Validation of manual muscle testing and a subset of eight muscles for adult and juvenile idiopathic inflammatory myopathies

Arthritis Care and Research - Tập 62 Số 4 - Trang 465-472 - 2010
Lisa G. Rider1, Deloris E. Koziol2, Edward H. Giannini3, Minal Jain2, Michaele R. Smith2, Kristi Whitney-Mahoney4, Brian M. Feldman4, Susan Wright5, Carol B. Lindsley5, Lauren M. Pachman6, María L. Villalba7, Daniel J. Lovell3, Suzanne L. Bowyer8, Paul H. Plötz7, Frederick W. Miller7, Jeanne E. Hicks2
1Environmental Autoimmunity Group, Office of Clinical Research, National Institute of Environmental Health Sciences/NIH, 10 Center Drive, Bethesda, MD 20892-1301, USA.
2Clinical Center, NIH, Department of Health and Human Services, Bethesda, Maryland
3Cincinnati Children's Hospital Medical Center
4University of Toronto
5University of Kansas
6Children's Memorial Hospital and Northwestern University, Chicago, Illinois
7NATIONAL INSTITUTES OF HEALTH
8Indiana Univ.-Purdue Univ. Indianapolis

Tóm tắt

AbstractObjectiveTo validate manual muscle testing (MMT) for strength assessment in juvenile and adult dermatomyositis (DM) and polymyositis (PM).MethodsPatients with PM/DM (73 children and 45 adults) were assessed at baseline and reevaluated 6–9 months later. We compared Total MMT (a group of 24 proximal, distal, and axial muscles) and Proximal MMT (7 proximal muscle groups) tested bilaterally on a 0–10 scale with 144 subsets of 6 and 96 subsets of 8 muscle groups tested unilaterally. Expert consensus was used to rank the best abbreviated MMT subsets for face validity and ease of assessment.ResultsThe Total, Proximal, and best MMT subsets had excellent internal reliability (Total MMT rs = 0.91–0.98), and consistency (Cronbach's α = 0.78–0.97). Inter‐ and intrarater reliability were acceptable (Kendall's W 0.68–0.76, rs = 0.84–0.95). MMT subset scores correlated highly with Total and Proximal MMT scores and with the Childhood Myositis Assessment Scale, and correlated moderately with physician global activity, functional disability, magnetic resonance imaging, and axial and distal MMT scores, and, in adults, with creatine kinase level. The standardized response mean for Total MMT was 0.56 in juveniles and 0.75 in adults. Consensus was reached to use a subset of 8 muscles (neck flexors, deltoids, biceps, wrist extensors, gluteus maximus and medius, quadriceps, and ankle dorsiflexors) that performed as well as the Total and Proximal MMT, and had good face validity and ease of assessment.ConclusionThese findings aid in standardizing the use of MMT for assessing strength as an outcome measure for myositis.

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Arthritis Care and Research

Tập 62 Số 4

465-472

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