| Summary: | 碩士 === 國立臺灣大學 === 物理治療學研究所 === 92 === Abstract
Purposes. The purpose of this study was to examine the test-retest reliability, the extent of the responsiveness and the severity and age effects on score changes of the gross motor domain of the Peabody Developmental Motor Scales-Second Edition (PDMS-2) for children with cerebral palsy. Methods. A proportional sampling method was used to recruit 32 children with cerebral palsy aged from 24 to 65 months, who then received regular physical or occupational therapy. The recruited children were evenly distributed based on age (<48mo. /≧48mo.), and severity according the Gross Motor Function Classification System (GMFCS) (GMFCS I-II/GMFCS III-V). The PDMS-2 was administered to each child three times, at the beginning of the study, at 1 week and at 3 months later, by a therapist blinded with the treatment status of the children. Results. The results demonstrated that the PDMS-2 had good test-retest reliability over one-week period (Intraclass correlation coefficients =.95-1.00). The internal responsiveness indices, p values of the paired t test, and effect size II, and the external responsiveness index, effect size III, showed that the PDMS-2 had significant differences and large responsiveness over a 3-month period. The other external responsiveness index, receiver operating characteristic curve analysis, revealed an acceptable accuracy probability to discriminate improvement or non-improvement while using the parents’ rating scale as external criteria for the Gross Motor Composite of the PDMS-2. However, only 44% of the children were greater than the measurement error of the Total Motor Composite of the PDMS-2. Further, only score changes of the Object Manipulation Subtest showed significant differences between the two severity groups. There was no significant difference in mean score changes between the two age groups. Discussion & Conclusion. The PDMS-2 has good test-retest reliability over one-week period and good internal responsiveness over 3-month period. The external responsiveness is not satisfied may due to the problems of the external criteria used. If only consider results of the internal responsiveness, all 3 composites and 5 subtests of the PDMS-2 might be used as an evaluative measure in children with CP aged from 24 to 65 months. The severity and age effects on score changes of the gross motor domain of the PDMS-2 for children with cerebral palsy need further study.
Key Wards: Cerebral Palsy, Responsiveness, Measurement, the Peabody Developmental Motor Scales-Second Edition
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