Dedering Asa, Gnospelius Asa, Elfving Britt
Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
Physiother Res Int. 2010 Dec;15(4):189-98. doi: 10.1002/pri.457.
Electromyographic (EMG) spectral parameters and endurance tests for back muscles have long been used to estimate low-back muscle fatigue.
The present purpose was to evaluate the test-retest reliability of a fatigue-testing protocol and to investigate associations between activity limitations and fatigue in patients with lumbar disc herniation.
To evaluate the reliability, endurance time, EMG spectral parameters and ratings of lumbar muscle fatigue and back pain were measured three times in 15 patients with lumbar disc herniation. The patients performed a modified Sørensen test with concurrent recordings of electromyography from the lumbar muscles at four recording sites. Ratings of their perceived fatigue and pain on a Borg scale were collected simultaneously. Recovery over five minutes was recorded. Questionnaires about activity, participation, self-efficacy and health were also used.
Endurance time had an ICC of 0.85 indicating good reliability. Initial, end and median frequency recovery had intraclass correlation coefficients (ICCs) over 0.6 that is acceptable but with large standard errors of measurement. The median frequency slopes for the four recording sites had ICCs of 0.19-0.48. Agreement coefficients for the Borg ratings ranged between 0.78 and 0.97. Moderate correlation was found between activity limitations and endurance time.
Endurance time measurement and Borg ratings may be recommended for evaluating intervention both with groups of patients, i.e. for research purposes, and for individuals. The median frequency parameters may be recommended for groups only. The study shows the importance of establishing the reliability of the patient category if the results are to be used to evaluate intervention.
长期以来，肌电图（EMG）频谱参数和背部肌肉耐力测试一直用于评估下背部肌肉疲劳。
本研究旨在评估疲劳测试方案的重测信度，并探讨腰椎间盘突出症患者活动受限与疲劳之间的关联。
为评估信度，对15例腰椎间盘突出症患者进行了3次测量，记录耐力时间、EMG频谱参数以及腰部肌肉疲劳和背痛的评分。患者进行改良的索伦森试验，同时在四个记录部位记录腰部肌肉的肌电图。同时收集他们在Borg量表上的主观疲劳和疼痛评分。记录五分钟内的恢复情况。还使用了关于活动、参与、自我效能和健康的问卷。
耐力时间的组内相关系数（ICC）为0.85，表明信度良好。初始、结束和中位数频率恢复的组内相关系数（ICC）超过0.6，这是可以接受的，但测量标准误差较大。四个记录部位的中位数频率斜率的ICC为0.19 - 0.48。Borg评分的一致性系数在0.78至0.97之间。发现活动受限与耐力时间之间存在中度相关性。
对于评估患者群体（即用于研究目的）和个体的干预措施，推荐使用耐力时间测量和Borg评分。中位数频率参数仅推荐用于群体。该研究表明，如果要使用结果评估干预措施，确定患者类别信度的重要性。
