Doctoral Program in Health Sciences, University of Seville, Seville, Spain; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
Musculoskelet Sci Pract. 2023 Apr;64:102738. doi: 10.1016/j.msksp.2023.102738. Epub 2023 Feb 28.
People with whiplash-associated disorders (WAD) commonly present with a variety of physical impairments. However, the reliability of physical tests has not been established for patients with acute WAD.
To assess test-retest reliability of different physical tests in acute WAD.
Intra-rater test-retest reliability.
Patients with acute WAD were recruited. Physical tests were used to evaluate articular, muscular and neural systems in two blocks of measurements separated by 10 min. Bland-Altman plots were performed to assess intrarater agreement, which included calculation of the mean difference (d) between rates, the 95% CI for d, the standard deviation of the differences and the 95% limits of agreement. Reliability was calculated via the standard error of measurement, the minimal detectable change, percent of agreement, the intraclass-correlation coefficient, and kappa coefficient.
47 patients participated. Test-retest reliability was excellent or good for almost all measures, except for extension ROM, ULTT for the radial nerve, and active cervical extension and upper cervical rotation performed in 4-point kneeling, which presented moderate reliability. Systematic bias was found in cervical ROM in flexion, left and right lateral-flexion, left and right rotation; left ULTT for radial nerve; right trapezius, suboccipitalis and temporalis muscles, left temporalis; C3, both sides of C1-C2, left C3-C4.
The majority of physical tests achieved good or excellent test-retest intra-rater reliability when tested in patients with acute WAD. Findings must be considered with caution for those tests which demonstrated systematic bias. Additional research is warranted to evaluate inter-rater reliability.
患有挥鞭样损伤相关疾病（WAD）的患者通常会出现多种身体功能障碍。然而，急性 WAD 患者的物理测试可靠性尚未得到证实。
评估急性 WAD 患者不同物理测试的重测信度。
内部测试者重测信度。
招募患有急性 WAD 的患者。使用物理测试在两次测量之间间隔 10 分钟的两个测量块中评估关节、肌肉和神经系统。 Bland-Altman 图用于评估内部一致性，包括计算速率之间的平均差值（d）、d 的 95%置信区间、差值的标准差和 95%一致性界限。可靠性通过测量误差的标准误差、最小可检测变化、百分比一致性、组内相关系数和kappa 系数进行计算。
47 名患者参与了研究。除了伸展 ROM、桡神经的 ULTT、四点跪位下主动颈椎伸展和上颈椎旋转的测量外，几乎所有测量指标的重测信度均为极好或良好，这些指标的重测信度为中度。在颈椎屈伸、左右侧屈、左右旋转的 ROM 中发现系统偏差；桡神经左侧 ULTT；右侧斜方肌、枕下肌和颞肌、左侧颞肌；C3、C1-C2 两侧、左侧 C3-C4。
当在急性 WAD 患者中进行测试时，大多数物理测试的内部测试者重测信度为极好或良好。对于那些表现出系统偏差的测试，结果必须谨慎考虑。需要进一步的研究来评估测试者间的可靠性。
