腰椎椎体旋转不对称运动触诊试验的观察者间和观察者内一致性

Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry.

作者信息

Bracht Marcelo Anderson, Nunes Guilherme S, Celestino Jardel, Schwertner Debora Soccal, França Leandro Cardoso, de Noronha Marcos

机构信息

Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil.

Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil ; Department of Allied Health, La Trobe University, Bendigo, VIC, Australia.

出版信息

Physiother Can. 2015 Spring;67(2):169-73. doi: 10.3138/ptc.2014-16.

DOI:10.3138/ptc.2014-16

PMID:25931669

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4407126/

Abstract

PURPOSE

To investigate inter- and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test.

METHODS

For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results.

RESULTS

Intra- and inter-observer agreement was verified by the kappa coefficient (κ) and the weighted kappa coefficient (κ w ). Values of κ and κ w varied from 0.07 (95% CI, -0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, -0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement.

CONCLUSION

The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable.

摘要

目的

通过运动触诊试验研究观察者间和观察者内对腰椎旋转（VR）不对称性评估的一致性。

方法

在这项前瞻性描述性重测研究中，从社区招募了51名无症状参与者（40名女性，11名男性；平均年龄23.3[标准差5.6]岁）。由同三名观察者在两个阶段对每位参与者进行评估，观察者通过触诊试验评估运动不对称性来评估VR。该试验通过交替对椎体的左右横突施加前后压力来进行，以确定横平面内的运动不对称性，从而确定椎体位置。观察者将椎体位置分为中立、向右旋转和向左旋转；他们对正在评估的参与者以及任何先前的结果不知情。

结果

通过kappa系数（κ）和加权kappa系数（κw）验证了观察者内和观察者间的一致性。观察者内一致性的κ和κw值范围为0.07（95%CI，-0.10至0.245）至0.37（95%CI，0.11 - 0.63），观察者间一致性的κ和κw值范围为0.12（95%CI，-0.06至0.29）至0.30（95%CI，0.08 - 0.52）。