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严晓华,何 璐,郑 韵,徐开寿.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[J].中国康复医学杂志,2015,(1):18~21
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    点此下载全文
严晓华  何 璐  郑 韵  徐开寿
广州医科大学附属妇女儿童医疗中心,广州,510120
基金项目:广州市科技计划项目(2014J4100136);广东省医学科研基金立项课题(A2013514)
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摘要:
      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R2-R1外)均大于0.75,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
Inter-rater reliability of modified Ashworth scale and modified Tardieu scale in children with spastic cerebral palsy    Download Fulltext
Guangzhou Women and Children's Medical Center, 510120
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Abstract:
      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 acceptable limit of 0.75, except the R2-R1 of hamstring. They all concentrated in the 95% confidence interval(P<0.001). Conclusion:The MTS is reliable for the assessment of spasticity in lower extremities of children spastic CP, and should be used widely in clinic, but MAS should be used with cautions in assessment of lower extremity spasticity of children with spastic CP.
Keywords:modified Ashworth scale  modified Tardieu scale  reliability  spasticity  cerebral palsy
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