Sacco I C N, Onodera A N, Butugan M K, Taddei U T, Mendes Y C, Galhardo B, Padua M, Dreyer S H, Lobo R A S, Aliberti S
University of Sao Paulo, Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, São Paulo, Brazil.
Knee. 2010 Jan;17(1):92-5. doi: 10.1016/j.knee.2009.05.008. Epub 2009 Jul 1.
The aim was to investigate inter-tester and intra-tester reliability and parallel reliability between a visual assessment method and a method using a pachymeter for locating the mid-point of the patella in determining the medial/lateral patella orientation. Fifteen asymptomatic subjects were assessed and the mid-point of the patella was determined by both methods on two separate occasions two weeks apart. Inter-tester reliability was obtained by ANOVA and by intraclass correlation coefficient (ICC); intra-tester reliability was obtained by a paired t-test and ICC; and parallel reliability was obtained by Pearson's Correlation and ICC, for the measurement on the first and second evaluations. There was acceptable inter-tester agreement (p=0.490) and reliability for the visual inspection (ICC=0.747) and for the pachymeter (ICC=0.716) at the second evaluation. The inter-tester reliability in the first evaluation was unacceptable (visual ICC=0.604; pachymeter ICC=0.612). Although there was statistical similarity between measurements for the first and second evaluations for all testers, intra-tester reliability was not acceptable for both methods: visual (examiner 1 ICC=0.175; examiner 2 ICC=0.189; examiner 3 ICC=0.155) and pachymeter (examiner 1 ICC=0.214; examiner 2 ICC=0.246; examiner 3 ICC=0.069). Parallel reliability gave a perfect correlation at the first evaluation (r=0.828; p<0.001) and at the second (r=0.756; p<0.001) and reliability was between acceptable and very good (ICC=[0.748-0.813]). Both visual and pachymeter methods provide reliable and similar medial/lateral patella orientation and are reliable between different examiners, but the results between the two assessments at 2 weeks' interval demonstrated an unacceptable reliability.
目的是研究在确定髌骨内外侧方向时，视觉评估方法与使用测厚仪确定髌骨中点的方法之间的测试者间信度、测试者内信度和平行信度。对15名无症状受试者进行了评估，并在相隔两周的两个不同时间点通过两种方法确定髌骨中点。通过方差分析和组内相关系数（ICC）获得测试者间信度；通过配对t检验和ICC获得测试者内信度；通过Pearson相关性和ICC获得第一次和第二次评估测量的平行信度。在第二次评估时，视觉检查（ICC=0.747）和测厚仪（ICC=0.716）的测试者间一致性和信度是可接受的（p=0.490）。第一次评估时测试者间信度不可接受（视觉ICC=0.604；测厚仪ICC=0.612）。尽管所有测试者第一次和第二次评估的测量结果在统计学上具有相似性，但两种方法的测试者内信度均不可接受：视觉（检查者1 ICC=0.175；检查者2 ICC=0.189；检查者3 ICC=0.155）和测厚仪（检查者1 ICC=0.214；检查者2 ICC=0.246；检查者3 ICC=0.069）。平行信度在第一次评估时呈现完美相关性（r=0.828；p<0.001），在第二次评估时（r=0.756；p<0.001），信度在可接受和非常好之间（ICC=[0.748 - 0.813]）。视觉和测厚仪方法在确定髌骨内外侧方向时均提供可靠且相似的结果，并且在不同检查者之间具有可靠性，但间隔两周的两次评估结果显示信度不可接受。
