CAJ | 학술논문

目的探讨手持式电子肌力测定仪在痉挛型脑瘫儿童下肢肌力测定中的信度.方法以2009年2月至11月在复旦大学附属儿科医院康复中心接受康复治疗的28例3岁以上的痉挛型脑瘫患儿为研究对象,采用手持式肌力测定仪(HHD)标准化操作方法测定患儿下肢髋、膝、踝等部位肌群的肌力,任意选取20例患儿在接受第1次HHD测定后休息10 min,再由同一测试者进行重复测试,通过比较前后测试结果间的相关性来确定HHD的重测信度;在非同一天任意选取15例患儿在接受第1次HHD测定后休息10 min,再由不同测试者进行重复测试,通过比较前后测试结果间的相关性来确定HHD的不同测试者间信度.结果 HHD在测定痉挛型脑瘫患儿下肢肌群时有良好的重测信度(ICC值在0.74～0.97之间)和不同测试者间信度(ICC值在0.63～0.97之间),其中髋屈曲、足跖屈和膝伸展肌群的重测信度最高(ICC值在0.94～0.97之间),髋屈曲、足背屈的不同测试者间信度最高(ICC值在0.90～0.97之间).结论采用标准化的测试方法,手持式电子肌力测定仪在痉挛型脑瘫儿童下肢肌力测定中具有良好的重测信度和不同测试者间信度,可以良好地评价脑瘫患儿的下肢肌力.
목적 탐토수지식전자기력측정의재경련형뇌탄인동하지기력측정중적신도.방법 이2009년2월지11월재복단대학부속인과의원강복중심접수강복치료적28례3세이상적경련형뇌탄환인위연구대상,채용수지식기력측정의(HHD)표준화조작방법측정환인하지관、슬、과등부위기군적기력,임의선취20례환인재접수제1차HHD측정후휴식10 min,재유동일측시자진행중복측시,통과비교전후측시결과간적상관성래학정HHD적중측신도;재비동일천임의선취15례환인재접수제1차HHD측정후휴식10 min,재유불동측시자진행중복측시,통과비교전후측시결과간적상관성래학정HHD적불동측시자간신도.결과 HHD재측정경련형뇌탄환인하지기군시유량호적중측신도(ICC치재0.74～0.97지간)화불동측시자간신도(ICC치재0.63～0.97지간),기중관굴곡、족척굴화슬신전기군적중측신도최고(ICC치재0.94～0.97지간),관굴곡、족배굴적불동측시자간신도최고(ICC치재0.90～0.97지간).결론 채용표준화적측시방법,수지식전자기력측정의재경련형뇌탄인동하지기력측정중구유량호적중측신도화불동측시자간신도,가이량호지평개뇌탄환인적하지기력.
Objective To determine the reliability of hand-held electronic dynamometer (HHD) tests for lower limb muscle strength measurement in children with spastic cerebral palsy (CP). Methods Twenty-eight children ( 15 boys and 13 girls; mean age 5 years 8 months) with different types of CP (2 with spastic quadriplegia,8 spastic diplegia, 6 hemiplegia, 1 triplegia and 1 monoplegia) , and at different functional levels ( 19 graded at gross motor function classification system level Ⅰ, 6 level Ⅱ, 2 level Ⅲ and 1 level Ⅳ ) were recruited from the Rehabilitation Center of the Children's Hospital of Fudan University. Standardized HHD protocols were used to measure the strength of their hip, knee and ankle muscles. The HHD test was performed by the same examiner twice with an interval of 10 min in between. The HDD test was also performed with 15 randomly selected CP children by 2 examiners with an interval of 10 min in between. The test-retest and inter-rater reliabilities of the HDD readings were determined by calculating the intra- and inter-class correlation coefficients. Results The HHD measurements showed fine testretest reliability ( ICC = 0.74-0.97 ) and inter-rater reliability ( ICC = 0.63-0.97 ) in measuring lower-limb muscle strength of children with spastic CP, with the highest test-retest reliability for the hip flexion, foot plantar flexion and knee extension muscle groups. The highest inter-rater reliability was achieved with the hip flexion and foot dorsiflexion muscle groups. Conclusions Standardized HHD testing of lower-limb muscle strength in children with spastic CP shows fine test-retest and inter-rater reliability. The HHD can reliably assess the lower-limb muscle strength of children with spastic CP.