Luomajoki Hannu, Kool Jan, de Bruin Eling D, Airaksinen Olavi
Physiotherapie Reinach, 5734 Reinach, Switzerland.
BMC Musculoskelet Disord. 2007 Sep 12;8:90. doi: 10.1186/1471-2474-8-90.
Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine.
We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.
The kappa values for inter-tester reliability ranged between 0.24 - 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 - 0.96, all tests but one showed substantial reliability [k > 0.6].
Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.
运动控制功能障碍[MCD]会降低对运动的主动控制。MCD患者可能是非特异性腰痛患者中的一个重要亚组。诊断基于对主动运动的观察。尽管在临床上广泛使用，但仅有少数研究用于确定该测试的可靠性。本研究的目的是确定腰椎运动控制功能障碍测试的观察者间和观察者内可靠性。
我们对27例非特异性腰痛患者和13例有其他诊断但无背痛的患者进行标准化测试组的录像，该测试组包括10项运动控制主动运动测试。四名物理治疗师在对所有其他患者信息及彼此不知情的情况下，独立地将每次观察的测试表现评定为正确或不正确。该研究在瑞士赖纳赫的一家私人物理治疗门诊进行。计算了评分者间和评分者内结果的kappa系数、百分比一致性和置信区间。
测试者间可靠性的kappa值在0.24 - 0.71之间。十项测试中有六项显示出较高的可靠性[k > 0.6]。测试者内可靠性在0.51 - 0.96之间，除一项测试外所有测试均显示出较高的可靠性[k > 0.6]。
通过观看有或无背痛患者执行任务的影片，物理治疗师能够可靠地将本系列运动控制任务中的大多数测试评定为执行正确与否。
