Reliability of clinical outcome measures in Charcot-Marie-Tooth disease.
We assessed inter- and intra-rater reliability of outcome measures in Charcot-Marie-Tooth disease (CMT) patients. In 40 CMT patients, we assessed reliability of Overall Neuropathy Limitations Scale (ONLS), 10-m timed walk (T10MW), 9-hole-peg test (9-HPT), maximal voluntary isometric contraction (MVIC) of arm (elbow flexion, hand-grip, and three-point pinch) and leg (knee extension, foot dorsiflexion/plantar flexion). Reliability was substantial for ONLS, excellent for T10MW and 9-HPT. For MVIC, inter and intra-rater reliability was excellent for hand contractions; for leg contractions, intra-rater agreement was moderate to substantial, whereas inter-rater agreement was poor. An ad hoc device was produced to immobilize the foot and MVIC reliability was re-assessed in 26 CMT patients, resulting in excellent inter-rater and intra-rater reliability for foot dorsiflexion, and clear inter-rater improvement for foot plantar flexion. All outcome measures appear adequate for CMT assessment. Use of an immobilization device improves foot MVIC reliability, preventing biased findings in patients with greater strength.
Solari
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A
Neuroepidemiology Unit, IRCCS Foundation, C. Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy. solari@istituto-besta.it
Laurà
M
M
Salsano
E
E
Radice
D
D
Pareyson
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm / Q000294:innervation / Q000503:physiopathology; D001205:Ascorbic Acid / Q000627:therapeutic use*; D002607:Charcot-Marie-Tooth Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods; D015588:Observer Variation; D015990:Placebo Effect; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012149:Restraint, Physical / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
D001205:Ascorbic Acid