Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care

Giulia Camilla Varnier; Silvia Rosina; Cristina Ferrari; Angela Pistorio; Alessandro Consolaro; Francesca Bovis; Sara Dalprà; Clarissa Pilkington; Susan Maillard; Adele Civino; Elena Tsitsami; Jaime de Inocencio; Marija Jelusic; Jelena Vojinovic; Graciela Espada; Balahan Makay; Maria Martha Katsicas; Polixeni Pratsidou-Gertsi; Dragana Lazarevic; Anand Prahalad Rao; Denise Pires Marafon; Nicolino Ruperto; Alberto Martini; Angelo Ravelli

doi:10.1002/acr.23491

Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care

Giulia Camilla Varnier, Silvia Rosina, Cristina Ferrari, Angela Pistorio, Alessandro Consolaro, Francesca Bovis, Sara Dalprà, Clarissa Pilkington, Susan Maillard, Adele Civino, Elena Tsitsami, Jaime de Inocencio, Marija Jelusic, Jelena Vojinovic, Graciela Espada, Balahan Makay, Maria Martha Katsicas, Polixeni Pratsidou-Gertsi, Dragana Lazarevic, Anand Prahalad RaoDenise Pires Marafon, Nicolino Ruperto, Alberto Martini, Angelo Ravelli

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To develop and test a hybrid measure of muscle strength for juvenile dermatomyositis (JDM), which is based on the combination of the Manual Muscle Testing 8 (MMT8) and the Childhood Myositis Assessment Scale (CMAS), but is more comprehensive than the former and more feasible than the latter.

METHODS: The hybrid MMT/CMAS (hMC) is composed of all 8 items of the MMT8 and 3 items of the CMAS: 1) time of head lift; 2) assessment of abdominal muscles; 3) floor rise. The score ranges from 0 to 100, with 100 indicating normal muscle strength. Validation procedures were conducted using three large multinational patient samples including a total of 810 JDM patients.

RESULTS: The hMC revealed face and content validity, good construct validity, excellent test-retest reliability (intraclass correlation coefficient = 0.99) and internal consistency (Chronbach's alpha = 0.94), strong responsiveness to clinical change over time (standardized response mean = 0.8 among patients judged as improved by the caring physician), and satisfactory capacity to discriminate patients judged as being in the states of inactive disease or low, moderate, or high disease activity by the physician (p < 0.001) or patients whose parents were satisfied or not satisfied with illness course (p < 0.001).

CONCLUSION: The hMC was found to possess good measurement properties in a large population of patients with a wide range of disease activity and severity. The new tool, which is primarily intended for use in routine clinical care, should be further tested in other populations of patients evaluated prospectively. This article is protected by copyright. All rights reserved.

Original language	English
Journal	Arthritis care and research : the official journal of the Arthritis Health Professions Association
DOIs	https://doi.org/10.1002/acr.23491
Publication status	E-pub ahead of print - Dec 15 2017

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10.1002/acr.23491

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Varnier, G. C., Rosina, S., Ferrari, C., Pistorio, A., Consolaro, A., Bovis, F., Dalprà, S., Pilkington, C., Maillard, S., Civino, A., Tsitsami, E., de Inocencio, J., Jelusic, M., Vojinovic, J., Espada, G., Makay, B., Katsicas, M. M., Pratsidou-Gertsi, P., Lazarevic, D., ... Ravelli, A. (2017). Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care. Arthritis care and research : the official journal of the Arthritis Health Professions Association. https://doi.org/10.1002/acr.23491

Varnier, GC, Rosina, S, Ferrari, C, Pistorio, A , Consolaro, A, Bovis, F, Dalprà, S, Pilkington, C, Maillard, S, Civino, A, Tsitsami, E, de Inocencio, J, Jelusic, M, Vojinovic, J, Espada, G, Makay, B, Katsicas, MM, Pratsidou-Gertsi, P, Lazarevic, D, Rao, AP, Pires Marafon, D, Ruperto, N , Martini, A & Ravelli, A 2017, 'Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care', Arthritis care and research : the official journal of the Arthritis Health Professions Association. https://doi.org/10.1002/acr.23491

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title = "Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care",

abstract = "OBJECTIVE: To develop and test a hybrid measure of muscle strength for juvenile dermatomyositis (JDM), which is based on the combination of the Manual Muscle Testing 8 (MMT8) and the Childhood Myositis Assessment Scale (CMAS), but is more comprehensive than the former and more feasible than the latter.METHODS: The hybrid MMT/CMAS (hMC) is composed of all 8 items of the MMT8 and 3 items of the CMAS: 1) time of head lift; 2) assessment of abdominal muscles; 3) floor rise. The score ranges from 0 to 100, with 100 indicating normal muscle strength. Validation procedures were conducted using three large multinational patient samples including a total of 810 JDM patients.RESULTS: The hMC revealed face and content validity, good construct validity, excellent test-retest reliability (intraclass correlation coefficient = 0.99) and internal consistency (Chronbach's alpha = 0.94), strong responsiveness to clinical change over time (standardized response mean = 0.8 among patients judged as improved by the caring physician), and satisfactory capacity to discriminate patients judged as being in the states of inactive disease or low, moderate, or high disease activity by the physician (p < 0.001) or patients whose parents were satisfied or not satisfied with illness course (p < 0.001).CONCLUSION: The hMC was found to possess good measurement properties in a large population of patients with a wide range of disease activity and severity. The new tool, which is primarily intended for use in routine clinical care, should be further tested in other populations of patients evaluated prospectively. This article is protected by copyright. All rights reserved.",

author = "Varnier, {Giulia Camilla} and Silvia Rosina and Cristina Ferrari and Angela Pistorio and Alessandro Consolaro and Francesca Bovis and Sara Dalpr{\`a} and Clarissa Pilkington and Susan Maillard and Adele Civino and Elena Tsitsami and {de Inocencio}, Jaime and Marija Jelusic and Jelena Vojinovic and Graciela Espada and Balahan Makay and Katsicas, {Maria Martha} and Polixeni Pratsidou-Gertsi and Dragana Lazarevic and Rao, {Anand Prahalad} and {Pires Marafon}, Denise and Nicolino Ruperto and Alberto Martini and Angelo Ravelli",

year = "2017",

month = dec,

day = "15",

doi = "10.1002/acr.23491",

language = "English",

journal = "Arthritis care and research : the official journal of the Arthritis Health Professions Association",

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TY - JOUR

T1 - Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care

AU - Varnier, Giulia Camilla

AU - Rosina, Silvia

AU - Ferrari, Cristina

AU - Pistorio, Angela

AU - Consolaro, Alessandro

AU - Bovis, Francesca

AU - Dalprà, Sara

AU - Pilkington, Clarissa

AU - Maillard, Susan

AU - Civino, Adele

AU - Tsitsami, Elena

AU - de Inocencio, Jaime

AU - Jelusic, Marija

AU - Vojinovic, Jelena

AU - Espada, Graciela

AU - Makay, Balahan

AU - Katsicas, Maria Martha

AU - Pratsidou-Gertsi, Polixeni

AU - Lazarevic, Dragana

AU - Rao, Anand Prahalad

AU - Pires Marafon, Denise

AU - Ruperto, Nicolino

AU - Martini, Alberto

AU - Ravelli, Angelo

PY - 2017/12/15

Y1 - 2017/12/15

N2 - OBJECTIVE: To develop and test a hybrid measure of muscle strength for juvenile dermatomyositis (JDM), which is based on the combination of the Manual Muscle Testing 8 (MMT8) and the Childhood Myositis Assessment Scale (CMAS), but is more comprehensive than the former and more feasible than the latter.METHODS: The hybrid MMT/CMAS (hMC) is composed of all 8 items of the MMT8 and 3 items of the CMAS: 1) time of head lift; 2) assessment of abdominal muscles; 3) floor rise. The score ranges from 0 to 100, with 100 indicating normal muscle strength. Validation procedures were conducted using three large multinational patient samples including a total of 810 JDM patients.RESULTS: The hMC revealed face and content validity, good construct validity, excellent test-retest reliability (intraclass correlation coefficient = 0.99) and internal consistency (Chronbach's alpha = 0.94), strong responsiveness to clinical change over time (standardized response mean = 0.8 among patients judged as improved by the caring physician), and satisfactory capacity to discriminate patients judged as being in the states of inactive disease or low, moderate, or high disease activity by the physician (p < 0.001) or patients whose parents were satisfied or not satisfied with illness course (p < 0.001).CONCLUSION: The hMC was found to possess good measurement properties in a large population of patients with a wide range of disease activity and severity. The new tool, which is primarily intended for use in routine clinical care, should be further tested in other populations of patients evaluated prospectively. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: To develop and test a hybrid measure of muscle strength for juvenile dermatomyositis (JDM), which is based on the combination of the Manual Muscle Testing 8 (MMT8) and the Childhood Myositis Assessment Scale (CMAS), but is more comprehensive than the former and more feasible than the latter.METHODS: The hybrid MMT/CMAS (hMC) is composed of all 8 items of the MMT8 and 3 items of the CMAS: 1) time of head lift; 2) assessment of abdominal muscles; 3) floor rise. The score ranges from 0 to 100, with 100 indicating normal muscle strength. Validation procedures were conducted using three large multinational patient samples including a total of 810 JDM patients.RESULTS: The hMC revealed face and content validity, good construct validity, excellent test-retest reliability (intraclass correlation coefficient = 0.99) and internal consistency (Chronbach's alpha = 0.94), strong responsiveness to clinical change over time (standardized response mean = 0.8 among patients judged as improved by the caring physician), and satisfactory capacity to discriminate patients judged as being in the states of inactive disease or low, moderate, or high disease activity by the physician (p < 0.001) or patients whose parents were satisfied or not satisfied with illness course (p < 0.001).CONCLUSION: The hMC was found to possess good measurement properties in a large population of patients with a wide range of disease activity and severity. The new tool, which is primarily intended for use in routine clinical care, should be further tested in other populations of patients evaluated prospectively. This article is protected by copyright. All rights reserved.

U2 - 10.1002/acr.23491

DO - 10.1002/acr.23491

M3 - Article

C2 - 29245175

SN - 0893-7524

JO - Arthritis care and research : the official journal of the Arthritis Health Professions Association

JF - Arthritis care and research : the official journal of the Arthritis Health Professions Association

ER -

Development and testing of a hybrid measure of muscle strength in juvenile dermatomyositis for use in routine care

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