Segarra V, Dueñas L, Torres R, Falla D, Jull G, Lluch E
CEREDE Sports Medicine, Barcelona, Spain; International Institute of Exercise Science and Health, Spain.
Department of Physiotherapy, University of Valencia, Valencia, Spain.
Man Ther. 2015 Aug;20(4):570-9. doi: 10.1016/j.math.2015.01.007. Epub 2015 Jan 26.
Apart from the cranio-cervical flexion test and the deep neck flexor endurance test, evidence related to reliability of cervical movement control dysfunction tests is lacking.
This study investigated the inter- and intra-tester reliability of a battery of cervical movement control dysfunction tests and the effect of clinician experience on reliability in 15 patients with chronic neck pain and 17 non-neck pain controls. In addition, it explored whether impaired performance on this battery of tests was more frequently observed in the neck pain group.
Inter and intra-tester reliability study.
Participants were videotaped while performing a battery of nine active cervical movement control dysfunction tests. Two physiotherapists, with different levels of experience, independently rated all tests on two occasions two weeks apart. They were masked to participants' neck pain or non-neck pain status.
Inter-tester reliability for the complete battery of tests was substantial (κ = 0.69; 95% CI: 0.62, 0.76). Intra-rater reliability values for the expert (κ = 0.86; 95% CI: 0.79, 0.92) and novice (κ = 0.76; 95% confidence intervals (CI): 0.68, 0.84) were overall comparable suggesting that novices can achieve good accuracy with the battery of tests if trained. The frequency of impaired performances in cervical movement control dysfunction tests was low and comparable between groups. Only two tests achieved a greater number of impaired ratings in the patient group.
Although reliable, further research in larger neck pain populations is required to explore this battery of tests, in order to establish their diagnostic accuracy for identifying clinically relevant cervical movement control dysfunction.
除颅颈屈曲试验和颈深屈肌耐力试验外，缺乏与颈椎运动控制功能障碍测试可靠性相关的证据。
本研究调查了一组颈椎运动控制功能障碍测试在测试者之间和测试者内部的可靠性，以及临床医生经验对15名慢性颈部疼痛患者和17名无颈部疼痛对照者可靠性的影响。此外，还探讨了在这组测试中表现受损的情况是否在颈部疼痛组中更频繁地出现。
测试者之间和测试者内部的可靠性研究。
参与者在进行一组九项主动颈椎运动控制功能障碍测试时被录像。两名经验水平不同的物理治疗师在相隔两周的两个时间点独立对所有测试进行评分。他们对参与者的颈部疼痛或无颈部疼痛状态不知情。
整套测试的测试者间可靠性较高（κ = 0.69；95%置信区间：0.62，0.76）。专家（κ = 0.86；95%置信区间：0.79，0.92）和新手（κ = 0.76；95%置信区间：0.68，0.84）的测试者内可靠性值总体相当，这表明新手如果经过训练，使用这组测试可以达到较好的准确性。颈椎运动控制功能障碍测试中表现受损的频率较低，且两组之间相当。只有两项测试在患者组中获得了更多的受损评分。
尽管该组测试具有可靠性，但仍需要在更大的颈部疼痛人群中进行进一步研究，以探索这组测试，从而确定其在识别临床上相关的颈椎运动控制功能障碍方面的诊断准确性。
