Evaluation of three different ways of assessing tremor in multiple sclerosis
Evaluation of three different ways of assessing tremor in multiple sclerosis
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DOI：
10.1136/jnnp.68.6.756
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发表时间：
2000-06-01
影响因子：
11
通讯作者：
Bain, PG
中科院分区：
文献类型：
--
作者：
Alusi, SH;Worthington, J;Bain, PG
目的——检验三种简单评估多发性硬化症患者上肢震颤的方法的相对可靠性和有效性。 方法——三名检查者通过研究患者检查录像、螺旋图和笔迹样本，以 0-10 级独立评估多发性硬化症患者上肢震颤的严重程度。还评估了震颤严重程度评分与手臂灵活性测试评分和震颤相关残疾量表的相关性。结果-姿势震颤评级具有良好的评估者内和评估者间可靠性。然而，当评估动态震颤时，这些可靠性会降低，部分原因是辨距困难是一个混杂因素。螺旋和手写的评级颤动的评级者内部可靠性也很好，但评级者间可靠性仅为中等至中等。所有三种方法的震颤严重程度评分与九孔钉测试、手指敲击测试和震颤相关日常生活活动（ADL）问卷获得的分数高度相关，表明这三种方法都是评估多发性硬化症震颤的有效方法。 结论：多发性硬化症姿势震颤可以使用临床评定量表以有效且可靠的方式进行评分，并且如果评级由同一检查者进行，则可以从螺旋和笔迹样本中进行评分。然而，动态震颤评分不太可靠。此外，九孔钉和手指敲击测试为患有多发性硬化症的颤抖患者的上肢功能提供了有用的客观评估。
Objectives-To examine the comparative reliability and validity of three simple ways of rating upper limb tremor in patients with multiple sclerosis.Methods-Three examiners independently rated severity of upper limb tremor in patients with multiple sclerosis on a 0-10 scale by studying videotape recordings of patients' examinations, spiral drawings, and handwriting samples. The correlations of the tremor severity scores with scores from arm dexterity tests and a tremor related disability scale were also assessed.Results-Rating tremor on posture had a good intrarater and interrater reliability. However, these reliabilities decreased when kinetic tremor mas assessed, in part because dysmetria was a confounding factor. The intrarater reliabilities of rating tremor from spirals and handwriting were also good but the interrater reliabilities were only fair to moderate. Tremor severity scored by all three methods correlated highly with scores obtained from the nine hole peg test, finger tapping test, and a tremor related activities of daily living (ADL) questionnaire, indicating that all three methods were valid ways of assessing tremor in multiple sclerosis.Conclusion-Multiple sclerosis tremors in posture can be scored using a clinical rating scale in a valid and reliable way, and from spirals and handwriting samples if the ratings are carried out by the same examiner. However, scoring kinetic tremor was less reliable. In addition, the nine hole peg and finger tapping tests provide useful objective assessments of upper limb function in tremulous patients with multiple sclerosis.