Elaboração e confiabilidade da escala funcional do subir e do descer escada para Distrofia Muscular de Duchenne

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. Objectives: 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. Conclusion: 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. © Revista Brasileira de Fisioterapia.