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仰卧位与侧卧位下肩关节内旋被动活动度测量的可靠性。

Reliability of shoulder internal rotation passive range of motion measurements in the supine versus sidelying position.

机构信息

University of Minnesota, Minneapolis, MN, USA.

出版信息

J Orthop Sports Phys Ther. 2010 Sep;40(9):589-94. doi: 10.2519/jospt.2010.3197.


DOI:10.2519/jospt.2010.3197
PMID:20805626
Abstract

STUDY DESIGN: Clinical measurement, reliability. OBJECTIVE: To compare intrarater and interrater reliability of shoulder internal rotation (IR) passive range of motion measurements utilizing a standard supine position and a sidelying position. BACKGROUND: Glenohumeral IR range of motion deficits are often noted in patients with shoulder pathology. Excellent intrarater reliability has been found when measuring this motion. However, interrater reliability has been reported as poor to fair. Some clinicians currently use a sidelying position for IR stretching with patients who have shoulder pathology. However, no objective data exist for IR passive range of motion measured in this sidelying position, either in terms of reliability or normative values. METHODS: Seventy subjects (mean age, 36.8 years), with (n = 19) and without (n = 51) shoulder pathology, were included in this study. Shoulder IR passive range of motion of the dominant shoulder or involved shoulder was measured by 2 investigators in 2 positions: (1) a standard supine position, with the shoulder at 90 degrees of abduction, and (2) in sidelying on the tested side, with the shoulder flexed to 90 degrees . RESULTS: Intrarater reliability for supine measurements was good to excellent (ICC3,1 = 0.70-0.93) and for sidelying measurements was excellent (ICC3,1 = 0.94-0.98). Interrater reliability was fair to good for the supine measurement (ICC2,2 = 0.74-0.81) and good to excellent for the sidelying measurement (ICC2,2 = 0.88-0.96). The mean (range) value of the dominant shoulder sidelying IR passive range of motion was 40 degrees (11 degrees to 69 degrees ) for healthy subjects and 25 degrees (-16 degrees to 49 degrees) for subjects with shoulder pathology. CONCLUSIONS: For subjects with shoulder pathology, measurements of shoulder IR made in the sidelying position had superior intrarater and interrater reliability compared to those in the standard supine position.

摘要

研究设计:临床测量,可靠性。 目的:比较利用标准仰卧位和侧卧位测量肩内旋(IR)被动活动范围的内部和外部可靠性。 背景:肩袖病变患者常出现盂肱关节 IR 活动范围不足。当测量这种运动时,已经发现了很好的内部可靠性。但是,已经报道了外部可靠性为差到中等。一些临床医生目前在患有肩部疾病的患者中使用侧卧位进行 IR 伸展。然而,在这种侧卧位下,无论是在可靠性还是在正常范围内,都没有关于 IR 被动活动范围的客观数据。 方法:本研究纳入了 70 名受试者(平均年龄 36.8 岁),其中(n = 19)和不(n = 51)有肩部疾病。由 2 名研究人员在 2 种体位下测量优势肩或受累肩的肩内旋被动活动范围:(1)标准仰卧位,肩关节外展 90 度,(2)患侧侧卧,肩关节弯曲 90 度。 结果:仰卧位测量的内部可靠性为优到极好(ICC3,1 = 0.70-0.93),侧卧位测量的内部可靠性为极好(ICC3,1 = 0.94-0.98)。仰卧位测量的外部可靠性为中等到良好(ICC2,2 = 0.74-0.81),侧卧位测量的外部可靠性为好到极好(ICC2,2 = 0.88-0.96)。健康受试者的优势肩侧卧 IR 被动活动范围的平均值(范围)为 40 度(11 度至 69 度),肩部病变患者为 25 度(-16 度至 49 度)。 结论:对于肩部病变患者,与标准仰卧位相比,侧卧位测量的肩部 IR 具有更高的内部和外部可靠性。

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