School of Physical Therapy, University of the Incarnate Word, San Antonio, TX, USA.
College of Health and Human Services, Bowling Green State University, Bowling Green, OH, USA.
J Man Manip Ther. 2021 Jun;29(3):189-195. doi: 10.1080/10669817.2020.1844853. Epub 2020 Nov 24.
: Previous studies on learning joint mobilization techniques have used expert practitioners as the reference standard as there is no current evidence on what ideal forces would be for effective mobilizations. However, none of these trials have documented the reliability or accuracy of the reference standard. Therefore, the purpose of this study was to report both the reliability and accuracy of an expert physical therapist (PT) acting as a reference standard for a manual therapy joint mobilization trial.: A secondary analysis was performed using data from a published randomized, controlled, crossover study. The mobilization technique studied was the central posterior to anterior (PA) joint mobilization of the L3 vertebra. Reliability and accuracy data for the reference standard were collected over four time periods spanning 16 weeks.: Intrarater reliability of the expert PT for R1 and R2 joint forces was excellent (R1 Force ICC 0.95, 95%CI 0.76-0.99 and R2 Force ICC 0.90, 95%CI 0.49-0.99). Additionally, the expert PT was 92.3% accurate (mean % error±SD, 7.7 ± 5.5) when finding Grade III mean peak mobilization force and 85.1% accurate (mean % error±SD, 14.9 ± 8.3) when finding Grade IV mean peak mobilization force. Finally, correlations between actual applied forces and computed ideal forces were excellent (Pearson r 0.79-0.92, n = 24, < 0.01 for all correlations).: The expert PT in this manual therapy joint mobilization trial showed excellent reliability and accuracy as the reference standard. The study supports the use of implementing quantitative feedback devices into the teaching of joint mobilization when a reliable and accurate reference standard has been identified.: 2b.
: 先前关于学习关节松动技术的研究使用专家从业者作为参考标准，因为目前尚无关于有效松动的理想力的证据。然而，这些试验都没有记录参考标准的可靠性或准确性。因此，本研究的目的是报告作为手法治疗关节松动试验参考标准的专家物理治疗师（PT）的可靠性和准确性。
: 使用已发表的随机、对照、交叉研究的数据进行了二次分析。所研究的松动技术是 L3 椎骨的中央后至前（PA）关节松动。在跨越 16 周的四个时间段内收集了参考标准的可靠性和准确性数据。
: 专家 PT 对 R1 和 R2 关节力的内部评估者可靠性为优秀（R1 力 ICC 0.95，95%CI 0.76-0.99 和 R2 力 ICC 0.90，95%CI 0.49-0.99）。此外，当找到 3 级平均峰值松动力时，专家 PT 的准确率为 92.3%（平均%误差±SD，7.7±5.5），当找到 4 级平均峰值松动力时，准确率为 85.1%（平均%误差±SD，14.9±8.3）。最后，实际施加力与计算理想力之间的相关性非常好（Pearson r 0.79-0.92，n = 24，所有相关性均为<0.01）。
: 在这个手法治疗关节松动试验中，作为参考标准的专家 PT 表现出了极好的可靠性和准确性。该研究支持在确定可靠且准确的参考标准后，将定量反馈设备引入关节松动教学中。
: 2b。
