Barrett Eva, McCreesh Karen, Lewis Jeremy
Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Man Ther. 2014 Feb;19(1):10-7. doi: 10.1016/j.math.2013.09.003. Epub 2013 Oct 26.
A wide array of instruments are available for non-invasive thoracic kyphosis measurement. Guidelines for selecting outcome measures for use in clinical and research practice recommend that properties such as validity and reliability are considered. This systematic review reports on the reliability and validity of non-invasive methods for measuring thoracic kyphosis.
A systematic search of 11 electronic databases located studies assessing reliability and/or validity of non-invasive thoracic kyphosis measurement techniques. Two independent reviewers used a critical appraisal tool to assess the quality of retrieved studies. Data was extracted by the primary reviewer. The results were synthesized qualitatively using a level of evidence approach.
27 studies satisfied the eligibility criteria and were included in the review. The reliability, validity and both reliability and validity were investigated by sixteen, two and nine studies respectively. 17/27 studies were deemed to be of high quality. In total, 15 methods of thoracic kyphosis were evaluated in retrieved studies. All investigated methods showed high (ICC ≥ .7) to very high (ICC ≥ .9) levels of reliability. The validity of the methods ranged from low to very high.
The strongest levels of evidence for reliability exists in support of the Debrunner kyphometer, Spinal Mouse and Flexicurve index, and for validity supports the arcometer and Flexicurve index. Further reliability and validity studies are required to strengthen the level of evidence for the remaining methods of measurement. This should be addressed by future research.
有多种仪器可用于非侵入性胸椎后凸测量。临床和研究实践中选择结局指标的指南建议考虑有效性和可靠性等属性。本系统评价报告了非侵入性测量胸椎后凸方法的可靠性和有效性。
对11个电子数据库进行系统检索，查找评估非侵入性胸椎后凸测量技术可靠性和/或有效性的研究。两名独立评审员使用关键评估工具评估检索到的研究的质量。由第一评审员提取数据。结果采用证据水平法进行定性综合。
27项研究符合纳入标准并被纳入本评价。分别有16项、2项和9项研究对可靠性、有效性以及可靠性和有效性进行了调查。27项研究中有17项被认为质量较高。检索到的研究共评估了15种胸椎后凸测量方法。所有研究方法均显示出高（组内相关系数ICC≥0.7）至非常高（ICC≥0.9）的可靠性水平。这些方法的有效性从低到非常高不等。
有最强证据水平支持可靠性的是德布勒纳后凸测量仪、脊柱鼠标和Flexicurve指数，支持有效性的是角度计和Flexicurve指数。需要进一步开展可靠性和有效性研究，以加强其余测量方法的证据水平。这应由未来的研究加以解决。
