GMFM 66在0-3岁脑性瘫痪患儿粗大运动评估中的信度和效度研究

目的采用Rasch分析法确定粗大运动功能测试量表(GMFM)66项在0～3岁脑性瘫痪(脑瘫)患儿粗大运动功能评估中的信度和效度.方法对171例0～3岁脑瘫患儿用GMFM 88项量表进行评估,获得有效样本298个,采用Rasch统计方法筛选出GMFM 73项,同时获得各样本的GMFM 73项分值,通过GMFM 73项与GMFM 66分值之间以及改变分值之间进行相关性分析来判断GMFM 66项在0～3岁脑瘫患儿粗大运动评估中的信度和效度.结果GMFM 73项分值与GMFM 66分值高度相关(r=0.9848,P＜0.001),不同月龄和类型的脑瘫患儿GMFM 73项分值与GMFM 66分值之间也呈高度相关(r=0.9484～0.9958,P＜0.001);在问隔(3.6±1.5)个月后,GMFM 73项的平均改变分值为4.37±4.51,GMFM 66的平均改变分值为4.19±4.29,两者改变分值之间呈高度相关(r=0.8700,P＜0.001),GMFM 66的精确度和效应尺度略高于GMFM 73.结论GMFM 66项在0～3岁脑瘫患儿粗大运动功能评估中具有良好的信度和效度.

Study on the reliability and validity of the 66-item version on the gross motor function measure in 0-3 year olds with cerebral palsy

Objective To examine the reliability and validity of the 66-item version on the gross motor function measure (GMFM-66) to assess the gross motor functions of children below 3 years old with cerebral palsy. Methods 298 valid samples were obtained from 171 children with cerebral palsy (male 126, female 45 with mean age 19 months, age range 3-36 months) measured with GMFM-88. Then a 73-item version of GMFM (GMFM-73) special for these children was obtained by Rasch analysis. Both GMFM-66 and GMFM-73 scores of to each sample were obtained. The reliability and validity of GMFM-66 were evaluated through analyzing the correlation between the scores and between the changed scores of these two GMFM versions. The relative precision of GMFM-73 versus GMFM-66 was also analyzed. Results Significant correlations were found between the scores and between the changed scores of these two versions of GMFM. A 14% less gain in relative precision was achieved when using GMFM-73 versus GMFM-66. Conclusion Results indicated that the GMFM-66 had good reliability and validity in assessing the gross motor functions of children below 3 years old with cerebral palsy.