{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:15:27Z","timestamp":1786976127371,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,8,12]],"date-time":"2018-08-12T00:00:00Z","timestamp":1534032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To develop and test a hybrid measure of muscle strength for juvenile dermatomyositis (\n                      <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content>\n                      ), which is based on the combination of the Manual Muscle Testing in 8 muscles (\n                      <jats:styled-content style=\"fixed-case\">MMT<\/jats:styled-content>\n                      \u20108) and the Childhood Myositis Assessment Scale (\n                      <jats:styled-content style=\"fixed-case\">CMAS<\/jats:styled-content>\n                      ) but is more comprehensive than the former and more feasible than the latter.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The hybrid\n                      <jats:styled-content style=\"fixed-case\">MMT<\/jats:styled-content>\n                      \u20108\/\n                      <jats:styled-content style=\"fixed-case\">CMAS<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">hMC<\/jats:styled-content>\n                      ) is composed of all 8 items of the\n                      <jats:styled-content style=\"fixed-case\">MMT<\/jats:styled-content>\n                      \u20108 and 3 items of the\n                      <jats:styled-content style=\"fixed-case\">CMAS<\/jats:styled-content>\n                      : time of head lift, assessment of abdominal muscles, and floor rise. The score ranges 0\u2013100, with 100 indicating normal muscle strength. Validation procedures were conducted using 3 large multinational patient samples, including a total of 810\n                      <jats:styled-content style=\"fixed-case\">JDM<\/jats:styled-content>\n                      patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:styled-content style=\"fixed-case\">hMC<\/jats:styled-content>\n                      revealed face and content validity, good construct validity, excellent test\u2013retest reliability (intraclass correlation coefficient = 0.99), and internal consistency (Cronbach's \u03b1 = 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 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) or patients whose parents were satisfied or not satisfied with the illness course (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:styled-content style=\"fixed-case\">hMC<\/jats:styled-content>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.23491","type":"journal-article","created":{"date-parts":[[2017,12,16]],"date-time":"2017-12-16T16:50:01Z","timestamp":1513443001000},"page":"1312-1319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Development and Testing of a Hybrid Measure of Muscle Strength in Juvenile Dermatomyositis for Use in Routine Care"],"prefix":"10.1002","volume":"70","author":[{"given":"Giulia Camilla","family":"Varnier","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Rosina","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Pistorio","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Consolaro","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova and Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bovis","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Dalpr\u00e0","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Pilkington","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Maillard","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Civino","sequence":"additional","affiliation":[{"name":"Ospedale Vito Fazzi Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Tsitsami","sequence":"additional","affiliation":[{"name":"Children's Hospital Agia Sofia Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"de Inocencio","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Jelusic","sequence":"additional","affiliation":[{"name":"University Hospital Center Zagreb Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Vojinovic","sequence":"additional","affiliation":[{"name":"University of Ni\u0161 Ni\u0161 Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Espada","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Ricardo Guti\u00e9rrez Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balahan","family":"Makay","sequence":"additional","affiliation":[{"name":"Dokuz Eyl\u00fcl University Hospital Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Martha","family":"Katsicas","sequence":"additional","affiliation":[{"name":"Hospital de Pediatr\u00eda Juan P. 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