Contesse Marielle G, Hodges Jason, Staunton Hannah, Lowes Linda P, Elmankabadi Bassem, Elder Sonya J, Ormazabal Maitea Guridi, Dalle Pazze Laura, Leffler Mindy G
Casimir, Kingston, Massachusetts, USA.
Roche Products Limited, Welwyn Garden City, UK.
Physiother Res Int. 2023 Jan 30:e1993. doi: 10.1002/pri.1993.
Patients with Duchenne muscular dystrophy (DMD) change their movement patterns to compensate for muscle weakness. The Duchenne Video Assessment (DVA) measures ease of movement through evaluation of compensatory movements. The DVA directs caregivers to video record patients performing home-based movement tasks using a mobile application, and DVA-certified physical therapists evaluate the videos using scorecards with prespecified compensatory movement criteria. Two qualitative interview studies were conducted to select movement tasks for the DVA that are relevant to patients with DMD and able to reflect changes in function.
Qualitative interviews with eligible physical therapists were conducted remotely. Physical therapists were asked to spontaneously suggest movement tasks prior to evaluating specific movement tasks selected a priori. Analysts conducted a content analysis to investigate whether movement tasks selected a priori were confirmed as relevant to the population of interest and able to show changes in function.
The studies included five physical therapists to select tasks for ambulatory patients with DMD and six for non-ambulatory patients. For an ambulatory population, all five experts confirmed Climb Five Stairs, Run, Stand Up from Sitting, Sit Up from Supine, and Jump Forward, and four (80%) confirmed Walk as relevant and able to show functional changes. For a non-ambulatory population, all six experts confirmed Eat 10 Bites, Roll Over in Bed, Shift Weight in Bed, Take T-Shirt Off, Put T-Shirt On, Put Arms on Armrest, and Reach Across Table to Grab Cell Phone, and five (83%) confirmed Raise Hands Above Head as relevant and able to show functional changes.
Physical therapists confirmed the DVA movement tasks as relevant to patients with DMD and able to reflect changes in function. The use of the DVA in clinical trials provides an opportunity to collect data not seen in clinic and reduce travel burden for families.
杜氏肌营养不良症（DMD）患者会改变其运动模式以代偿肌肉无力。杜氏视频评估（DVA）通过评估代偿性运动来衡量运动的难易程度。DVA指导护理人员使用移动应用程序对患者在家中执行的运动任务进行视频记录，并且经DVA认证的物理治疗师使用具有预先指定的代偿性运动标准的记分卡对视频进行评估。进行了两项定性访谈研究，以选择与DMD患者相关且能够反映功能变化的DVA运动任务。
对符合条件的物理治疗师进行远程定性访谈。在评估预先选定的特定运动任务之前，要求物理治疗师自发提出运动任务。分析人员进行了内容分析，以调查预先选定的运动任务是否被确认为与目标人群相关且能够显示功能变化。
研究纳入了五名物理治疗师为能够行走的DMD患者选择任务，六名物理治疗师为不能行走的患者选择任务。对于能够行走的人群，所有五名专家都确认“爬五级楼梯”“跑步”“从坐姿站起”“从仰卧位坐起”和“向前跳跃”与目标人群相关且能够显示功能变化，四名（80%）专家确认“行走”符合要求。对于不能行走的人群，所有六名专家都确认“吃十口食物”“在床上翻身”“在床上转移身体重量”“脱掉T恤”“穿上T恤”“将手臂放在扶手上”和“伸手越过桌子拿手机”与目标人群相关且能够显示功能变化，五名（83%）专家确认“将手举过头顶”符合要求。
物理治疗师确认DVA运动任务与DMD患者相关且能够反映功能变化。在临床试验中使用DVA提供了一个收集在诊所中看不到的数据并减轻家庭出行负担的机会。
