Lin Jiu-jenq, Yang Jing-Lan
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 7 Chun-Shan S Rd, Taipei, Taiwan.
Man Ther. 2006 May;11(2):146-52. doi: 10.1016/j.math.2005.05.002. Epub 2005 Aug 10.
The purposes of this study were (1) to examine intratester and intertester reliability of measurement of anterior and posterior shoulder tightness in patients with stiff shoulders (SS), and (2) to assess construct validity by determining the relations between shoulder tightness, shoulder range of motion (ROM), and self-report measures of functional limitation. Anterior and posterior shoulder tightness were measured by two testers in below-chest abduction and cross-chest adduction tests with an inclinometer, respectively, in 16 patients with SS. Both the intratester and intertester reliability for shoulder tightness measurements were good (intratester ICC=0.84 and 0.91; intertester ICC=0.82 and 0.89). The limit of intra-tester and inter-tester agreement (mean, -0.3+/-4.4 degrees ) was acceptable as compared to the standard deviations of the measurements (range, 6.2-7.4 degrees ). Significant relationships between internal rotation and posterior shoulder tightness (R2=0.448, P=0.002), external rotation and anterior shoulder tightness (R2=0.499, P=0.003), and functional disabilities and posterior shoulder tightness (R2=0.432, P=0.006) were found. Significant correlations between shoulder internal rotation and cross-chest adduction, shoulder external rotation and below-chest abduction were observed, indicating that internal and external rotations might be related to posterior and anterior shoulder stiffness. The study also revealed significant relationship between functional disabilities and cross-chest adduction. Below-chest abduction and cross-chest adduction were found to provide reliable data. The construct validity of the abduction and adduction tests is supported by the relationship among these measurements, shoulder ROM, and functional disabilities in patients with SS.
（1）检查僵硬肩部（SS）患者肩部前侧和后侧紧绷度测量的测试者内和测试者间信度；（2）通过确定肩部紧绷度、肩部活动范围（ROM）和功能受限的自我报告测量之间的关系来评估结构效度。16例SS患者的肩部前侧和后侧紧绷度分别由两名测试者使用倾角仪在胸部以下外展和胸前内收测试中进行测量。肩部紧绷度测量的测试者内和测试者间信度均良好（测试者内ICC = 0.84和0.91；测试者间ICC = 0.82和0.89）。与测量的标准差（范围6.2 - 7.4度）相比，测试者内和测试者间一致性的限度（均值，-0.3±4.4度）是可接受的。发现内旋与肩部后侧紧绷度（R2 = 0.448，P = 0.002）、外旋与肩部前侧紧绷度（R2 = 0.499，P = 0.003）以及功能障碍与肩部后侧紧绷度（R2 = 0.432，P = 0.006）之间存在显著关系。观察到肩部内旋与胸前内收、肩部外旋与胸部以下外展之间存在显著相关性，表明内旋和外旋可能与肩部后侧和前侧僵硬有关。该研究还揭示了功能障碍与胸前内收之间存在显著关系。发现胸部以下外展和胸前内收可提供可靠数据。这些测量、肩部ROM和SS患者功能障碍之间的关系支持了外展和内收测试的结构效度。
