Reliability of clinical outcome measures in CMT

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Reliability of clinical outcome measures in Charcot-Marie-Tooth

disease

http://www.nmd-journal.com/article/PIIS0960896607007237/abstract

A. Solaria, M. Lauràb, E. Salsanob, D. Radicec, D. Pareysonb

Abstract

We assessed inter- and intra-rater reliability of outcome measures in

Charcot-Marie-Tooth disease (CMT) patients. In 40 CMT patients, we

assessed reliability of Overall Neuropathy Limitations Scale (ONLS),

10-m timed walk (T10MW), 9-hole-peg test (9-HPT), maximal voluntary

isometric contraction (MVIC) of arm (elbow flexion, hand-grip, and

three-point pinch) and leg (knee extension, foot dorsiflexion/plantar

flexion). Reliability was substantial for ONLS, excellent for T10MW

and 9-HPT. For MVIC, inter and intra-rater reliability was excellent

for hand contractions; for leg contractions, intra-rater agreement

was moderate to substantial, whereas inter-rater agreement was poor.

An ad hoc device was produced to immobilize the foot and MVIC

reliability was re-assessed in 26 CMT patients, resulting in

excellent inter-rater and intra-rater reliability for foot

dorsiflexion, and clear inter-rater improvement for foot plantar

flexion.

All outcome measures appear adequate for CMT assessment. Use of an

immobilization device improves foot MVIC reliability, preventing

biased findings in patients with greater strength.

Keywords: Reliability, Outcome measures, Randomised clinical trial,

Charcot-Marie-Tooth disease

a Neuroepidemiology Unit, IRCCS Foundation, " C. Besta " Neurological

Institute, Via Celoria 11, 20133 Milan, Italy

b Division of Biochemistry and Genetics, IRCCS Foundation, " C. Besta "

Neurological Institute, Milan, Italy

c Division of Epidemiology and Biostatistics, European Institute of

Oncology, Milan, Italy