中文版北极星移动评价量表在Duchenne型肌营养不良症患儿的信度和效度研究  

Reliability and validity of the Chinese version of North Star Ambulatory Assessment for children with Duchenne muscular dystrophy

作　　者：史惟[1] 李惠[1] 李西华[2] 苏怡[1] 赵蕾[2] 陆恺[1] 胡晓平[2] 翟淳[1] 周水珍[2] 

机构地区：[1]位复旦大学附属儿科医院康复中心,上海201102 [2]位复旦大学附属儿科医院神经科,上海201102

出　　处：《中国循证儿科杂志》2017年第4期246-250,共5页Chinese Journal of Evidence Based Pediatrics

摘　　要：目的确定中文版北极星移动评价量表(NSAA)应用在Duchenne型肌营养不良症(DMD)患儿的信度和效度。方法纳入对象为2014年1月至2016年1月在复旦大学附属儿科医院康复科接受功能评估的DMD患儿,均经基因检测或肌肉活检明确诊断,能独立行走≥10 m,无严重认知障碍。2名物理治疗师同时对DMD患儿进行测试,检验不同测试者间的信度;同一评价者在第1次评价后3~7 d进行第2次评价,检测重测信度;采用《国际功能、残疾和健康分类》儿童和青少年版(ICF-CY)的类目编码与NSAA的项目概念进行关联,确定NSAA的内容效度;通过分析NSAA的分值与6 min步行距离的相关性进行关联效度分析。结果 2个治疗师对20名DMD男孩的不同测试结果间的信度分析显示,NSAA原始分和线性分信度ICC分别为0.96和0.97;1名治疗师前后3~7 d重测16名DMD男孩,NSAA的原始分和线性分具有很好的重测信度(ICC=0.96);NSAA17个项目共与8个ICF-CY编码发生了20次关联,8个编码都属于d4(移动)下属,表明NSAA的评价内容主要聚焦于DMD患儿活动能力中的移动能力;143例DMD男孩的NSAA原始分和线性分与6min步行距离具有中等程度的相关性(r分别为0.40和0.38)。结论中文版NSAA量表无论是原始分还是线性分都具有良好的心理测量学特性,结合其他的评价指标,NSAA可以有效地评价中国DMD男孩的活动能力。Objective To determine the reliability and validity of North Star Ambulatory Assessment （ NSAA ）. Methods Inclusion criteria： Children diagnosed by gene detection or muscle biopsy as DMD and accepted functional assessment in Childeren＂ s Hospital of Fudan University from January 2014 to January 2016,being able to walk more than ten meters independently, and in addition , without severe cognitive retardation were recruited. Twenty patients were scored by two different physical therapeutists at the same time to detect inter-rater reliability. Sixteen patients were scored the second time 3-7 days after the first assessment by the same physical therapeutist to detect test-retest reliability. Relate ageneral category encording w,ay of International Classification of Functioning,Disability and Health-Child and Youth version（ICF-CY） and project concept of NSAA were used to determine content validity of NSAA. Criterion related validity analysis w,as performed by analyzing the correlation between NSAA scores of 143 children and 6 minutes walking distance（6MWT） .Results The reliability analysis of the different test results of two therapists on twenty children showed that the NSAA raw scores and linear scores had excellent inter-rater reliability （ICC = 0.96,0.97） ; 16 boys were assessed by the same therapeutist twice with an interval of 3 ？7 days and the results showed that raw and linear scores of NSAA had great test-retest reliability （ICC = 0.96）; Twenty linkages were made between seventeen items of NSAA and eight codes of ICY- CY,all of the eight codes belonged to d4（ mobility ） ,which meant that contents of NSAA evaluation mainly focused on mobility of DMD patients.The NSAA raw scores and linear scores of all 143 boys and 6MWT,had a fair degree of relationship between the two measures （ r = 0.40 and r = 0.38）. Conclusion Chinese version of NSAA has good psychometric pr

关 键 词：DUCHENNE型肌营养不良症 活动 评估 信度 效度 

分 类 号：R746.2[医药卫生—神经病学与精神病学]