title: Elaboration and reliability of functional evaluation on going up and downstairs scale for Duchenne Muscular Dystrophy.
abstract: BACKGROUND
  Instruments of functional evaluation for patients with Duchenne Muscular Dystrophy (DMD), available from the literature, are limited and scarce, making clinical decision on Physiotherapy difficulty.
  
  
  OBJECTIVE
  To describe the process of creating a functional assessment scale in patients with DMD while going up and down the stairs, as well as to analyse the intra and inter-rater reliability of this scale.
  
  
  METHODS
  The scale development consisted of five stages: 1) to elaborate a script for directed observation based upon literature, 2) to describe a sequence of movements assessing 120 video recordings from 30 children (from 5 to 11 years) with DMD while going up and down stairs, 3) to elaborate a scale considering the degree of difficulty to execute the movements, 4) to create handbook, and 5) to submit both the scale and the handbook to be assess by 10 examiners, and review to create the final version. Both repeatability (researcher) and reproducibility (two independent examiners) were tested by using the IntraClass Correlation Coefficient (ICC) and Weighted Kappa respectively.
  
  
  RESULTS
  The scale encloses five phases for going up and four phases for going downstairs. Our results showed both excellent intra and intertester reliability, with values of Weighted Kappa > 0.78 in all phases and ICCs > 0.89, with p<0.05 for all scores.
  
  
  CONCLUSIONS
  The proposed scale showed excellent repeatability and reproducibility, requiring continuing the studies to assess its accuracy, validity and to create digital tools to improve data collection.
authors.affiliation: Laboratório de Fisioterapia e Comportamento, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Lilian A Y
authors.initials: LA
authors.lastname: Fernandes
authors.forename: Fátima A
authors.initials: FA
authors.lastname: Caromano
authors.forename: Michele E
authors.initials: ME
authors.lastname: Hukuda
authors.forename: Renata
authors.initials: R
authors.lastname: Escorcio
authors.forename: Eduardo V
authors.initials: EV
authors.lastname: Carvalho
mesh_terms: D002648:Child; D002675:Child, Preschool; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D020388:Muscular Dystrophy, Duchenne / Q000503:physiopathology*; D015588:Observer Variation; D015203:Reproducibility of Results