Shirk Crystal, Sandrey Michelle A, Erickson Mia
Summersville Memorial Hospital, Summersville, WV, USA.
J Athl Train. 2006 Jan-Mar;41(1):93-9; discussion 99-101.
Neither reliability nor validity data exist for the Root method of clinically assessing first ray position or mobility by experienced and inexperienced examiners.
To determine intrarater and interrater reliability for first ray position and mobility measurements in experienced and inexperienced examiners.
Single-blind prospective reliability study.
Physical therapy clinic.
Four examiners, 2 experienced and 2 inexperienced, obtained first ray position and mobility measurements. Both feet of 36 subjects (14 males, 22 females) were measured.
INTERVENTION(S): Each examiner evaluated first ray position and mobility for each of the subjects' feet on 2 separate occasions using the manual assessment techniques described by Root.
MAIN OUTCOME MEASURE(S): First ray position (normal, plantar flexed, dorsiflexed) and mobility (normal, hypermobile, hypomobile) decisions were made.
We calculated kappa correlation coefficients for intrarater and interrater reliability. For position, intrarater and interrater reliability ranged from .03 to .27 for all examiners, experienced and inexperienced. For mobility, intrarater and interrater reliability ranged from .02 to .26 for experienced, inexperienced, and experienced/inexperienced. The percentage agreement (P(O)) values for all examiners were less than 58%. For individual values for position, intrarater and interrater reliability ranged from .00 to .26. For individual values for mobility, intrarater and interrater reliability ranged from .00 to .26. The P(O) values for all examiners were less than 50%.
Clinical experience was not associated with higher kappa coefficients or P(O) values when examiners assessed first ray position or mobility. Clinicians should acknowledge the poor reliability of first ray measurements, especially when making treatment decisions. Finally, a validity study to compare the Root techniques with a gold standard is warranted.
无论是经验丰富还是经验不足的检查者，采用Root法对第一跖列位置或活动度进行临床评估，均不存在可靠性或有效性数据。
确定经验丰富和经验不足的检查者对第一跖列位置和活动度测量的内部评级者和外部评级者可靠性。
单盲前瞻性可靠性研究。
物理治疗诊所。
4名检查者，2名经验丰富，2名经验不足，对第一跖列位置和活动度进行测量。测量了36名受试者（14名男性，22名女性）的双脚。
每位检查者使用Root描述的手动评估技术，在2个不同时间点对每位受试者的双脚进行第一跖列位置和活动度评估。
确定第一跖列位置（正常、跖屈、背屈）和活动度（正常、活动过度、活动不足）。
我们计算了内部评级者和外部评级者可靠性的kappa相关系数。对于位置，所有检查者（经验丰富和经验不足）的内部评级者和外部评级者可靠性范围为0.03至0.27。对于活动度，经验丰富、经验不足以及经验丰富/经验不足的检查者，其内部评级者和外部评级者可靠性范围为0.02至0.26。所有检查者的一致性百分比（P(O)）值均小于58%。对于位置的个体值，内部评级者和外部评级者可靠性范围为0.00至0.26。对于活动度的个体值，内部评级者和外部评级者可靠性范围为0.00至0.26。所有检查者的P(O)值均小于50%。
检查者评估第一跖列位置或活动度时，临床经验与更高的kappa系数或P(O)值无关。临床医生应认识到第一跖列测量的可靠性较差，尤其是在做出治疗决策时。最后，有必要进行一项效度研究，将Root技术与金标准进行比较。
