Elaboration and reliability of functional evaluation on going up and downstairs scale for Duchenne Muscular Dystrophy

Background: Instruments of functional evaluation for patients with Duchenne Muscular Dystrophy (DMD), available from the literature, are limited and scarce, making clinical decision on Physiotherapy difficulty. Objectives: To describe the process of creating a functional assessment scale in patients with DMD while going up and down the stairs, as well as to analyse the intra and inter-rater reliability of this scale. Methods: The scale development consisted of five stages: 1) to elaborate a script for directed observation based upon literature, 2) to describe a sequence of movements assessing 120 video recordings from 30 children (from 5 to 11 years) with DMD while going up and down stairs, 3) to elaborate a scale considering the degree of difficulty to execute the movements, 4) to create handbook, and 5) to submit both the scale and the handbook to be assess by 10 examiners, and review to create the final version. Both repeatability (researcher) and reproducibility (two independent examiners) were tested by using the IntraClass Correlation Coefficient (ICC) and Weighted Kappa respectively. Results: The scale encloses five phases for going up and four phases for going downstairs. Our results showed both excellent intra and intertester reliability, with values of Weighted Kappa greater than or equal to 0.78 in all phases and ICCs greater than or equal to 0.89, with p