摘要：

目的 评价定量等长肌力测定在Duchenne 型和Becker 型肌营养不良症患儿下肢肌力测定中的信度。方法 共21 例Duchenne 型（19 例）和Becker 型（2 例）肌营养不良症患儿，采用手持式肌力测定仪检测患儿髋、膝、踝等部位肌群肌力，比较不同检测者间和同一检测者两次测试结果间的相关性，以评价手持式肌力测定仪的不同检测者间信度和重测信度。结果 手持式肌力测定仪测定Duchenne型和Becker型肌营养不良症患儿下肢肌群具有良好的不同检测者间信度（ICC = 0.762 ~ 0.978）和重测信度（ICC = 0.690 ~ 0.938），但二者对远端肌群（足跖屈和足背屈）信度均相对较低。结论 手持式肌力测定仪在Duchenne 型和Becker 型肌营养不良症患儿下肢肌力测定中具有较好的不同检测者间信度和重测信度，可以用于监测肌力变化和评价临床疗效。

关键词: 肌营养不良, 杜氏, 肌力, 下肢

Abstract:

Objective To determine the reliability of hand-held dynamometry (HHD) for lower limb isometric muscle strength measurement in children with Duchenne and Becker muscular dystrophy (DMD/BMD).  Methods  A total of 21 children [20 males and one female; mean age was (7.88 ± 2.87) years, ranging between 3.96-14.09 years; mean age at diagnosis was (5.88 ± 2.88) years, ranging between 1.35-12.89 years; mean height was (120.64 ± 16.30) cm, ranging between 97-153 cm; mean body weight was (24.62 ± 9.05) kg, ranging between 14-50 kg] with DMD (19/21) and BMD (2/21) were involved from Rehabilitation Center of Children's Hospital of Fudan University. The muscle strength of hip, knee and ankle was measured by HHD under standardized test methods. The test-retest results were compared to determine the inter-test reliability, and the results among testers were compared to determine the inter-tester reliability.  Results   HHD showed fine inter-tester reliability (ICC = 0.762-0.978) and inter-test reliability (ICC = 0.690-0.938) in measuring lower limb muscle strength of children with DMD/BMD. Results also showed relatively poor reliability in distal muscle groups (foot plantar flexion and dorsiflexion).  Conclusions  HHD, showing fine inter-tester and inter-test reliability in measuring the lower limb muscle strength of children with DMD/BMD, can be used in monitoring muscle strength changing and assessing effects of clinical interventions.

Key words: Muscular dystrophy, Duchenne, Muscle strength, Lower extremity