Standardization of an Objective Test of Motor Recovery in Hemiplegia (II)

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This report describes the fundamental examination of the 10-Grade-Test for motor recovery in hemiplegia. The inter-rater agreement of the test and subtest judgements was assessed on the data obtained from 18 raters and 12 subjects of Stages III and IV allocated according to a PBIB design (Step 3). Then the inter - rater, intra-rater and day-to-day variations in ratings or judgements were analyz ed on the data of 153 post-stroke patients, 142 upper and 107 lower limbs, of various Stages of recovery. The agreement in subtest judgement was higher than 70% for the majority of subtests, and the coefficient of determination of Gradein the upper limb was 0.984 and that in the lower 0.966. The proposed 10-Grade-Test seems to be practicable and reliable although few individual subtests are to be refined (Step 4).<BR>On the same date of 153 subjects, the ordered arrangement according to difficulty of subtests was examined according to Guttman's scalogram analysis. Studies on the item-score matrix and the individual ogives (characteristic curves) of subtests revealed the subtests for the associated reaction of the upper and the lower limbs and few others of the lower lacking the monotonous nature of ogive. It is, however, that the peculiar pattern of ogive for the associated reaction seems rather reflecting the very nature of the recovery process in post-stroke hemiplegia.<BR>The results of principal component analyses suggest that the subtests of both limbs are to be classified into 3 groups, namely, those for the associated reaction, the evolution and the dissolution of pathological synergy patterns. The proposed set of subtests appear to span at least a quasi-unidimensional scale with clinical meaning (Step 5).<BR>At this end of study, a 12-Grade-Test which gives 13 grades is formulated as a candidate deemed more sensitive than the initial 10-Grade-Test.
一般社団法人日本臨床薬理学会の論文

Standardization of an Objective Test of Motor Recovery in Hemiplegia (II)

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