摘要
目的本研究通过应用粗大运动功能测量(GMFM)对两组研究对象的粗大运动功能进行评定,以检验GMFM的效度、信度和反应度等标准化指标。方法应用GMFM对31例7个月—7岁的脑瘫患儿和17例3个月—5岁2个月的健康儿童在入选时及3个月后进行两次测量,并以神经肌肉系统缺陷程度、美国脑瘫学会障碍分级、治疗性分级作为疗效标准进行效度研究;应用GMFM对10例脑瘫患儿在入选时和1周后进行2次测量以研究组内信度;由2个测量者应用GMFM同时进行测量对10例脑瘫患儿以研究组间信度。结果对照组中,3岁以上儿童第一次GMFM结果较3岁内组高(P<0.05),而两次GMFM改变量则较低(P<0.05);脑瘫组第一次GMFM测量结果及两次GMFM改变量均低于对照组(P<0.05);脑瘫组第一次GMFM测量结果及两次GMFM改变量与神经肌肉系统缺陷程度、美国脑瘫学会障碍分级、治疗性分类均呈负相关(P<0.05)。组内和组间信度研究均具有很高的相关性(ICC>0.90)。结论GMFM用于测量脑瘫患儿的粗大运动状况、随时间出现或由于干预而出现的运动功能改变,具有良好的效度、信度和反应度,能定量地反映脑瘫患儿的粗大运动功能状况和改变,适合在临床康复中应用。
Objective: To test the validity and reliability of gross motor functional measure(GMFM) by assessing the gross motor of subjects (children with CP and children without motor delays) with GMFM in order to provide the evidences of clinical application of GMFM. Method: Two groups of children participated in this study. The first group (patient group) comprised 31 children with CP. The second group (control group) were consisted of 17 non-disabled children. All subjects were assessed with the GMFM twice over a 3-month period. Ten of the children with CP were assessed twice with GMFM within one week by the researcher and one therapist. Result: In the first assessment, scores of older (>3 years of age) non-disabled children was higher than that of younger (≤3 years of age)(P<0.05).And the change of scores of younger non-disabled children was higher than that of older(P<0.05). Scores of the first assessment and change of scores of children with CP were lower than non-disabled children(P<0.05). There were negative moderate correlation among scores of GMFM, the amount of change of GMFM and the severity of neuromuscular impairment for CP(P<0.05), the disability classification of American Academy for Cerebral Palsy(P<0.05) and the therapeutic grade for CP(P<0.05). The intra-rater reliability and inter-rater reliability of GMFM were ICC>0.90.Conclusion:The GMFM has good validity and responsiveness, and high intra- and inter-raters reliability on assessing change in gross motor function in children with cerebral palsy. It can also quantify the gross motor function and the change of gross motor function over time in children with cerebral palsy.Author′s address Dept. of Rehabilitation Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080
出处
《中国康复医学杂志》
CAS
CSCD
2004年第3期170-173,共4页
Chinese Journal of Rehabilitation Medicine
