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

Abstract：

OBJECTIVE:To validate manual muscle testing (MMT) for strength assessment in juvenile and adult dermatomyositis (DM) and polymyositis (PM). METHODS:Patients 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. RESULTS:The Total, Proximal, and best MMT subsets had excellent internal reliability (Total MMT r(s) = 0.91-0.98), and consistency (Cronbach's alpha = 0.78-0.97). Inter- and intrarater reliability were acceptable (Kendall's W 0.68-0.76, r(s) = 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. CONCLUSION:These findings aid in standardizing the use of MMT for assessing strength as an outcome measure for myositis.

journal_name

Arthritis Care Res (Hoboken)

journal_title

Arthritis care & research

authors

Rider LG,Koziol D,Giannini EH,Jain MS,Smith MR,Whitney-Mahoney K,Feldman BM,Wright SJ,Lindsley CB,Pachman LM,Villalba ML,Lovell DJ,Bowyer SL,Plotz PH,Miller FW,Hicks JE

doi

10.1002/acr.20035

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

465-72

issue

eissn

2151-464X

issn

2151-4658

journal_volume

pub_type

临床试验,杂志文章,多中心研究

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