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原始莱纳特-施罗特(LS)脊柱侧弯分类在物理治疗实践中的可靠性。

Reliability of the original Lehnert-Schroth (LS) scoliosis classification in physiotherapy practice.

作者信息

Borysov Maksym, Nan Xiaofeng, Weiss Hans-Rudolf, Turnbull Deborah, Kleban Alexander

机构信息

Orttech-plus Rehabilitation Service, Ukraine.

Nan Xiaofeng's Spinal Orthopedic Workshop, China.

出版信息

J Phys Ther Sci. 2020 Oct;32(10):647-652. doi: 10.1589/jpts.32.647. Epub 2020 Oct 3.

Abstract

[Purpose] The foundations of the scoliosis specific and evidence-based physiotherapy program according to Schroth is the original the Lehnert-Schroth (LS) classification which is still in use today. The purpose of this paper is to test the reliability of the LS classification system, using clinical and radiological images of scoliosis patients as classified by specialist experienced clinicians. [Participants and Methods] A list of 40 pictures of X-Rays and a list of 40 clinical pictures (all posterior trunk images) of patients with idiopathic scoliosis were provided by the second author. Three specialist professional physiotherapists or orthotists rated all clinical and radiological pictures according to these two patterns of the LS classification. [Results] The intra-observer Kappa value was 0.90 (clinical) and 1.00 (x-rays). The inter-observer Kappa values at average was 0.65 (clinical) and 0.71 (x-rays). [Conclusion] For the application of classifying the patients when prescribing postural advice and exercises from the Schroth program the LS-classification seems an easy to use and highly reliable tool. This test demonstrated sufficient reliability with respect to the x-rays, but the tests of the clinical pictures alone, demonstrated fair levels of reliability, which indicates that it is an appropriate tool for physiotherapists when an x-ray is not available.

摘要

[目的] 基于施罗斯方法的脊柱侧弯特异性循证物理治疗方案的基础是最初的莱纳特 - 施罗斯(LS)分类法,该分类法至今仍在使用。本文的目的是通过由经验丰富的专科临床医生分类的脊柱侧弯患者的临床和放射影像,来测试LS分类系统的可靠性。[参与者与方法] 第二作者提供了40张特发性脊柱侧弯患者的X光片列表和40张临床图片列表(均为躯干后部图像)。三名专业物理治疗师或矫形师根据LS分类的这两种模式对所有临床和放射影像进行评分。[结果] 观察者内Kappa值在临床方面为0.90,在X光片方面为1.00。观察者间Kappa值平均在临床方面为0.65,在X光片方面为0.71。[结论] 对于在从施罗斯方案中为患者开姿势建议和锻炼处方时进行分类应用而言,LS分类法似乎是一种易于使用且高度可靠的工具。该测试表明X光片具有足够的可靠性,但仅对临床图片的测试显示出一定程度的可靠性,这表明当没有X光片时,它对物理治疗师来说是一种合适的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/616e/7590844/038681f30cb5/jpts-32-647-g001.jpg

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