REVAL - Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.
Phys Ther. 2022 Oct 6;102(10). doi: 10.1093/ptj/pzac088.
The purpose of this study was to investigate the test-retest reliability, measurement error, and interpretability of new motor fatigability outcomes of grip and pinch strength for children with unilateral cerebral palsy (UCP).
Motor fatigability during grip and pinch strength was measured twice (within 48 hours) in both hands of 50 children (mean age = 11 years 2 months; 14, 31, and 5 children with Manual Ability Classification System levels I, II, and III, respectively) using a 30-second static and dynamic maximum exertion protocol. For static motor fatigability, the Static Fatigue Index (SFI) and mean force (Fmean) in the first (Fmean1) and last (Fmean3) 10 seconds were calculated. For dynamic motor fatigability, Fmean1, Fmean3, and the number of peaks in the first and last 10 seconds were calculated.
For static motor fatigability, the intraclass correlation coefficients (ICCs) were moderate to high for Fmean1 and Fmean3 (0.56-0.88), and the SFI showed low to moderate reliability (ICC = 0.32-0.72). For dynamic motor fatigability, the ICCs were moderate to high for all outcomes (0.54-0.91). The standard error of measurement agreement and the smallest detectable difference agreement were large in all outcomes, except for the SFI in static motor fatigability. Details per age group are provided. In general, younger children (6-11 years old) showed lower reliability than older children (12-18 years old).
Most outcome measures for static and dynamic motor fatigability of grip and pinch strength show moderate to high reliability in children with UCP, indicating that these tests can be used reliably to investigate the presence of motor fatigability in UCP, especially in older children. Standard error of measurement agreement and smallest detectable difference agreement indicated that these outcome measures should be interpreted with caution when evaluating change.
Most of the proposed outcome measures for static and dynamic motor fatigability of grip and pinch are reliable in children with UCP and can be used for discriminative purposes.
本研究旨在探讨新的握力和捏力运动疲劳测试结果在单侧脑瘫（UCP）儿童中的重测信度、测量误差和可解释性。
本研究使用 30 秒静态和动态最大用力方案，在 50 名儿童（平均年龄 11 岁 2 个月；分别有 14、31 和 5 名儿童的手动能力分类系统水平为 I、II 和 III）的双手上，两次（48 小时内）测量握力和捏力的运动疲劳度。对于静态运动疲劳度，计算静态疲劳指数（SFI）和前 10 秒（Fmean1）和后 10 秒（Fmean3）的平均力（Fmean）。对于动态运动疲劳度，计算 Fmean1、Fmean3 和前 10 秒和后 10 秒的峰值数。
对于静态运动疲劳度，Fmean1 和 Fmean3 的组内相关系数（ICC）为中度到高度（0.56-0.88），SFI 的可靠性为低到中度（ICC=0.32-0.72）。对于动态运动疲劳度，所有结果的 ICC 均为中度到高度（0.54-0.91）。除了静态运动疲劳度的 SFI 外，所有结果的测量误差标准和最小可检测差异协议都较大。每个年龄组的详细信息都有提供。一般来说，年龄较小的儿童（6-11 岁）的可靠性低于年龄较大的儿童（12-18 岁）。
在 UCP 儿童中，握力和捏力的静态和动态运动疲劳的大多数测试结果都具有中度到高度的可靠性，这表明这些测试可用于可靠地研究 UCP 中运动疲劳的存在，尤其是在年龄较大的儿童中。测量误差标准和最小可检测差异协议表明，在评估变化时，应谨慎解释这些测试结果。
握力和捏力的静态和动态运动疲劳的大多数建议测试结果在 UCP 儿童中具有可靠性，可用于区分目的。
