使用改良托马斯试验测量髋关节伸展活动范围的测角法和三角测量法的可靠性

Reliability of goniometric and trigonometric techniques for measuring hip-extension range of motion using the modified Thomas test.

作者信息

Wakefield C Brent, Halls Amanda, Difilippo Nicole, Cottrell G Trevor

机构信息

Exercise Science and Health Promotion and.

出版信息

J Athl Train. 2015 May;50(5):460-6. doi: 10.4085/1062-6050-50.2.05. Epub 2015 Jan 6.

Abstract

CONTEXT

Goniometric assessment of hip-extension range of motion is a standard practice in clinical rehabilitation settings. A weakness of goniometric measures is that small errors in landmarking may result in substantial measurement error. A less commonly used protocol for measuring hip range of motion involves applying trigonometric principles to the length and vertical displacement of the upper part of the lower extremity to determine hip angle; however, the reliability of this measure has never been assessed using the modified Thomas test.

OBJECTIVE

To compare the intrarater and interrater reliability of goniometric (GON) and trigonometric (TRIG) techniques for assessing hip-extension range of motion during the modified Thomas test.

DESIGN

Controlled laboratory study.

SETTING

Institutional athletic therapy facility.

PATIENTS OR OTHER PARTICIPANTS

A total of 22 individuals (12 men, 10 women; age range, 18-36 years) with no pathologic knee or back conditions.

MAIN OUTCOME MEASURE(S): Hip-extension range of motion of each participant during a modified Thomas test was assessed by 2 examiners with both GON and TRIG techniques in a randomly selected order on 2 separate days.

RESULTS

The intraclass correlation coefficient (ICC) revealed that the reliability of the GON technique was low for both the intrarater (ICC = 0.51, 0.54) and interrater (ICC = 0.30, 0.65) comparisons, but the reliability of the TRIG technique was high for both intrarater (ICC = 0.90, 0.95) and interrater (ICC = 0.91, 0.94) comparisons. Single-factorial repeated-measures analyses of variance revealed no mean differences in scoring within or between examiners for either measurement protocol, whereas a difference was observed when comparing the TRIG and GON tests due to the differences in procedures used to identify landmarks.

CONCLUSIONS

Using the TRIG technique to measure hip-extension range of motion during the modified Thomas test results in superior intrarater and interrater reliability when compared with the GON technique.

摘要

背景

在临床康复环境中,对髋关节伸展活动范围进行角度测量评估是一种标准做法。角度测量方法的一个缺点是,在确定测量标志点时的小误差可能会导致显著的测量误差。一种较少使用的测量髋关节活动范围的方案是应用三角学原理,根据下肢上部的长度和垂直位移来确定髋关节角度;然而,这种测量方法的可靠性从未使用改良托马斯试验进行评估。

目的

比较在改良托马斯试验中,角度测量(GON)和三角测量(TRIG)技术评估髋关节伸展活动范围时的测量者内和测量者间可靠性。

设计

对照实验室研究。

地点

机构运动治疗设施。

患者或其他参与者

共有22名个体(12名男性,10名女性;年龄范围18 - 36岁),无膝关节或背部疾病。

主要观察指标

在改良托马斯试验中,由两名检查者分别采用GON和TRIG技术,以随机选择的顺序在两个不同日期对每位参与者的髋关节伸展活动范围进行评估。

结果

组内相关系数(ICC)显示,GON技术在测量者内(ICC = 0.51,0.54)和测量者间(ICC = 0.30,0.65)比较中的可靠性较低,但TRIG技术在测量者内(ICC = 0.90,0.95)和测量者间(ICC = 0.91,0.94)比较中的可靠性较高。单因素重复测量方差分析显示,两种测量方案在检查者内部或检查者之间的评分均无平均差异,而在比较TRIG和GON测试时,由于用于确定标志点的程序不同,观察到了差异。

结论

与GON技术相比,在改良托马斯试验中使用TRIG技术测量髋关节伸展活动范围时,测量者内和测量者间的可靠性更高。

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