Ageberg Eva, Flenhagen Johan, Ljung Jonatan
Division of Physiotherapy, Department of Health Sciences, Lund University, Lund Sweden.
BMC Musculoskelet Disord. 2007 Jul 3;8:57. doi: 10.1186/1471-2474-8-57.
Sensory information from mechanoreceptors in the skin, muscles, tendons, and joint structures plays an important role in joint stability. A joint injury can lead to disruption of the sensory system, which can be measured by proprioceptive acuity. When evaluating proprioception, assessment tools need to be reliable. The aim of this study was to assess the test-retest reliability of a device designed to measure knee proprioception.
Twenty-four uninjured individuals (14 women and 10 men) were examined with regard to test-retest reliability of knee kinesthesia, measured by the threshold to detection of passive motion (TDPM). Measurements were performed towards extension and flexion from the two starting positions, 20 degrees and 40 degrees knee joint flexion, giving four variables. The mean difference between test and retest together with the 95% confidence interval (test 2 minus test 1), the intraclass correlation coefficient (ICC2,1), and Bland and Altman graphs with limits of agreement, were used as statistical methods for assessing test-retest reliability.
The intraclass correlation coefficients ranged from 0.59 to 0.70 in all variables except one. No difference was found between test and retest in three of the four TDPM variables. TDPM would need to decrease between 10% and 38%, and increase between 17% and 24% in groups of uninjured subjects to be 95% confident of detecting a real change. The limits of agreement were rather wide in all variables. The variables associated with the 20-degree starting position tended to have higher intraclass correlation coefficients and narrower limits of agreement than those associated with 40 degrees.
Three TDPM variables were considered reliable for observing change in groups of subjects without pathology. However, the limits of agreement revealed that small changes in an individual's performance cannot be detected. The higher intraclass correlation coefficients and the narrower limits of agreement in the variables associated with the starting position of 20 degrees knee joint flexion, indicate that these variables are more reliable than those associated with 40 degrees. We, therefore, recommend that the TDPM be measured with a 20-degree starting position.
来自皮肤、肌肉、肌腱和关节结构中机械感受器的感觉信息在关节稳定性中起重要作用。关节损伤可导致感觉系统中断，这可通过本体感觉敏锐度来测量。在评估本体感觉时，评估工具需要可靠。本研究的目的是评估一种用于测量膝关节本体感觉的设备的重测信度。
对24名未受伤个体（14名女性和10名男性）进行检查，以评估通过被动运动检测阈值（TDPM）测量的膝关节运动觉的重测信度。从两个起始位置，即膝关节屈曲20度和40度，分别向伸展和屈曲方向进行测量，得出四个变量。测试与重测之间的平均差异以及95%置信区间（测试2减去测试1）、组内相关系数（ICC2,1）以及带有一致性界限的布兰德-奥特曼图，被用作评估重测信度的统计方法。
除一个变量外，所有变量的组内相关系数在0.59至0.70之间。在四个TDPM变量中的三个变量中，测试与重测之间未发现差异。在未受伤受试者组中，TDPM需要降低10%至38%，并升高17%至24%，才能有95%的把握检测到真正的变化。所有变量的一致性界限都相当宽。与20度起始位置相关的变量往往比与40度相关的变量具有更高的组内相关系数和更窄的一致性界限。
三个TDPM变量被认为对于观察无病理状态的受试者组中的变化是可靠的。然而，一致性界限表明无法检测到个体表现中的微小变化。与膝关节屈曲20度起始位置相关的变量具有更高的组内相关系数和更窄的一致性界限，表明这些变量比与40度相关的变量更可靠。因此，我们建议在20度起始位置测量TDPM。
