Shultz Sandra J, Nguyen Anh-Dung, Windley Thomas C, Kulas Anthony S, Botic Timothy L, Beynnon Bruce D
Applied Neuromechanics Research Laboratory, 237B HHP, University of North Carolina at Greensboro, Greensboro, NC 27402, USA.
Clin J Sport Med. 2006 Mar;16(2):155-61. doi: 10.1097/00042752-200603000-00012.
To determine whether multiple examiners could be trained to measure lower extremity anatomic characteristics with acceptable reliability and precision, both within (intratester) and between (intertester) testers. We also determined whether testers trained 18 months apart could perform these measurements with good agreement.
University's Applied Neuromechanics Research Laboratory.
Sixteen, healthy participants (7 men, 9 women).
Six investigators measured 12 anatomic characteristics on the right lower extremity in the Fall of 2004. Four testers underwent training immediately preceding the study, and measured subjects on 2 separate days to examine intratester reliability. Two testers trained 18 months before the study (Spring 2002) measured each subject on day 1 to examine the consistency of intertester reliability when testers are trained at different times.
Knee laxity, genu recurvatum, quadriceps angle, tibial torsion, tibiofemoral angle, hamstring extensibility, pelvic angle, navicular drop, femur length, tibial length, and hip anteversion.
With few exceptions, all testers consistently measured each variable between test days (intraclass correlation coefficient>or=0.80). Intraclass correlation coefficient values were lower for intertester reliability (0.48 to 0.97), and improved from day 1 to day 2. Intertester reliability was similar when comparing testers trained 18 months before those trained immediately before the study. Absolute measurement error varied considerably across individual testers.
Multiple investigators can be trained at different times to measure anatomic characteristics with good to excellent intratester reliability. Intratester reliability did not always ensure acceptable intertester reliability or measurement precision, suggesting more training (or more experience) may be required to achieve acceptable measurement reliability and precision between multiple testers.
确定是否可以对多名检查者进行培训，使其在检查者内部（测试者内）和检查者之间（测试者间）以可接受的可靠性和精度测量下肢解剖特征。我们还确定了间隔18个月接受培训的检查者是否能在测量时达成良好的一致性。
大学的应用神经力学研究实验室。
16名健康参与者（7名男性，9名女性）。
2004年秋季，6名研究人员对右侧下肢的12项解剖特征进行了测量。4名测试者在研究开始前立即接受培训，并在2个不同日期对受试者进行测量，以检验测试者内可靠性。2名在研究前18个月（2002年春季）接受培训的测试者在第1天对每名受试者进行测量，以检验在不同时间接受培训的测试者之间的测试者间可靠性的一致性。
膝关节松弛度、膝反张、股四头肌角、胫骨扭转、胫股角、腘绳肌伸展性、骨盆角、舟骨下降、股骨长度、胫骨长度和髋关节前倾角。
除少数例外，所有测试者在不同测试日之间对每个变量的测量结果一致（组内相关系数≥0.80）。测试者间可靠性的组内相关系数值较低（0.48至0.97），且从第1天到第2天有所提高。将在研究前18个月接受培训者与在研究前立即接受培训者进行比较时，测试者间可靠性相似。个体测试者的绝对测量误差差异很大。
可以在不同时间对多名研究人员进行培训，使其以良好至优异的测试者内可靠性测量解剖特征。测试者内可靠性并不总能确保可接受的测试者间可靠性或测量精度，这表明可能需要更多培训（或更多经验）才能在多名测试者之间实现可接受的测量可靠性和精度。
