基于ICF的儿童运动功能和活动能力测量工具的内容和心理测量特性研究

Content and psychometric properties of children's motor function and activity measurements using ICF

目的 分析儿童运动运动功能和活动测量工具的内容和心理测量特性。方法 选择6种常用儿童运动功能和活动测量工具,包括粗大运动功能测量(GMFM)、布尼氏动作熟练度测试第2版(BOT-2)、Peabody运动发育量表(PDMS-2)、儿童标准运动协调能力评估测试(MABC-2)、大肌肉群动作发展测试第三版(TGMD-3)和功能性动作筛查(FMS)。采用《国际功能、残疾和健康分类》(ICF)的联系规则、类目和编码,分析其测量内容和心理测量特性。结果 在身体功能维度,测量工具的内容主要涉及神经肌肉骨骼和运动相关功能(b7),包括关节活动功能(b710)、关节稳定功能(b715)、肌肉力量功能(b730)、运动反射功能(b750)、随意运动控制功能(b760)、手臂或腿的支撑功能(b7603)和步态功能(b770)等;在活动和参与维度,内容主要涉及活动(d4),包括改变身体的基本姿势(d410)、保持一种身体姿势(d415)、移动自身(d420)、步行(d450)、奔跑(d4552)和跳跃(d4553)等。GMFM的评定者间信度和重测信度非常优秀,BOT-2的评定者间信度、重测信度和内部一致性良好,PDMS-2的评定者间信度和重测信度均极好,MABC-2的重测信度和内部一致性良好,具有优秀的模型拟合程度,TGMD-3的内部一致性和重测信度优秀,FMS的内部一致性和重测信度优秀。结论 6种常用儿童运动功能和活动测量工具主要测量ICF身体功能维度的神经肌肉骨骼和运动相关功能(b7),活动和参与维度的活动(d4)。PDMS-2可用于儿童运动功能和活动能力的全面评估,TGMD-3和GMFM用于评估儿童粗大运动功能,BOT-2、MABC-2和FMS用于评估儿童的运动发育与协调能力、功能性运动模式。BOT-2、PDMS-2、MABC-2和TGMD-3是常模参照测量,GMFM和FMS是标准参照测量。常模参照的测量工具由于建立了适用于不同目的的常模,心理测量特性指标更加优秀,并有更加广泛的应用。6项测量工具信度良好~优秀,内部一致性中等~优秀,效度优秀。

Objective To analyze the content and psychometric properties of measurement tools for children's gross motor function and activity.Methods Six measurement tools for children's gross motor function and activity were selected,including Gross Motor Function Measure(GMFM),Bruininks-Oseretsky Test of Motor Proficiency-Second Edition(BOT-2),Peabody Developmental Motor Scales-Second Edition(PDMS-2),Movement Assessment Battery for Children-Second Edition(MABC-2),Test of Gross Motor Development-Third Edition(TGMD-3)and Functional Movement Screen(FMS).International Classification of Functioning,Disability,and Health(ICF)linking rules,categories and coding were used to analyze the content of measurement dimensions and items of these six tools,and their psychometric properties were explored.Results For the body function,the content of these six tools primarily addressed neuromusculoskeletal and movement-re‐lated functions(b7),such as mobility of joint functions(b710),stability of joint functions(b715),muscle power functions(b730),motor reflexes functions(b750),control of voluntary movement functions(b760),supportive functions of arm or leg(b7603)and gait patterns functions(b770).For the activities and participation,the content primarily addressed mobility(d4),such as changing and maintaining body positions(d410,d415),transferring oneself(d420),walking(d450),running(d4552),and jumping(d4553).GMFM was good in inter-rater and test-retest reliability;BOT-2 was good in inter-rater reliability,test-retest reliability and internal consistency;PDMS-2 was good in inter-rater and test-retest reliability;MABC-2 was good in test-retest reliability and internal consis‐tency with an excellent model fit;TGMD-3 was good in internal consistency and test-retest reliability;and FMS was good in internal consistency and test-retest reliability.Conclusion The six tools for motor and activity function measurement primarily concern neuro-musculoskeletal and movement-related functions(b7)for ICF body function,and mobility(d4)for activities and participation.PDMS-2 is suggested for a comprehensive evaluation of children's motor functions and activities;TGMD-3 and GMFM for gross motor functions;and BOT-2,MABC-2 and FMS for motor development,coordination and functional movement patterns.BOT-2,PDMS-2,MABC-2 and TGMD-3 are norm-referenced measures,whereas GMFM and FMS are criterion-referenced.Norm-referenced tools,due to their established norms tailored for various ob‐jectives,boast superior psychometric properties and wider applications.All the six tools exhibit good to excellent reliability,and internal consistency coefficients ranging from moderate to excellent.Their validity also spans from moderate to excellent.