Clough William T, Canapp Sherman O, Taboada Luis De, Dycus David L, Leasure Christopher S
Department of Orthopedic Surgery, Veterinary Orthopedic and Sports Medicine Group, Annapolis Junction, Maryland, United States.
LiteCure LLC, Carlsbad, California, United States.
Vet Comp Orthop Traumatol. 2018 Nov;31(6):391-395. doi: 10.1055/s-0038-1667063. Epub 2018 Oct 9.
Weight distribution and off-loading at the stance are commonly used subjective assessments during the orthopaedic examination. The clinical relevance, sensitivity and specificity of limb off-loading have not yet been established. The aim of the study was to assess off-loading on a weight distribution platform (WDP) and determine the sensitivity and specificity at various cut-off points for the detection of objective lameness (OL) and orthopaedic disease (OD).
The total pressure index was used to determine OL on a pressure-sensitive walkway (PSW). Normal weight distribution on both the PSW and WDP was considered 30/30/20/20. A total pressure index standard deviation of 2 was used. The sensitivity and specificity of the WDP for the identification of OL and OD was determined at cut-off points 1 to 6 below normal weight distribution values.
All patients in the study ( = 50) had confirmed OD. The PSW identified 36/50 (74%) patients as OL; these were deemed to be OL for sensitivity and specificity analysis of WDP data. At cut-off point 1, the WDP had the highest sensitivity for OD (84%) and OL (97%). At cut-off point 6, the WDP had the highest specificity for OD (98%) and OL (98%). The highest combination of sensitivity and specificity for both OD (1.65) and OL (1.80) was at cut-off point 2.
DISCUSSION/CONCLUSION: The WDP provided the highest combined sensitivity and specificity at cut-off point 2 below the normal value for the detection of both OL and OD.
在骨科检查中,站立时的体重分布和负荷转移是常用的主观评估方法。肢体负荷转移的临床相关性、敏感性和特异性尚未确定。本研究的目的是评估在体重分布平台(WDP)上的负荷转移情况,并确定在不同临界点检测客观跛行(OL)和骨科疾病(OD)时的敏感性和特异性。
使用总压力指数在压敏人行道(PSW)上确定OL。PSW和WDP上的正常体重分布被认为是30/30/20/20。使用总压力指数标准差为2。在低于正常体重分布值的临界点1至6处,确定WDP识别OL和OD的敏感性和特异性。
研究中的所有患者(n = 50)均确诊为OD。PSW将36/50(74%)的患者识别为OL;这些患者被视为用于WDP数据敏感性和特异性分析的OL。在临界点1,WDP对OD(84%)和OL(97%)的敏感性最高。在临界点6,WDP对OD(98%)和OL(98%)的特异性最高。OD(1.65)和OL(1.80)的敏感性和特异性的最高组合在临界点2。
讨论/结论:对于检测OL和OD,WDP在低于正常值的临界点2处提供了最高的综合敏感性和特异性。