定量等长肌力测定在Duchenne型和Becker型肌营养不良症患儿下肢肌力测定中的信度评价

Reliability of hand-held dynamometry for measurement of lower limb muscle strength in children with Duchenne and Becker muscular dystrophy

目的评价定量等长肌力测定在Duchenne型和Becker型肌营养不良症患儿下肢肌力测定中的信度。方法共21例Duchenne型（19例）和Becker型（2例）肌营养不良症患儿,采用手持式肌力测定仪检测患儿髋、膝、踝等部位肌群肌力,比较不同检测者间和同一检测者两次测试结果间的相关性,以评价手持式肌力测定仪的不同检测者间信度和重测信度。结果手持式肌力测定仪测定Duchenne型和Becker型肌营养不良症患儿下肢肌群具有良好的不同检测者间信度（ICC=0.762~0.978）和重测信度（ICC=0.690~0.938）,但二者对远端肌群（足跖屈和足背屈）信度均相对较低。结论手持式肌力测定仪在Duchenne型和Becker型肌营养不良症患儿下肢肌力测定中具有较好的不同检测者间信度和重测信度,可以用于监测肌力变化和评价临床疗效。

ObjectiveTo determine the reliability of hand-held dynamometry（HHD） for lower limbisometric muscle strength measurement in children with Duchenne and Becker muscular dystrophy（DMD/BMD）.MethodsA total of 21 children [20 males and one female; mean age was（7.88 ± 2.87） years,ranging between 3.96-14.09 years; mean age at diagnosis was（5.88 ± 2.88） years, ranging between1.35-12.89 years; mean height was（120.64 ± 16.30） cm, ranging between 97-153 cm; mean body weightwas（24.62 ± 9.05） kg, ranging between 14-50 kg] with DMD（19/21） and BMD（2/21） were involved fromRehabilitation Center of Children＇s Hospital of Fudan University. The muscle strength of hip, knee andankle was measured by HHD under standardized test methods. The test-retest results were compared todetermine the inter-test reliability, and the results among testers were compared to determine the inter-testerreliability.ResultsHHD showed fine inter-tester reliability（ICC = 0.762-0.978） and inter-test reliability（ICC = 0.690-0.938） in measuring lower limb muscle strength of children with DMD/BMD. Results alsoshowed relatively poor reliability in distal muscle groups（foot plantar flexion and dorsiflexion）.ConclusionsHHD, showing fine inter-tester and inter-test reliability in measuring the lower limb musclestrength of children with DMD/BMD, can be used in monitoring muscle strength changing and assessingeffects of clinical interventions.