Analan Pınar Doruk, Yilmaz Emine Ece, Adam Mehmet, Leblebici Berrin
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University Adana Research and Education Center: Kazım Karabekir Cad. 4227. Sok. No 37 Yüreğir, Adana, Turkey.
J Phys Ther Sci. 2015 Oct;27(10):3255-8. doi: 10.1589/jpts.27.3255. Epub 2015 Oct 30.
[Purpose] Reimers' hip migration percentage (MP) is commonly used to document the extent of hip displacement in children with cerebral palsy (CP). However, factors such as poor administration of pelvic radiographs, a lack of concentration, inexperience, or a busy clinical environment may result in variations in the MP measurements. The aim of this study was to compare the differences in the MP results of two physiatrists with varying levels of experience to determine the role of experience in the measurement's accuracy. [Subjects and Methods] This retrospective study included 62 hip radiographs of 31 children with spastic CP. Two physiatrists with different experience levels calculated the baseline MP on two occasions six weeks apart. Correlations, intra- and inter-rater reliabilities, and differences in the MPs were compared. [Results] Correlations and inter- and intra-rater reliabilities of the measurements were excellent. There were no statistically significant intra- or inter-rater differences for either of the two measurement points. Inter-rater correlations for each session were 0.94. [Conclusion] Experience does not appear to be a factor in the evaluation of MP, and inter-rater differences do not cause problems regarding patient follow-up. Therefore, repeated pelvic radiographs are not necessary in the evaluation of MP in children with CP unless indicated.
[目的] 赖默斯髋关节移位百分比（MP）常用于记录脑瘫（CP）患儿髋关节移位的程度。然而，骨盆X线片投照不佳、注意力不集中、经验不足或临床环境繁忙等因素可能导致MP测量结果出现差异。本研究的目的是比较两名经验水平不同的物理治疗师的MP结果差异，以确定经验在测量准确性中的作用。[对象与方法] 本回顾性研究纳入了31例痉挛型CP患儿的62张髋关节X线片。两名经验水平不同的物理治疗师在相隔六周的两个时间点计算基线MP。比较了相关性、评分者内和评分者间的可靠性以及MP的差异。[结果] 测量的相关性以及评分者内和评分者间的可靠性都非常好。两个测量点中的任何一个，评分者内或评分者间均无统计学显著差异。每次测量的评分者间相关性为0.94。[结论] 经验似乎不是评估MP的一个因素，评分者间的差异在患者随访方面也不会造成问题。因此，除非有指征，在CP患儿MP评估中无需重复骨盆X线片检查。
