Reliability of Spinal Alignment and Range of Motion Measure in children and adolescents with cerebral palsy

ABSTRACT Cerebral palsy is the most frequent cause of physical disability in childhood due to permanent movement and posture development disorders and secondary musculoskeletal problems. The Spinal Alignment and Range of Motion Measure (SAROMM) assess postural deviations and trunk extensibility. This is a cross-sectional study with a convenience sample to evaluate the reliability of SAROMM and to validate its use in clinical practice. In total, 50 children participated in Stage 1 (video evaluation, with and without the instruction manual), and 25 children participated in Stage 2 (in-person evaluation). In Stage 1, the intra-examiner reliability showed almost perfect agreement in all domains (κ ranging from 0.98 to 1.0), except ankle, with a moderate agreement (κ=0.62). Inter-examiner reliability without using the manual showed no agreement (κ ranging from −0.00 to 0.10); with the use of the manual showed weak agreement in all domains (κ from 0.41 to 0.59), except ankle, which showed a minimal agreement (κ=0.20). In Stage 2, inter-examiner reliability showed almost perfect agreement in all domains (κ ranging from 0.93 to 0.97). SAROMM has excellent intra- and inter-examiner reliability, and in-person assessment with the instructions manual is essential.

【摘要】 脑瘫（Cerebral palsy）是儿童时期最常见的肢体残疾病因，其源于永久性运动与姿势发育障碍及继发肌肉骨骼问题。脊柱对齐与活动度评估量表（Spinal Alignment and Range of Motion Measure, SAROMM）用于评估姿势偏差与躯干伸展性。本研究为横断面研究，采用便利抽样方法，旨在评估SAROMM的信度并验证其临床应用价值。总计50名儿童参与第一阶段研究（视频评估，分别设置使用与未使用操作手册两种场景），25名儿童参与第二阶段研究（面对面实地评估）。第一阶段中，除踝关节维度的评定者内部一致性为中等水平（κ=0.62）外，其余所有维度的评定者内部一致性均达到近乎完美程度（κ值范围为0.98~1.0）。未使用操作手册时的评定者间一致性无统计学意义（κ值范围为-0.00~0.10）；使用操作手册时，除踝关节维度一致性极低（κ=0.20）外，其余所有维度的评定者间一致性均为弱水平（κ值范围为0.41~0.59）。第二阶段中，评定者间所有维度的一致性均达到近乎完美程度（κ值范围为0.93~0.97）。SAROMM具备优异的评定者内部与评定者间信度，且配合操作手册开展面对面评估是必不可少的。