腰椎前屈活动度评估：两种常用临床测试的测试者间信度及同时效度
Assessments of lumbar flexion range of motion: intertester reliability and concurrent validity of 2 commonly used clinical tests.
作者信息
Robinson Hilde Stendal, Mengshoel Anne Marit
机构信息
From the Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.
出版信息
Spine (Phila Pa 1976). 2014 Feb 15;39(4):E270-5. doi: 10.1097/BRS.0000000000000131.
STUDY DESIGN
Cross-sectional.
OBJECTIVE
To compare intertester reliability and concurrent validity of 2 frequently used methods for assessing lumbar flexion range of motion: the fingertip-to-floor distance (FFD) test and the modified Schober (mSchober) test.
SUMMARY OF BACKGROUND DATA
An assessment of lumbar flexion range of motion is often incorporated in the clinical evaluation of patients with low back pain, as well as in clinical studies when examining the effects of different therapies on these patients. In both cases, the validity and reliability of assessment methods are important.
METHODS
The FFD test and the mSchober test were used in a heterogeneous study sample (n = 98) including patients with low back pain, pelvic girdle pain, and individuals without pain in either of these areas. Each participant was examined by 2 of 3 randomly selected assessors on the same day. Intraclass correlation coefficient3,1, together with the Bland and Altman plot, were used to examine intertester reliability. Absolute reliability was calculated by the smallest detectable change. The relationship between the 2 tests was measured using Pearson correlation coefficient (r), which was used as the measure of concurrent validity.
RESULTS
The FFD test and the mSchober test showed an intraclass correlation coefficient of 0.93 and 0.77, and a smallest detectable change of 9.8 and 1.8 cm, respectively. There was a medium negative correlation between the 2 tests; an increase in the mSchober test resulted in a decrease in the FFD test (r = -0.47, P ≤ 0.001).
CONCLUSION
In our heterogeneous study sample, the FFD and the mSchober test showed excellent intertester reliability but with a relatively large smallest detectable change. However, the medium correlation between these 2 tests to measure lumbar flexion range of motion indicates that they do not fully assess the same phenomenon and hence should be used in combination when examining patients.
LEVEL OF EVIDENCE
研究设计
横断面研究。
目的
比较两种常用的评估腰椎前屈活动范围的方法的检查者间可靠性和同时效度：指尖至地面距离（FFD）试验和改良Schober（mSchober）试验。
背景数据总结
腰椎前屈活动范围的评估常用于腰痛患者的临床评估，以及在研究不同疗法对这些患者的疗效时的临床研究中。在这两种情况下，评估方法的效度和可靠性都很重要。
方法
在一个异质性研究样本（n = 98）中使用FFD试验和mSchober试验，该样本包括腰痛患者、骨盆带疼痛患者以及在这两个区域均无疼痛的个体。每位参与者在同一天由3名随机选择的评估者中的2名进行检查。使用组内相关系数3,1以及Bland和Altman图来检查检查者间可靠性。通过最小可检测变化计算绝对可靠性。使用Pearson相关系数（r）测量两种试验之间的关系，该系数用作同时效度的指标。
结果
FFD试验和mSchober试验的组内相关系数分别为0.93和0.77，最小可检测变化分别为9.8和1.8 cm。两种试验之间存在中等程度的负相关；mSchober试验增加导致FFD试验减少（r = -0.47，P≤0.001）。
结论
在我们的异质性研究样本中，FFD试验和mSchober试验显示出优异的检查者间可靠性，但最小可检测变化相对较大。然而，这两种测量腰椎前屈活动范围的试验之间的中等相关性表明它们并未完全评估相同的现象，因此在检查患者时应联合使用。
证据水平
2级。
Zotero 插件