Tyros I, Soundy A, Heneghan N R
School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
Man Ther. 2016 Sep;25:81-6. doi: 10.1016/j.math.2016.06.006. Epub 2016 Jun 15.
Whiplash Associated Disorders (WAD) grade II are the most prevalent group of whiplash patients seen on a regular basis by musculoskeletal physiotherapists. Impairment of vibration sensibility may be an early indicator of nerve pathology and it has previously been demonstrated in individuals with chronic WAD symptoms utilising vibrameters. A less expensive option, such the tuning fork (TF) may assist with these measures, but research regarding its measurement properties is lacking.
To investigate the intra- and inter-rater reliability of vibration sensibility of the median nerve in chronic WAD II (CWAD II).
A double blinded, within day intra- and inter-rater reliability study was undertaken. A convenience sample of 26 individuals (8 males, 18 females, age mean 29.9 ± 10.0 years) with CWADII was recruited.
WAD I, III & indications of neuropathic pain. Vibration attenuation times were recorded from skin innervated by the median nerve (thenar eminence).
Descriptive statistics (mean scores) and reliability statistics [intraclass correlation coefficient (ICC2,1) and Bland and Altman limits of agreement] were undertaken with p = 0.05. Almost perfect intra-rater reliability (Intraclass Correlation Coefficiency (ICC): 0.972-0.955) and inter-rater reliability (ICC: 0.983) were identified. Confidence Intervals (CI) for inter-rater reliability were 95% CI: -1.461 to -0.056.
Almost perfect reliability scores across intra- and inter-rater reliability were found. This provides evidence that, with a standardised testing protocol the TF can be a highly reliable means of vibration sensibility testing. Future studies assessing the validity of the TF in different WAD populations may provide further information about the usefulness of this protocol.
挥鞭样损伤相关疾病（WAD）二级是肌肉骨骼物理治疗师定期诊治的最常见的挥鞭样损伤患者群体。振动感觉受损可能是神经病变的早期指标，此前已在患有慢性WAD症状的个体中使用振动计进行了证实。一种成本较低的选择，如音叉（TF），可能有助于这些测量，但缺乏关于其测量特性的研究。
研究慢性WAD二级（CWAD II）患者正中神经振动感觉的评分者内和评分者间信度。
进行了一项双盲、日内评分者内和评分者间信度研究。招募了26名CWAD II患者的便利样本（8名男性，18名女性，平均年龄29.9±10.0岁）。
WAD一级、三级及神经性疼痛指征。记录正中神经支配皮肤（鱼际隆起）的振动衰减时间。
采用p = 0.05进行描述性统计（平均得分）和信度统计[组内相关系数（ICC2,1）以及布兰德和奥特曼一致性界限]。确定了几乎完美的评分者内信度（组内相关系数（ICC）：0.972 - 0.955）和评分者间信度（ICC：0.983）。评分者间信度的置信区间（CI）为95% CI：-1.461至-0.056。
发现评分者内和评分者间信度的可靠性评分几乎完美。这提供了证据表明，通过标准化测试方案，音叉可以成为振动感觉测试的高度可靠手段。未来评估音叉在不同WAD人群中有效性的研究可能会提供有关该方案实用性的更多信息。
