Department of Physical Therapy, National Cheng Kung University, 1 University Road, Tainan, Taiwan 701.
Res Dev Disabil. 2014 Jan;35(1):162-70. doi: 10.1016/j.ridd.2013.10.011. Epub 2013 Nov 5.
The purpose of this study was to determine the intra- and inter-rater reliability of classifying the movement patterns of rising from supine to stand in the children with typical development (TD) and mild to moderate developmental delay (DD). Sixty-eight children with TD and 20 children with DD aged 2 through 6 years were videotaped during rising. Two trained pediatric physical therapists independently viewed each videotape and classified the movement patterns of upper extremities (UE), trunk/axial (AX) and lower extremities (LE) regions using descriptive categories developed by previous researchers. Kappa statistic and average percentage of agreement were calculated to determine reliability. The average agreement rate of intra-rater ranged from 90% to 97% in TD group for three regions, and 79% to 89% in DD group; the agreement rate between raters ranged from 82% to 95% in TD group for three regions, and 71% to 87% in DD group. Using kappa statistic guidelines, high intra- and inter-rater reliabilities (k>0.81) were found in TD group, except inter-rater reliability for LE. Substantial intra- and inter-reliabilities (0.61<k<0.81) were found in DD group. As comparing the reliabilities of three regions, the lowest intra- and inter-rater reliabilities were found at the LE region in both groups. As taking age into consideration and dividing each group into subgroups by 2-year interval, in DD group, the intra-rater reliabilities were higher in younger participants (aged 2-4 years), except for the LE region, but the results of inter-rater reliabilities were variable. For the children with TD, the levels of inter-rater reliability increased for the UE region and decreased for LE region in older age, but the results for these two regions were reverse for the children with DD. The findings of this study suggested that the complexities and difficulties affecting reliabilities in classifying the movement patterns of rising were related to developmental capability, age and body region. In order to improve intra- and inter-rater reliabilities, extra training is needed in examining the children with DD, particularly for the UE and LE regions.
本研究旨在确定从仰卧位到站立位的上升运动模式在典型发育（TD）和轻度至中度发育迟缓（DD）儿童中的内部和内部评定者之间的可靠性。对 68 名 TD 儿童和 20 名 2 至 6 岁的 DD 儿童进行录像，在上升过程中对其进行拍摄。两名训练有素的儿科物理治疗师分别观看每段录像，并使用之前研究人员开发的描述性类别对上肢（UE）、躯干/轴向（AX）和下肢（LE）区域的运动模式进行分类。计算 Kappa 统计量和平均一致性百分比以确定可靠性。TD 组三个区域的内部评定者平均一致性率为 90%至 97%，DD 组为 79%至 89%；TD 组三个区域的评定者之间的一致性率为 82%至 95%，DD 组为 71%至 87%。使用 Kappa 统计量指南，在 TD 组中发现了高的内部和外部评定者可靠性（k>0.81），除了 LE 区域的外部评定者可靠性外。在 DD 组中发现了适度的内部和外部可靠性（0.61<k<0.81）。比较三个区域的可靠性，在两个组中，LE 区域的内部和外部评定者的可靠性最低。考虑到年龄因素，并按 2 岁间隔将每个组划分为亚组，在 DD 组中，除了 LE 区域外，年龄较小的参与者（2-4 岁）的内部评定者可靠性更高，但外部评定者的结果则各不相同。对于 TD 儿童，在年龄较大时，UE 区域的外部评定者可靠性增加，而 LE 区域的可靠性降低，但对于 DD 儿童，这两个区域的结果则相反。本研究的结果表明，影响上升运动模式分类可靠性的复杂性和困难与发育能力、年龄和身体区域有关。为了提高内部和外部评定者的可靠性，需要对 DD 儿童进行额外的检查培训，特别是对 UE 和 LE 区域。
