Tan Jia Ling, Thomas Nicole Maree, Johnston Leanne Marie
a Division of Physiotherapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.
b Department of Physiotherapy , Children's Health Queensland Hospital and Health Service , Brisbane , Australia.
Phys Occup Ther Pediatr. 2017 Nov;37(4):362-373. doi: 10.1080/01942638.2016.1244872. Epub 2016 Dec 27.
Examine the inter-rater reliability of the Daniels and Worthingham (D&W) manual muscle test (MMT) protocol for children with spina bifida between experienced and novice physiotherapists.
Thirteen children with spina bifida (two males) aged 6 to 18 years were recruited from a spina bifida service in a state-wide tertiary children's hospital. Each child had the muscle strength of 19, and lower limb muscles were measured bilaterally by one experienced and one novice physiotherapist using the D&W MMT protocol. Examiner and limb order were counterbalanced. Standard training and recording sheets were used. Agreement between raters was examined with quadratic weighted kappa (κ), percentage exact agreement (%EA), and the Bland-Altmann Limits of Agreement (LoA). Minimal detectable change (MDC) was calculated.
Inter-rater agreement between the experienced and novice raters was excellent (κ = 0.95; 95% confidence interval: 0.94-0.96); %EA was good (72.3%); and clinically appropriate LoA levels were -1.30-1.40. The MDC was 1.11 points on a six-point MMT scale.
The D&W MMT protocol, when used after standard training and with standard recording sheets, was reproducible for children with spina bifida, aged 6-18 years.
检验经验丰富和新手物理治疗师对脊柱裂儿童进行丹尼尔斯和沃辛厄姆（D&W）徒手肌力测试（MMT）方案时的评分者间信度。
从一家全州范围的三级儿童医院的脊柱裂服务机构招募了13名年龄在6至18岁之间的脊柱裂儿童（两名男性）。每个儿童有19块肌肉的力量，由一名经验丰富的和一名新手物理治疗师使用D&W MMT方案对其双侧下肢肌肉进行测量。检查者和肢体顺序进行了平衡处理。使用标准的训练和记录表。通过二次加权kappa（κ）、精确百分比一致性（%EA）以及布兰德-奥特曼一致性界限（LoA）来检验评分者之间的一致性。计算最小可检测变化（MDC）。
经验丰富的评分者和新手评分者之间的评分者间一致性极佳（κ = 0.95；95%置信区间：0.94 - 0.96）；%EA良好（72.3%）；临床适宜的LoA水平为 -1.30至1.40。在六点MMT量表上，MDC为1.11分。
D&W MMT方案在经过标准训练并使用标准记录表后，对于6至18岁的脊柱裂儿童具有可重复性。
