改良Ashworth量表与改良Tardieu量表在痉挛型脑瘫患儿评定中的信度.pdfVIP

ChineseJournalofRehabilitationMedicine, Jan.2015,Vol. 30, No.1 ·临床研究· 改良Ashworth量表与改良Tardieu量表在 痉挛型脑瘫患儿评定中的信度研究* 1,2 2 2 2,3 严晓华 何 璐 郑 韵 徐开寿 摘要 目的：检验改良Ashworth 量表（MAS ）与改良Tardieu 量表（MTS ）评定脑瘫（CP ）儿童肢体痉挛时评定者间的信度。 方法：共收集20 例痉挛型脑瘫患儿，其中8 例为偏瘫型脑瘫，12例为双瘫型脑瘫，30 个痉挛下肢，分别由两名治疗师 使用MAS 与MTS 对患儿患侧下肢痉挛的腘绳肌、踝跖屈肌群进行测量，以检验MAS 与MTS 的评定者间的信度。 结果：MAS 在腘绳肌和踝跖屈肌群的评定者间信度较低（kappa 值为0.379—0.436 ）；而MTS 的肌肉反应特性X 评定 者间信度较好（kappa 值为0.653—0.829）；而各角度测量的评定者间信度的ICC 值（除腘绳肌R -R 外）均大于0.75 ， 2 1 且在95%置信区间集中（P ＜0.001 ）。 结论：MTS 在脑瘫下肢的应用信度较好，能较好地反映肌肉痉挛情况，有较好的临床价值，而MAS 量表在痉挛型脑 瘫儿童下肢肢体痉挛评定的信度较低，临床中应用于疗效评定时需谨慎。 关键词 改良Tardieu 量表；改良Ashworth 量表；信度；痉挛；脑瘫 中图分类号：R742.3,R722 文献标识码：A 文章编号：1001-1242（2015 ）-01-0018-04 Inter-rater reliability of modified Ashworth scale and modified Tardieu scale in children with spastic ce⁃ rebral palsy/YAN Xiaohua,HE Lu,ZHENG Yun, et al.//Chinese Journal of Rehabilitation Medicine, 2015, 30(1):18—21 Abstract Objective:To examine the inter- rater reliability of modified Ashworth scale(MAS) and modified Tardieu scale (MTS) for children with spastic cerebral palsy(CP). Method:Twenty children with spastic CP (8 hemiplegia, 12 diplegia, in total 30 spastic lower extremities) were included in this study. Two scales were applied to assess the spastic hamstring and ankle plantar flexors of each child by two trained therapists to examine the reliability of scales. Result:The inter- rater reliability of MAS was poor to moderate and the kappa value were between 0.379— 0.436, while the kappa value was of the quality of muscle reaction(X) of MTS were between 0.653—0.829. In angle measurement of MTS, the ICC value was reached the