Vernon Howard, Proctor Dan, Bakalovski Dianna, Moreton Jesse
Canadian Memorial Chiropractic College, Graduate Education and Research, Toronto, Ontario, Canada M2H 3J1.
J Manipulative Physiol Ther. 2010 Jan;33(1):20-8. doi: 10.1016/j.jmpt.2009.11.011.
The purpose of this study was to develop and determine the face validity of additional cervical nonorganic simulation tests.
Four simulation tests were either selected from the literature or newly designed: simulated sitting trunk/shoulder rotation (SR; test no. 1), active vs passive cervical rotation (CR; test no. 2), Libman's test (LT; test no. 3) of pressure over the mastoid process, and side-lying passive shoulder abduction (SA; test no. 4). Three groups, 1 without neck pain (n = 44) and 2 with neck pain (n = 43 and 27), were formed. Outcome measures consisted of questions on provocation of pain (Yes/No) and appropriateness (Yes/No) as well as measurements of cervical rotation (goniometric) and pressure pain threshold (pressure algometer). Group test responses were evaluated and scored. A threshold of acceptance was established at 80% agreement for face validity. Ranges of rotation and pressure threshold values were analyzed with the Student t test.
In nonneck pain subjects, all 4 tests were rated as nonpainful and 3 were rated as "appropriate" for neck pain examination (not SR). In neck pain subjects, this test and SA were rated as nonpainful, whereas LT was rated as painful in 26% of subjects. Only CR and LT were rated as "appropriate." In neck pain subjects, passive rotations exceeded actives by 10% to 14% (P = .000). On a second round of testing with a slightly modified method, SR and SA achieved acceptable "appropriateness."
Once 2 tests were slightly modified, all 4 tests were found to have acceptable face validity. Further research into the reliability of these tests as well as into the combinations of these tests is warranted.
本研究旨在开发并确定额外的颈椎非器质性模拟试验的表面效度。
从文献中选取或新设计了四项模拟试验：模拟坐位躯干/肩部旋转（SR；试验1）、主动与被动颈椎旋转（CR；试验2）、乳突部压力的利布曼试验（LT；试验3）以及侧卧被动肩部外展（SA；试验4）。形成了三组，一组无颈部疼痛（n = 44），两组有颈部疼痛（n = 43和27）。结果测量包括关于疼痛激发（是/否）和适宜性（是/否）的问题，以及颈椎旋转测量（角度计）和压力痛阈测量（压力痛觉计）。对各组试验反应进行评估和评分。表面效度的接受阈值设定为80%的一致性。使用学生t检验分析旋转范围和压力阈值。
在无颈部疼痛的受试者中，所有四项试验均被评为无疼痛，三项试验被评为对颈部疼痛检查“适宜”（SR试验除外）。在有颈部疼痛的受试者中，该试验和SA试验被评为无疼痛，而LT试验在26%的受试者中被评为疼痛。只有CR和LT试验被评为“适宜”。在有颈部疼痛的受试者中，被动旋转比主动旋转超出10%至14%（P = .000）。在第二轮采用略有修改方法的测试中，SR和SA试验达到了可接受的“适宜性”。
一旦对两项试验进行了轻微修改，发现所有四项试验均具有可接受的表面效度。有必要对这些试验的可靠性以及这些试验的组合进行进一步研究。
