英国医学研究理事会肌力测试在重症监护室患儿中的评定者间信度

doi:10.3969/j.issn.1006-9771.2024.04.016

Abstract

Abstract:

Objective To investigate the inter-rater reliability of Medical Research Council (MRC) muscle strength test in critically ill children.

Methods From June, 2022, to March, 2023, 41 critically ill children aged two to twelve years were involved from the Pediatric Intensive Care Unit of Children's Hospital of Fudan University. Two physiotherapists implemented MRC muscle strength tests separately.

Results MRC total score was good in inter-rater reliability (ICC = 0.788, 95%CI 0.636 to 0.881, P < 0.001), as well as both the scores of upper limbs and lower limbs (ICC = 0.641 to 0.803, 95%CI 0.419 to 0.890, P < 0.001). For children more than seven years old, MRC total score was excellent in inter-rater reliability (ICC = 0.855, 95%CI 0.692 to 0.935, P < 0.001).

Conclusion MRC muscle strength test is good in inter-rater reliability for critically ill children, especially for school-age children.

Key words: children, critically ill, muscle strength test, reliability

CLC Number:

LU Kai, LIU Yuxin, WANG Sujuan, CHEN Weiming, XU Yetao, ZHOU Hao, YAO Yelin, YIN Huanhuan, ZHANG Zhengzheng, DU Yan. Inter-rater reliability of Medical Research Council muscle strength test in pediatric intensive care unit[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 493-496.

Figures/Tables 4

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Table 4

References 19

[1]	SCHEFOLD J C, BIERBRAUER J, WEBER-CARSTENS S. Intensive care unit acquired weakness (ICUAW) and muscle wasting in critically ill patients with severe sepsis and septic shock[J]. J Cachexia Sarcopenia Muscle, 2010, 1(2): 147-157. doi: 10.1007/s13539-010-0010-6
[2]	刘蕾, 李景辉, 刘芙蓉, 等. ICU获得性肌无力病理生理机制的研究进展[J]. 中华危重症医学杂志(电子版), 2018, 11(2): 133-138.
[3]	LATRONICO N, FENZI F, RECUPERO D, et al. Critical illness myopathy and neuropathy[J]. Lancet, 1996, 347: 1579-1582. pmid: 8667865
[4]	FAN E, CHEEK F, CHLAN L, et al. ATS Committee on ICU-acquired Weakness in Adults; American Thoracic Society. An official American Thoracic Society Clinical Practice guideline: the diagnosis of intensive care unit-acquired weakness in adults[J]. Am J Respir Crit Care Med, 2014 190(12): 1437-1446.
[5]	SCHALLER S J, ANSTEY M, BLOBNER M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial[J]. Lancet, 2016, 388(10052): 1377-1388. doi: S0140-6736(16)31637-3 pmid: 27707496
[6]	CHRISTAKOU A, PAPADOPOULOS E, PATSAKI I, et al. Functional assessment scales in a general intensive care unit. A review[J]. Hosp Chronicles, 2013, 8(4): 164-170.
[7]	潘世琴, 王丽, 王玉宇. 危重症患者肌力评定方法的研究进展[J]. 中国康复理论与实践, 2019, 25(9): 1052-1056. doi: 10.3969/j.issn.1006-9771.2019.09.011
	PAN S Q, WANG L, WANG Y Y. Advance in muscle strength assessment for critical patients (review)[J]. Chin J Rehabil Theory Pract, 2019, 25(9): 1052-1056.
[8]	VANHOREBEEK I, LATRONICO N, VAN DEN BERGHE G. ICU-acquired weakness[J]. Intensive Care Med, 2020, 46(4): 637-653. doi: 10.1007/s00134-020-05944-4 pmid: 32076765
[9]	VANPEE G, HERMANS G, SEGERS J, et al. Assessment of limb muscle strength in critically ill patients: a systematic review[J]. Crit Care Med, 2014, 42(3): 701-711. doi: 10.1097/CCM.0000000000000030 pmid: 24201180
[10]	HERMANS G, CLERCKX B, VANHULLEBUSCH T, et al. Interobserver agreement of Medical Research Council sum-score and handgrip strength in the intensive care unit[J]. Muscle Nerve, 2012, 45: 18-25. doi: 10.1002/mus.22219 pmid: 22190301
[11]	HOUGH C L, LIEU B K, CALDWELL E S. Manual muscle strength testing of critically ill patients: feasibility and interobserver agreement[J]. Crit Care, 2011, 15: R43. doi: 10.1186/cc10005
[12]	KLEYWEG R P, VAN DER MECHÉ F G, SCHMITZ P I. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barré syndrome[J]. Muscle Nerve, 1991, 14: 1103-1109. doi: 10.1002/mus.880141111 pmid: 1745285
[13]	FAN E, CIESLA N D, TRUONG A D, et al. Inter-rater reliability of manual muscle strength testing in ICU survivors and simulated patients[J]. Intensive Care Med, 2010, 36: 1038-1043. doi: 10.1007/s00134-010-1796-6 pmid: 20213068
[14]	CONNOLLY B A, JONES G D, CURTIS A A, et al. Clinical predictive value of manual muscle strength testing during critical illness: an observational cohort study[J]. Crit Care, 2013, 17: R229. doi: 10.1186/cc13052
[15]	SIU K, AL-HARBI S, CLARK H, et al. Feasibility and reliability of muscle strength testing in critically ill children[J]. J Pediatr Intensive Care, 2015, 4(4): 218-224. doi: 10.1055/s-0035-1563544 pmid: 31110873
[16]	TAYLOR C. Intensive care unit acquired weakness[J]. Anaesth Intensive Care Med, 2018, 19 (3): 79-82. doi: 10.1016/j.mpaic.2017.12.009
[17]	MOKKINK L B, TERWEE C B, PATRICK D L, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study[J]. Qual Life Res, 2010, 19: 539-549. doi: 10.1007/s11136-010-9606-8 pmid: 20169472
[18]	PARATZ J D, BERSTEN A D. Muscle strength assessment in critically ill patients with handheld dynamometry: an investigation of reliability, minimal detectable change, and time to peak force generation[J]. J Crit Care, 2013, 28: 77-86. doi: 10.1016/j.jcrc.2012.03.001 pmid: 22520490
[19]	BOHANNON R W. Manual muscle testing: Does it meet the standards of an adequate screening test?[J]. Clin Rehabil, 2005, 19: 662-667. doi: 10.1191/0269215505cr873oa pmid: 16180603

变量	n	ICC	95%CI	P值
总分	41	0.788	0.636~0.881	< 0.001
年龄
≥ 7岁	23	0.855	0.692~0.935	< 0.001
< 7岁	18	0.695	0.356~0.874	0.001
≥ 5岁	31	0.757	0.555~0.875	< 0.001
< 5岁	10	0.718	0.242~0.920	0.004

疾病类型	n	ICC	95%CI	P值
神经系统	11	0.687	0.175~0.905	0.008
呼吸系统	17	0.763	0.465~0.907	< 0.001
其他	13	0.883	0.669~0.963	< 0.001

肌群	n	ICC	95%CI	P值
肩外展	82	0.584	0.421~0.711	< 0.001
肘屈曲	82	0.585	0.422~0.711	< 0.001
腕伸展	82	0.439	0.249~0.597	< 0.001
髋屈曲	82	0.640	0.475~0.758	< 0.001
膝伸展	82	0.796	0.700~0.864	< 0.001
踝背屈	82	0.649	0.494~0.762	< 0.001

Inter-rater reliability of Medical Research Council muscle strength test in pediatric intensive care unit

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肢体	n	ICC	95%CI	P值
上肢	41	0.641	0.419~0.791	< 0.001
下肢	41	0.803	0.660~0.890	< 0.001

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