全身运动细化评估在高危儿运动发育中的信度研究

Reliability of detailed assessment of general movements for motor development in high risk infants

目的研究全身运动细化评估的信度,为其应用于高危儿运动发育随访的临床工作建立相应的基础。方法纳入接受全身运动评估的87例高危儿的90个录像,周龄在34~58周之间。由评估者采用"早产儿和足月儿全身运动细化评分表"和"3~5月龄婴儿细化评分表"进行评分,获得全身运动评估的最优性评分。计算不同评估者间和同一评估者两次评估间的组内相关系数(ICC值)。结果扭动阶段全身运动细化评估评估者间总项目分的信度ICC值为0.941,各亚类分的信度ICC值为0.881~0.933;两位评估者总项目分的重测信度ICC值分别为0.983和0.879,各亚类分的重测信度ICC值为0.876~0.943。不安阶段全身运动细化评估评估者间总项目分的ICC值为0.976,各亚类分的信度ICC值为0.819~0.909;两位评估者总项目分的重测信度ICC值分别为0.955和0.959,各亚类分的重测信度ICC值为0.588~0.905。结论全身运动细化评估具有良好的评估者间信度和重测信度,可以应用于高危儿运动发育随访的临床工作之中。

Objective To study the reliability of the detailed assessment of general movements,and establish a corresponding basis for its application in high risk infants follow-up clinical work for motor development. Methods The analysis was based on 90 video recordings of 87 infants who had been videoed from 34 to 58weeks postmenstrual age.The motor optimality score was assessed according to the detailed assessment of ' Preterm and Term General Movement' and ' Assessment of Motor Repertoire-3to 5Months'.The intraclass correlation coefficient(ICC)of inter-raters and test-retest reliability were investigated. Results The inter-raters ICC values of the total score of the detailed assessment in writhing movements was 0.941,while the inter-raters ICC values were 0.881 to 0.933 of the subgroups;The test-retest ICC values of the total score was 0.983 and 0.879,while the test-retest ICC values were 0.876 to 0.943 of the subgroups.The inter-raters ICC values of the total score of the detailed assessment in fidgety movements was 0.976,while the inter-raters ICC values were 0.819 to 0.909 of the subgroups;The test-retest ICC values of the total score was 0.955 and 0.959,while the test-retest ICC values were 0.588 to 0.905 of the subgroups. Conclusion The detailed assessment of general movements is reliable in inter-raters and test-retest as applied in high risk infants,and can be used for its follow-up clinical work for motor development.