Piva Sara R, Fitzgerald Kelley, Irrgang James J, Jones Scott, Hando Benjamin R, Browder David A, Childs John D
Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, USA.
BMC Musculoskelet Disord. 2006 Mar 31;7:33. doi: 10.1186/1471-2474-7-33.
The reliability and measurement error of several impairment measures used during the clinical examination of patients with patellofemoral pain syndrome (PFPS) has not been established. The purpose was to determine the inter-tester reliability and measurement error of measures of impairments associated with PFPS in patients with PFPS.
A single group repeated measures design was used. Two pairs of physical therapists participated in data collection. Examiners were blinded to each others' measurements.
Thirty patients (age 29 +/- 8; 17 female) with PFPS participated in this study. Inter-tester reliability coefficients were substantial for measures of hamstrings, quadriceps, plantarflexors, and ITB/TFL complex length, hip abductors strength, and foot pronation (ICCs from .85 to .97); moderate for measures of Q-angle, tibial torsion, hip external rotation strength, lateral retinacular tightness, and quality of movement during a step down task (ICCs from .67 to .79); and poor for femoral anteversion (ICC of .45). Standard error of measurement (SEM) for measures of muscle length ranged from 1.6 degrees to 4.3 degrees. SEM for Q-angle, tibial torsion, and femoral anteversion were 2.4 degrees, 2.9 degrees, and 4.5 degrees respectively. SEM for foot pronation was 1 mm. SEM for measures of muscle strength was 1.8 Kg for abduction and 2.4 Kg for external rotation.
Several of the impairments associated with PFPS had sufficient reliability and low measurement error. Further investigation is needed to test if these impairment measurements are related to physical function and whether or not they are useful for decision-making.
髌股疼痛综合征(PFPS)患者临床检查中使用的几种损伤测量方法的可靠性和测量误差尚未确定。目的是确定PFPS患者中与PFPS相关的损伤测量方法的测试者间可靠性和测量误差。
采用单组重复测量设计。两对物理治疗师参与数据收集。检查者对彼此的测量结果不知情。
30例PFPS患者(年龄29±8岁;17例女性)参与了本研究。测试者间可靠性系数对于腘绳肌、股四头肌、跖屈肌、髂胫束/阔筋膜张肌复合体长度、髋外展肌力量和足内翻测量为高(组内相关系数[ICC]为0.85至0.97);对于Q角、胫骨扭转、髋外旋力量、外侧支持带紧张度和下台阶任务中的运动质量测量为中等(ICC为0.67至0.79);对于股骨前倾测量为低(ICC为0.45)。肌肉长度测量的测量标准误(SEM)范围为1.6度至4.3度。Q角、胫骨扭转和股骨前倾的SEM分别为2.4度、2.9度和4.5度。足内翻的SEM为1毫米。肌肉力量测量的SEM外展为1.8千克,外旋为2.4千克。
与PFPS相关的几种损伤具有足够的可靠性和低测量误差。需要进一步研究以测试这些损伤测量是否与身体功能相关以及它们是否对决策有用。