- 期刊
費城兒童醫院嬰兒神經肌肉疾病測試在臺灣之信度研究
Reliability of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) in Taiwan
摘要
背景與目的：動作功能是評估脊髓性肌肉萎縮症（spinal muscular atrophy, SMA）病程進展與治療成效的重要指標。費城兒童醫院嬰兒神經肌肉疾病測試（Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders, CHOP INTEND）是專門為第一型或無獨坐能力的SMA個案所設計的動作功能評估工具。本研究是要探討臺灣物理治療師在經過線上培訓課程後的CHOP INTEND評估信度。方法：共12位曾接受過CHOP INTEND實體課程訓練的物理治療師參加線上培訓課程，並在課程前後透過線上影片進行CHOP INTEND評分。資料分析使用組內相關係數分析治療師在培訓前後的測試者間信度，並使用斯皮爾曼等級相關係數評量治療師與黃金標準的評估一致性。結果：在培訓前後，治療師均有很高的CHOP INTEND測試者間信度，培訓前組內相關係數（intra-class correlation coefficient, ICC）（1,1）= 0.992，培訓後ICC（1,1）= 0.993-0.999（所有p<0.01）。在培訓前，僅有42%的治療師與黃金標準的評分達到高度相關（r>0.8）；但在培訓後，則有77%治療師評分與黃金標準達到高至非常高度相關。結論：對於已經熟悉CHOP INTEND的物理治療師，線上培訓課程有助於維持良好的測試者間信度，並且與資深評估者達到高度的一致性。本研究結果可以提供未來舉辦評估工具培訓課程以及擬定SMA追蹤計畫的參考。
並列摘要
Background and Purpose: Motor function is an important indicator for disease progression and treatment efficacy for spinal muscular atrophy (SMA). The Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) is a motor assessment tool specifically designed for individuals with type I SMA or those who cannot sit alone. The purpose of this study was to examine the reliability of CHOP INTEND among Taiwanese physical therapists before and after an online training program. Method: Twelve physical therapists who previously had received a face-to-face CHOP INTEND training course participated in an online training program. All therapists performed CHOP INTEND assessments via video reviews before and after the online course. Intra-class correlation coefficient (ICC) analyses were conducted to examine the inter-rater reliability among therapists. Spearman rank correlation coefficients were used to assess the performance of individual therapists to the gold standard score. Results: Inter-rater reliability of CHOP INTEND among therapists was excellent, both before (ICC = 0.992) and post-training (ICC = 0.993-0.999) (all p < 0.01). At baseline, only 42% of therapists showed a high correlation to the gold standard scores (r > 0.8); while after the online training course, 77% of therapists' scoring demonstrated a high to very high correlation to the gold standard. Conclusion: For physical therapists who are familiar with CHOP INTEND, the annual online training program is beneficial for therapists to maintain excellent inter-rater reliability and agreements with the gold standard. Our results provide a reference for future training programs of motor assessment tools and SMA follow-up plans.