Shields Richard K, Schlechte Janet, Dudley-Javoroski Shauna, Zwart Bradley D, Clark Steven D, Grant Susan A, Mattiace Vicki M
Graduate Program in Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1190, USA.
Arch Phys Med Rehabil. 2005 Oct;86(10):1969-73. doi: 10.1016/j.apmr.2005.06.001.
To test the interrater reliability of a standardized method to analyze knee bone mineral density (BMD) using dual-energy x-ray absorptiometry (DXA); to compare spine, hip, and knee BMD of people with spinal cord injury (SCI) with able-bodied controls; and to determine the relation between hip BMD and knee BMD in SCI and able-bodied subjects.
Criterion standard and masked comparison.
Primary care university hospital.
A convenience sample of 11 subjects with complete SCI was age and sex matched with 11 able-bodied control subjects.
Not applicable.
Four raters analyzed regions of interest according to operational definitions recently developed to standardize the analysis of BMD of the knee. Subjects with chronic SCI and matched controls underwent conventional DXA scans of the spine and hips and "less conventional" scans of the distal femurs and proximal tibias. The relation between hip and knee BMD was analyzed.
The knee measurements were highly reliable (femur intraclass correlation coefficient model 2,1 [ICC(2,1)]=.98; tibia ICC(2,1)=.89). Subjects with SCI had lower BMD values than controls at all hip and knee sites (P<.05). Lumbar spine BMD did not differ between groups. Hip BMD was moderately predictive of distal femur BMD (R2=.67), but less correlated with the proximal tibia (R2=.38).
Knee BMD can be reliably analyzed using DXA with this protocol. Subjects with SCI have diminished knee and hip BMD. Low hip BMD is associated with low distal femur BMD.
使用双能X线吸收法（DXA）测试分析膝关节骨密度（BMD）的标准化方法的评分者间信度；比较脊髓损伤（SCI）患者与健全对照者的脊柱、髋部和膝关节骨密度；并确定SCI患者和健全受试者中髋部骨密度与膝关节骨密度之间的关系。
标准对照和盲法比较。
大学初级保健医院。
11名完全性SCI患者的便利样本，在年龄和性别上与11名健全对照者匹配。
不适用。
4名评分者根据最近制定的操作定义分析感兴趣区域，以标准化膝关节骨密度分析。慢性SCI患者和匹配的对照者接受脊柱和髋部的传统DXA扫描以及股骨远端和胫骨近端的“不太传统”扫描。分析髋部和膝关节骨密度之间的关系。
膝关节测量结果具有高度可靠性（股骨组内相关系数模型2,1 [ICC(2,1)] = 0.98；胫骨ICC(2,1) = 0.89）。SCI患者在所有髋部和膝关节部位的骨密度值均低于对照组（P < 0.05）。两组之间腰椎骨密度无差异。髋部骨密度对股骨远端骨密度有中度预测性（R2 = 0.67），但与胫骨近端的相关性较小（R2 = 0.38）。
使用该方案通过DXA可以可靠地分析膝关节骨密度。SCI患者的膝关节和髋部骨密度降低。低髋部骨密度与低股骨远端骨密度相关。
