Balzer Julia, Fahr Annina, Keller Jeffrey W, van der Linden Marietta L, Mercer Thomas H, van Hedel Hubertus J A
Swiss Children's Rehab, University Children's Hospital Zurich, Zurich, Switzerland.
Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, United Kingdom.
Clin Neurophysiol Pract. 2022 Mar 17;7:107-114. doi: 10.1016/j.cnp.2022.03.003. eCollection 2022.
To quantify selective voluntary motor control (SVMC) objectively and more precisely, we combined the "Selective Control Assessment of the Lower Extremity" (SCALE) with surface electromyography. The resulting Similarity Index (SI) measures the similarity of muscle activation patterns. This study evaluated the preliminary validity and reliability of this novel SI measure in children with cerebral palsy (CP).
We investigated concurrent validity by correlating the SI of 24 children with CP (median age 10.6 years) with comparator assessments. For discriminative validity, the patients' SI scores were compared to 31 neurologically intact age-matched peers. Test-retest reliability was quantified using intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values.
The SI correlated strongly with the SCALE (ρ = 0.90, p < .001) and the Gross Motor Function Classification System (ρ = -0.74, p < .001). SI scores were significantly lower in children with CP compared to healthy peers. Test-retest reliability appeared good (for the more and less affected leg, ICC ≥ 0.84, and MDC ≤ 0.17).
Validity and reliability of the SI leg and total scores lay within clinically acceptable ranges. Further clinimetric analyses should include responsiveness.
A neurophysiology-based assessment could contribute to a more refined assessment of SVMC impairments.
为了更客观、精确地量化选择性自主运动控制（SVMC），我们将“下肢选择性控制评估”（SCALE）与表面肌电图相结合。由此产生的相似性指数（SI）可测量肌肉激活模式的相似性。本研究评估了这种新型SI测量方法在脑瘫（CP）儿童中的初步有效性和可靠性。
我们通过将24例CP儿童（中位年龄10.6岁）的SI与对照评估进行相关性分析，来研究同时效度。为了评估区分效度，将患者的SI分数与31名年龄匹配的神经功能正常的同龄人进行比较。使用组内相关系数（ICC）和最小可检测变化（MDC）值来量化重测信度。
SI与SCALE（ρ = 0.90，p <.001）和粗大运动功能分类系统（ρ = -0.74，p <.001）密切相关。与健康同龄人相比，CP儿童的SI分数显著更低。重测信度似乎良好（对于受累程度较高和较低的腿，ICC≥0.84，MDC≤0.17）。
SI腿部和总分的有效性和可靠性处于临床可接受范围内。进一步的临床计量学分析应包括反应性。
基于神经生理学的评估可能有助于更精确地评估SVMC损伤。
