欢迎访问《中国循证儿科杂志》官方网站，今天是
English Version
中国循证儿科杂志

中国循证儿科杂志 ›› 2017, Vol. 12 ›› Issue (4): 246-250.

• 论著 • 上一篇    下一篇

中文版北极星移动评价量表在Duchenne型肌营养不良症患儿的信度和效度研究

史惟1,3）,李惠1,3）,李西华2）,苏怡1）,赵蕾2）,陆恺1）,胡晓平2）,翟淳1）,周水珍2）   

  1. 复旦大学附属儿科医院上海，201102；1）康复中心，2）神经科，3）共同第一作者
  • 收稿日期:2017-07-21 修回日期:2017-08-11 出版日期:2017-08-25 发布日期:2017-08-25
  • 通讯作者: 史惟

Reliability and validity of the Chinese version of North Star Ambulatory Assessment for children with Duchenne muscular dystrophy

SHI Wei1,3), LI Hui1, 3), LI Xi-huan2), SU Yi1), ZHAO Lei2), LU Kai1), HU Xiao-ping2), ZHAI Chun1), ZHOU Shui-zhen2)   

  1. Children's Hospital of Fudan University, Shanghai 201102,China; 1) Rehabilitation Center, 2) Department of Neurology, 3) Co-first author
  • Received:2017-07-21 Revised:2017-08-11 Online:2017-08-25 Published:2017-08-25
  • Contact: SHI Wei

PDF

1427

摘要：

目的：确定中文版北极星移动评价量表（NSAA）应用在Duchenne型肌营养不良症（DMD）患儿的信度和效度。方法：纳入对象为2014年1月至2016年1月在复旦大学附属儿科医院康复科接受功能评估的DMD患儿，均经基因检测或肌肉活检明确诊断，能独立行走≥10 m，无严重认知障碍。2名物理治疗师同时对DMD患儿进行测试，检验不同测试者间的信度；同一评价者在第1次评价后3~7 d进行第2次评价，检测重测信度；采用《国际功能、残疾和健康分类》儿童和青少年版（ICF-CY）的类目编码与NSAA的项目概念进行关联，确定NSAA的内容效度；通过分析NSAA的分值与6 min步行距离的相关性进行关联效度分析。结果：2个治疗师对20名DMD男孩的不同测试结果间的信度分析显示，NSAA原始分和线性分信度ICC分别为0.96和0.97；1名治疗师前后3～7 d重测16名DMD男孩，NSAA的原始分和线性分具有很好的重测信度（ICC=0.96）；NSAA17个项目共与8个ICF-CY编码发生了20次关联，8个编码都属于d4（移动）下属，表明NSAA的评价内容主要聚焦于DMD患儿活动能力中的移动能力；143例DMD男孩的NSAA原始分和线性分与6min步行距离具有中等程度的相关性（r分别为0.40和0.38）。结论：中文版NSAA量表无论是原始分还是线性分都具有良好的心理测量学特性，结合其他的评价指标，NSAA可以有效地评价中国DMD男孩的活动能力。

Abstract:

Objective: To determine the reliability and validity of North Star Ambulatory Assessment (NSAA).Methods: Inclusion criteria: Children diagnosed by gene detection or muscle biopsy as DMD and accepted functional assessment in Childeren's Hospital of Fudan University from January 2014 to January 2016,being able to walk more than ten meters independently,and in addition ,without severe cognitive retardation were recruited. Twenty patients were scored by two different physical therapeutists at the same time to detect inter-rater reliability. Sixteen patients were scored the second time 3-7 days after the first assessment by the same physical therapeutist to detect test-retest reliability.Relate ageneral category encording way of International Classification of Functioning，Disability and Health-Child and Youth version(ICF-CY) and project concept of NSAA were used to determine content validity of NSAA. Criterion related validity analysis was performed by analyzing the correlation between NSAA scores of 143 children and 6 minutes walking distance(6MWT).Results: The reliability analysis of the different test results of two therapists on twenty children showed that the NSAA raw scores and linear scores had excellent inter-rater reliability（ICC=0.96，0.97）; 16 boys were assessed by the same therapeutist twice with an interval of 3~7 days and the results showed that raw and linear scores of NSAA had great test-retest reliability（ICC=0.96）;Twenty linkages were made between seventeen items of NSAA and eight codes of ICY-CY,all of the eight codes belonged to d4(mobility), which meant that contents of NSAA evaluation mainly focused on mobility of DMD patients.The NSAA raw scores and linear scores of all 143 boys and 6MWT, had a fair degree of relationship between the two measures(r=0.40 and r=0.38).Conclusion: Chinese version of NSAA has good psychometric properties in test-retest reliability and inter-rater reliability in both raw and linear scores. Combined with other measurements, NSAA may effectively evaluate the activity of the patients with DMD in China.