Kilby Julia, Heneghan Nicola R, Maybury Mark
Physiotherapy Department, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, United Kingdom.
Man Ther. 2012 Jun;17(3):259-62. doi: 10.1016/j.math.2011.08.008. Epub 2011 Sep 25.
Manual palpation (MP) is commonly used for the assessment of patients with neuromusculoskeletal dysfunction. During assessment of lumbo-pelvic disorders in particular, it may be used not only to explore pain and resistance in the region, but also to evaluate the symmetry and movement quality of the area. Whilst reliability of MP has been extensively investigated, its validity remains relatively under researched. The aim of this study was to explore the accuracy of MP of lumbo-pelvic bony points. Ultrasound images of three bony landmarks [4th lumbar spinous process (L4), left and right posterior superior iliac spines (PSIS)] were acquired from models (n = 3) in the prone position and the points marked with an ultra-violet (UV) pen. Nine musculoskeletal physiotherapists were asked to identify the bony landmarks using MP. Measurements (mms) were taken between the UV marks and the palpators' marks. The mean error (standard deviation) (mm) for MP of L4, LPSIS, RPSIS were 15.63 (3.89), 20.07 (4.60), 20.59 (2.79) respectively. Bland and Altman analysis gave a mean value of 0.173, with 95% limits of agreement ranging from -27.8 to 26.3. This study suggests that MP of specific lumbo-pelvic bony points has limited validity.
手法触诊（MP）常用于评估神经肌肉骨骼功能障碍患者。特别是在评估腰骶部疾病时，它不仅可用于探查该区域的疼痛和阻力，还可用于评估该区域的对称性和运动质量。虽然对手法触诊的可靠性已进行了广泛研究，但其有效性仍相对缺乏研究。本研究的目的是探讨腰骶部骨点手法触诊的准确性。从俯卧位的模型（n = 3）获取三个骨性标志[第4腰椎棘突（L4）、左右髂后上棘（PSIS）]的超声图像，并用紫外线（UV）笔标记这些点。九名肌肉骨骼物理治疗师被要求使用手法触诊来识别骨性标志。测量紫外线标记与触诊者标记之间的距离（毫米）。L4、左侧PSIS、右侧PSIS手法触诊的平均误差（标准差）（毫米）分别为15.63（3.89）、20.07（4.60）、20.59（2.79）。Bland和Altman分析得出平均值为0.173，95%一致性界限为-27.8至26.3。本研究表明，特定腰骶部骨点的手法触诊有效性有限。
