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中国循证儿科杂志

中国循证儿科杂志 ›› 2018, Vol. 13 ›› Issue (1): 35-39.

• 论著 • 上一篇    下一篇

复旦中文版神经肌肉疾病运动功能评估量表在儿童和青少年中的信度和效度研究

史惟1)，李惠1)，李西华2)，翟淳1)，赵蕾2)，陆恺1)，胡超平2)，周水珍2)#br#   

  1. 复旦大学附属儿科医院 上海，201102；1) 康复中心；2) 神经科
  • 收稿日期:2018-01-29 修回日期:2018-02-25 出版日期:2018-02-25 发布日期:2018-02-25
  • 通讯作者: 史惟

Reliability and validity of Fudan Chinese version of Motor Function Measure for young children with neuromuscular diseases

SHI Wei1)，LI Hui1)， LI Xi-hua2)， ZHAI Chun1)， ZHAO Lei2)， LU Kai1)，HU Chao-ping2)， ZHOU Shui-zhen2)   

  1. Children's Hospital of Fudan University, Shanghai 201102,China; 1) Rehabilitation Center; 2) Department of Neurology
  • Received:2018-01-29 Revised:2018-02-25 Online:2018-02-25 Published:2018-02-25
  • Contact: SHI Wei

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摘要： 目的：验证复旦中文版神经肌肉疾病（NMD）运动功能评估量表（MFM）在中国儿童和青少年NMD中的信度和效度。 方法：2013年6月至2017年7月在复旦大学附属儿科医院（我院）神经科经基因检测或肌肉活检明确诊断为各类NMD、＞2岁且在我院康复科接受过复旦中文版MFM20和MFM32评估的患儿，排除1年内接受过手术、具有严重认知障碍和测试前3 d内从事过严重影响体力的活动患儿。2名物理治疗师同时进行MFM20和MFM32测试，检验不同测试者间的信度；同一评价者在第1次评价后间隔3~7d进行第2次评价，检测重测信度；以6 min步行距离（6MWT）和4项功能性计时测试为效度指标；通过分析MFM分值与之的相关性确定关联效度。通过分析纳入对象中杜氏进行性肌营养不良（DMD）患儿的MFM分值与北极星移动量表（NSAA）分值之间的相关性确定关联效度。 结果：372例患儿符合本文纳入排除标准，平均（6.5±2.7）岁，<7岁222例，男性338例，其中DMD 263例，重测信度（2~7岁16例，>7岁38例）和测试者间信度（2~7岁16例，＞7岁29例）检测结果显示，MFM32和MFM20的总分和各分区分值ICC=0.89~0.97。基于372例患儿，MFM32和MFM20的总分和D1区分值与6MWT和功能性计时测试结果具有中等和较强的相关性（r=0.48~0.73），与D2和D3分区的分值相关性为中等和较弱。在263例DMD患儿中，MFM32和MFM20的总分和D1区分值与NSAA分值的相关性为强和极强相关性。 结论：复旦中文版MFM量表在儿童和青少年NMD患儿中具有很好的信度和效度，可以有效地测定NMD患儿的运动功能状态。

Abstract: Objective：To determine the reliability and validity of Fudan Chinese version of Motor Function Measure for young children with neuromuscular diseases(NMD). Methods：Inclusion criteria: Children diagnosed as all kinds of NMD aged above 2 years old by detecting genes or muscle biopsy in Department of Neurology of Children's Hospital of Fudan University and accepted Fudan Chinese version of Motor Function Measure in Rehabilitation Department from June 2013 to July 2017. Exclusion criteria: Children who had accepted surgical operation within 1 year; children with severe cognition impairments; children who had taken part in activities severely affecting physical strength before the measurement. To determine the reliability of interraters, 2 physical therapists conducted MFM20 and MFM32 at the same time. To determine the retest reliability, the same rater evaluated the test for a second time at the interval of 3 to 7 d after the first evaluation. The 6 minute walk distance Test (6 MWT) and 4 timed function test were the validity index. By analyzing the correlation between the MFM score and 6 MWT or 4 timed function test, the correlation validity was determined. By analyzing the correlation between the MFM score and North Star Ambulatory Assessment (NSAA) score of children with Duchenne muscular dystrophy (DMD) including objects,the correlation validity was determined. Results：A total of 372 cases were included in this study, with average age of (6.5±2.7) years. Among them, 222 cases were <7 years, 338 were males, and 263 were diagnosed with DMD. Sixteen cases aged 2 to 7 years were tested for the retest validity, while 16 cases aged 2 to 7 years and 29 cases aged above 7 years were tested for the interraters validity. The results indicated that of the total scores of MFM32, MFM20 and the subscore of each domain, ICC was 0.89 to 0.97. There were moderate and strong correlation between the total scores of MFM32, MFM20 and D1 domain subscore , the result of 6 MWT and timed function test of all the children (r=0.48 to 0.73), with D2 and D3 domains subscores, the correlation was moderate and weak. For children with DMD, the correlation of the total scores of MFM32 and MFM20 and the subscore of D1 domain and NSAA was strong and great. Conclusion：Fudan Chinese version of Motor Function Measure indicates satisfactory reliability and validity for young children with NMD , and thus it could be used to test the status of motor function in children with NMD reliably and effectively.