Elveru R A, Rothstein J M, Lamb R L
Department of Physical Therapy, Malcolm Grow Medical Center, Andrews Air Force Base, Camp Springs, MD 20331.
Phys Ther. 1988 May;68(5):672-7. doi: 10.1093/ptj/68.5.672.
Measurements of the subtalar joint neutral (STJN) position and passive range of motion (PROM) of the ankle joint and the subtalar joint (STJ) are often part of a physical therapy evaluation. These measurements may be used in treatment planning, such as in the prescription of specialized shoes or orthoses. Therefore, reliability of these measurements, as they are obtained clinically, must be determined. The purpose of this study was to examine the reliability of measurements of the STJN position and of ankle and STJ PROM. To determine reliability, repeated measurements of the STJN position and of STJ PROM were taken on the involved feet of 43 patients with neurologic orthopedic disorders (including both feet of 7 patients), and measurements of ankle PROM (dorsiflexion and plantar flexion) were taken on 42 of these patients (including both feet of 7 patients). Intraclass correlation coefficients (ICCs) for intratester reliability ranged from .74 to .90 for ankle and STJ measurements. The ICCs for intertester reliability were .25 for measuring the STJN position, .32 for STJ inversion, and .17 for SJJ eversion. The ICCs for intertester reliability were .50 for ankle dorsiflexion and .72 for ankle plantar flexion. Goniometric measurements of the STJN position and of PROM of the ankle and STJ appear to be moderately reliable if taken by the same therapist over a short period of time. With the exception of ankle plantar flexion, these measurements cannot be considered to be reliable between therapists.
距下关节中立位（STJN）以及踝关节和距下关节（STJ）的被动活动范围（PROM）测量通常是物理治疗评估的一部分。这些测量结果可用于治疗方案规划，比如用于开具特殊鞋子或矫形器的处方。因此，必须确定这些临床获得的测量结果的可靠性。本研究的目的是检验STJN位置以及踝关节和距下关节PROM测量的可靠性。为确定可靠性，对43例神经骨科疾病患者（包括7例患者的双足）的患侧足部进行了STJN位置和距下关节PROM的重复测量，并对其中42例患者（包括7例患者的双足）进行了踝关节PROM（背屈和跖屈）测量。测试者内部可靠性的组内相关系数（ICC）在踝关节和距下关节测量中范围为0.74至0.90。测量STJN位置的测试者间可靠性ICC为0.25，距下关节内翻为0.32，距下关节外翻为0.17。踝关节背屈的测试者间可靠性ICC为0.50，踝关节跖屈为0.72。如果由同一位治疗师在短时间内进行测量，STJN位置以及踝关节和距下关节PROM的角度测量似乎具有中等可靠性。除踝关节跖屈外，这些测量结果在不同治疗师之间不可认为是可靠的。
