Department of Orthopaedics and Traumatology, Gazi University, Besevler, 06510, Ankara, Turkey.
Department of Public Health, Gazi University, Besevler, Ankara, Turkey.
Spine Deform. 2021 Mar;9(2):333-339. doi: 10.1007/s43390-020-00221-2. Epub 2020 Oct 8.
This study aimed to evaluate the diagnostic aptitude of a modified Adams forward bending test (MAFBT), which addresses the coupling phenomenon of axial rotation with reference to the side-bending movement. Also, this evaluation was facilitated by the introduction of our rotational flexibility index (RFI).
Thirty-two female and eight male AIS patients were included in this study from a single institution. In the MAFBT, subjects were asked to bend to the convex side of the curve in the forward bending position. Scoliometric measurements were done during the AFBT and MAFBT. Utilizing anteroposterior standing plain radiographs curve flexibility indices were calculated. The diagnostic aptitude of the MAFBT was evaluated based on the receiver operating characteristic (ROC) curves and area under the curve (AUC). The RFI was also assessed, which considered AFBT and MAFBT parameters as a specified function.
Significant correlations were noted between the Cobb angle and AFBT (p = 0.005), fulcrum bending and the MAFBT (p = 0.0001), side-bending and MAFBT (p = 0.0001). There were significant positive correlations between rotational flexibility as based on fulcrum bending radiograph to that of the RFI (r = 0.4, p = 0.036) and side-bending technique (r = 0.4, p = 0.008). Based on ROC analyses (AUC range 0.7-0.8), the MAFBT demonstrated high specificity and sensitivity rates for flexible and rigid curves, respectively.
This is the first study to report that the MAFBT is a simple and reliable test for the clinical assessment of rotational flexibility in AIS patients. The study further noted that the novel RFI has clinical utility in the assessment of AIS.
本研究旨在评估改良的 Adams 前屈试验（MAFBT）的诊断能力，该试验针对轴向旋转与侧屈运动的耦合现象进行了修正。此外，通过引入我们的旋转柔韧性指数（RFI），使评估变得更加容易。
本研究共纳入了来自单家机构的 32 名女性和 8 名男性 AIS 患者。在 MAFBT 中，要求患者在向前弯曲的位置向曲线的凸侧弯曲。在 AFBT 和 MAFBT 期间进行脊柱侧凸测量。利用前后位站立位平片计算曲线柔韧性指数。根据受试者工作特征（ROC）曲线和曲线下面积（AUC）评估 MAFBT 的诊断能力。还评估了 RFI，它将 AFBT 和 MAFBT 参数作为特定函数进行评估。
Cobb 角与 AFBT 之间存在显著相关性（p=0.005），旋转轴弯曲与 MAFBT 之间存在显著相关性（p=0.0001），侧屈与 MAFBT 之间存在显著相关性（p=0.0001）。基于旋转轴弯曲的旋转柔韧性与 RFI（r=0.4，p=0.036）和侧屈技术（r=0.4，p=0.008）之间存在显著正相关。根据 ROC 分析（AUC 范围 0.7-0.8），MAFBT 对柔韧性和僵硬性曲线的特异性和敏感性均较高。
这是第一项报道 MAFBT 是一种简单可靠的 AIS 患者旋转柔韧性临床评估方法的研究。该研究进一步指出，新型 RFI 在 AIS 的评估中具有临床应用价值。
