School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.
Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand; Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Musculoskelet Sci Pract. 2018 Dec;38:63-68. doi: 10.1016/j.msksp.2018.09.010. Epub 2018 Sep 25.
Hyperkyphosis may be frequently found nowadays due to the change in current lifestyles of sustained flexion postures and age-related system decline. The occiput-wall distance (OWD) is a practical measure that is commonly used to screen and monitor thoracic hyperkyphosis in epidemiologic studies. However, there was no clear evidence to support the clinical utility of the tool as compared to the data from direct standard measures.
To investigate psychometric properties-including validity, reliability, and appropriate cut-off point-of the OWD to determine the presence of thoracic hyperkyphosis, as compared to a standard Cobb's method.
Observational study.
This study was conducted in ninety-nine participants, aged 10 years and above who had different degrees of thoracic hyperkyphosis from several communities. All participants were assessed for their severity of thoracic hyperkyphosis using the OWD, and 14 participants were involved in a reliability study. Within 7 days later, all participants were at a hospital to complete a radiographic examination.
Outcomes from OWD had good concurrent validity with the Cobb angles (r = 0.683, P < 0.001) and excellent rater reliability when assessed by well-trained health professionals (ICCs > 0.9, P < 0.001). The OWD of at least 6.5 cm had the best diagnostic properties to determine the presence of thoracic hyperkyphosis (sensitivity = 71.4%, specificity = 76.6%, and area under the curve = 0.846).
The findings support validity and reliability of OWD, and offer a clear cut-off point to determine the presence of thoracic hyperkyphosis for clinical utility in various settings.
由于当前生活方式中持续的弯曲姿势和与年龄相关的系统衰退，现在可能经常会出现脊柱过度后凸。枕墙距（OWD）是一种常用的实用测量方法，用于筛查和监测流行病学研究中的胸段脊柱过度后凸。然而，与直接标准测量相比，该工具的临床实用性尚无明确证据支持。
研究 OWD 的心理测量特性，包括有效性、可靠性和适当的截断点，以确定其在诊断胸段脊柱过度后凸方面的临床实用性，与 Cobb 方法相比。
观察性研究。
本研究纳入了 99 名年龄在 10 岁及以上、来自不同社区的存在不同程度胸段脊柱过度后凸的参与者。所有参与者均使用 OWD 评估其胸段脊柱过度后凸的严重程度，其中 14 名参与者参与了可靠性研究。7 天后，所有参与者均在医院完成放射学检查。
OWD 与 Cobb 角具有良好的同时效度（r=0.683，P<0.001），当由经过良好培训的卫生专业人员进行评估时，具有极好的评分者可靠性（ICC>0.9，P<0.001）。OWD 至少为 6.5cm 时，具有最佳的诊断性能来确定胸段脊柱过度后凸的存在（敏感性为 71.4%，特异性为 76.6%，曲线下面积为 0.846）。
这些发现支持 OWD 的有效性和可靠性，并为确定胸段脊柱过度后凸的存在提供了明确的截断点，具有在各种环境下的临床实用性。
