使用Symmio应用程序进行的自我运动筛查在识别肌肉骨骼风险因素方面是可靠且有效的。
Self-Movement Screening using the Symmio Application is Reliable and Valid for Identifying Musculoskeletal Risk Factors.
作者信息
Matsel Kyle, Kirsch Jonathan, Netelbeek Tessa, Rodriguez Rolando, Velic Ervin, Schwartzkopf-Phifer Kate
机构信息
Physical Therapy, University of Evansville.
Los Angeles Dodgers Baseball Organization, Los Angeles, CA.
出版信息
Int J Sports Phys Ther. 2023 Apr 1;18(2):439-449. doi: 10.26603/001c.73319. eCollection 2023.
BACKGROUND
Musculoskeletal health problems are one of the greatest healthcare expenses in the United States but patient-driven screening procedures to detect risk factors do not exist.
HYPOTHESIS/PURPOSE: The purpose was to establish the inter-rater reliability of the Symmio Self-Screen application in untrained individuals and to investigate its accuracy to detect MSK risk factors such as pain with movement, movement dysfunction, and decreased dynamic balance.
STUDY DESIGN
Cross-Sectional.
METHODS
Eighty (42 male, 38 female) healthy individuals mean age 26.5 ± 9.4 participated in the study. The inter-rater reliability of Symmio application was established by comparing self-screen scores from untrained subjects with the results simultaneously determined by a trained healthcare provider. Each subject was evaluated for pain with movement, movement dysfunction, and deficits in dynamic balance by two trained evaluators who were blinded to the Symmio results. The validity of Symmio was determined by comparing self-screen performance dichotomized as pass or fail with the reference standard of pain with movement, failure on the Functional Movement Screen™, and asymmetry on the Y Balance Test-Lower Quarter™ using three separate 2x2 contingency tables.
RESULTS
The mean Cohen's kappa coefficient was 0.68 (95% CI, 0.47-0.87) and the absolute agreement was 89% between self-assessment of subjects and the observation of a trained healthcare provider. There were significant associations for the presence of pain with movement (=0.003), movement dysfunction (=0.001), and dynamic balance deficits (=0.003) relative to poor Symmio performance. The accuracy of Symmio to identify pain with movement, movement dysfunction, and dynamic balance deficits were 0.74 (95% CI, 0.63-0.83), 0.73 (95% CI, 0.62-0.82), and 0.69 (95% CI, 0.57-0.79), respectively.
CONCLUSIONS
The Symmio Self-Screen application is a reliable and feasible screening tool that can be used to identify MSK risk factors.
LEVEL OF EVIDENCE
Level 2.
背景
肌肉骨骼健康问题是美国最大的医疗保健费用之一，但目前不存在由患者驱动的用于检测风险因素的筛查程序。
假设/目的：目的是确定Symmio自我筛查应用程序在未经培训的个体中的评分者间信度，并研究其检测肌肉骨骼风险因素的准确性，如运动时疼痛、运动功能障碍和动态平衡下降。
研究设计
横断面研究。
方法
80名（42名男性，38名女性）健康个体参与了研究，平均年龄为26.5±9.4岁。通过比较未经培训的受试者的自我筛查分数与训练有素的医疗保健提供者同时得出的结果，来确定Symmio应用程序的评分者间信度。由两名对Symmio结果不知情的训练有素的评估人员对每个受试者进行运动时疼痛、运动功能障碍和动态平衡缺陷的评估。通过使用三个独立的2x2列联表，将自我筛查表现分为通过或未通过，并与运动时疼痛的参考标准、功能性运动筛查™失败以及Y平衡测试-下半身™不对称进行比较，来确定Symmio的有效性。
结果
受试者自我评估与训练有素的医疗保健提供者的观察之间的平均科恩kappa系数为0.68（95%CI，0.47-0.87），绝对一致性为89%。相对于Symmio表现不佳，运动时疼痛（=0.003）、运动功能障碍（=0.001）和动态平衡缺陷（=0.003）的存在存在显著关联。Symmio识别运动时疼痛、运动功能障碍和动态平衡缺陷的准确性分别为0.74（95%CI，0.63-0.83）、0.73（95%CI，0.62-0.82）和0.69（95%CI，0.57-0.79）。
结论
Symmio自我筛查应用程序是一种可靠且可行的筛查工具，可用于识别肌肉骨骼风险因素。
证据水平
2级。
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