Patroncini Maja, Hannig Susanne, Meichtry André, Luomajoki Hannu
Zurich University of Applied Sciences, School of health professions, Institute of Physiotherapy, Technikumstrasse 70, 8400 Winterthur, Switzerland.
BMC Musculoskelet Disord. 2014 Nov 29;15:402. doi: 10.1186/1471-2474-15-402.
Movement control impairment reduces active control of movement. Patients with this might form an important subgroup among patients with mechanical cervical pain. Diagnosis is based on the observation of active movement tests. Although widely used clinically, few studies have been performed to determine the reliability of a test battery. The aim of this study was to determine the inter-tester reliability of movement control impairment [MCI] tests on the cervical spine.
Forty-five subjects (31 patients with neck pain, 14 healthy controls) were videotaped while performing a standardized test battery consisting of 13 tests of active movement control. Using observation, two experienced physiotherapists independently rated test performances as correct or incorrect. One of them was blinded to all other patient information and both to each other. Kappa coefficients and 95% confidence intervals [CI] for inter-tester results were calculated.
The kappa values for inter-tester reliability ranged in from 0.47-1.0 of the 13 tests, 2 demonstrated perfect reliability (k = 1.0), 4 excellent (k 0.81-0.99), 6 substantial (k 0.61-0.8) and 1 good (k 0.41-0.6).
The physiotherapists were able reliably rate the majority the tests in this series of motor control tasks. There have been studies performed describing the assessment and treatment of movement control impairment problems and low back pain. However, no study has involved the assessment of the cervical dysfunction subgroup. This study presents a reliable test battery, for clinical use, to perform more specific examination of this subgroup.
运动控制障碍会降低对运动的主动控制能力。患有这种障碍的患者可能是机械性颈痛患者中的一个重要亚组。诊断基于对主动运动测试的观察。尽管该测试在临床上广泛使用,但很少有研究来确定一组测试的可靠性。本研究的目的是确定颈椎运动控制障碍(MCI)测试的测试者间可靠性。
45名受试者(31名颈部疼痛患者,14名健康对照者)在进行由13项主动运动控制测试组成的标准化测试组时被录像。两名经验丰富的物理治疗师通过观察独立将测试表现评定为正确或不正确。其中一人对所有其他患者信息不知情,且两人相互不知情。计算测试者间结果的kappa系数和95%置信区间(CI)。
13项测试的测试者间可靠性kappa值范围为0.47 - 1.0,2项显示出完美可靠性(k = 1.0),4项为优秀(k 0.81 - 0.99),6项为高度一致(k 0.61 - 0.8),1项为良好(k 0.41 - 0.6)。
物理治疗师能够可靠地对这一系列运动控制任务中的大多数测试进行评分。已有研究描述了运动控制障碍问题和下背痛的评估与治疗。然而,尚无研究涉及颈椎功能障碍亚组的评估。本研究提供了一组可靠的测试,供临床使用,以对该亚组进行更具体的检查。