A motor function measure scale for neuromuscular diseases. Construction and validation study

A new scale for motor function measurement has been developed for neuromuscular diseases. The validation study included 303 patients, aged 6-62 years. Seventy-two patients had Duchenne muscular dystrophy, 32 Becker muscular dystrophy, 30 limb-girdle muscular dystrophy, 39 facio-scapulo-humeral dystrophy, 29 myotonic dystrophy, 21 congenital myopathy, 10 congenital muscular dystrophy, 35 spinal muscular atrophy and 35 hereditary neuropathy. The scale comprised 32 items, in three dimensions: standing position and transfers, axial and proximal motor function, distal motor function. Agreement coefficients for inter-rater reliability were excellent (kappa=0.81-0.94) for nine items, good (kappa=0.61-0.80) for 20 items and moderate (kappa=0.51-0.60) for three items. High correlations were found between the total score and other scores: Vignos (r=0.91) and Brooke (r=0.85) grades, Functional Independence Measure (r=0.91), the global severity of disability evaluated with visual analog scales by physicians (r=0.88) and physiotherapists (r=0.91). This scale is reliable, does not require any special equipment and is well-accepted by patients. Its sensitivity to change is being assessed to permit its use in clinical trials of neuromuscular diseases.

[1]  D. Cadman,et al.  THE GROSS MOTOR FUNCTION MEASURE: A MEANS TO EVALUATE THE EFFECTS OF PHYSICAL THERAPY , 1989, Developmental medicine and child neurology.

[2]  S. Poiraudeau,et al.  Guide des outils de mesure et d’évaluation en médecine physique et de réadaptation: Par François Béthoux et Paul Calmels, Éditions Frison-Roche, 75006 Paris , 2004 .

[3]  T. Munsat Quantification of neurologic deficit , 1989 .

[4]  R. H. Jebsen,et al.  An objective and standardized test of hand function. , 1969, Archives of physical medicine and rehabilitation.

[5]  M. Brooke,et al.  Clinical trial in duchenne dystrophy. I. The design of the protocol , 1981, Muscle & nerve.

[6]  E. Bower,et al.  Finnie's handling the young child with cerebral palsy at home , 1997 .

[7]  R. Abresch,et al.  Quality of life. Issues for persons with neuromuscular diseases. , 1998, Physical medicine and rehabilitation clinics of North America.

[8]  Alija Kulenović,et al.  Standards for Educational and Psychological Testing , 1999 .

[9]  J. Miller,et al.  Clinical investigation in duchenne dystrophy: 2. Determination of the “power” of therapeutic trials based on the natural history , 1983, Muscle & nerve.

[10]  G. Smith,et al.  A rating scale for amyotrophic lateral sclerosis: Description and preliminary experience , 1987, Annals of neurology.

[11]  ITEM ASSESSMENT IN THE DEVELOPMENT OF A DIAGNOSTIC MOTOR PERFORMANCE TEST FOR MYOPATHY IN CHILDREN , 1993, Developmental medicine and child neurology.

[12]  F. Norris,et al.  The administration of guanidine in amyotrophic lateral sclerosis , 1974, Neurology.

[13]  P. Schmitz,et al.  Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain‐Barré syndrome , 1991, Muscle & nerve.

[14]  E. Mattsson,et al.  Physical capacity in non-ambulatory people with Duchenne muscular dystrophy or spinal muscular atrophy: a longitudinal study. , 2002, Developmental medicine and child neurology.

[15]  W. Dixon,et al.  BMDP statistical software , 1983 .

[16]  V. Dubowitz,et al.  Quantitation of muscle function in children: A prospective study in duchenne muscular dystrophy , 1982, Muscle & nerve.

[17]  P. Vignos,et al.  Management of progressive muscular dystrophy in childhood. , 1963, JAMA.

[18]  J. Fermanian Evaluer correctement la validité d'une échelle : les nombreux pièges à éviter. , 1996 .

[19]  A. Zupan Assessment of the functional abilities of the upper limbs in patients with neuromuscular diseases. , 1996, Disability and rehabilitation.

[20]  S. Iannaccone,et al.  Prospective study of spinal muscular atrophy before age 6 years. DCN/SMA Group. , 1993, Pediatric neurology.