Zanesljivost in veljavnost modificirane Ashworthove lestvice pri otrocih s cerebralno paralizo : magistrsko delo

Mikša-Pušnik, Daša (avtor), Pirkmajer, Sergej (mentor), Grapar Žargi, Tina (komentor)

Uvod: Pri cerebralni paralizi ali statični encefalopatiji kot posledici trajne in nenapredujoče okvare razvijajočih se možganov, je značilen čezmerno vzdražen refleks na razteg. S pomočjo standardizirane modificirane Ashworthove lestvice subjektivno ocenimo od hitrosti raztega mišice odvisno povečanje odpora na pasiven razteg (tj. spastičnost). Namen: Ovrednotiti zanesljivost posameznega preiskovalca in zanesljivost med preiskovalci za modificirano Ashworthovo lestvico ter sočasno veljavnost modificirane Ashworthove lestvice in Tardieujeve lestvice pri otrocih s cerebralno paralizo. Metode dela: Vključenih je bilo 24 otrok s cerebralno paralizo. Zanesljivost posameznega preiskovalca in zanesljivost med preiskovalci smo ugotavljali za modificirano Ashworthovo lestvico, pri izračunu sočasne veljavnosti smo dodali še rezultate Tardieujeve lestvice. Za vrednotenje zanesljivosti in veljavnosti je bil uporabljen koeficient intraklasne korelacije (ICC), pri veljavnosti smo izvedli tudi analizo s Spearmanovim koeficientom korelacije. V izračun smo vključili vse preiskovane mišice, ne glede na anatomsko razvrstitev gibalne oviranosti. Rezultati: Zanesljivost posameznega preiskovalca je bila v vzorcu visoka pri vseh preiskovanih mišicah (ICC = 0,91–0,99). Zanesljivost med preiskovalci je bila v vzorcu dobra, koeficient intraklasne korelacije je znašal od 0,80 do 0,89. V vzorcu smo pri vseh preiskovanih mišicah izračunali zmerno povezanost med Tardieujevo lestvico in modificirano Ashworthovo lestvico. Razprava in zaključek: Izsledki raziskave so v vzorcu pokazali visoko zanesljivost posameznega preiskovalca. Zanesljivost med preiskovalci se je v vzorcu izkazala za dobro. V vzorcu smo potrdili zmerno povezanost vključenih lestvic. Z namenom posplošitve na populacijo, bi bilo statistično analizo smotrno preveriti na večjem vzorcu. Smiselno bi bilo poenotenje protokola, ponovna standardizacija lestvice, vključujoč objektivnejšo, kvantitativno opredelitev spastičnosti.

• Jezik: Slovenski jezik
• Ključne besede: otroci, cerebralna paraliza, ocenjevanje spastičnosti, merske lastnosti
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2020
• PID: 20.500.12556/RUL-113767
• COBISS.SI-ID: 5775467
• Datum objave v RUL: 01.02.2020

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Reliability and validity of modified Ashworth scale in children with cerebral palsy : master thesis

Izvleček

Introduction: Cerebral palsy or static encephalopathy as a permanent and unprogressing impairment of developing brain, results in overactivity of the stretch reflex. Standarised Modified Ashworth Scale can be used for subjective assessment of a velocity-dependent response of muscle to passive stretching, (i.e. spasticity). Purpose: The aim of this work was to evaluate intra- and interrater reliability of modified Ashworth scale and concurrent validity of modified Ashworth scale in comparison to Tardieu scale in children with cerebral palsy. Methods: 24 children with cerebral palsy were subjected. Intra- and interrater reliability was assessed with Modified Ashworth Scale. Outcomes of Tardieu Scale were added for assessment of concurrent validity. For the assessment of reliability and concurrent validity, intraclass correlation coefficient (ICC) was used. Furthermore, Spearman's correlation coefficient for validity was tested. All the assessed muscles were included in the calculation, regardless of the anatomical classification of physical impairment. Results: Intrarater reliability in our sample was excellent in all investigating muscle (ICC = 0,91– 0,99). Good interrater reliability in the sample was observed, with intraclass correlation coefficient from 0,80 to 0,89. Moderate positive correlation in all investigating muscles between Tardieu scale and modified Ashworth scale has been calculated. Discussion and conclusion: The outcomes of our research confirmed excellent intrarater reliability in the sample. Interrater reliability in the sample was assessed as good. In the sample moderate positive correlation was confirmed. For the generalization of the outcomes on population level, statistical analysis should be repeated in a larger sample. An unification, restandardization of the scale, including more objective, quantitative definition of spasticity should be considered in further research.

• Ključne besede: children, cerebral palsy, spasticity assessment, psychometric properties