一种用于评估环转腕关节运动的客观设备的验证

Validation of an objective device for assessing circumductive wrist motion.

作者信息

Franko Orrin I, Lal Shalini, Pauyo Thierry, Alexander Marcus, Zurakowski David, Day Charles

机构信息

Harvard Medical School, Boston, MA 02215, USA.

出版信息

J Hand Surg Am. 2008 Oct;33(8):1293-300. doi: 10.1016/j.jhsa.2008.03.012.

DOI:10.1016/j.jhsa.2008.03.012

PMID:18929191

Abstract

PURPOSE

Circumduction of the wrist consists of a circular motion combining flexion, extension, and radioulnar deviation without simultaneous supination or pronation of the forearm. This pattern of flexion-extension and radial-ulnar deviation coupling is vital in common tasks; however, its evaluation in hand clinics is limited by the availability and ease of current tools. We present the construct, criterion, test-retest, and inter-rater validity of a new circumduction measurement device.

METHODS

Splint volunteers (n = 42) and hand clinic patients (n = 51) were studied to assess different aspects of validity and reliability for the circumduction jig. Known-group validation was used to assess construct validity and demonstrate the ability of the device to differentiate between patients with lesser or greater circumduction values. Criterion validity was demonstrated by comparing the circumduction measures of the device to flexion, extension, ulnar deviation, and radial deviation. Test-retest reliability was established by comparing the results of repeated circumduction measures for the hand clinic patients by 2 blinded, independent researchers, and inter-rater reliability was determined by evaluating the correlation in circumduction measures taken on the same patient by different blinded, independent researchers.

RESULTS

Circumduction measurements significantly decreased (test for trend, p < .01) across the 3 different treatments that represented progressively reduced range of motion, establishing construct validity of the device. Flexion, extension, and radioulnar deviation all correlated significantly with circumduction; the correlation values ranged from 0.46 to 0.82 (p < .01) among all subjects (93 subjects, 228 measurements). Intra-rater reliability was 0.98 (p < .01) for both evaluators, and inter-rater reliability was 0.94 (p < .01).

CONCLUSIONS

The present validation study demonstrated criterion, construct, test-retest, and inter-rater reliability for a newly designed circumduction measurement device.

摘要

目的

腕关节环转运动是一种圆周运动，它结合了屈曲、伸展以及桡尺偏斜，且前臂不同时进行旋前或旋后。这种屈伸与桡尺偏斜耦合的模式在日常活动中至关重要；然而，在手部诊所中，对其评估受到现有工具的可用性和易用性的限制。我们展示了一种新型环转测量装置的结构效度、效标效度、重测信度和评分者间信度。

方法

对夹板志愿者（n = 42）和手部诊所患者（n = 51）进行研究，以评估环转夹具效度和信度的不同方面。已知组验证用于评估结构效度，并证明该装置区分环转值较小或较大患者的能力。通过将该装置的环转测量值与屈曲、伸展、尺偏和桡偏测量值进行比较来证明效标效度。通过两名盲法、独立的研究人员对手部诊所患者重复进行环转测量的结果进行比较，建立重测信度，通过评估不同盲法、独立的研究人员对同一患者进行的环转测量之间的相关性来确定评分者间信度。

结果

在代表逐渐减小的运动范围的3种不同治疗中，环转测量值显著降低（趋势检验，p <.01），确立了该装置的结构效度。屈曲、伸展和桡尺偏斜均与环转显著相关；在所有受试者（93名受试者，228次测量）中，相关值范围为0.46至0.82（p <.01）。两位评估者的评分者内信度均为0.98（p <.01），评分者间信度为0.94（p <.01）。