Abstract:
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Author:C. Vuillerot1, P. Rippert1, C. Brd1 and the NM-Score study group21 L'Escale, HFME, HCL, France2 France (Angers, Grenoble, Hendaye, Lille, Marseille, Montpellier, Nice, Paris, St Denis de la Rion, St Etienne, Toulouse, Vandoeuvre les Nancy, Villeneuve d'Asq), Belgium (Brussels), Switzerland (Lausanne) Introduction: Considering the current progress made in terms of research and caretaking of neuromuscular diseases, interest of developing valid outcome measures to assess evolution of motor function (MF) has recently increased. In this context, our group constructed and validated the Motor Function Measure (MFM) to monitor MF in patients with neuromuscular diseases. This tool provides measures of MF capacities under optimal conditions in 3 dimensions: standing and transfers (D1), axial and proximal MF (D2) and distal MF (D3). In order to complete the patients' MF description, we suggest a new classification in levels of MF for neuromuscular diseases over D1, D2 and D3 analogous to the staging and grading system used for the Gross Motor Disability Classification System in the cerebral palsy field. This new classification focuses on the MF performances under ordinary circumstances, rather than capacities observed under optimal conditions.Objective:The goal of the poster is to describe the construction of a first version of classification, named NM-score and to analyse interrater reliabilities of the classification.Results:A first version of NM-score was proposed by experts. Major and minor criterions were defined in five level of severity for D1, D2 and D3. Content validities of the proposed NM-score were examined using a Delphi survey process and interrater reliabilities were examined via an experimental phase. 71 patients with neuromuscular diseases from 6 to 60 years of age were recruited in 6 centres. Each of them was evaluated using NM-score by two therapists. Chance-corrected agreements (k) of 0.720, 0.624 and 0.559 were determined for D1, D2 and D3, respectively.Conclusion:We do not wish to replace MFM that we consider as the gold standard for the measure of the MF in neuromuscular diseases but to create an extra tool, with the idea of a meaningful valid and reproducible classification in 5 levels of severity. This new classification could be useful both in clinical practice and research.The levels of k for the 3 dimensions support the interrater reliability of NM-score. Improvements of NM-score are discussed with regard to our results.
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