Cooperstein Robert, Lucente Marc
Palmer College of Chiropractic, San Jose, CA.
Palmer College of Chiropractic, Port Orange, FL.
J Chiropr Med. 2017 Jun;16(2):103-110. doi: 10.1016/j.jcm.2017.01.001. Epub 2017 Mar 18.
The primary objective of the current study was to determine the reliability between methods of supine and prone leg length inequality (LLI) assessment. The secondary objective was to determine if the degree of examiner confidence affected the degree of intermethod agreement.
Two experienced doctors of chiropractic assessed 43 participants for LLI, one using a prone and the other a supine method. They stated whether they were confident or not confident in their findings.
Kappa values for intermethod agreement were 0.16 for the full data set; 0.00 for the n = 20 subgroup with both examiners confident; 0.24 for the n = 18 subgroup with 1 examiner confident; and 0.55 for the n = 5 subgroup with neither examiner confident. Supine and prone measures exhibited slight agreement for the full data set, but no agreement when both examiners were confident. The moderate agreement with both examiners not confident may be an artifact of small sample size.
This study found that supine and prone assessments for leg length inequality were not in agreement. Positioning the patient in the prone position may increase, decrease, reverse, or offset the observed LLI that is seen in the supine position.
本研究的主要目的是确定仰卧位和俯卧位腿长不等（LLI）评估方法之间的可靠性。次要目的是确定检查者的信心程度是否会影响方法间的一致性程度。
两名经验丰富的脊椎按摩师对43名参与者进行LLI评估，一人采用俯卧位方法，另一人采用仰卧位方法。他们说明了自己对检查结果是否有信心。
整个数据集的方法间一致性kappa值为0.16；两名检查者都有信心的n = 20亚组的kappa值为0.00；一名检查者有信心的n = 18亚组的kappa值为0.24；两名检查者都没有信心的n = 5亚组的kappa值为0.55。仰卧位和俯卧位测量在整个数据集中表现出轻微的一致性，但当两名检查者都有信心时则没有一致性。两名检查者都没有信心时的中度一致性可能是小样本量的假象。
本研究发现，仰卧位和俯卧位腿长不等评估结果不一致。将患者置于俯卧位可能会增加、减少、逆转或抵消仰卧位观察到的LLI。
