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脑瘫儿童上肢选择性控制测试的有效性和可靠性:一项前瞻性横断面研究。

The validity and reliability of the Test of Arm Selective Control for children with cerebral palsy: a prospective cross-sectional study.

机构信息

Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

Dev Med Child Neurol. 2018 Apr;60(4):374-381. doi: 10.1111/dmcn.13671. Epub 2018 Jan 31.

Abstract

AIM

This study examined the reliability and validity of the Test of Arm Selective Control (TASC) to examine upper extremity selective voluntary motor control in children and adolescents with all types of spastic cerebral palsy (CP).

METHOD

Fifty-six participants with CP, ranging in age from 5 years 9 months to 18 years 11 months (average 11y 7mo, SD 3y 9mo; 25 males, 31 females), participated in this prospective cross-sectional study. They were evaluated using the TASC and several clinical measures.

RESULTS

TASC and Manual Ability Classification System (r=-0.529, p<0.001), TASC and ABILHAND-Kids (r=0.596, p<0.001), and TASC and affected extremities (r=-0.486, p=0.001) were moderately correlated. There was a weak correlation between the TASC and Gross Motor Function Classification System (r=-0.363, p=0.006) and no correlation between the TASC and age (p=0.366) or rater (p=0.713). Interrater reliability for upper extremity total score (intraclass correlation coefficient [ICC]=0.92-0.94) and upper extremity limb scores (ICC=0.92-0.96) was high for two independent rater groups (p≤0.001). Average time to administer was 16 minutes, 18 seconds.

INTERPRETATION

The TASC is a reliable and valid tool for objective assessment of selective voluntary motor control. Clinically this measure may guide the selection of medical, surgical, or therapy interventions and may improve outcome prognosis.

WHAT THIS PAPER ADDS

The Test of Arm Selective Control (TASC) demonstrates a high degree of reliability and multiple aspects of validity when assessing upper extremity selective control in those with cerebral palsy. The TASC is an upper limb companion to the Selective Control Assessment of the Lower Extremity.

摘要

目的

本研究旨在检验选择性上肢运动控制测试(Test of Arm Selective Control,TASC)的信度和效度,以评估各种痉挛型脑瘫儿童和青少年的上肢选择性随意运动控制能力。

方法

本前瞻性病例交叉研究共纳入 56 名脑瘫患儿,年龄 5 岁 9 个月至 18 岁 11 个月(平均 11 岁 7 个月,标准差 3 岁 9 个月;男性 25 名,女性 31 名)。他们接受了 TASC 和几种临床评估。

结果

TASC 与 Manual Ability Classification System(r=-0.529,p<0.001)、TASC 与 ABILHAND-Kids(r=0.596,p<0.001)和 TASC 与患侧肢体(r=-0.486,p=0.001)均呈中度相关。TASC 与 Gross Motor Function Classification System(r=-0.363,p=0.006)呈弱相关,与年龄(p=0.366)或评估者(p=0.713)无相关性。两组独立评估者的上肢总分(组内相关系数 [ICC]=0.92-0.94)和上肢肢体评分(ICC=0.92-0.96)的复测信度均较高(p≤0.001)。平均执行时间为 16 分 18 秒。

结论

TASC 是一种可靠且有效的工具,可用于客观评估选择性随意运动控制。临床上,该评估方法可能有助于选择医疗、手术或治疗干预措施,并改善预后。

本研究的重要意义

选择性上肢运动控制测试(TASC)在评估脑瘫患者上肢选择性控制能力时具有较高的信度和多方面的效度。TASC 是选择性下肢运动控制评估的上肢配套评估工具。

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