van Rooijen Diana E, Lalli Stefania, Marinus Johan, Maihöfner Christian, McCabe Candida S, Munts Alex G, van der Plas Anton A, Tijssen Marina A J, van de Warrenburg Bart P, Albanese Alberto, van Hilten Jacobus J
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Pain Med. 2015 Mar;16(3):488-93. doi: 10.1111/pme.12541. Epub 2014 Sep 12.
Sustained abnormal postures (i.e., fixed dystonia) are the most frequently reported motor abnormalities in complex regional pain syndrome (CRPS), but these symptoms may also develop after peripheral trauma without CRPS. Currently, there is no valid and reliable measurement instrument available to measure the severity and distribution of these postures. The range of motion scale (ROMS) was therefore developed to assess the severity based on the possible active range of motion of all joints (arms, legs, trunk, and neck), and the present study evaluates its reliability and validity.
Inter- and intra-rater reliability of the ROMS was determined in 16 patients with abnormal sustained postures, who were videotaped following a standard video protocol in a university hospital. The recordings were rated by a panel of international experts. In addition, 30 patients were clinically tested with both the Burke-Fahn-Marsden (BFM) scale as well as the ROMS to assess construct validity.
Inter-rater reliability for total ROMS scores showed an intra-class correlation coefficient (ICC) of 0.85. The majority of the scores for the separate joints (13 out of 18) demonstrated an almost perfect agreement with ICCs ranging from 0.81 to 0.94; of the other items, one showed fair, one moderate, and three substantial agreement. The ICCs for the intra-rater reliability ranged from moderate to almost perfect (0.68-0.98). Spearman's correlation coefficients between corresponding body areas as measured with the ROMS or BFM were all above 0.82.
The ROMS is a reliable and valid instrument to evaluate the severity and distribution of sustained abnormal postures.
持续性异常姿势（即固定性肌张力障碍）是复杂区域疼痛综合征（CRPS）中最常报告的运动异常，但这些症状也可能在外周创伤后出现而不伴有CRPS。目前，尚无有效且可靠的测量工具来测量这些姿势的严重程度和分布情况。因此，开发了运动范围量表（ROMS），以根据所有关节（手臂、腿部、躯干和颈部）可能的主动运动范围来评估严重程度，本研究评估了其可靠性和有效性。
在一家大学医院，按照标准视频协议对16例有持续性异常姿势的患者进行录像，以确定ROMS的评分者间信度和评分者内信度。录像由一组国际专家进行评分。此外，对30例患者进行了伯克 - 法恩 - 马斯登（BFM）量表和ROMS的临床测试，以评估结构效度。
ROMS总分的评分者间信度显示组内相关系数（ICC）为0.85。单独关节的大多数评分（18个中的13个）显示出几乎完美的一致性，ICC范围为0.81至0.94；其他项目中，一个显示一般一致性，一个显示中等一致性，三个显示高度一致性。评分者内信度的ICC范围从中等至几乎完美（0.68 - 0.98）。用ROMS或BFM测量的相应身体部位之间的斯皮尔曼相关系数均高于0.82。
ROMS是评估持续性异常姿势严重程度和分布的可靠且有效的工具。
