{"title":"后天性脑损伤患者肌张力评估：系统性综述","authors":"Ilaria Casadei , Fabio Betti , Roberto Tedeschi","doi":"10.1016/j.motcer.2023.09.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>This study determined which muscle tone assessment scale has the best psychometric properties in patients with acquired brain injury.</p></div><div><h3>Methods</h3><p>The systematic review included cross-sectional studies of diagnostic accuracy in which the sample consisted of adult patients with acquired brain injury of various etiologies, and the outcomes were the psychometric properties of muscle tone rating scales. The main databases consulted were PubMed, Cochrane Central Register of Controlled Trials and PEDro. Risk of bias and applicability were assessed using QUADAS-2, a specific tool for diagnostic studies. The characteristics of each study were presented in a synaptic table, and the results were described schematically and narratively.</p></div><div><h3>Results</h3><p>The search yielded 1056 results, of which only 13 were included in the systematic review after full-text analysis. The population of nine studies involved adult patients with upper motor neuron lesions of various etiologies, while in four studies the sample analyzed consisted of children with cerebral palsy. With regard to spasticity, the Ashworth scale and the modified Ashworth scale demonstrated low to moderate inter-operator reliability and low validity. The modified Ashworth scale, on the other hand, demonstrated high inter-operator reliability in the assessment of upper limb districts. The modified Tardieu scale was found to have low to moderate inter-operator reliability and moderate to high intra-operator reliability, with greater concordance of scores than the modified Ashworth scale. The Hypertonia Assessment Tool, the Barry-Albright Dystonia Scale, the Unified Dystonia Assessment Scale and the Burke-Fahn-Marsden Movement Scale, studied on samples of children with cerebral palsy, showed moderate to good inter-operator reliability and good internal consistency.</p></div><div><h3>Conclusion</h3><p>The systematic review identified a series of muscle tone assessment scales and analyzed the psychometric properties of each tool.</p></div>","PeriodicalId":39498,"journal":{"name":"Motricite Cerebrale","volume":"45 1","pages":"Pages 5-14"},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0245591923000821/pdfft?md5=85551b97c234fe9c7b2710affd77583d&pid=1-s2.0-S0245591923000821-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Évaluation du tonus musculaire chez les patients ayant subi une lésion cérébrale acquise : une revue systématique\",\"authors\":\"Ilaria Casadei , Fabio Betti , Roberto Tedeschi\",\"doi\":\"10.1016/j.motcer.2023.09.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>This study determined which muscle tone assessment scale has the best psychometric properties in patients with acquired brain injury.</p></div><div><h3>Methods</h3><p>The systematic review included cross-sectional studies of diagnostic accuracy in which the sample consisted of adult patients with acquired brain injury of various etiologies, and the outcomes were the psychometric properties of muscle tone rating scales. The main databases consulted were PubMed, Cochrane Central Register of Controlled Trials and PEDro. Risk of bias and applicability were assessed using QUADAS-2, a specific tool for diagnostic studies. The characteristics of each study were presented in a synaptic table, and the results were described schematically and narratively.</p></div><div><h3>Results</h3><p>The search yielded 1056 results, of which only 13 were included in the systematic review after full-text analysis. The population of nine studies involved adult patients with upper motor neuron lesions of various etiologies, while in four studies the sample analyzed consisted of children with cerebral palsy. With regard to spasticity, the Ashworth scale and the modified Ashworth scale demonstrated low to moderate inter-operator reliability and low validity. The modified Ashworth scale, on the other hand, demonstrated high inter-operator reliability in the assessment of upper limb districts. 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引用次数: 0
摘要
本研究确定了哪种肌张力评估量表在后天性脑损伤患者中具有最佳的心理测量特性。方法系统性综述包括诊断准确性的横断面研究，研究样本包括各种病因导致的后天性脑损伤成年患者，研究结果为肌张力评分量表的心理测量特性。查阅的主要数据库包括 PubMed、Cochrane Central Register of Controlled Trials 和 PEDro。使用QUADAS-2对偏倚风险和适用性进行了评估，QUADAS-2是一种专门用于诊断性研究的工具。每项研究的特征均以突触表的形式呈现，研究结果以图表和叙述的方式进行了描述。结果检索共获得 1056 项结果，其中只有 13 项在全文分析后纳入了系统综述。九项研究的研究对象是上运动神经元病变的成年患者，病因各不相同，而四项研究的分析样本是脑瘫儿童。在痉挛方面，阿什沃斯量表和改良阿什沃斯量表的操作者间信度为中低，效度较低。另一方面，改良阿什沃斯量表在评估上肢区时表现出较高的操作者间可靠性。经修订的 Tardieu 量表的操作者间信度为中低，操作者内部信度为中高，得分一致性高于经修订的 Ashworth 量表。在脑瘫儿童样本中研究的肌张力过高评估工具、巴里-阿尔布莱特肌张力障碍量表、统一肌张力障碍评估量表和伯克-法恩-马斯登运动量表显示出中等至良好的操作者间可靠性和良好的内部一致性。
Évaluation du tonus musculaire chez les patients ayant subi une lésion cérébrale acquise : une revue systématique
Objective
This study determined which muscle tone assessment scale has the best psychometric properties in patients with acquired brain injury.
Methods
The systematic review included cross-sectional studies of diagnostic accuracy in which the sample consisted of adult patients with acquired brain injury of various etiologies, and the outcomes were the psychometric properties of muscle tone rating scales. The main databases consulted were PubMed, Cochrane Central Register of Controlled Trials and PEDro. Risk of bias and applicability were assessed using QUADAS-2, a specific tool for diagnostic studies. The characteristics of each study were presented in a synaptic table, and the results were described schematically and narratively.
Results
The search yielded 1056 results, of which only 13 were included in the systematic review after full-text analysis. The population of nine studies involved adult patients with upper motor neuron lesions of various etiologies, while in four studies the sample analyzed consisted of children with cerebral palsy. With regard to spasticity, the Ashworth scale and the modified Ashworth scale demonstrated low to moderate inter-operator reliability and low validity. The modified Ashworth scale, on the other hand, demonstrated high inter-operator reliability in the assessment of upper limb districts. The modified Tardieu scale was found to have low to moderate inter-operator reliability and moderate to high intra-operator reliability, with greater concordance of scores than the modified Ashworth scale. The Hypertonia Assessment Tool, the Barry-Albright Dystonia Scale, the Unified Dystonia Assessment Scale and the Burke-Fahn-Marsden Movement Scale, studied on samples of children with cerebral palsy, showed moderate to good inter-operator reliability and good internal consistency.
Conclusion
The systematic review identified a series of muscle tone assessment scales and analyzed the psychometric properties of each tool.
期刊介绍：
La recherche et les traitements des atteintes cérébrales Motricité cérébrale sa adresse aux ?praticiens de la motricité concernés par le examen et la rééducation des handicapés souffrant de troubles neurologiques et associés, allant du polyhandicap a le IMC. Motricité cérébrale publie des études et des évaluations sur les conséquences motrices, psychomotrices, pédagogiques et sociales résultant des atteintes cérébrales. La revue propose également des articles de clinique et de réadaptation.
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