M. Contesse , A. Sapp , C. Zigler , W. Chen , J. Marshall , G. Gensler , C. Brown , R. Barnes , D. King , S. Wilson , M. Leffler
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引用次数: 0
摘要
杜兴氏肌肉营养不良症(DMD)患者通过改变运动模式来补偿肌无力。杜兴视频评估(DVA)是一种基于家庭的工具,通过识别运动代偿来测量运动的难易程度。DVA 指导护理人员使用移动应用程序录制患者在家尝试特定运动任务(如爬 5 级楼梯)的视频。DVA 2.0 包含 18 项运动任务,可通过与其功能组相关的任务子集对处于任何疾病阶段的患者进行评估。经 DVA 认证的理疗师使用具有临床意义的代偿运动标准("项目")的验证记分卡对视频进行评分。ARISE 是一项纵向观察研究,研究对象为 150 名 2 岁及以上的 DMD 患者,目的是评估 DVA 2.0 在 24 个月内的测量特性。利用基线数据,我们评估了 DVA 2.0 记分卡和标准之间的关系,以确认它们为结果提供了不同的信息。我们评估了每对标准之间的相关性,并根据比较标准中的等级数量确定了相关类型(多序列、等级-双序列、Phi)。我们使用斯皮尔曼相关矩阵评估记分卡之间的关系。对相关性极强(>|0.9|)的标准和记分卡进行了内容重叠探索,并考虑将其删除。除一对标准外,所有记分卡和所有标准的相关性都低于阈值。其中,"伸手穿过桌子拿手机 "的一对标准高于阈值(rpc = 0.971),但研究人群中有 15% 的人在这两个标准的严重程度上存在差异。由于专家共识之前已经确定了每项标准的临床意义,而且保留这两项标准可以为 15%的研究人群提供额外信息,因此这两项标准都被保留了下来。研究结果证实,所有 DVA 2.0 标准和记分卡都提供了有关 DMD 患者活动自如程度的独特信息。
365P Duchenne video assessment 2.0 scorecard performance: evaluation of inter-item and inter-scorecard relationships
People with Duchenne muscular dystrophy (DMD) compensate for muscle weakness by changing their movement patterns. The Duchenne Video Assessment (DVA) is a home-based tool that measures ease of movement through identification of movement compensations. The DVA directs caregivers to video record patients attempting specific movement tasks (e.g., Climb 5 Stairs) at home using a mobile application. DVA 2.0 comprises 18 movement tasks and assesses patients at any disease stage through a subset of tasks relevant to their functional group. DVA-certified physical therapists rate the videos using validated scorecards with clinically meaningful compensatory movement criteria (“items”). ARISE is a longitudinal, observational study of 150 participants with DMD aged 2 and older to evaluate the measurement properties of DVA 2.0 over 24 months. Using baseline data, we evaluated the relationships among DVA 2.0 scorecards and criteria to confirm that they contribute distinct information to the outcome. We assessed the correlation between each criteria pair, and correlation type (polychoric, rank-biserial, Phi) was determined by number of levels within compared criteria. We assessed inter-scorecard relationships using a Spearman correlation matrix. Criteria and scorecards with very strong correlations (>|0.9|) were explored for content overlap and considered for removal. All scorecards and all but one pair of criteria had correlations below the threshold. One pair of criteria for Reach Across the Table to Grab a Cell Phone was above the threshold (rpc = 0.971), but 15% of the study population differed in severity level for the two criteria. Since expert consensus previously established the clinical meaningfulness of each criterion and maintaining both criteria provides additional information for 15% of the study population, both were retained. The results confirm that all DVA 2.0 criteria and scorecards contribute distinct information about the ease of movement of people with DMD.
期刊介绍:
This international, multidisciplinary journal covers all aspects of neuromuscular disorders in childhood and adult life (including the muscular dystrophies, spinal muscular atrophies, hereditary neuropathies, congenital myopathies, myasthenias, myotonic syndromes, metabolic myopathies and inflammatory myopathies).
The Editors welcome original articles from all areas of the field:
• Clinical aspects, such as new clinical entities, case studies of interest, treatment, management and rehabilitation (including biomechanics, orthotic design and surgery).
• Basic scientific studies of relevance to the clinical syndromes, including advances in the fields of molecular biology and genetics.
• Studies of animal models relevant to the human diseases.
The journal is aimed at a wide range of clinicians, pathologists, associated paramedical professionals and clinical and basic scientists with an interest in the study of neuromuscular disorders.