Murphy Donald R, Byfield David, McCarthy Peter, Humphreys Kim, Gregory Amy A, Rochon Ryan
Department of Community Health, Brown University School of Medicine, Providence, RI, USA.
J Manipulative Physiol Ther. 2006 Jun;29(5):374-7. doi: 10.1016/j.jmpt.2006.04.012.
The hip extension test may be a clinical sign of impaired motor control in the lumbar spine, which may have a negative impact on spine stability. The purpose of this study is to evaluate the interexaminer reliability of the hip extension test for suspected dynamic instability of the lumbar spine in patients with chronic low back pain.
Forty-two patients with chronic low back pain participated in this interexaminer reliability study. Chronic low back pain was defined as pain of greater than 7 weeks duration in the area between T12 and the buttocks, with or without leg pain. Two doctors of chiropractic simultaneously observed and independently assessed the left and right prone hip extension test on all 42 patients. Results for both examiners were given to an independent recorder. Each examiner was blinded to the results of the other examiner.
The mean age of subjects was 38 years (SD 12.35); 73.8% were female. Sixty-eight percent (SD 1.72) reported current back pain intensity greater than 5 on an 11-point numerical rating scale. The mean score for the Roland-Morris Low Back Pain and Disability questionnaire was 5.8 (SD 4.34). The kappa measure of agreement was 0.72 for the left leg and 0.76 for the right leg. This indicated a substantial strength of agreement between examiners for both left and right hip extension tests. For the 8 cases of disagreement, rater 1 generally rated the tests as positive, whereas rater 2 consistently rated the tests as negative.
The hip extension test appears to have good reliability in detecting deviation of the lumbar spine from the midline. Validity with regard to the test's ability to distinguish patients with chronic low back pain from normal individuals and its relation to lumbar spine stability remains to be determined.
髋关节后伸试验可能是腰椎运动控制受损的一种临床体征，这可能会对脊柱稳定性产生负面影响。本研究的目的是评估髋关节后伸试验在慢性下腰痛患者中对疑似腰椎动态不稳定的检查者间可靠性。
42例慢性下腰痛患者参与了这项检查者间可靠性研究。慢性下腰痛定义为T12至臀部区域持续时间超过7周的疼痛，伴有或不伴有腿痛。两名整脊医生同时对所有42例患者的左右俯卧位髋关节后伸试验进行观察并独立评估。两位检查者的结果交给一名独立记录员。每位检查者对另一位检查者的结果不知情。
受试者的平均年龄为38岁（标准差12.35）；73.8%为女性。68%（标准差1.72）的患者在11点数字评分量表上报告当前背痛强度大于5。罗兰 - 莫里斯下腰痛与残疾问卷的平均得分为5.8（标准差4.34）。左腿的一致性kappa测量值为0.72，右腿为0.76。这表明检查者在左右髋关节后伸试验中的一致性强度较高。在8例不一致的情况中，评分者1通常将试验评为阳性而评分者2始终将试验评为阴性。
髋关节后伸试验在检测腰椎偏离中线方面似乎具有良好的可靠性。该试验区分慢性下腰痛患者与正常个体的能力及其与腰椎稳定性的关系的有效性仍有待确定。
