MyotonPRO在脑卒中患者肌张力检测中的信度研究

Inter-rater Reliability of MyotonPRO for Assessing Muscle Mechanical Properties in Stroke Patients

目的:评估在B超引导下运用数字化肌肉评估系统MyotonPRO定量检测脑卒中患者的上肢肌肉张力、弹性和硬度等参数的评价者间信度。方法:经过培训的康复医师A(评定者A)和康复治疗师B(评定者B)分别使用MyotonPRO在B超引导下对28名脑卒中患者患侧肱二头肌、桡侧腕屈肌的肌肉张力、弹性和硬度进行检测。记录用10次扫描模式所测得的肌肉阻尼振荡频率(F值)、对数衰减值(D值)及动态硬度(S值)。通过SPSS进行分析组内相关系数(ICC),计算相应的标准测量误差(SEM,SEM%)和最小可测变化值(MDC90,MDC90%),并用Bland-Altman分析绘制Bland-Altman图。结果:肱二头肌、桡侧腕屈肌的F值、D值和S值在评定者A、B间的重测信度相关系数ICC均>0.9,SEM和MDC90显示出小的测量误差(SEM%<10%,MDC90%<25%)。Bland-Altman分析结果显示,肱二头肌、桡侧腕屈肌F值、D值和S值在评定者A、B间的重测一致性佳,符合临床检测需求。结论:在B超引导下数字化肌肉评估系统MyotonPRO对脑卒中患者的上肢肌肉张力、弹性和硬度评估具有极佳的评价者间信度。

Objective:To examine the inter-rater reliability of MyotonPRO under B-ultrasound guidance in assessment of stroke patients'muscle tone.Methods:A total of 28 stroke patients were assessed their muscle mechanical properties of biceps brachii and flexor carpi radialis muscles in relaxed state with MyotonPRO under the B-ultrasound guidance by two testers within 24 hours.Interrater reliability of muscle properties was determined using intraclass correlation coefficient (ICC),the standard error of measurement (SEM),the minimal detectable change (MDC90)and Bland-Airman analysis were performed by SPSS.Results:The ICC was above 0.9 in the ten-time scan pattern.The SEM and MDC90 of biceps brachii and flexor carpi radialis muscles indicated small measurement error (SEM%<10%,MDCg0%<25%).The Bland-Airman analysis revealed no systematic errors between testers.Conclusion:Assessing muscle mechanical properties using MyotonPRO are reliable between testers in measuring the muscle properties in stroke patients.