Gray Kurt, Dalal Rajiv, Davis Weaver Jullet, Randolph Saungaylia
Florida Agricultural & Mechanical University, School of Allied Health Sciences, Division of Physical Therapy, Tallahassee, FL, USA.
Florida Agricultural & Mechanical University, School of Allied Health Sciences, Division of Physical Therapy, Tallahassee, FL, USA.
J Bodyw Mov Ther. 2021 Apr;26:233-237. doi: 10.1016/j.jbmt.2020.12.008. Epub 2020 Dec 11.
Medical professionals frequently encounter forward head postures (FHP) in the treatment of cervical spine pain. In the clinical setting, FHP measurements are often described subjectively using the phrase, "patient demonstrates forward head posture." There are reliable tools that can objectively measure FHP, but they are not frequently used in the clinical setting on a regular basis because the tools are unavailable, inconvenient or overly time-consuming. The objective of this study was to confirm if FHP can be reliably measured using a novel posture-measuring device. The Posture Measuring Device (PMD) was designed to quickly obtain objective measurements of FHP in the outpatient clinical setting. A pilot study demonstrated good to excellent reliability in intra-rater (test-retest) measurements and good interrater reliability using two first-year Doctor of Physical Therapy Students as raters. This study is to confirm that the PMD is able to provide intra-rater and interrater reliability using two physical therapists and two second-year Doctor of Physical Therapy students to obtain FHP measurements.
Twenty-three college-aged subjects were measured individually using a PMD by a panel of four raters consisting of two physical therapists and two second-year physical therapy students to develop interrater reliability. Each rater measured each subject twice on two separate occasions to obtain a measure of intra-rater (relative) reliability.
Pearson Correlations demonstrate high intra-rater correlation with inconsistent interrater correlation. The average measured Intraclass Correlation Coefficient (ICC) was .822 with a 95% confidence interval indicating a high degree of reliability between the eight measurements performed on each subject. Cronbach's alpha results confirm the ICC findings of strong correlation among the eight raters (α = 0.87).
Objective measurement of forward head posture is valuable to document and monitor patient response to treatment. This study identifies a convenient and time-efficient method for measuring forward head in the clinical setting. The PMD demonstrated a high degree of reliability in intra-rater measurements of FHP.
医学专业人员在治疗颈椎疼痛时经常会遇到头部前倾姿势（FHP）。在临床环境中，FHP的测量通常是主观描述的，使用的表述是“患者表现出头部前倾姿势”。有一些可靠的工具可以客观地测量FHP，但由于这些工具无法获取、使用不便或耗时过长，它们在临床环境中并不经常被定期使用。本研究的目的是确认是否可以使用一种新型姿势测量设备可靠地测量FHP。姿势测量设备（PMD）旨在在门诊临床环境中快速获得FHP的客观测量值。一项试点研究表明，在内部评估者（重测）测量中具有良好至优秀的可靠性，并且使用两名一年级物理治疗博士生作为评估者时具有良好的评估者间可靠性。本研究旨在确认PMD能否通过两名物理治疗师和两名二年级物理治疗博士生获得FHP测量值，从而提供内部评估者和评估者间的可靠性。
由两名物理治疗师和两名二年级物理治疗学生组成的四名评估者小组，使用PMD对23名大学生年龄的受试者进行单独测量，以建立评估者间的可靠性。每位评估者在两个不同的场合对每位受试者进行两次测量，以获得内部评估者（相对）可靠性的测量值。
Pearson相关性显示内部评估者相关性高，但评估者间相关性不一致。平均测量的组内相关系数（ICC）为0.822，95%置信区间表明对每个受试者进行的八次测量之间具有高度可靠性。Cronbach's alpha结果证实了ICC的发现，即八名评估者之间存在强相关性（α = 0.87）。
头部前倾姿势的客观测量对于记录和监测患者对治疗的反应很有价值。本研究确定了一种在临床环境中测量头部前倾的便捷且高效的方法。PMD在FHP的内部评估者测量中显示出高度可靠性。
