《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 630-638.doi: 10.3969/j.issn.1006-9771.2023.06.002

• 专题 运动功能与身体活动评定 • 上一篇    下一篇

适用于残疾儿童青少年运动功能和运动能力测量工具的结构、内容和心理测量特性的系统综述

刘辉1,2,3, 尹航4, 贾绍辉1, 邱服冰5()   

  1. 1.武汉体育学院运动医学院，湖北武汉市430079
    2.武汉体育学院运动健康智能装备湖北省工程研究中心，湖北武汉市 430079
    3.武汉体育学院国家体育总局体育工程重点实验室，湖北武汉市 430079
    4.武汉商学院，湖北武汉市 430056
    5.深圳大学体育学院，广东深圳市 518060
  • 收稿日期:2023-06-15 出版日期:2023-06-25 发布日期:2023-07-14
  • 通讯作者: 邱服冰(1966-)，男，汉族，湖北公安县人，副教授，主要研究方向：体育与健康，康复心理学，运动与康复。E-mail： 13902932056@163.com
  • 作者简介:刘辉(1980-)，男，汉族，湖北黄石市人，硕士，副教授，主要研究方向：运动干预与健康促进、适应性体育、ICF-CY。
  • 基金资助:
    1.中国残联残疾人辅助器具专项研究课题(2022CDPFAT-24);2.武汉体育学院"十四五"湖北省高等学校优势特色学科(群)鄂教研(2021-05);3.武汉体育学院中青年科研创新团队项目(21KT14)

Structure, contents and psychometric properties of measurement of motor function and motor ability applicable to children and adolescents with disabilities: a systematic review

LIU Hui1,2,3, YIN Hang4, JIA Shaohui1, QIU Fubing5()   

  1. 1. College of Sport Medicine, Wuhan Sports University, Wuhan, Hubei 430079, China
    2. Engineering Research Center of Sports Health Intelligent Equipment of Hubei Province, Wuhan Sports University, Wuhan, Hubei 430079, China
    3. Key Laboratory of Sports Engineering of General Administration of Sport of China, Wuhan Sports University, Wuhan, Hubei 430079, China
    4. Wuhan Business University, Wuhan, Hubei 430056, China
    5. Physical Education College, Shenzhen University, Shenzhen, Guangdong 518060, China
  • Received:2023-06-15 Published:2023-06-25 Online:2023-07-14
  • Contact: QIU Fubing, E-mail: 13902932056@163.com
  • Supported by:
    Research Project of China Disabled Persons' Federation on Assistive Devices for the Disabled(2022CDPFAT-24);14th Five-Year-Plan Advantageous and Characteristic Disciplines (Groups) of Colleges and Universities in Hubei Province under Grant(2021-05);Young and Middle-Aged Scientific Research and Innovation Team Project of Wuhan Sports University(21KT14)

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摘要：

目的 基于《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)对4种残疾儿童青少年运动功能和运动能力评估工具的主要结构和内容特征及其心理测量特性进行评估。
方法 检索PubMed、Medline、Web of Science数据库，收集建库至2023年5月发表的有关残疾儿童青少年身体活动的测量/报告工具的文献。运用ICF-CY对残疾儿童青少年运动功能和运动能力的评估工具的主要结构和内容特征进行分析，采用基于共识的健康测量工具选择标准(COSMIN)对评估工具的心理测量特性进行质量评估。
结果 最终纳入9篇文献，确定4项工具，包括粗大运动功能测试(GMFM-88)、Peabody发育性运动量表2 (PDMS-2)、Bruininks-Oseretsky运动能力测试2 (BOT-2)和儿童运动评估成套测验第二版(MABC-2)。GMFM-88由A区(卧位与翻身)、B区(坐位)、C区(爬行与跪)、D区(站立位)、E区(行走于跑跳)5个维度88个项目组成；涉及身体功能和结构中的关节活动功能(b710)、随意运动控制功能(b760)等，活动与参与的改变身体的基本姿保持(d410)、保持一种身体姿势(d415)等内容；在内部一致性信度、重测信度、内容效度、结构效度方面达到良好至优秀水平。PDMS-2由6项子测验组成，包括反射、姿势、移动、实物操纵、抓握和视觉运动整合，共249项；涉及身体功能和结构中的记忆功能(b144)、关节活动功能(b710)等，以及活动与参与的看(d110)、模仿(d130)等；在内部一致性信度、重测信度、内容效度、结构效度及假设检验和跨文化性上具有良好的心理测量特性。BOT-2分为长版和短版。长版由8个子测验组成，共53项；涉及ICF-CY身体功能和结构的关节活动功能(b710)、关节稳定功能(b715)等，以及活动与参与的模仿(d130)、学习计算(d150)等；在内部一致性信度、内容效度、结构效度等心理测量特性上达到优秀水平，在信度和重测信度上达到良好水平。MABC-2由活动能力测试和检查表两部分组成，共30项；涉及ICF-CY身体功能和结构的关节活动功能(b710)、关节稳定功能(b715)等，以及活动与参与的精巧手的使用(d440)、手和手臂的使用(d445)；有良好的信度、内容效度、结构效度等心理测量特性。
结论 本系统综述基于ICF-CY对4类残疾儿童青少年运动功能和运动能力评估工具的主要结构和内容特征进行分析，并且采用COSMIN对4类评估工具的心理测量特性(内部一致性、重测信度、内容效度、结构效度、跨文化一致性等)进行质量评价。从结构和内容特征看，PDMS-2的内容最广，且与BOT-2、MABC-2均会测量有关手的精细动作、动态与静态平衡相关的内容。GMFM-88更侧重于姿势控制等粗大运动功能的评估。4项工具均有较高的内部一致性信度、重测信度、内容效度和结构效度，BOT-2和PDMS-2信度较高，GMFM-88和MABC-2次之。为了保证测量的信度和效度，康复工作者和教育工作者在运用适用于残疾儿童青少年的运动功能和运动能力测量工具之前，均需要主试接受标准化的培训，并且取得相关测量资质后，方可运用标准化的工具进行测量。鉴于是常模参照测量，需要将测量结果转换为标准分。

关键词: 残疾, 儿童, 青少年, 运动功能, 运动能力, 测量工具

Abstract:

Objective To evaluate the main structural and content features of four instruments for motor function and motor ability assessment and their psychometric properties for children and adolescents with disabilities, based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY).
Methods PubMed, Medline and Web of Science databases were searched for literature on motor function and motor ability assessment for children and adolescents with disabilities published from establishment to May, 2023. The main structural and content characteristics of the tools were analyzed using ICF-CY, and the quality of measurement tools was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).
Results Nine papers were eventually included, and four assessment tools were identified, including Gross Motor Function Measure-88 (GMFM-88), Peabody Developmental Motor Scales second edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), and Movement Assessment Battery for Children second edition (MABC-2). The GMFM-88 consisted of 88 items in five dimensions: zone A (lying and rolling), zone B (sitting), zone C (crawling and kneeling), zone D (standing), and zone E (walking and running and jumping); it involved joint movement function (b710), random movement control function (b760), etc., in body function; and the change of basic body posture to maintain a body posture (d410) and maintain a body posture (d415) in activity and participation, with good to excellent levels of internal consistency reliability, test-retest reliability, content validity, and structural validity. The PDMS-2 consisted of six subtests, including reflexes, posture, movement, physical manipulation, grasping and visuomotor integration, with a total of 249 items; it involved memory function (b144) and joint mobility function (b710) in body function; as well as looking (d110) and imitation (d130) in activity and participation; with good psychometric properties in terms of internal consistency reliability, test-retest reliability, content validity, structural validity, and hypothesis testing and cross-cultural feasibility. There are two versions of BOT-2: long form and short form. The long form consisted of eight subtests with 53 items, involving joint mobility function (b710) and joint stability function (b715) in body function; as well as imitation (d130) and learned calculation (d150) in activity and participation; it achieved excellent levels of psychometric properties in terms of internal consistency reliability, content validity, and structural validity, and good level in reliability and test-retest reliability. MABC-2 consisted of two parts: an activity ability test and a checklist with 30 items; it involved joint mobility function (b710), joint stability function (b715), etc., in body function; as well as fine-hand use (d440), hand and arm use (d445) in activity and participation; with good psychometric properties such as reliability, content validity, and structural validity.
Conclusion This systematic review analyzed the main structural and content characteristics of four types of measurement tools for assessing motor function and motor ability in children and adolescents with disabilities based on the ICF-CY, and evaluated the quality of psychometric properties (internal consistency reliability, test-retest reliability, content validity, structural validity, and cross-cultural consistency, etc.) of the four types of measurement tools using the COSMIN criteria. For the structure and content, PDMS-2 appears the broadest content, and measures fine hand movements, dynamic and static balance, along with the BOT-2 and MABC-2. GMFM-88 focuses more on gross motor functions such as postural control. Four instruments show high internal consistency reliability, test-retest reliability, content validity and structural validity, while the BOT-2 and PDMS-2 show better reliability. To ensure the reliability and validity of the measures, rehabilitation workers and educators need to receive standardized training and qualification before using the standardized instruments for motor function and motor ability for children with disabilities. With norm-referenced measures, the results need to be converted to standard scores.

Key words: disability, children, adolescents, motor function, motor ability, measurement tools

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