Luedtke Kerstin, Schoettker-Königer Thomas, Hall Toby, Reimer Christine, Grassold Maike, Hasselhoff-Styhler Petra, Neulinger Christian, Obrocki Max, Przyhoda Philipp, Schäfer Axel
Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
Institute of Health Sciences, Academic Physiotherapy, University of Luebeck, Lübeck, Germany.
BMC Musculoskelet Disord. 2020 Aug 11;21(1):535. doi: 10.1186/s12891-020-03525-6.
Headache is a common and costly health problem. Although the pathogenesis of headache is heterogeneous, reported contributing factors are dysfunctions of the upper cervical spine. The flexion rotation test (FRT) is a commonly used diagnostic test to detect upper cervical movement impairment. A digital goniometer may support precise measurement of movement impairment in the upper cervical spine. However, its reliability and validity is not assessed, yet. The aim of this study was to investigate the reliability and validity of the digital goniometer compared to an ultrasound-based movement analysis system.
Two separate cross-sectional studies were conducted using the digital goniometer EasyAngle (Meloq AB, Stockholm, Sweden) for a) investigating the concurrent validity of upper cervical range of motion (ROM) during the FRT and b) determining the inter- and intra-rater reliability in the target population of patients with head and neck pain. Sixty-two participants, 39 with and 23 without head and neck pain, were recruited for the concurrent validity study. For the reliability study, a total of 50 participants were recruited. Intraclass correlation coefficients (ICC) and Bland Altmann plots were used to assess validity and ICC values, Bland Altmann plots as well as Kappa coefficients were used for estimating intra-rater and inter-rater reliability.
Concurrent validity was strong with an ICC (2,1) of 0.97 for ROM to either side (95%CI = 0.95-0.98). Bland Altman Plots revealed a mean difference between measurement systems of 0.5° for the left and 0.11° for the right side. The inter-rater ICC (2,1) was 0.66 (95%CI 0.47-0.79, p < 0.001, SEM 6.6°), indicating good reliability. The limits of agreement were between 10.25° and - 11.89°, the mean difference between both raters was - 0.82°. Intra-rater reliability for the measurement of ROM during the FRT was between 0.96 (ICC 3,1) for rater 1 and 0.94 (ICC 3,1) for rater 2.
The digital goniometer demonstrated strong concurrent validity and good to strong reliability and can be used in clinical practice to accurately determine movement impairment in the upper cervical spine.
German Registry of Clinical Trials DRKS00013051 .
头痛是一个常见且代价高昂的健康问题。尽管头痛的发病机制具有异质性，但报告的促成因素是上颈椎功能障碍。屈伸旋转试验（FRT）是一种常用的诊断试验，用于检测上颈椎活动障碍。数字测角仪可能有助于对上颈椎活动障碍进行精确测量。然而，其可靠性和有效性尚未得到评估。本研究的目的是调查数字测角仪与基于超声的运动分析系统相比的可靠性和有效性。
进行了两项独立的横断面研究，使用数字测角仪EasyAngle（瑞典斯德哥尔摩的Meloq AB公司），a）研究FRT期间上颈椎活动范围（ROM）的同时效度，b）确定头颈疼痛患者目标人群中评分者间和评分者内的可靠性。招募了62名参与者，其中39名有头颈疼痛，23名没有头颈疼痛，进行同时效度研究。对于可靠性研究，共招募了50名参与者。组内相关系数（ICC）和Bland Altmann图用于评估效度，ICC值、Bland Altmann图以及Kappa系数用于估计评分者内和评分者间的可靠性。
同时效度很强，两侧ROM的ICC（2,1）为0.97（95%CI = 0.95 - 0.98）。Bland Altman图显示测量系统之间的平均差异，左侧为0.5°，右侧为0.11°。评分者间ICC（2,1）为0.66（95%CI 0.47 - 0.79，p < 0.001，SEM 6.6°），表明可靠性良好。一致性界限在10.25°和 - 11.89°之间，两位评分者之间的平均差异为 - 0.82°。FRT期间ROM测量的评分者内可靠性，评分者1为0.96（ICC 3,1），评分者2为0.94（ICC 3,1）。
数字测角仪显示出很强的同时效度和良好到很强的可靠性，可用于临床实践中准确确定上颈椎的活动障碍。
德国临床试验注册中心DRKS00013051 。
