Physical Therapy Program, Maryville University, St. Louis, MO, USA.
Physiother Theory Pract. 2023 Sep 2;39(9):1993-1999. doi: 10.1080/09593985.2022.2058439. Epub 2022 Mar 27.
Determining the mobility of the costovertebral joints might be important in patients with neck-upper thoracic pain. Little research has been performed on observer agreement when assessing the mobility of these joints.
The purpose of this study was to determine intra- and inter-observer agreements when assessing costovertebral joint mobility of the upper three ribs in those with and without neck pain and to compare the difference between the Kappa and AC statistic.
Forty-four participants, with and without current neck/upper-thoracic pain, were assessed by two raters. Raters applied a posterior to anterior pressure to the anatomical neck of the first three ribs bilaterally. Mobility was graded: normal, increased, or decreased. An AC1, for nominal data, AC2 for ordinal data, and the Kappa statistics were used to analyze the results. The AC statistics determines chance agreement different than Kappa.
AC1 showed "moderate to very good" (0.74-1.0) intra-rater reliability, while inter-rater reliability showed "fair to good" agreement (0.51-0.79). Using the AC2 Intra-rater reliability was "very good" and "almost perfect" (AC2: 0.93-1.0), while using the AC2 was "good to very good" and "good to almost perfect" (0.76-0.94). Kappa values for intra-rater reliability ranged from "fair to moderate" (0.38-0.54), while inter-rater reliability ranged from "poor to fair" (-0.10-0.26).
Posterior/anterior pressure is a reliable method to assess the mobility of the upper costovertebral joints. Assessing costovertebral mobility is important when establishing a movement diagnosis in patients with neck/upper thoracic pain.
在患有颈胸上部疼痛的患者中，确定肋椎关节的活动性可能很重要。很少有研究对评估这些关节活动性的观察者一致性进行研究。
本研究的目的是确定在有或没有颈痛的患者中评估上三个肋的肋椎关节活动性时的观察者内和观察者间一致性，并比较 Kappa 和 AC 统计之间的差异。
44 名参与者有或没有当前的颈/胸上部疼痛，由两名评估者进行评估。评估者在双侧将向后至向前的压力施加到第一至第三肋的解剖颈上。活动度分为正常、增加或减少。使用名义数据的 AC1、有序数据的 AC2 和 Kappa 统计来分析结果。AC 统计确定了不同于 Kappa 的机会一致性。
AC1 显示出“中度到极好”（0.74-1.0）的观察者内可靠性，而观察者间可靠性显示出“公平到良好”的一致性（0.51-0.79）。使用 AC2 时，观察者内可靠性为“极好”和“几乎完美”（AC2：0.93-1.0），而使用 AC2 时，观察者间可靠性为“良好到极好”和“良好到几乎完美”（0.76-0.94）。观察者内可靠性的 Kappa 值范围从“公平到中度”（0.38-0.54），而观察者间可靠性的 Kappa 值范围从“差到公平”（-0.10-0.26）。
后/前向压力是评估上肋椎关节活动性的可靠方法。在对颈/胸上部疼痛患者进行运动诊断时，评估肋椎关节的活动性很重要。
