de Oliveira Isadora Orlando, de Vasconcelos Rodrigo Antunes, Pilz Bruna, Teixeira Paulo Eduardo Portes, de Faria Ferreira Eduarda, Mello Wilson, Grossi Débora Bevilaqua
Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil.
Wilson Mello Institute, Campinas, Brazil.
J Man Manip Ther. 2018 Feb;26(1):36-42. doi: 10.1080/10669817.2017.1350328. Epub 2017 Jul 5.
To observe the distribution of patients who presented with low back pain (LBP) and to determine the between therapists' interrater reliability of assessments in a private outpatient setting using treatment-based classification (TBC) subgroups.
An observational and methodological study was conducted. Four hundred and twenty-nine patients (231 male; 198 female) presenting LBP symptoms and referred to conservative treatment were assessed by 13 physical therapists who conducted a 60-min examination process utilizing TBC subgroups. Interrater reliability analyses from six raters were assessed using Fleiss' kappa and previously recorded data ( = 30).
In this study, 65.74% of patients were classified in only one subgroup, the most prevalent being stabilization (21.91%), followed by extension (15.38%), traction (11.89%), flexion (10.96%), manipulation (5.13%), and lateral shift (0.47%). Approximately 20.98% of patients were classified in two subgroups, where the most frequent overlaps were flexion + stabilization (7.46%), extension + stabilization (6.06%), flexion + traction (4.20%), extension + manipulation (1.86%), and 13.29% of patients were not classified in any TBC subgroup. Analysis of interrater reliability showed a kappa value of 0.62 and an overall agreement of 66% between raters.
LBP is a heterogeneous clinical condition and several classification methods are proposed in the attempt to observe better outcomes for patients. Eighty-five percent of patients assessed were able to be classified when using the TBC assessment and reliability analysis showed a substantial agreement between raters.
2c.
观察出现腰痛（LBP）患者的分布情况，并确定在私人门诊环境中使用基于治疗的分类（TBC）亚组时治疗师之间评估的评分者间信度。
进行了一项观察性和方法学研究。13名物理治疗师对429名出现LBP症状并接受保守治疗的患者（231名男性；198名女性）进行了评估，这些治疗师使用TBC亚组进行了60分钟的检查过程。使用Fleiss' kappa和先前记录的数据（n = 30）对6名评分者的评分者间信度分析进行了评估。
在本研究中，65.74%的患者仅被分类到一个亚组中，最常见的是稳定型（21.91%），其次是伸展型（15.38%）、牵引型（11.89%）、屈曲型（10.96%）、手法治疗型（5.13%）和侧移型（0.47%）。约20.98%的患者被分类到两个亚组中，最常见的重叠类型是屈曲 + 稳定型（7.46%）、伸展 + 稳定型（6.06%）、屈曲 + 牵引型（4.20%）、伸展 + 手法治疗型（1.86%），13.29%的患者未被分类到任何TBC亚组中。评分者间信度分析显示kappa值为0.62，评分者之间的总体一致性为66%。
腰痛是一种异质性临床病症，为了观察患者更好的治疗效果，人们提出了几种分类方法。使用TBC评估时，85%接受评估的患者能够被分类，并且信度分析显示评分者之间有实质性的一致性。
2c。
