Miller S A, Mayer T, Cox R, Gatchel R J
Productive Rehabilitation Institute of Dallas for Ergonomics (PRIDE), Texas.
Spine (Phila Pa 1976). 1992 Mar;17(3):345-8. doi: 10.1097/00007632-199203000-00017.
The modified Schöber technique, a method for assessing lumbar spine flexion, was subjected to an analysis of reliability. Fifty normal subjects (21 men, 29 women) were evaluated for lumbar flexion mobility using a blind inter-rater "worst case" protocol. Simultaneously, other sources of error affecting test reliability, such as presence of dimples of Venus, relationship of skin distraction to movement of underlying structures, and upper level of Schöber skin landmarks were also considered. Analysis suggested that systematic error can be introduced that adversely affects inter-rater reliability (r = 0.71). Moreover, skin landmarks are inconsistently present, being completely absent in 26% of cases. Skin tends to distract even over completely immobile bony structures (eg, the sacrum), whereas, on average, only 3.5 of the 6 spinal segments (T12-S1) are included in the Schöber technique for purported measurement of "lumbar spine flexion." The utility of this method is questioned on both scientific and clinical grounds.
改良的许伯尔技术是一种评估腰椎前屈的方法，该技术接受了可靠性分析。采用盲法评估者间“最坏情况”方案，对50名正常受试者（21名男性，29名女性）的腰椎前屈活动度进行了评估。同时，还考虑了其他影响测试可靠性的误差来源，如是否存在臀沟、皮肤牵张与深层结构运动的关系以及许伯尔皮肤标志的上限。分析表明，可能会引入系统性误差，对评估者间的可靠性产生不利影响（r = 0.71）。此外，皮肤标志的出现并不一致，在26%的病例中完全不存在。即使在完全不动的骨性结构（如骶骨）上，皮肤也容易出现牵张，而在所谓测量“腰椎前屈”的许伯尔技术中，平均仅包括6个脊柱节段（T12-S1）中的3.5个。基于科学和临床理由，对该方法的实用性提出了质疑。
