Chaleat-Valayer E, Bard-Pondarre R, Bernard J C, Roumenoff F, Lucet A, Denis A, Occelli P, Touzet S
Médecin de Médecine Physique et de Réadaptation, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France.
Ergothérapeute, Service enfants - adolescents, Croix-Rouge française CMCR des Massues, 92 rue Edmond Locard, 69005 Lyon, France.
Eur J Paediatr Neurol. 2017 Sep;21(5):754-762. doi: 10.1016/j.ejpn.2017.04.1332. Epub 2017 May 10.
To evaluate the inter- and intra-rater reliability of two previously developed classifications of upper limb and hand patterns.
Two hundred and twelve films of patients with CP (118 of UL postures and 94 of hand tasks; median age 14, 3-46 years) were viewed by 18 examiners from 2 different rehabilitation centers, and one expert who had participated in the design of the classifications. They classed upper limb (3 patterns with sub-types) and hand patterns (2 patterns with subtypes) twice, at 2 months' interval. Inter- and intra-rater reliability were analysed.
Intra-rater and inter-rater reliability were very high for upper limb and hand patterns (0.87 < k < 0.92), and high for the subtypes (0.58 < k < 0.68). Examiners stated that both classifications were useful and feasible in clinical practice.
Despite the single, short training session on use of the classifications, agreement between the examiners and the expert examiner was good to high, confirming that these classifications are easy to use and reliable. The classifications proposed here provide homogenous terminology for use in both clinical practice and research, to describe, evaluate and follow-up changes in upper limb and hand patterns in patients with cerebral palsy, particularly those with dyskinesia.
评估先前开发的两种上肢和手部模式分类方法在评估者间和评估者内的可靠性。
来自两个不同康复中心的18名检查者以及一名参与分类设计的专家查看了212例脑瘫患者的影像资料（118例上肢姿势影像和94例手部动作影像；中位年龄14岁，3 - 46岁）。他们对上肢（3种模式及亚型）和手部模式（2种模式及亚型）进行了两次分类，间隔2个月。分析了评估者间和评估者内的可靠性。
上肢和手部模式的评估者内及评估者间可靠性非常高（0.87 < k < 0.92），亚型的可靠性较高（0.58 < k < 0.68）。检查者表示这两种分类方法在临床实践中均有用且可行。
尽管对分类方法的使用仅进行了一次简短培训，但检查者与专家检查者之间的一致性良好到高度一致，证实了这些分类方法易于使用且可靠。此处提出的分类方法提供了统一的术语，可用于临床实践和研究，以描述、评估和随访脑瘫患者，尤其是运动障碍患者上肢和手部模式的变化。
