La mesure de fonction motrice, outil d’évaluation clinique des maladies neuromusculaires. Étude de validation

A new scale for motor function measurement has been developed for neuromuscular diseases. After the study of a preliminary and a first version, the validation study included 303 patients, aged 6 to 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 sensitivity for change was evaluated with 152 patients one year after. The scale comprised 32 items, in three dimensions: standing position and transfers, axial and proximal motor function, distal motor function. High correlations (>0.80) were found between the total score and other scores: Vignos and Brooke grades, Functional Independence Measure, the global severity of disability evaluated with visual analog scales by physicians and physiotherapists. This scale is reliable, does not require any special equipment and is well accepted by patients. It takes an average of 36 min (range 8-75) to complete the scale. Preliminary results of the second evaluation showed good sensitivity to change since last visit, considering rating by patient, investigator or physiotherapist. Also, significant differences in scores are obtained with the greatest deterioration observed in Duchenne patients.

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

[2]  F. Guillemin,et al.  [Measurement of the functional capacity in rheumatoid polyarthritis: a French adaptation of the Health Assessment Questionnaire (HAQ)]. , 1991, Revue du rhumatisme et des maladies osteo-articulaires.

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

[4]  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.

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

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

[7]  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.

[8]  J. Fries,et al.  The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. , 1982, The Journal of rheumatology.

[9]  Jacques Fermanian,et al.  A motor function measure scale for neuromuscular diseases. Construction and validation study , 2005, Neuromuscular Disorders.

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

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

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

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

[14]  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 .

[15]  M. Main,et al.  The Hammersmith functional motor scale for children with spinal muscular atrophy: a scale to test ability and monitor progress in children with limited ambulation. , 2001, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.