摘要
Abstract
Objective To determine the reliability and validity of Chinese version of Mini Manual Ability Classification System ( Mini-MACS) for Cerebral Palsy. Methods Inclusion criteria:Children diagnosed as cerebral palsy aged from 1 to<4 in Children 's Hospital of Fudan University and Shanghai cooperation hospitals of children's rehabilitation cooperation group from October to November 2017. Exclusion criteria:Children with severe hearing and visual impairments. The test retest reliability of Mini-MACS was determined by analyzing the relationship between site operation evaluation and video evaluation results. The Mini-MACS inter rater reliability was determined by analyzing different inter rater (caregivers, occupational therapists and physical therapist). By analyzing the correlation of the fine motor ability scores of Fine Motor Function Measure scale( FMFM) , the validity of Mini-MACS was determined.ResuIts 76 children with CP were included, of them 18 cases were from Children's Hospital of Fudan University, 58 cases were from Shanghai children's rehabilitation group cooperation units; 46 male, 30 female; average age was(2.5±0.9) months, 25 cases aged 1 to 2 years, 23 cases aged～<3 years, 28 cases aged ～4 years; 29 spastic quadriplegia, 11 double paralysis, 27 hemiplegia, 2 athetosis, 2 ataxia type, and 5 could not be classified;7 of them Gross Motor Function Classification System(GMFCS) grade Ⅰ, 27 grade Ⅱ, 16 grade Ⅲ, 16 grade Ⅳ, 10 grade Ⅴ. The results of OT's site evaluation and video evaluation showed that the Mini-MACS had a good retest reliability, and the ICC value was 0.96 (95％ CI: 0.94-0.98). At the same time, the mini-MACS had a good inter rater reliability. The ICC value between OT and PT was 0.97 (95％ CI:0.94-0.98), and the ICC value of OT and primary caregivers was 0.92 (95％ CI:0.86-0.95). Among 1～2, 2～3 and 3～4 years old group, all three age groups showed high retest reliability ( ICC value between 0 remarks ～1.00) , and 3 ～4 inter rater reliability between the evaluators was lower than 1～2 and 2～3 years old groups; In particular, the reliability between OT and primary caregivers was significantly lower than that of the other two groups ( ICC= 0.64) . There was a good parallel validity between Mini-MACS and fine motor ability score, and Spearman correlation coefficient was -0.76.ConcIusion The Chinese version of Mini MACS has a good inter rater reliability and parallel validity. It is suitable for the classification of younger children with cerebral palsy.关键词
脑瘫/幼儿/手功能/分级/信度/效度Key words
Cerebral palsy/Mini/Manual ability/Classification/Reliability/Validity
