Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan.
Res Dev Disabil. 2013 May;34(5):1528-35. doi: 10.1016/j.ridd.2013.01.026. Epub 2013 Mar 5.
This study examines the criterion-related validity and clinimetric properties of the Assessment of Preschool Children's Participation (APCP) for children with cerebral palsy (CP). Eighty-two children with CP (age range, two to five years and 11 months) and their caregivers participated in this study. The APCP consists of diversity and intensity scores in the areas of play (PA), skill development (SD), active physical recreation (AP), social activities (SA), and total areas. Tests were administered at baseline and at six-month follow-up. Concurrent and predictive validities were identified by assessing the strength of correlations between APCP scores and criterion-related measures--the 66-item Gross Motor Function Measure (GMFM-66) and Functional Independence Measure for Children (WeeFIM). Responsiveness was measured by standardized response mean (SRM). Minimal detectable change (MDC) at the 95% confidence level (MDC95) and minimal clinically important difference (MCID) were analyzed. The APCP with GMFM-66 and WeeFIM had fair to excellent concurrent validity (r=0.39-0.85) and predictive validity (r=0.46-0.82). The SRM values of the APCP diversity and intensity scales in all areas were 0.8-1.3. The MDC95 and MCID ranges for all areas (i.e., PA, SD, AP, SA, and total areas) were 0.1-0.7 and 0.4-1.2 points for intensity scores, respectively, and 4-17% and 10-19% for diversity scores, respectively. Therefore, the APCP scale was markedly responsive to change. Clinicians and researchers can use these clinimetric APCP data to determine whether a change score represents a "true" or clinically meaningful effect at post-treatment and follow-up.
本研究考察了用于脑瘫儿童的儿童参与评估(APCP)的效标关联效度和临床计量学特性。82 名脑瘫儿童(年龄范围为 2 至 5 岁 11 个月)及其照顾者参与了这项研究。APCP 包括游戏(PA)、技能发展(SD)、积极体育娱乐(AP)、社会活动(SA)和总区域的多样性和强度评分。在基线和 6 个月随访时进行了测试。通过评估 APCP 分数与标准相关措施——66 项粗大运动功能测量(GMFM-66)和儿童功能性独立测量(WeeFIM)之间的相关性,确定了同时性和预测效度。通过标准化反应均值(SRM)来衡量反应性。在 95%置信水平(MDC95)下分析最小可检测变化(MDC)和最小临床重要差异(MCID)。APCP 与 GMFM-66 和 WeeFIM 具有良好到极好的同时性效度(r=0.39-0.85)和预测效度(r=0.46-0.82)。所有区域的 APCP 多样性和强度量表的 SRM 值为 0.8-1.3。所有区域(即 PA、SD、AP、SA 和总区域)的 MDC95 和 MCID 范围分别为强度评分的 0.1-0.7 和 0.4-1.2 点,多样性评分的 4-17%和 10-19%。因此,APCP 量表对变化具有显著的反应性。临床医生和研究人员可以使用这些临床计量学 APCP 数据来确定治疗后和随访时的变化分数是否代表“真实”或具有临床意义的效果。