Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies: II. The childhood myositis assessment scale (CMAS): a quantitative tool for the evaluation of muscle function

作者：Daniel J. Lovell, Carol B. Lindsley, Robert M. Rennebohm, S. Ballinger, Suzanne L. Bowyer, Edward H. Giannini, Jeanne E. Hicks, Joseph E. Levinson, Richard J. Mier, Lauren M. Pachman, Murray H. Passo, Marı́a Pérez-Vázquez, Ann M. Reed, Kenneth N. Schikler, Michaele Smith, Lawrence Zemel, Lisa G. Rider, in cooperation with THE JUVENILE DERMATOMYOSITIS DISEASE ACTIVITY COLLABORATIVE STUDY GROUP · 发表于：Arthritis & Rheumatism · 年份：1999 · DOI：10.1002/1529-0131(199910)42:10<2213::aid-anr25>3.0.co;2-8 · 被引用次数：243 · 研究领域：Inflammatory Myopathies and Dermatomyositis、Parkinson's Disease and Spinal Disorders、Rheumatoid Arthritis Research and Therapies

OBJECTIVE: To develop, validate, and determine the measurement characteristics of a quantitative tool for assessing the severity of muscle involvement in children with idiopathic inflammatory myopathies. METHODS: The Childhood Myositis Assessment Scale (CMAS) was developed from 2 existing observational functional assessment tools to assess muscle function in the areas of strength and endurance across a wide range of ability and ages. The 14 ordinal items included were chosen to assess primarily axial and proximal muscle groups and are ranked with standard performance and scoring methods. Following the development of the CMAS, a training video and written instructions were developed and reviewed by the physicians participating in this study. Subsequently, utilizing a randomized block design, 12 physicians independently scored 10 children (9 with dermatomyositis, 1 with polymyositis; ages 4-15 years) twice in one day (morning and afternoon) on the CMAS. A pediatric physical therapist performed quantitative manual muscle strength testing (MMT) twice on each child (morning and afternoon), including the neck, trunk, and proximal and distal extremity muscle groups. RESULTS: The CMAS has a potential range of 0-51, with higher scores indicating greater muscle strength and endurance. The observed mean for the 10 patients was 36.4 (median 44, SD 14.1, observed range 5-51). The total score for the CMAS correlated with the physician's global assessment (by visual analog scale) of disease...