慢性下腰痛患者腰椎活动范围和最大等长肌力评估的可靠性
Reliability of the assessment of lumbar range of motion and maximal isometric strength in patients with chronic low back pain.
作者信息
Roussel Nathalie A, Truijen Steven, De Kerf Ilse, Lambeets Dirk, Nijs Jo, Stassijns Gaëtane
机构信息
Division of Musculoskeletal Physiotherapy, Department of Health Sciences, University College of Antwerp, Belgium.
出版信息
Arch Phys Med Rehabil. 2008 Apr;89(4):788-91. doi: 10.1016/j.apmr.2007.09.039.
OBJECTIVE
To examine the interobserver reliability of the assessment of lumbar range of motion (ROM) and maximal isometric strength in patients with chronic low back pain (CLBP) using commercially available equipment.
DESIGN
A prospective repeated-measures design.
SETTING
Ambulatory care in a university hospital.
PARTICIPANTS
Twelve patients (5 men, 7 women; age range, 20-52y) with CLBP, with a mean visual analog scale score of 31.5+/-25.8mm, volunteered for the study. The duration of their symptoms was 63+/-115 months and the mean Oswestry Disability Index score was 31%.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Movements of the lumbar spine were assessed with commercially available equipment. Both the range of motion (ROM) and the maximal isometric strength for flexion, extension, lateroflexion, and rotation of the lumbar spine were evaluated twice to analyze the interobserver reliability. The same test procedure was performed on 2 separate days by 2 investigators who were blinded to the outcome of the assessment of their colleague. The order of investigator was balanced, so that each investigator tested the same number of patients as first investigator.
RESULTS
The intraclass correlation coefficient varied between .91 and .98 for the measurements of the lumbar ROM and was between .93 and .97 for all the strength measurements. Post hoc power analysis confirmed previous power analysis, that is, despite the small sample size, an excellent power was found for the observed interobserver reliability coefficients (power range, 0.93-1.00). No learning effect was found when comparing the results of the second measurement with the first measurement (P>.05).
CONCLUSIONS
The interobserver reliability is excellent for the measurement of the ROM of the lumbar spine and for the maximal isometric strength using specific devices in patients with CLBP.
目的
使用市售设备检查慢性下腰痛(CLBP)患者腰椎活动度(ROM)评估和最大等长肌力评估的观察者间可靠性。
设计
前瞻性重复测量设计。
地点
大学医院的门诊护理。
参与者
12名CLBP患者(5名男性,7名女性;年龄范围20 - 52岁)自愿参加本研究,其平均视觉模拟量表评分为31.5±25.8mm。症状持续时间为63±115个月,平均奥斯威斯利功能障碍指数评分为31%。
干预措施
不适用。
主要观察指标
使用市售设备评估腰椎运动。对腰椎的活动度(ROM)以及前屈、后伸、侧屈和旋转的最大等长肌力进行两次评估,以分析观察者间可靠性。由两名对其同事评估结果不知情的研究者在两个不同日期进行相同的测试程序。研究者顺序是平衡的,以便每位研究者测试的患者数量与第一位研究者相同。
结果
腰椎ROM测量的组内相关系数在0.91至0.98之间,所有力量测量的组内相关系数在0.93至0.97之间。事后功效分析证实了先前的功效分析,即尽管样本量小,但观察到的观察者间可靠性系数具有出色的功效(功效范围为0.93 - 1.00)。将第二次测量结果与第一次测量结果进行比较时未发现学习效应(P>0.05)。
结论
对于CLBP患者,使用特定设备测量腰椎ROM和最大等长肌力时,观察者间可靠性极佳。