Sarabia José M, Roldan Alba, Henríquez Matías, Reina Raul
Sport Research Centre, Department of Sports Sciences, Miguel Hernández University, 03202 Elche, Spain.
Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain.
Int J Environ Res Public Health. 2021 Apr 19;18(8):4320. doi: 10.3390/ijerph18084320.
This study aimed (1) to determine the appropriateness of using decision trees as a classification tool for determining the allocation of sport classes of para-footballers with "moderate vs. mild" cerebral palsy (CP) profiles of spastic diplegia/hemiplegia and ataxia/athetosis based on observational outcomes by international classifiers, and (2) to identify what key observational features were relevant to discriminating among different impairment levels. A sample of 16 experienced international classifiers from five world regions participated in this study, observing activity limitation of a final sample of 21 international CP footballers when performing 16 gross-motor and sports-specific tests for balance ( = 3), coordination ( = 5), running, accelerations and decelerations ( = 3), jumping ( = 4), and change of direction ability ( = 1). For the overall sample (336 observations), the model included eight decision nodes and 24 branches with 17 leaves, including side-step, side-stepping, and triple hop as the tests with the best sensitivity (precision = 67.0%). For those with spastic diplegia (64 observations: Two nodes, six branches with five leaves), the range of motion in the side-step test and the balance in the tandem walk tests correctly classified 89.1% of the observations. In those with athetosis and ataxia (96 observations), the model included five nodes, 15 branches, and 11 leaves (176 observations, precision = 86.5%). For those with spastic hemiplegia, a model containing two nodes, six branches, and five leaves had 90.9% accuracy, including observational features of balance in the side-step test and symmetry in the side-stepping test. The observational tool used in this study, based on the impact of specific impairment measurements of hypertonia, athetosis, and ataxia, can be used to determine which assessments are more appropriate for discriminating between functional profiles in para-footballers with CP.
（1）确定使用决策树作为分类工具的适当性，该工具用于根据国际分级员的观察结果，确定患有痉挛性双侧瘫/偏瘫以及共济失调/手足徐动症的“中度与轻度”脑瘫（CP）的脑瘫足球运动员的运动类别分配；（2）确定哪些关键观察特征与区分不同损伤水平相关。来自五个世界地区的16名经验丰富的国际分级员参与了本研究，他们在21名国际脑瘫足球运动员进行16项用于评估平衡（=3）、协调（=5）、跑步、加速和减速（=3）、跳跃（=4）以及变向能力（=1）的大肌肉运动和特定运动测试时，观察其活动受限情况。对于总体样本（336次观察），该模型包括8个决策节点、24个分支和17个叶节点，其中侧步、侧步走和三级跳作为敏感性最佳的测试（精确率=67.0%）。对于患有痉挛性双侧瘫的患者（64次观察：2个节点、6个分支和5个叶节点），侧步测试中的运动范围和串联行走测试中的平衡正确分类了89.1%的观察结果。对于患有手足徐动症和共济失调的患者（96次观察），该模型包括5个节点、15个分支和11个叶节点（176次观察，精确率=86.5%）。对于患有痉挛性偏瘫的患者，一个包含2个节点、6个分支和5个叶节点的模型准确率为90.9%，包括侧步测试中的平衡观察特征和侧步走测试中的对称性。本研究中使用的观察工具，基于张力亢进、手足徐动症和共济失调的特定损伤测量的影响，可用于确定哪些评估更适合区分患有脑瘫的脑瘫足球运动员的功能概况。
