Litvan I, Mangone C A, Werden W, Bueri J A, Estol C J, Garcea D O, Rey R C, Sica R E, Hallett M, Bartko J J
Neuroepidemiology Branch, NINDS, NIH, Bethesda, MD 20814-3559, USA.
Neurology. 1996 Oct;47(4):969-72. doi: 10.1212/wnl.47.4.969.
The assessment of deep tendon reflexes is useful for localization and diagnosis of neurologic disorders, but only a few studies have evaluated their reliability. We assessed the reliability of four neurologists, instructed in two different countries, in using the National Institute of Neurological Disorders and Stroke (NINDS) Myotatic Reflex Scale. To evaluate the role of training in using the scale, the neurologists randomly and blindly evaluated a total of 80 patients, 40 before and 40 after a training session. Inter- and intraobserver reliability were measured with kappa statistics. Our results showed substantial to near-perfect intraobserver reliability, and moderate-to-substantial interobserver reliability of the NINDS Myotatic Reflex Scale. The reproducibility was better for reflexes in the lower than in the upper extremities. Neither educational background nor the training session influenced the reliability of our results. The NINDS Myotatic Reflex Scale has sufficient reliability to be adopted as a universal scale.
对深部腱反射的评估有助于神经系统疾病的定位和诊断，但仅有少数研究评估了其可靠性。我们评估了在两个不同国家接受培训的四位神经科医生使用美国国立神经疾病与中风研究所（NINDS）肌伸张反射量表的可靠性。为了评估培训在使用该量表中的作用，这些神经科医生随机且盲法评估了总共80例患者，其中40例在培训课程之前评估，40例在培训课程之后评估。采用kappa统计量测量观察者间和观察者内的可靠性。我们的结果显示，NINDS肌伸张反射量表的观察者内可靠性为高度至近乎完美，观察者间可靠性为中度至高度。下肢反射的可重复性优于上肢。教育背景和培训课程均未影响我们结果的可靠性。NINDS肌伸张反射量表具有足够的可靠性，可作为通用量表采用。
