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以肩部疼痛为主诉的患者,其颈胸段和肩部体格检查的评分者间信度。

Interrater reliability of the cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain.

作者信息

Burns Scott A, Cleland Joshua A, Carpenter Kristin, Mintken Paul E

机构信息

Temple University, Philadelphia, PA, USA; Select Medical, Novacare Rehabilitation, Conshohocken, PA, USA.

Department of Physical Therapy, Franklin Pierce University, Manchester, NH, USA; Rehabilitation Services, Concord Hospital, Concord, NH, USA.

出版信息

Phys Ther Sport. 2016 Mar;18:46-55. doi: 10.1016/j.ptsp.2015.07.001. Epub 2015 Jul 17.

Abstract

OBJECTIVE

Examine the interrater reliability of cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain.

DESIGN

Single-group repeated-measures design for interrater reliability.

SETTING

Orthopaedic physical therapy clinics.

PARTICIPANTS

Twenty-one patients with a primary complaint of shoulder pain underwent a standardized examination by a physical therapist (PT). A PT conducted the first examination and one of two additional PTs conducted the 2nd examination.

MAIN OUTCOME MEASURES

The Cohen κ and weighted κ were used to calculate the interrater reliability of ordinal level data. Intraclass correlation coefficients model 2,1 (ICC2,1) and the 95% confidence intervals were calculated to determine the interrater reliability.

RESULTS

The kappa coefficients ranged from -.24 to .83 for the mobility assessment of the glenohumeral, acromioclavicular and sternoclavicular joints. The kappa coefficients ranged from -.20 to .58 for joint mobility assessment of the cervical and thoracic spine. The kappa coefficients ranged from .23 to 1.0 for special tests of the shoulder and cervical spine.

CONCLUSIONS

The present study reported the reliability of a comprehensive upper quarter physical examination for a group of patients with a primary report of shoulder pain. The reliability varied considerably for the cervical and shoulder examination and was significantly higher for the examination of muscle length and cervical range of motion.

摘要

目的

检查以肩部疼痛为主诉的患者的颈胸段和肩部体格检查的评分者间信度。

设计

用于评分者间信度的单组重复测量设计。

设置

骨科物理治疗诊所。

参与者

21例以肩部疼痛为主诉的患者接受了物理治疗师(PT)的标准化检查。一名PT进行第一次检查,另外两名PT中的一名进行第二次检查。

主要观察指标

使用Cohen κ系数和加权κ系数计算有序水平数据的评分者间信度。计算组内相关系数模型2,1(ICC2,1)和95%置信区间以确定评分者间信度。

结果

肩肱关节、肩锁关节和胸锁关节活动度评估的κ系数范围为-0.24至0.83。颈椎和胸椎关节活动度评估的κ系数范围为-0.20至0.58。肩部和颈椎特殊检查的κ系数范围为0.23至1.0。

结论

本研究报告了一组以肩部疼痛为主诉的患者进行全面上肢体格检查的信度。颈椎和肩部检查的信度差异很大,肌肉长度和颈椎活动度检查的信度明显更高。

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