Kropmans T, Dijkstra P, Stegenga B, Stewart R, de Bont L
Department of Oral and Maxillofacial Surgery, Groningen University Hospital, The Netherlands.
Eur J Oral Sci. 2000 Feb;108(1):9-13. doi: 10.1034/j.1600-0722.2000.00747.x.
Changes in maximal mouth opening reflect the impact of temporomandibular disorders and the effect of a therapeutic intervention. No information about the amount of change in maximal mouth opening with regard to reasoned decision-making is available. The smallest detectable difference, as a measure of reliability assessment, provides this information and is expressed in the unit of the measurement instrument. Twenty-five consecutive patients (5 males, 20 females) with a painfully restricted temporomandibular joint participated in this study. Measurements of maximal mouth opening were performed by two well-trained observers on two separate measurement days, one week apart. The maximal mouth opening measurements were repeated three times. Inter-observer, intra-observer, and test-retest reliability varied between 0.90 and 0.96. Inconsistency in measurement results analyzed in terms of absolute error variance, i.e. the measurement facets plus all the interactions, represented 11% of total variance. The smallest detectable difference of maximal mouth opening varied from 9 to 6 mm. For being successful in painfully restricted temporomandibular joint patients, statistically as well as clinically, the clinician has to measure at least 9 mm of improvement in maximal mouth opening. To reduce the smallest detectable difference from 9 to 6 mm, repeated measurement is necessary.
最大开口度的变化反映了颞下颌关节紊乱病的影响以及治疗干预的效果。目前尚无关于基于合理决策的最大开口度变化量的相关信息。作为可靠性评估指标的最小可检测差异可提供此信息，并以测量仪器的单位表示。25例患有疼痛性颞下颌关节受限的连续患者（5例男性，20例女性）参与了本研究。由两名训练有素的观察者在相隔一周的两个不同测量日对最大开口度进行测量。最大开口度测量重复三次。观察者间、观察者内以及重测信度在0.90至0.96之间。根据绝对误差方差分析测量结果的不一致性，即测量方面加上所有相互作用，占总方差的11%。最大开口度的最小可检测差异在9至6毫米之间变化。为了在疼痛性颞下颌关节受限患者中取得成功，无论是在统计学还是临床上，临床医生必须测量到最大开口度至少有9毫米的改善。为了将最小可检测差异从9毫米降低到6毫米，重复测量是必要的。
