Reliability of composite spasticity scale for brain injured patients

Abstract

目的: 测试综合痉挛量表在国内使用的可行性及重复测试信度。 方法: 测试 17例脑损伤患者 ,年龄 2 2— 75岁 (5 0 .1± 17.0岁 ) ;发病 2— 37周 (16 .9± 10 .8周 ) ;其中男 11例 ,女 6例 ;颅脑外伤 4例 ,脑卒中 13例 (脑梗塞 6例 ,脑出血 7例 )。由同一位医生在 1周内 2次评定患侧下肢的痉挛 ,内容包括跟腱反射、小腿三头肌的肌张力及踝阵挛。对量表的重复测试信度作等级间相关系数 (ICC)分析。 结果: 本组脑损伤患者综合痉挛量表得分的单次测试最低为 8.9± 2 .8分 ,最高为 9.6± 3.2分 ,总体测试为 9.2± 0 .3分 ,属于轻度痉挛。同一天重复测试的ICC分别为 0 .96— 0 .99(第 1天 ) ,0 .95— 0 .99(第 2天 ) ,2次总体ICC为 0 .94— 0 .99。 结论: 综合痉挛量表内容简单 ,评定标准清楚 ,重复测试信度良好 ,适用于国内脑损伤患者下肢痉挛的评定。 Objective: To test the intra-rater reliability of Composite Spasticity Scale (CSS) used on brain injured patients. Method: Spasticity of the ankle plantarflexors was evaluated with CSS in 17 patients. They were 11 males, 6 females, aged from 22 to 75 years (50.1±SD17.0). Among them, 13 were stroke (6 with cerebral infarction, 7 with hemorrhage) and 4 with traumatic brain injury, 2 to 37 weeks (16.9±10.8) post-injury. Spasticity was assessed twice at the same time on different days within one week by the same doctor. Intraclass correlation coefficient (ICC) was analyzed. Result: CSS score in a single session ranged from 8.9±2.8 to 9.6±3.2 . The score from two sessions averaged 9.2±0.3, indicating that this group of patients manifested mild spasticity in the ankle plantarflexors. The ICC within the same session was 0.96-0.99 for the first session and 0.95-0.99 for the second session. The ICC from the two sessions averaged 0.94-0.99. Conclusion: CSS is a simple, sensitive and reliable scale for measurement of spasticity in the lower extremity of brain injuried patients.