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汉堡建筑工人研究中的骶髂关节诊断

Sacroiliac joint diagnostics in the Hamburg Construction Workers Study.

作者信息

Toussaint R, Gawlik C S, Rehder U, Rüther W

机构信息

Department of Orthopedics, University Hospital Eppendorf, Hamburg, Germany.

出版信息

J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):139-43. doi: 10.1016/S0161-4754(99)70126-0.

Abstract

BACKGROUND

In the medical literature, test procedures for sacroiliac joint diagnostics are viewed as controversial. The provocation tests are based on provoked sacroiliac pain, whereas the palpation tests examine the motion of the sacroiliac joint or describe the condition indirectly if limitation of the sacroiliac function is present. It must be presumed that the use of different test results in the detection of varying functional phenomena of a sacroiliac dysfunction or, alternatively, that identical effects of a dysfunction are evaluated in differing ways.

OBJECTIVE

This article presents results with regard to the consistency of tests for sacroiliac joint dysfunctions carried out on participants from the building trade.

DESIGN AND PARTICIPANTS

The consistency of the tests (standing flexion test, spine test, iliac compression test, iliac springing test) used in a cross-section investigation of a cohort of 480 male construction workers is presented. To evaluate the degree of consistency of the test procedure the percentage agreement and the kappa value, including a confidence interval of 95%, are given.

RESULTS

The consistency between the iliac compression test and the three sacroiliac palpation tests could not be shown to be statistically significant. The consistency between the three palpation tests was moderate to good and the percentage agreement was acceptable (87.4%, 88.6%, 80.9%).

CONCLUSIONS

It may be assumed that the palpation tests characterize the same dysfunction of the sacroiliac joint. Standing flexion test, spine test, and iliac springing test seem to be valuable tools for sacroiliac joint diagnostics.

摘要

背景

在医学文献中,骶髂关节诊断的测试程序存在争议。激发试验基于诱发的骶髂关节疼痛,而触诊试验则检查骶髂关节的活动情况,或者在存在骶髂关节功能受限的情况下间接描述其状况。必须假定,使用不同的测试会检测到骶髂关节功能障碍的不同功能现象,或者,相反地,对功能障碍的相同影响会以不同方式进行评估。

目的

本文介绍了对建筑行业参与者进行的骶髂关节功能障碍测试的一致性结果。

设计与参与者

呈现了对480名男性建筑工人队列进行横断面调查时所使用的测试(站立前屈试验、脊柱试验、髂骨挤压试验、髂骨弹跳试验)的一致性。为了评估测试程序的一致程度,给出了百分比一致性和kappa值,包括95%的置信区间。

结果

髂骨挤压试验与三项骶髂关节触诊试验之间的一致性未显示出统计学意义。三项触诊试验之间的一致性为中等至良好,百分比一致性可接受(87.4%、88.6%、80.9%)。

结论

可以假定触诊试验可表征骶髂关节的相同功能障碍。站立前屈试验、脊柱试验和髂骨弹跳试验似乎是骶髂关节诊断的有价值工具。

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