Kleinfield Steven L, Daniel Dwain, Ndetan Harrison
Parker College of Chiropractic.
J Chiropr Educ. 2011 Fall;25(2):164-8. doi: 10.7899/1042-5055-25.2.164.
The purpose of this study is to examine the perceptions of the value of five orthopedic tests (straight leg raise, Braggard's test, Kemp's test, Valsalva maneuver, and Patrick's fabere test) in the diagnosis of specific neuromusculoskeletal conditions among the chiropractic faculty at a large chiropractic college.
This is an observational study that employed a survey of 41 academic and clinic faculty members with a Doctor of Chiropractic degree.
Of the 12 posed questions, only five demonstrated statistically significant consistency (positive straight leg raise for the presence of disc pathology, positive Valsalva maneuver for the presence of disc pathology, negative Valsalva maneuver to rule out disc pathology, negative Braggard's test to rule out the presence of disc pathology, and positive Patrick's fabere test for the presence of hip joint pathology). Subgroup analysis demonstrated that the school of graduation may be the only predictor of consistency.
There were strong indications that faculty members were not consistent in their perception of the value for common orthopedic tests for diagnosing specific conditions. In an evidence-based model of education, there should be a consensus among academic and clinical faculty in order for the students to learn, integrate, and apply in practice what they have learned in the classroom. Active intervention in the academic process is required to accomplish necessary change.
本研究旨在调查一所大型脊椎按摩疗法学院的脊椎按摩疗法教员对五项骨科检查(直腿抬高试验、布拉加德试验、坎普试验、瓦尔萨尔瓦动作和帕特里克试验)在诊断特定神经肌肉骨骼疾病中的价值的看法。
这是一项观察性研究,对41名拥有脊椎按摩疗法博士学位的学术和临床教员进行了调查。
在提出的12个问题中,只有5个显示出统计学上的显著一致性(直腿抬高试验阳性提示椎间盘病变、瓦尔萨尔瓦动作阳性提示椎间盘病变、瓦尔萨尔瓦动作阴性可排除椎间盘病变、布拉加德试验阴性可排除椎间盘病变、帕特里克试验阳性提示髋关节病变)。亚组分析表明,毕业院校可能是一致性的唯一预测因素。
有强烈迹象表明,教员们对用于诊断特定疾病的常见骨科检查的价值的看法并不一致。在基于证据的教育模式中,学术和临床教员之间应该达成共识,以便学生能够学习、整合并在实践中应用他们在课堂上学到的知识。需要在学术过程中进行积极干预以实现必要的变革。