Dunleavy Kim, Mariano Herman, Wiater Timothy, Goldberg Allon
Physical Therapy, Wayne State University, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA.
J Back Musculoskelet Rehabil. 2010;23(4):209-14. doi: 10.3233/BMR-2010-0269.
The purposes of this study were to: 1) investigate the inter-rater and intra-rater reliability of use of the Flexicurve for measurement of spinal length (L), thoracic (TL) and lumbar length (LL), thoracic (TW) and lumbar width (LW), and 2) quantify measurement error and minimal detectable change at the 95% CI (MDC95) for the same measurements.
Flexicurve measurements of the thoracolumbar spine were recorded by two examiners in standing. Intra-class correlation coefficients were calculated to determine the intra- and inter-rater reliability. Measurement error and MDC95 were calculated to determine length and width measurements that would constitute real change in spinal curvature.
Thoracolumbar length (L) measurements had the highest degree of intra-rater reliability (0.93), while TL, TW, LL, LW showed moderate to good intra-rater reliability (0.61-0.80). Inter-rater reliability for all measurements was moderate (0.58-0.72). Measurement error was moderate to high for TW, LL, and LW (15-25%), and low for L and TL (1-6%). The %MDC95 for TW, LL, and LW found in this study was high (>40%), but was low for L (3.5%).
Thoracolumbar length measurement with the Flexicurve showed good intra-rater reliability, low measurement error, and low MDC95 and may be a useful measure in clinical practice.
本研究的目的是：1）调查使用柔性曲线测量脊柱长度（L）、胸段长度（TL）和腰段长度（LL）、胸段宽度（TW）和腰段宽度（LW）时的评分者间和评分者内信度；2）量化相同测量在95%置信区间（MDC95）的测量误差和最小可检测变化。
两名检查者对站立位的胸腰段脊柱进行柔性曲线测量并记录。计算组内相关系数以确定评分者内和评分者间信度。计算测量误差和MDC95以确定构成脊柱曲率实际变化的长度和宽度测量值。
胸腰段长度（L）测量的评分者内信度最高（0.93），而TL、TW、LL、LW显示出中度至良好的评分者内信度（0.61 - 0.80）。所有测量的评分者间信度为中度（0.58 - 0.72）。TW、LL和LW的测量误差为中度至高（15 - 25%），而L和TL的测量误差较低（1 - 6%）。本研究中TW、LL和LW的MDC95百分比很高（>40%），但L的MDC95百分比很低（3.5%）。
使用柔性曲线测量胸腰段长度显示出良好的评分者内信度、低测量误差和低MDC95，可能是临床实践中的一种有用测量方法。
