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膝关节骨关节炎患者与健康对照者下肢压力疼痛、振动觉检测及触觉检测阈值测量的可靠性

Reliability of pressure pain, vibration detection, and tactile detection threshold measurements in lower extremities in subjects with knee osteoarthritis and healthy controls.

作者信息

Jakorinne P, Haanpää M, Arokoski J

机构信息

a Institute of Clinical Medicine , University of Eastern Finland , Kuopio , Finland.

b Department of Physical and Rehabilitation Medicine , Kuopio University Hospital , Kuopio , Finland.

出版信息

Scand J Rheumatol. 2018 Nov;47(6):491-500. doi: 10.1080/03009742.2018.1433233. Epub 2018 Jun 25.

DOI:10.1080/03009742.2018.1433233
PMID:29939097
Abstract

OBJECTIVES

Quantitative sensory testing (QST) is a method to assess somatosensory function in osteoarthritis (OA), but reliability data on the performance of different QST modalities on different joint structures are missing. The main aims of our study were to assess intertester and intratester reliability of tactile detection thresholds (TDTs), vibration detection thresholds (VDTs), and pressure pain thresholds (PPTs) on different knee joint structures.

METHOD

In total, 32 subjects with knee OA and 32 volunteers with healthy knees participated. TDTs, VDTs, and PPTs were examined on the medial tibial condyle, medial tibiofemoral joint line, and rectus femoris muscle twice on the first visit and once after 1-3 weeks.

RESULTS

The intratester and intertester intraclass correlation coefficients (ICCs) of PPT measurements varied from 0.60 to 0.90 on different joint structures, showing good to excellent reliability. Intratester reliability (ICC 0.64-0.76) of VDT measurements was higher than intertester reliability (0.48-0.75). The intertester reliability of TDT measurements was excellent in subjects with knee OA (ICC 0.84-0.86) and good in controls (0.67) on the medial tibial condyle. Intratester reliability of TDT measurements varied greatly.

CONCLUSION

PPT testing is a reliable tool for measuring pain thresholds on different joint structures. The VDT measurement is reliable when taken by the same evaluator. The reliability of TDT measurements depends on the site of the measurement.

摘要

目的

定量感觉测试(QST)是评估骨关节炎(OA)躯体感觉功能的一种方法,但不同QST模式在不同关节结构上表现的可靠性数据缺失。我们研究的主要目的是评估不同膝关节结构上触觉检测阈值(TDT)、振动检测阈值(VDT)和压痛阈值(PPT)的测试者间和测试者内可靠性。

方法

共有32名膝骨关节炎患者和32名健康膝关节志愿者参与。在首次就诊时,对内侧胫骨髁、内侧胫股关节线和股直肌进行两次TDT、VDT和PPT检查,1 - 3周后再检查一次。

结果

不同关节结构上PPT测量的测试者内和测试者间组内相关系数(ICC)在0.60至0.90之间,显示出良好至优秀的可靠性。VDT测量的测试者内可靠性(ICC 0.64 - 0.76)高于测试者间可靠性(0.48 - 0.75)。内侧胫骨髁上,膝骨关节炎患者TDT测量的测试者间可靠性极佳(ICC 0.84 - 0.86),对照组良好(0.67)。TDT测量的测试者内可靠性差异很大。

结论

PPT测试是测量不同关节结构疼痛阈值的可靠工具。VDT测量由同一名评估者进行时是可靠的。TDT测量的可靠性取决于测量部位。

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