Kvåle Alice, Ljunggren Anne Elisabeth, Johnsen Tom Backer
Section of Physiotherapy Science, Faculty of Medicine, University of Bergen, Norway.
Physiother Res Int. 2003;8(1):36-52. doi: 10.1002/pri.270.
An examination method based on psychosomatic physiotherapy, with 24 standardized tests related to general aspects of mobility, flexibility and the ability to relax, is used in some pain and rehabilitation clinics in Scandinavia in order to document where--and to what degree--patients have aberrations within the domain 'movement'. The measurement properties of the movement tests have, however, not been investigated in patients with long-lasting musculoskeletal pain. The aims of the present study were, therefore, to investigate inter-tester reliability and validity (construct, discriminative and concurrent validity) related to movement.
The study design was cross-sectional. Reliability was examined by three physiotherapists examining 19 people. Construct validity was studied by means of structural equation modelling (SEM). Discriminative validity was examined by comparing movement data from 247 patients with long-lasting musculoskeletal pain, and 104 healthy subjects. The patient sample was categorized according to localized or widespread pain, and movement scores compared between the groups. Most patients filled in a psychological screening questionnaire (MMPI-2), plus information about pain intensity and function, and concurrent validity of the movement measures were examined by correlation.
SEM results indicated a modified movement scale, consisting of 16 items in four subscales. Both the original and modified versions showed good reliability, and scores differed significantly between healthy subjects and patients, and between patients with localized versus widespread pain. A relationship was found between the movement tests and psychological characteristics, but mainly in patients with widespread pain. Significant relationships were found between the ability to relax and pain, and between all aspects of movement and function.
Movement may be reliably and validly assessed with composite scores from 4 x 4 items. The method may be useful as a global screening instrument in order to examine where, and to what extent, patients with long-lasting pain problems have movement aberrations; findings to be addressed in treatment.
基于身心物理治疗的一种检查方法，包含24项与活动能力、灵活性及放松能力等一般方面相关的标准化测试，在斯堪的纳维亚半岛的一些疼痛与康复诊所中被采用，目的是记录患者在“运动”领域存在异常的部位及程度。然而，这些运动测试的测量特性尚未在患有持续性肌肉骨骼疼痛的患者中进行研究。因此，本研究的目的是调查与运动相关的测试者间信度和效度（结构效度、区分效度和同时效度）。
本研究设计为横断面研究。由三名物理治疗师对19人进行检查以评估信度。通过结构方程模型（SEM）研究结构效度。通过比较247例患有持续性肌肉骨骼疼痛的患者和104名健康受试者的运动数据来检验区分效度。将患者样本根据局部或广泛疼痛进行分类，并比较两组之间的运动评分。大多数患者填写了一份心理筛查问卷（MMPI - 2），并提供了有关疼痛强度和功能的信息，通过相关性检验运动测量的同时效度。
SEM结果表明，一个修改后的运动量表由四个分量表中的16个项目组成。原始版本和修改后的版本均显示出良好的信度，健康受试者与患者之间以及局部疼痛与广泛疼痛患者之间的评分存在显著差异。发现运动测试与心理特征之间存在关联，但主要存在于广泛疼痛的患者中。发现放松能力与疼痛之间以及运动的各个方面与功能之间存在显著关系。
可以通过4×4项目的综合评分可靠且有效地评估运动。该方法作为一种整体筛查工具可能有用，以便检查患有持续性疼痛问题的患者在何处以及在多大程度上存在运动异常；这些发现将在治疗中得到解决。
