Tederko Piotr, Krasuski Marek, Maciejasz Paweł
Klinika Rehabilitacji Akademii Medycznej, Konstancin.
Ortop Traumatol Rehabil. 2007 Mar-Apr;9(2):156-67.
Range of motion (ROM) is a parameter of prime importance for clinical assessment of spinal function. Many spinal ROM assessment techniques of varying reliability are currently in use. Immobilization of the pelvis and lower extremities improves control of the neutral position and decreases the error resulting from compensatory hip motion during measurement. To present a prototypic station for active 3-dimensional spinal ROM assessment; to analyze repeatability of measurements and reproducibility of the neutral position.
A quintuple 3-dimensional measurement of the lumbar and thoracic active range of motion in 12 healthy volunteers.
The series of results obtained for each subject fulfilled the criteria of a normal distribution. The mean values of thoracic ROM were as follows: sagittal 40.1 degrees (SD=5.56 degrees; mean coefficient of variation CV=13.88%); horizontal 75.2 degrees (SD=6.01 degrees; CV=7.99%); frontal 34.0 degrees (SD=3.01 degrees; CV=8.84%). The mean values of lumbar ROM were as follows: sagittal 112.0 degrees (SD=4.13; CV=3.68%); horizontal 14.8 degrees (SD=3.77 degrees; CV=25.45%); frontal 67.6 degrees (SD=2.72 degrees; CV=4.03%). Inter-class correlation coefficients for particular subjects ranged between 0.95 and 0.99 (p<0.0001). Mean reproducibility of the neutral position was 1.08 degrees-2.63 degrees in thoracic spine and 1.23 degrees-2.31 degrees in lumbar spine. Comparison of the results with literature data revealed good neutral position reproducibility and high values of inter-class correlation coefficients in the present study. Potential reasons for assessment errors are discussed. Recommendations for the construction of an improved immobilizer for diagnostic purposes are presented.
Validated spinal ROM measurements are useful in monitoring patients with musculoskeletal disorders. Immobilization of the pelvis and lower limbs improves repeatability of thoracic and lumbar ROM assessment and reproducibility of a neutral position. The prototype enables highly repeatable measurements, but requires technical improvements.
活动范围（ROM）是脊柱功能临床评估的一个至关重要的参数。目前使用着许多可靠性各异的脊柱ROM评估技术。固定骨盆和下肢可改善中立位的控制，并减少测量期间因髋关节代偿性运动导致的误差。介绍一种用于主动三维脊柱ROM评估的原型工作站；分析测量的重复性和中立位的再现性。
对12名健康志愿者的腰椎和胸椎主动活动范围进行五次三维测量。
为每个受试者获得的一系列结果符合正态分布标准。胸椎ROM的平均值如下：矢状面40.1度（标准差=5.56度；平均变异系数CV=13.88%）；水平面75.2度（标准差=6.01度；CV=7.99%）；额状面34.0度（标准差=3.01度；CV=8.84%）。腰椎ROM的平均值如下：矢状面112.0度（标准差=4.13；CV=3.68%）；水平面14.8度（标准差=3.77度；CV=25.45%）；额状面67.6度（标准差=2.72度；CV=4.03%）。特定受试者的组内相关系数在0.95至0.99之间（p<0.0001）。中立位的平均再现性在胸椎为1.08度至2.63度，在腰椎为1.23度至2.31度。将结果与文献数据进行比较，发现在本研究中中立位再现性良好且组内相关系数值较高。讨论了评估误差的潜在原因。提出了用于诊断目的的改进固定器构建建议。
经过验证的脊柱ROM测量对于监测肌肉骨骼疾病患者很有用。固定骨盆和下肢可提高胸椎和腰椎ROM评估的重复性以及中立位的再现性。该原型能够进行高度可重复的测量，但需要技术改进。
