Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain‐Barré syndrome

TLDR

In Guillain‑Barré syndrome, functional deficits are typically measured with a multi‑category scale, but its interobserver agreement is unknown and it is insensitive for bedridden or ventilated patients. The study aims to develop an additional score (MRC‑sumscore) to assess overall muscle strength in Guillain‑Barré syndrome. The MRC‑sumscore aggregates muscle strength across all limbs into a single numeric value. Both the functional scale and the MRC‑sumscore show almost perfect interobserver agreement (k = 0.85 and r² = 0.96), and the MRC‑sumscore is easier to assess and more sensitive for bedridden or ventilated patients.

Abstract

Abstract In studies of Guillain‐Barré syndrome, functional deficit is usually assessed according to a functional scale consisting of several categories. The level of interobserver agreement in this scoring method is not known; furthermore, this method seems to be insensitive when applied to bedridden and artificially ventilated patients. We have developed an additional score (MRC‐sumscore), reflecting muscle strength in general. Both scoring methods, tested in Guillain‐Barré patients, have an almost perfect interobserver agreement. For the functional score k = 0.85, and for the MRC‐sumscore r 2 = 0.96. The MRC‐sumscore is easily assessed and more sensitive than the functional score when patients are bedridden or artificially ventilated.