背景:描述伸手运动模式质量的有效且可靠的评估工具可以为MS(pwMS)患者的运动表现缺陷提供有价值的见解。达到性能规模,为中风开发的,是评估pwMS运动模式的一个有前途的量表。然而,pwMS缺乏量表的心理测量特性。
目标:首先,探讨改良的达人表现量表在MS患者(mRPS)中应用的内容效度。其次,研究pwMSmRPS的心理测量特性(会话内和会话间的信度和并发效度)。
方法:45pwMS(平均EDSS6.6pt,IQR6-7.5)执行了mRPS,该mRPS对动作模式和补偿的质量进行了评估,以掌握任务。内容有效性由专家小组基于对进行RPS的受试者的观察来确定。可靠性是基于一天内的五次重复,两天之间。对于并发有效性,国际功能分类两个级别的结局指标与mRPS相关:身体结构和功能水平:上肢Fugl-Meyer评估(FMA-UL),最大等距手部握力(HGS;活动水平:动作研究手臂测试(ARAT),盒和块测试(BBT),九孔钉测试(NHPT)和躯干损伤量表2.0(TIS2.0)以及手动能力测量36(MAM-36)的感知表现。
结果:仅对躯干位移子量表的评分进行了量表修改。mRPS在会话内可靠性方面具有出色的一致性得分(Kappa范围在0.85和0.98之间),在会话间可靠性方面具有中等至出色的一致性得分(K:0.66-1.00)。关于有效性,mRPS与ARAT高度相关(rho=0.74,p<0.001),其次是与树干性能的中等相关性(TIS2.0,Rho=0.61,p<0.001),手功能(BBT:rho=0.64,p<0.001;NHPT:rho=-0.61,p<0.001)和感知性能(MAM36rho=0.53,p<0.001)。
结论:mRPS是一种可靠的测量工具,用于描述在pwMS中到达时使用的运动模式质量和运动补偿。关于并发有效性,mRPS与上肢和躯干表现的其他指标部分相关。
BACKGROUND: A valid and reliable assessment tool to describe the quality of the movement pattern of
reaching can provide valuable insights into motor performance deficits in persons with MS (pwMS). The
Reaching Performance Scale, developed for stroke, is a promising scale to assess movement patterns in pwMS. However, psychometric properties of the scale are lacking in pwMS.
OBJECTIVE: Firstly, to investigate the content validity of the modified
Reaching Performance Scale for application in patients with MS (mRPS). Secondly, to investigate the psychometric properties (within- and between-session reliability and concurrent validity) of the mRPS for pwMS.
METHODS: Forty-five pwMS (mean EDSS 6.6 pt, IQR 6-7.5) executed the mRPS that rates the quality of movement patterns and compensations during reach to grasp tasks. The content validity was determined by an expert panel based on observations of subjects performing the RPS. The reliability was based on five repetitions within one day, and between two days. For the concurrent validity, outcome measures at two levels of the International Classification of Functioning were correlated with the mRPS: Body Structure and Function level: Fugl-Meyer Assessment of the Upper Limb (FMA-UL), maximal isometric hand grip strength (HGS; Activity level: Action Research Arm Test (ARAT), Box and Blocks Test (BBT), Nine Hole Peg Test (NHPT) and Trunk Impairment Scale 2.0 (TIS 2.0) as well as perceived performance by the Manual Ability Measure-36 (MAM-36).
RESULTS: Scale modifications were made only on the ratings of the trunk displacement subscale. The mRPS had excellent agreement scores for within-session reliability (range of Kappa between 0.85 and 0.98) and moderate-to-excellent agreement scores for between-session reliability (K: 0.66-1.00). Regarding validity, the mRPS was highly correlated with the ARAT (rho=0.74, p < 0.001), followed by moderate correlations with trunk performance (TIS 2.0, rho= 0.61, p < 0.001), hand function (BBT: rho=0.64, p < 0.001; NHPT: rho=-0.61, p < 0.001) and perceived performance (MAM36 rho= 0.53, p < 0.001).
CONCLUSIONS: The mRPS is a reliable measurement tool to describe the movement pattern quality and motor compensations used during
reaching in pwMS. Concerning concurrent validity, the mRPS is partially related to other measures of upper limb and trunk performance.