Evaluation Scale Development, Reliability for Sitting and Standing From the Chair for Duchenne Muscular Dystrophy

Abstract

The authors aimed to (a) develop a scale to evaluate non-wheelchair-dependent children with Duchenne muscular dystrophy (DMD) while sitting and standing from the chair, (b) test its reliability, and (c) correlate the scores of this scale with the time, the age and the Vignos. Thirty DMD boys performed sit-to-stand and stand-to-sit from the chair 4 times. Scale development was based on a previous movement characterization in healthy children and in DMD children and on suggestions by physical therapists with expertise in DMD. The final version of the scale was submitted to the analysis of reliability. The sitting evaluation consists of phases: flexion, contact of the hip with the chair, extension. The standing evaluation comprehends the phases: flexion; transference; extension. Sitting and standing phases presented an excellent reliability (intraclass correlation coefficient [ICC] ≥ 0.91) and a good reproducibility (ICC ≥ 0.89). The scores generated by sitting on the chair correlated to the time taken to perform the tasks (r = .69) and to the age of the patient (r = .44) and the score of standing from the chair also correlated to the time of performance (r = .66). The sit-to-stand functional evaluation scale DMD is a reliable assessment tool that allows the description and quantification of the functional performance of DMD children.

How often should sitting and rising from a chair be evaluated in patients with Duchenne muscular dystrophy?

“…The child can let himself fall on the chair during the trunk flexion phase. A previous study showed that the absence of trunk flexion (contact phase) and trunk extension (extension phase) was due to impaired eccentric muscle contraction 7 . As well, patients performed compensatory movements, such as upper limb support and trunk rotation and lateral tilting 7 .…”

“…A previous study showed that the absence of trunk flexion (contact phase) and trunk extension (extension phase) was due to impaired eccentric muscle contraction 7 . As well, patients performed compensatory movements, such as upper limb support and trunk rotation and lateral tilting 7 . In sit-to-stand, a progressive increase of the base of support with trunk flexion and rotation and upper limb support on the seat were observed.…”

“…Rising from the chair involves 1) trunk flexion, 2) weight transfer and 3) trunk extension. For both activities, higher scores denote a higher number of compensatory movements, therefore, poorer clinical and functional status 7 . Sit-to-stand was considered an accurate outcome measure to detect weight-bearing asymmetry 12 and functional independence 13 in stroke patients.…”

“…The FES-DMD has four domains: sitting and rising from a chair 7 ; walking 8 ; climbing up and down steps 9 ; and sitting down on, and standing up from the floor 10 . Excellent intra-and interrater reliabilities of all domains have been demonstrated 7,8,9,10 . In the FES-DMD, the tasks are videoed, which reduces evaluation time and patient fatigue (caused by the repetition of the activities).…”

“…In the FES-DMD, the tasks are videoed, which reduces evaluation time and patient fatigue (caused by the repetition of the activities). The scoring is based on the systematic observation of the videos and can also be performed with the assistance of FES-DMD-DATA software 7 . The FES-DMD-DATA offers the simultaneous observation of the video and the assessment chart on the same screen, which facilitates data collection and organization 11 .…”