Table 1_Assessing proprioception in children with upper motor neuron lesions: feasibility, validity, and reliability of the proprioception measurement tool.docx

IntroductionTo investigate the feasibility, discriminative and convergent validity, and reliability of a lower limb sensor-based proprioception measure in children with upper motor neuron (UMN) lesions.
MethodWe assessed three proprioception modalities (joint movement, joint position, and dynamic position sense) of the lower limbs in 49 children with UMN lesions and 50 typically developing (TD) peers (5–19 years). Forty-three children with UMN lesion had a congenital and six an acquired brain lesion and 82% were able to walk without a walking aid. We evaluated the feasibility, compared the test results between children with UMN lesions and TD peers, and calculated Spearman correlations (rs) between the modalities. We quantified relative reliability with Intra-Class Correlation Coefficients (ICC) and absolute reliability with Smallest Detectable Changes (SDC).
ResultsMost children with UMN lesions (>88%) found the tests easy to perform. The children with UMN lesions had significantly (p < 0.001) lower proprioceptive function than the TD children. The correlation between the three proprioceptive modalities was moderate to high (0.50 ≤ rs ≤ 0.79). The relative reliability for test-retest and the inter-rater reliability was moderate to high (ICCs = 0.65–0.97), and SDC was between 2° and 15°.
DiscussionThe three tests are feasible, and discriminative and convergent validity and reliability were confirmed. Further studies should investigate the influence on motor function and performance in children with UMN lesions.

引言：本研究旨在探讨基于下肢传感器的本体感觉评估工具在伴上运动神经元（upper motor neuron, UMN）损伤儿童中的可行性、区分效度、会聚效度以及信度。
方法：本研究纳入49名伴上运动神经元损伤的儿童与50名同龄典型发育（typically developing, TD）儿童（年龄5~19岁），对其下肢的3种本体感觉模式（关节运动觉、关节位置觉以及动态位置觉）进行评估。其中43名患儿为先天性脑损伤，6名为获得性脑损伤，82%的患儿可无需辅助器具行走。本研究评估了该评估工具的可行性，对比了上运动神经元损伤儿童与典型发育儿童的测试结果，并计算了各本体感觉模式间的斯皮尔曼相关系数（rs）。采用组内相关系数（Intra-Class Correlation Coefficients, ICC）量化相对信度，以最小可检测变化（Smallest Detectable Changes, SDC）量化绝对信度。
结果：超过88%的上运动神经元损伤儿童认为该测试易于完成。伴上运动神经元损伤的儿童其本体感觉功能显著低于典型发育儿童（p<0.001）。3种本体感觉模式间的相关性为中等到高度相关（0.50≤rs≤0.79）。重测相对信度与评定者间信度均为中等到高度水平（组内相关系数ICC=0.65~0.97），最小可检测变化SDC介于2°~15°之间。
讨论：本研究证实3项测试具有可行性，且该评估工具的区分效度、会聚效度与信度均达标。未来的研究可进一步探讨该工具对上运动神经元损伤儿童运动功能与运动表现的影响。