肩袖肌肌腱触诊的跨超声检查的内外检测者可靠性：一项横断面研究。
Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography.
机构信息
Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Alcalá de Henares, 28871 Madrid, Spain.
Instituto de Investigación Fisioterapia y Dolor, University of Alcala, Alcalá de Henares, 28805 Madrid, Spain.
出版信息
Medicina (Kaunas). 2020 Feb 18;56(2):83. doi: 10.3390/medicina56020083.
BACKGROUND AND OBJECTIVES
Palpation is an inherent and basic skill of health professionals-particularly manual therapists who base their diagnosis and treatment in a clinical environment. Many authors have previously described multiple palpation positions for supraspinatus muscle tendon (SMT); however, there are no current studies that evaluate palpation concordance reliability for the SMT in this particular position. This study aimed to investigate the intra- and inter-rater reliabilities of supraspinatus muscle tendon (SMT) palpation.
MATERIALS AND METHODS
Thirty-six healthy participants (14 females; aged 22-35 years) were recruited. Musculoskeletal ultrasound was used to measure the SMT localization after two physiotherapists performed the SMT palpation at two different times. The distance between the two marked points was used to analyze the analysis of true agreement between examiners. Finally, we analyzed if the demographic variables influenced the palpation procedure.
RESULTS
The intra-examiner reliability showed a high percentage of concordance for examiner 1 (E.1) (first palpation procedure (P.1) = 91.7%: second palpation procedure (P.2) = 95.8%) and examiner 2 (E.2) (P.1 = 91.6%; P.2 = 97.2%) and high percentage of inter-palpation agreement for E.1 (87.5%) and E.2 (88.9%). The inter-examiner reliability showed a high total concordance for the right shoulder (E.1 = 94.4%; E.2 = 95.8%) and left shoulder (E.1 = 93.05%; E.2 = 95.05%). The agreement (%) according to both examiners was 93.05% for the right shoulder and 94.4% for the left shoulder. The agreement between both examiners and the ultrasound (% of true agreement) was 92.9% for the right shoulder and 92.8% for the left shoulder. A statistically significant association (p = 0.02) was found for weight regarding concordance reliability; this was not seen for dominant arm, age, gender, body mass index, height, and tendon depth (p > 0.05).
CONCLUSIONS
The SMT palpation technique showed a high level of concordance and reproducibility.
背景与目的
触诊是健康专业人员（尤其是基于临床环境进行诊断和治疗的手动治疗师）固有的基本技能。许多作者已经描述了多种冈上肌肌腱（SMT）的触诊位置；然而，目前尚无研究评估该特定位置的 SMT 触诊的一致性可靠性。本研究旨在探讨冈上肌肌腱（SMT）触诊的内部和外部可靠性。
材料和方法
招募了 36 名健康参与者（14 名女性；年龄 22-35 岁）。肌骨超声用于测量两名物理治疗师在两次不同时间进行 SMT 触诊后 SMT 的定位。使用两个标记点之间的距离来分析检查者之间的真实一致性。最后，我们分析了人口统计学变量是否影响触诊过程。
结果
内部检查者可靠性显示，检查者 1（E.1）（第一次触诊程序（P.1）=91.7%：第二次触诊程序（P.2）=95.8%）和检查者 2（E.2）（P.1=91.6%；P.2=97.2%）的一致性比例很高，并且 E.1（87.5%）和 E.2（88.9%）之间的多次触诊一致性比例很高。外部检查者可靠性显示，右肩（E.1=94.4%；E.2=95.8%）和左肩（E.1=93.05%；E.2=95.05%）的总一致性很高。两位检查者的一致性（%）为右肩 93.05%，左肩 94.4%。两位检查者与超声的一致性（%）为右肩 92.9%，左肩 92.8%。体重与一致性可靠性呈统计学显著关联（p=0.02）；而惯用臂、年龄、性别、体重指数、身高和肌腱深度则无关联（p>0.05）。
结论
SMT 触诊技术具有高度的一致性和可重复性。
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