Rubio-Ochoa J, Benítez-Martínez J, Lluch E, Santacruz-Zaragozá S, Gómez-Contreras P, Cook C E
Department of Physical Therapy, Faculty of Physiotherapy, University of Valencia, Spain.
Department of Physical Therapy, Faculty of Physiotherapy, University of Valencia, Spain; Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije University Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium.
Man Ther. 2016 Feb;21:35-40. doi: 10.1016/j.math.2015.09.008. Epub 2015 Sep 21.
It has been suggested that differential diagnosis of headaches should consist of a robust subjective examination and a detailed physical examination of the cervical spine. Cervicogenic headache (CGH) is a form of headache that involves referred pain from the neck. To our knowledge, no studies have summarized the reliability and diagnostic accuracy of physical examination tests for CGH. The aim of this study was to summarize the reliability and diagnostic accuracy of physical examination tests used to diagnose CGH. A systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in four electronic databases (MEDLINE, Web of Science, Embase and Scopus). Full text reports concerning physical tests for the diagnosis of CGH which reported the clinometric properties for assessment of CGH, were included and screened for methodological quality. Quality Appraisal for Reliability Studies (QAREL) and Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) scores were completed to assess article quality. Eight articles were retrieved for quality assessment and data extraction. Studies investigating diagnostic reliability of physical examination tests for CGH scored poorer on methodological quality (higher risk of bias) than those of diagnostic accuracy. There is sufficient evidence showing high levels of reliability and diagnostic accuracy of the selected physical examination tests for the diagnosis of CGH. The cervical flexion-rotation test (CFRT) exhibited both the highest reliability and the strongest diagnostic accuracy for the diagnosis of CGH.
有人提出，头痛的鉴别诊断应包括全面的主观检查和对颈椎的详细体格检查。颈源性头痛（CGH）是一种牵涉颈部疼痛的头痛形式。据我们所知，尚无研究总结用于CGH体格检查测试的可靠性和诊断准确性。本研究的目的是总结用于诊断CGH的体格检查测试的可靠性和诊断准确性。按照PRISMA（系统评价和Meta分析的首选报告项目）指南在四个电子数据库（MEDLINE、科学网、Embase和Scopus）中进行了系统评价。纳入了有关诊断CGH的体格检查测试的全文报告，这些报告报告了评估CGH的临床测量特性，并对方法学质量进行了筛选。完成了可靠性研究质量评估（QAREL）和诊断准确性研究质量评估（QUADAS-2）评分以评估文章质量。检索了八篇文章进行质量评估和数据提取。调查CGH体格检查测试诊断可靠性的研究在方法学质量（偏倚风险较高）方面比诊断准确性研究得分更低。有充分证据表明所选体格检查测试对CGH诊断具有较高的可靠性和诊断准确性。颈椎屈伸旋转试验（CFRT）在诊断CGH方面表现出最高的可靠性和最强的诊断准确性。
