Nehemkis A M, Carver D W, Evanski P M
Clin Orthop Relat Res. 1979 Nov-Dec(145):158-62.
Physical examination of the patient with low back pain routinely includes a number of tests which are useful clinically to the orthopedist as suggestive of the presence of hysteria or malingering. These include tests of light touch differences medially and laterally in the same foot or leg, vibratory sensation in the lower extremities, forward flexion, straight-leg raising differences between the supine and sitting positions, and the Burns' bench test. The present study examined the specific predictive utility of these tests individually and as a composite battery in identifying low back pain patients with hysterical personality features. Twenty-five postoperative lumbar laminectomy and diskectomy patients were administered the MMPI and evaluated by physical examination. Silight to moderate correlations were found for each of the subtests with a Composite Hysteria Index derived from the MMPI. The predictability was improved by the use of a weighted combination of the individual tests obtained by multiple regression analysis. The results lend empirical support to: the predictive value of these clinical tests in definitively identifying 60% of those low back pain patients with hysterical personality features; decision rules for use in clinical practice were also developed.
对腰痛患者进行体格检查通常包括多项测试，这些测试对骨科医生在临床上判断是否存在癔症或诈病具有提示作用。这些测试包括同一足部或腿部内侧和外侧的轻触觉差异测试、下肢振动觉测试、前屈测试、仰卧位和坐位直腿抬高差异测试以及伯恩斯试验台测试。本研究分别考察了这些测试以及作为综合组套时在识别具有癔症人格特征的腰痛患者方面的具体预测效用。对25例接受腰椎椎板切除术和椎间盘切除术的患者进行了明尼苏达多相人格测验（MMPI）并通过体格检查进行评估。发现每个子测试与从MMPI得出的综合癔症指数之间存在轻度到中度的相关性。通过使用多元回归分析获得的各个测试的加权组合，预测性得到了提高。结果为以下内容提供了实证支持：这些临床测试在明确识别60%具有癔症人格特征的腰痛患者方面的预测价值；还制定了临床实践中使用的决策规则。
