PT  - JOURNAL ARTICLE
AU  - Silvia Rosina
AU  - Giulia C.  Varnier
AU  - Angela Pistorio
AU  - Clarissa Pilkington
AU  - Susan Maillard
AU  - Adele Civino
AU  - Elena Tsitsami
AU  - Claudia Bracaglia
AU  - Marija Jelusic
AU  - Adriana Cespedes-Cruz
AU  - Graciela Espada
AU  - Rolando Cimaz
AU  - Gerard Couillault
AU  - Rik Joos
AU  - Pierre Quartier
AU  - Anand P.  Rao
AU  - Clara Malattia
AU  - Nicolino Ruperto
AU  - Alessandro Consolaro
AU  - Angelo Ravelli
TI  - Development and Testing of Reduced Versions of the MMT-8 in Juvenile Dermatomyositis
AID  - 10.3899/jrheum.200543
DP  - 2020 Nov 15
TA  - The Journal of Rheumatology
PG  - jrheum.200543
4099  - http://www.jrheum.org/content/early/2021/02/24/jrheum.200543.short
4100  - http://www.jrheum.org/content/early/2021/02/24/jrheum.200543.full
AB  - Objective To develop and test shortened versions of the Manual Muscle Test-8 (MMT-8) in juvenile dermatomyositis ( JDM). Methods Construction of reduced tools was based on a retrospective analysis of individual scores of MMT-8 muscle groups in 3 multinational datasets. The 4 and 6 most frequently impaired muscle groups were included in MMT-4 and MMT-6, respectively. Metrologic properties of reduced tools were assessed by evaluating construct validity, internal consistency, discriminant ability, and responsiveness to change. Results Neck flexors, hip extensors, hip abductors, and shoulder abductors were included in MMT-4, whereas MMT-6 also included elbow flexors and hip flexors. Both shortened tools revealed strong correlations with MMT-8 and other muscle strength measures. Correlations with other JDM outcome measures were in line with predictions. Internal consistency was good (0.88–0.96) for both MMT-4 and MMT-6. Both reduced tools showed strong ability to discriminate between disease activity states, assessed by the caring physician or a parent (P < 0.001), and between patients whose parents were satisfied or not satisfied with illness course (P < 0.001). Responsiveness to change (assessed by both standardized response mean and relative efficiency) of MMT-4 and, to a lesser degree, MMT-6, was slightly superior to that of MMT-8. Conclusion Overall, the metrologic performance of MMT-4 and MMT-6 was comparable to that of the other established muscle strength tools, which indicates that they may be suitable for use in clinical practice and research, including clinical trials. The measurement properties of these tools should be further tested in other patient populations and evaluated prospectively.