、移动性和认知分量表、儿童功能性独立测量(WeeFIM)的总表现以及 Peabody 发育性运动量表的抓握和视觉运动整合。计算了 Pearson 相关系数。使用配对 t 检验和标准化反应均值来检查反应性,最小可检测变化在 90%置信水平下捕获,最小临床重要变化使用基于锚定和基于分布的方法进行估计。PMAL-QOM 在治疗前和治疗后均具有良好的同时效度和预测效度,而 PMAL-AOU 仅在治疗后具有良好的同时效度。PMAL-AOU 和 PMAL-QOM 在治疗后都对变化具有明显的反应性。PMAL-AOU 上至少提高 0.67 分,PMAL-QOM 上至少提高 0.66 分,可以被认为是真实的变化,而不是测量误差。PMAL-AOU 上的平均变化必须超过 0.39-0.94 的范围,PMAL-QOM 上的平均变化必须超过 0.38-0.74 的范围,才能被视为临床重要变化。

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