The Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1011-6. doi: 10.1007/s00167-011-1873-6. Epub 2012 Jan 13.
The primary purpose of this study was to investigate the intra-tester and inter-tester reliability of the dial test using a handheld digital inclinometer. Additionally, we examined the responsiveness of the test, and side-to-side differences for meaningful comparison.
MATERIALS/METHODS: Twenty-four healthy subjects (22.5 ± 2.8 years) participated in the study. The dial test was performed on both knees at 30° and 90° of knee flexion with the subject supine. While maintaining a neutral position of the ankle, an inclinometer was positioned parallel to the medial border of the foot to quantify external rotation of the tibia. Two examiners performed the dial test in a blinded manner. The minimal detectable change across repeated measures and side-to-side difference was calculated.
Intra-tester reliability for examiner 1 (E1) was 0.83 at 30° knee flexion and 0.89 at 90° knee flexion. Reliability values for examiner 2 (E2) were 0.86 at 30° and 0.87 at 90° knee flexion. Inter-tester reliability was 0.74 at 30° and 0.83 at 90°. The minimal detectable change (MDC) for E1 at 30° was ±9.4° and ±7.4° at 90°. For E2, the MDC value was ±9.1° at 30° and ±8.3° at 90°. Ninety-five percent limits of agreement for side-to-side difference was 16.1° and 11.3° ° for E1 at 30° and 90° and for E2 13.9° at 30° and 14.1° at 90°.
This instrumented dial test using a handheld digital inclinometer to measure external rotation can be performed with acceptable reliability in the clinical setting. A difference of 10° between two measurements on the same knee suggests that a meaningful change has occurred. For right to left comparison, differences greater than 15° suggest clinical significance.
III.
本研究的主要目的是使用手持数字测斜仪来研究dial 测试的组内和组间可靠性。此外，我们还研究了该测试的反应性，以及用于有意义比较的两侧差异。
材料/方法：24 名健康受试者（22.5±2.8 岁）参与了这项研究。在仰卧位下，让受试者膝关节屈曲 30°和 90°，在双侧膝关节上进行 dial 测试。在保持踝关节中立位置的同时，将测斜仪平行于足部的内侧缘放置，以量化胫骨的外旋。两位检查者以盲法进行了 dial 测试。计算了重复测量和两侧差异的最小可检测变化。
检查者 1（E1）的组内可靠性在膝关节屈曲 30°时为 0.83，在膝关节屈曲 90°时为 0.89。检查者 2（E2）的可靠性值在膝关节屈曲 30°时为 0.86，在膝关节屈曲 90°时为 0.87。组间可靠性在膝关节屈曲 30°时为 0.74，在膝关节屈曲 90°时为 0.83。E1 在膝关节屈曲 30°时的最小可检测变化（MDC）为±9.4°，在膝关节屈曲 90°时为±7.4°。E2 在膝关节屈曲 30°时的 MDC 值为±9.1°，在膝关节屈曲 90°时为±8.3°。E1 在膝关节屈曲 30°和 90°时，E2 在膝关节屈曲 30°和 90°时的两侧差异 95%一致性界限分别为 16.1°和 11.3°。
使用手持数字测斜仪测量外旋的这种仪器化 dial 测试在临床环境中具有可接受的可靠性。同一膝关节上两次测量的差值为 10°表明发生了有意义的变化。对于右侧与左侧的比较，差值大于 15°表明具有临床意义。
III 级。
