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Updated: Jun 5, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Development of an evaluation scale for sitting and standing from the ground for children with Duchenne muscular
Renata Escorcio1, Fatima Aparecida Caromano, Michele Emy Hukuda
1Laboratory of Physiotherapy and Behavior, School of Medicine, University of Sao Paulo, Brazil. reescorcio@hotmail.com
Insights
Researchers created a reliable scale to assess sit-to-stand movements in children with Duchenne muscular dystrophy (DMD). This new tool demonstrates excellent consistency and can aid in evaluating functional mobility for DMD patients.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Duchenne muscular dystrophy (DMD) significantly impacts motor function, particularly in activities like sitting and standing.
- Objective functional measures are crucial for tracking disease progression and treatment efficacy in pediatric DMD.
- Existing assessment tools may not fully capture the nuances of sit-stand transitions in this population.
Purpose of the Study:
- To develop and validate a reliable evaluation scale for the sit-stand from the ground activity in children with DMD.
- To assess the inter- and intra-examiner reliability of the newly developed scale.
- To examine the correlation of the scale with established measures like the Vignos Scale and patient age.
Main Methods:
- Development of the scale involved characterizing sit-stand movements in healthy children and those with DMD.
- Expert evaluation and iterative refinement of the scale and its accompanying manual.
- Rigorous testing of inter- and intra-examiner reliability using Intraclass Correlation Coefficients (ICC) and Kappa statistics.
- Correlation analysis with the Vignos Scale, age, and activity execution time.
Main Results:
- The scale demonstrated very good repeatability (ICC = 0.89 for sitting, 0.84 for standing) and excellent reproducibility (ICC = 0.93 and 0.92).
- Inter-examiner reliability (Kappa: 0.77–1.00) and intra-examiner reliability (Kappa: 0.80–1.00) were consistently excellent across all phases.
- Good correlations were observed between the scale and the Vignos Scale (age: r=0.58; stand: r=0.56).
Conclusions:
- The developed sit-stand evaluation scale is a reliable instrument for assessing this functional activity in children with DMD.
- The scale provides objective and reproducible measures crucial for clinical practice and research in pediatric neuromuscular disorders.
- This tool can aid clinicians in monitoring functional status and the impact of interventions in children with Duchenne muscular dystrophy.
Abstract:
The authors developed an evaluation scale for sit-stand from the ground for children with Duchenne muscular dystrophy (DMD) and tested its reliability. The construction occurred in stages: (a) the characterization of the movement in healthy children, (b) the characterization of the movement in children with DMD, (c) the elaboration of the 1st version of the scale and the manual, (d) the evaluation by experts and readjustments, and (e) the analysis of inter- and intraexaminer reliability and correlation with the Vignos Scale, age, and time for the execution of the activity. The scale comprehended 3 phases for sitting and 5 for the standing. A very good repeatability of the measures of sitting and standing (ICC = 0.89 and 0.84, respectively) and excellent reproducibility (ICC = 0.93 and 0.92, respectively) was demonstrated. The Kappa coefficient for the 8 phases in the interexaminer analysis varied from 0.77 to 1.00 (excellent reliability), and in the intraexaminer analysis varied from 0.80 to 1.00 (excellent reliability). Good correlation was found between the variables on the Vignos Scale (age: r = 0.58; stand: r = 0.56). The scale is a reliability instrument that allows evaluation of the activity of sitting and standing in children with DMD.
