Barakatt Edward T, Romano Patrick S, Riddle Daniel L, Beckett Laurel A
J Man Manip Ther. 2009;17(3):135-40. doi: 10.1179/jmt.2009.17.3.135.
Maitland's construct of musculoskeletal pain irritability is widely used by physical therapists but has not been defined to the extent that its measurement properties can be tested. The purpose of this study was to examine the inter-rater reliability of physical therapists' irritability judgments during application to patients with low back pain (LBP). Eighty patients with LBP received two consecutive examinations at their initial clinic visit by two physical therapists. Patients reported pain location and intensity prior to each evaluation. Therapists judged subjects' LBP as irritable or non-irritable. Inter-rater agreement of physical therapist irritability judgments was moderate (kappa = 0.44, prevalence-adjusted kappa = 0.50). This level of reliability of therapists' LBP irritability judgments may be improved upon by development of an operational definition of pain irritability. Further research is needed to identify measures appropriate for inclusion in an operational definition of pain irritability and to assess the value of making pain irritability judgments in evidence-based physical therapy practice.
梅特兰的肌肉骨骼疼痛易激惹性概念被物理治疗师广泛使用，但尚未明确到能够测试其测量属性的程度。本研究的目的是检验物理治疗师在对腰痛（LBP）患者进行评估时，其易激惹性判断的评分者间信度。80名腰痛患者在初次门诊时由两名物理治疗师连续进行了两次检查。患者在每次评估前报告疼痛部位和强度。治疗师将受试者的腰痛判断为易激惹性或非易激惹性。物理治疗师易激惹性判断的评分者间一致性为中等（kappa = 0.44，患病率调整kappa = 0.50）。通过制定疼痛易激惹性的操作性定义，治疗师对腰痛易激惹性判断的这种信度水平可能会得到提高。需要进一步的研究来确定适合纳入疼痛易激惹性操作性定义的测量方法，并评估在循证物理治疗实践中进行疼痛易激惹性判断的价值。
