School of Physical Therapy, Marshall University, Huntington, WV, USA; Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Spectrum Health Hospital, Grand Rapids, MI, USA.
J Hand Ther. 2019 Jan-Mar;32(1):103-109. doi: 10.1016/j.jht.2017.09.008.
Clinical measurement study.
The push-off test (POT) was recently conceived and found to be reliable and valid for assessing weight bearing through injured wrist or elbow. However, further research with larger sample can lend credence to the preliminary findings supporting the use of the POT.
This study examined the interrater reliability, construct validity, and measurement error for the POT in patients with wrist conditions.
Participants with musculoskeletal (MSK) wrist conditions were recruited. The performance on the POT, grip isometric strength of wrist extensors was assessed. The shortened version of the Disabilities of the Arm, Shoulder and Hand and numeric pain rating scale were completed. The intraclass correlation coefficient assessed interrater reliability of the POT. Pearson correlation coefficients (r) examined the concurrent relationships between the POT and other measures. The standard error of measurement and the minimal detectable change at 90% confidence interval were assessed as measurement error and index of true change for the POT.
A total of 50 participants with different elbow or wrist conditions (age: 48.1 ± 16.6 years) were included in this study. The results of this study strongly supported the interrater reliability (intraclass correlation coefficient: 0.96 and 0.93 for the affected and unaffected sides, respectively) of the POT in patients with wrist MSK conditions. The POT showed convergent relationships with the grip strength on the injured side (r = 0.89) and the wrist extensor strength (r = 0.7). The POT showed smaller standard error of measurement (1.9 kg). The minimal detectable change at 90% confidence interval for the POT was 4.4 kg for the sample.
This study provides additional evidence to support the reliability and validity of the POT. This is the first study that provides the values for the measurement error and true change on the POT scores in patients with wrist MSK conditions. Further research should examine the responsiveness and discriminant validity of the POT in patients with wrist conditions.
临床测量研究。
推离测试（POT）最近被提出，并被发现可用于评估受伤手腕或肘部的承重能力，具有可靠性和有效性。然而，进一步的大样本研究可以为支持使用 POT 的初步发现提供可信度。
本研究旨在检查 POT 在腕部疾病患者中的评分者间信度、结构效度和测量误差。
招募患有肌肉骨骼（MSK）腕部疾病的参与者。对 POT 和腕伸肌握力等速强度进行评估。同时完成简化版的上肢功能障碍问卷（DASH）和数字疼痛评分量表。采用组内相关系数评估 POT 的评分者间信度。Pearson 相关系数（r）用于评估 POT 与其他测量结果的同期相关性。测量误差和 POT 的真实变化指标采用测量误差和最小可检测变化（90%置信区间）评估。
共有 50 名患有不同肘部或腕部疾病的参与者（年龄：48.1 ± 16.6 岁）纳入本研究。研究结果强烈支持 POT 在腕部 MSK 疾病患者中的评分者间信度（患侧和健侧的组内相关系数分别为 0.96 和 0.93）。POT 与受伤侧握力（r = 0.89）和腕伸肌力量（r = 0.7）具有相似的相关性。POT 的测量误差较小（1.9 kg）。POT 在样本中的 90%置信区间最小可检测变化值为 4.4 kg。
本研究提供了额外的证据支持 POT 的可靠性和有效性。这是首个提供腕部 MSK 疾病患者 POT 评分测量误差和真实变化值的研究。进一步的研究应检查 POT 在腕部疾病患者中的反应性和判别有效性。
