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手臂振动综合征神经生理学测试在振动暴露工人和未暴露对照者中的重测信度。

Test-retest reliability of neurophysiological tests of hand-arm vibration syndrome in vibration exposed workers and unexposed referents.

作者信息

Gerhardsson Lars, Gillström Lennart, Hagberg Mats

机构信息

Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, University of Gothenburg, Medicinaregatan 16, Box 414, SE-405 30 Gothenburg, Sweden.

Company Health Service, Volvo Powertrain Corporation, SE-541 36 Skovde, Sweden.

出版信息

J Occup Med Toxicol. 2014 Nov 11;9(1):38. doi: 10.1186/s12995-014-0038-1. eCollection 2014.

Abstract

BACKGROUND

Exposure to hand-held vibrating tools may cause the hand-arm vibration syndrome (HAVS). The aim was to study the test-retest reliability of hand and muscle strength tests, and tests for the determination of thermal and vibration perception thresholds, which are used when investigating signs of neuropathy in vibration exposed workers.

METHODS

In this study, 47 vibration exposed workers who had been investigated at the department of Occupational and Environmental Medicine in Gothenburg were compared with a randomized sample of 18 unexposed subjects from the general population of the city of Gothenburg. All participants passed a structured interview, answered several questionnaires and had a physical examination including hand and finger muscle strength tests, determination of vibrotactile (VPT) and thermal perception thresholds (TPT). Two weeks later, 23 workers and referents, selected in a randomized manner, were called back for the same test-procedures for the evaluation of test-retest reliability.

RESULTS

The test-retest reliability after a two week interval expressed as limits of agreement (LOA; Bland-Altman), intra-class correlation coefficients (ICC) and Pearson correlation coefficients was excellent for tests with the Baseline hand grip, Pinch-grip and 3-Chuck grip among the exposed workers and referents (N = 23: percentage of differences within LOA 91 - 100%; ICC-values ≥0.93; Pearson r ≥0.93). The test-retest reliability was also excellent (percentage of differences within LOA 96-100 %) for the determination of vibration perception thresholds in digits 2 and 5 bilaterally as well as for temperature perception thresholds in digits 2 and 5, bilaterally (percentage of differences within LOA 91 - 96%). For ICC and Pearson r the results for vibration perception thresholds were good for digit 2, left hand and for digit 5, bilaterally (ICC ≥ 0.84; r ≥0.85), and lower (ICC = 0.59; r = 0.59) for digit 2, right hand. For the latter two indices the test-retest reliability for the determination of temperature thresholds was lower and showed more varying results.

CONCLUSION

The strong test-retest reliability for hand and muscle strength tests as well as for the determination of VPTs makes these procedures useful for diagnostic purposes and follow-up studies in vibration exposed workers.

摘要

背景

接触手持式振动工具可能会导致手臂振动综合征(HAVS)。目的是研究手部和肌肉力量测试以及用于确定热觉和振动觉阈值的测试的重测信度,这些测试在调查振动暴露工人的神经病变迹象时使用。

方法

在本研究中,将47名曾在哥德堡职业与环境医学科接受检查的振动暴露工人与从哥德堡市普通人群中随机抽取的18名未暴露受试者进行比较。所有参与者都通过了结构化访谈,回答了几份问卷,并进行了体格检查,包括手部和手指肌肉力量测试、振动觉(VPT)和热觉阈值(TPT)的测定。两周后,随机挑选23名工人和对照者回来进行相同的测试程序,以评估重测信度。

结果

以一致性界限(LOA;Bland-Altman)、组内相关系数(ICC)和Pearson相关系数表示的两周间隔后的重测信度,对于暴露工人和对照者(N = 23)的基线握力、捏力和三指握力测试非常好(LOA内差异百分比为91 - 100%;ICC值≥0.93;Pearson r≥0.93)。双侧第2和第5指的振动觉阈值测定以及双侧第2和第5指的温度觉阈值测定的重测信度也非常好(LOA内差异百分比为96 - 100%)。对于ICC和Pearson r,第2指左手和第5指双侧的振动觉阈值结果良好(ICC≥0.84;r≥0.85),而第2指右手的结果较低(ICC = 0.59;r = 0.59)。对于后两个指标,温度阈值测定的重测信度较低,结果变化更大。

结论

手部和肌肉力量测试以及VPT测定的强大重测信度使这些程序可用于振动暴露工人的诊断目的和随访研究。

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