摘要
目的探讨粗大运动功能分类系统(GMFCS)在痉挛型脑性瘫痪儿童中的信度和效度。方法收集2005年2月-2007年2月北京儿童医院神经康复病房收治的116例痉挛型脑性瘫痪儿童的临床资料,其中因不同原因退组并完成部分评估33例,参与全部评估过程83例。由神经内科医师和康复训练师分别使用GMFCS对入组儿童进行分级。在康复治疗前及治疗后4、8、12、16、28周,分别使用粗大运动功能量表(GMFM-66)评价入组儿童粗大运动能力,使用PEDI评价入组儿童日常生活能力。结果GMFCSⅠ、GMFCSⅡ、GMFCSⅢ代表不同粗大运动能力水平,具有良好的评价者间信度(Kappa=0.881)。GMFCS与GMFM-66均值呈负相关(rs=-0.742,P<0.05)。GMFCS与PEDI各组,即与功能性活动-自我照顾、功能性活动-移动、功能性活动-社会功能、看护者帮助-自我照顾、看护者帮助-移动、看护者帮助-社会功能原始分呈负相关(rs=-0.491～-0.713,P均<0.05);与功能性活动-移动相关性最高。结论GMFCS对痉挛型脑性瘫痪儿童具有良好的信度和效度,该评价方法简单易行,适合推广使用。
Objective To investigate the reliability and validity of gross motor function classification system （GMFCS） in evaluation of children with spastic cerebral palsy. Methods Clinical data of 116 children with spastic cerebral palsy were collected. All of them were hospitalized in Neurology and Rehabilitation Center, Beijing Children＇s Hospital between February 2005 and February 2007. Among them, 83 finished all therapies and evaluations, 33 withdrew. The diagnosis and the severity of spastic cerebral palsy were assessed by a pediatric neurologist and a physical therapist. gross motor function measurement-66 （GMFM-66） was used for assessment of gross motor function, and pediatric evaluation of disability inventory （PEDI） was used for assessment of daily life ability before therapy, 4 weeks, 8 weeks, 12 weeks, 16 weeks, and 28 weeks after therapy. Statistical analysis was done with SPSS 14.0. Results GMFCS Ⅰ , GMFCS Ⅱ , GMFCSⅢ represented different levels of gross motor function, with a good inter-rater reliability （Kappa = 0.934）. GMFCS showed a negative correlation with GMFM-66. GMFCS also had negative correlation with each subgroup of PEDI. There were negative correlations between functional skill and self care （rs = -0.578, P 〈 0.05）, functional skill and mobility （rs = -0.712, P 〈 0.05）, functional skill and social function （rs = -0.525, P 〈 0.05）, caregiver assistance and self care （rs = -0.546, P 〈 0.05） , caregiver assistance and mobility （rs = -0.674, P 〈 0.05） , earegiver assistance and social function. And GMFCS correlated most with functional skill-mobility. Conclusions GMFCS demonstrated reliability and validity in evaluation of children with spastic cerebral palsy, and was easy to conduct. We recommend its wide application.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2009年第3期264-266,277,共4页
Journal of Clinical Pediatrics
基金
美国亚利桑那洲科研基金项目(No.Y410503)
北京市科委国际合作项目(No.2007G05)
北京市中医药科技项目(No.JJ2005-17)
国家科委国际合作项目(No.2008DFA31850)
关键词
脑性瘫痪
粗大运动
信度
效度
ccerebral palsy
gross motor
reliability
validity
