Objective To develop a simplified functional scale and classification system to evaluate the functional abilities of patients with Duchenne muscular dystrophy (DMD). Methods A Comprehensive Functional Scale for DMD (CFSD) was developed using the modified Delphi method. The accompanying Ambulatory Functional Classification System for DMD (AFCSD) was developed based on previously published classification systems. Results The CFSD consists of 21 items and 78 sub-items, assessing body structure and function, activities, and participation. Inter-rater intraclass correlation coefficient values were above 0.7 for 17 items. The overall limits of agreement between the two examiners ranged from -6.21 to 3.11. The Spearman correlation coefficient between the total score on the AFCSD and the Vignos Functional Scale was 0.833, and 0.714 between the total score of the AFCSD and the Brooke scale. Significant negative correlations existed between the total score for each functional level of the AFCSD and each functional grade of the Vignos and Brooke scales. The total scores of the CFSD varied significantly between the functional grades of the Vignos scale, and specific grades of the Brooke scale. For the AFCSD, total scores of the CFSD varied significantly between the functional levels. Conclusion We have developed a new scale and the associated classification system, to assess the functional ability of children diagnosed with DMD. Preliminary evaluation of the psychometric properties of the functional scale and classification systems indicate sufficient reliability and concurrent validity.
Bibliographical noteFunding Information:
This work was funded by the grant from Seoul Broadcasting System and KG&G Corporation. The Medical Research Collaborating Center of the Seoul National University Biomedical Research Institute provided statistical advice for sample size estimation. The authors also wish to thank Professors Seong-Eun Koh, Bum-Sun Kwon, Jeongyi Kwon, Yong Beom Shin, and Jong Hee Chae for their expertise, which has enhanced the quality of our study. We also appreciate the assistance of Juyong Kim, Yu-Sun Min, Je Ho Kim, Kwang Dong Kim, and Woo Sung Son with data collection.
© 2018 by Korean Academy of Rehabilitation Medicine.
- Ambulatory function
- Duchenne muscular dystrophy
- Functional scale
- Scale development