Pile K D, Laurent M R, Salmond C E, Best M J, Pyle E A, Moloney R O
Wellington Regional Rheumatic Diseases Unit, Hutt Hospital, New Zealand.
Br J Rheumatol. 1991 Feb;30(1):29-34. doi: 10.1093/rheumatology/30.1.29.
Twenty-two measurements repeated non-sequentially on each of 10 patients by five observers were undertaken to determine their reliability for routine clinical use. Measurements without significant inter-observer variation or with a coefficient of reliability greater than 0.70 were cervical rotation, cervical lateral flexion, tragus to wall distance, fingertip to floor distance on sagittal and lateral flexion, C7 to iliac crest line distraction and modified Schober index. It is concluded that many of the currently used measurements are either statistically unreliable or clinically unhelpful in mild or moderate ankylosing spondylitis. The most clinically useful were cervical rotation using a protractor, cervical lateral flexion using a goniometer, thoracolumbar flexion as the C7 to iliac crest line distraction, thoracolumbar lateral flexion as the fingertip to floor distance and the modified Schober index.
五名观察者对10名患者中的每一位进行了22次非连续测量，以确定其在常规临床应用中的可靠性。观察者间无显著差异或可靠性系数大于0.70的测量项目有颈椎旋转、颈椎侧屈、耳屏至墙距离、矢状面和侧屈时指尖至地面距离、C7至髂嵴线牵张以及改良Schober指数。得出的结论是，在轻度或中度强直性脊柱炎中，许多目前使用的测量方法在统计学上不可靠或在临床上没有帮助。临床上最有用的测量方法是用量角器测量颈椎旋转、用角度计测量颈椎侧屈、将胸腰椎屈曲作为C7至髂嵴线牵张、将胸腰椎侧屈作为指尖至地面距离以及改良Schober指数。
