Reliability Study of Gross Motor Function Classification System and Delphi Survey of Expert Opinion for Clinical Use of this System in Japan
Reliability Study of Gross Motor Function Classification System and Delphi Survey of Expert Opinion for Clinical Use of this System in Japan
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日本粗大运动功能分类系统的可靠性研究及该系统临床使用专家意见的德尔菲调查
DOI：
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
E. Saitoh
中科院分区：
文献类型：
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作者：
I. Kondo;Toshio Teranishi;M. Iwata;S. Sonoda;E. Saitoh
本研究的目的是检验日本版大肌肉运动功能分类系统（GMFCS）的可靠性，并通过德尔菲调查确定专家对该系统临床使用的意见。可靠性研究对334名脑瘫患儿（男孩191名，女孩143名）进行，年龄从8个月到12岁（平均5岁7个月，标准差3岁1个月）。共有181名评估员参与了这项研究。两名评估员使用GMFCS修订版（日文1.1版）对每个儿童的大运动功能水平进行独立分类。GMFCS的这次修订是基于以前在日本进行的试点研究的结果。采用问卷法进行德尔菲调查，并从进行信度研究的各研究所20名评估员的回答中计算出肯定答复率。在信度研究中，总体kappa为0.67，但4.6岁年龄组的III级和IV级kappa均<0.40。在德尔菲调查中，5个层次中只有第3个层次的描述，正面反应率不≥80%。根据Rosenbaum及其同事报告的结果，这些发现和对III级和IV级描述的结构分析表明，GMFCS的可靠性部分降低是因为III级描述的年龄为4.6岁，这可能设定在比实际发展相对较低的水平。
The purpose of this study was to examine the reliability of the Japanese version of the Gross Motor Function Classification System (GMFCS) and to determine expert opinions on clinical use of this system using a Delphi survey. The reliability study was performed with 334 children (191 boys, 143 girls) with cerebral palsy, ranging in age from 8 months to 12 years (mean, 5 years 7 months ; standard deviation, 3 years 1 month). A total of 181 assessors participated in the study. Two assessors classified each child's level of gross motor function independently using a revised version of the GMFCS (Japanese version 1.1). This revision of the GMFCS was based on the results of previous pilot studies performed in Japan. A questionnaire was used for the Delphi survey, and the rate of positive response was calculated from the answers of 20 assessors at each institute that conducted the reliability study. In the reliability study, overall kappa was 0.67, but specific kappas <0.40 were found at level III and IV in the 4.6 year age group. In the Delphi survey, the rate of positive responses was not ≥80% only for the description of level III among the five levels. These findings and structural analysis of descriptions for level III and IV according to the results reported by Rosenbaum and coworkers suggest that reliability of the GMFCS was partly lowered because of the level III description for the age of 4.6 years, which might be set at a relatively lower level than actual development.
影响因子：
120.7
作者：
Rosenbaum, PL;Walter, SD;Galuppi, BE
通讯作者：
Galuppi, BE
影响因子：
3.2
作者：
Palisano, RJ;Hanna, SE;Galuppi, BE
通讯作者：
Galuppi, BE