Adhia Divya Bharatkumar, Bussey Melanie D, Ribeiro Daniel Cury, Tumilty Steve, Milosavljevic Stephan
School of Physical Education, University of Otago, Dunedin, New Zealand.
Man Ther. 2013 Feb;18(1):26-34. doi: 10.1016/j.math.2012.06.004. Epub 2012 Jul 10.
Joint kinematic assessment using an electromagnetic tracking device (EMTD) requires palpation-digitization (PD) of bony landmarks to define the anatomical axes. Errors in PD of bony landmarks can perturb the anatomical axes and affect the validity and reliability of kinematic measurements. The validity and reliability of PD for kinematic measurement needs to be explored before recommending its wider use. A systematic search of 15 electronic databases located studies assessing validity and/or reliability of PD for joint kinematic assessment. Two independent reviewers used the QUADAS and QAREL tools to assess quality of validity and reliability studies respectively. The results were synthesized qualitatively using a level of evidence approach. Eight studies satisfied the final eligibility criteria and were included in the review. The validity, intra-rater reliability and inter-rater reliability were assessed in three, seven and one study respectively. The overall level of evidence for validity of PD technique was strong with high correlation (≥0.80) reported by three high (≥60%) quality studies. The overall level of evidence for intra-rater reliability was also strong with very high ICC (≥0.90) and satisfactory SEM (SEM% ≤ 10%) reported by four high quality studies. However the level of evidence for inter-rater reliability was limited and needs to be addressed by future research.
使用电磁跟踪设备（EMTD）进行关节运动学评估需要对骨性标志进行触诊数字化（PD）以定义解剖轴。骨性标志PD中的误差会干扰解剖轴，并影响运动学测量的有效性和可靠性。在推荐更广泛使用PD之前，需要探索其用于运动学测量的有效性和可靠性。对15个电子数据库进行系统检索，找出评估PD用于关节运动学评估的有效性和/或可靠性的研究。两名独立评审员分别使用QUADAS和QAREL工具评估有效性和可靠性研究的质量。使用证据水平方法对结果进行定性综合。八项研究符合最终纳入标准并被纳入综述。分别在三项、七项和一项研究中评估了有效性、评分者内可靠性和评分者间可靠性。三项高质量（≥60%）研究报告的PD技术有效性的总体证据水平很强，相关性高（≥0.80）。四项高质量研究报告的评分者内可靠性的总体证据水平也很强，ICC非常高（≥0.90）且SEM令人满意（SEM%≤10%）。然而，评分者间可靠性的证据水平有限，需要未来的研究加以解决。
