脊柱相关性颈臂痛临床框架的组内和组间可靠性。
Inter- and intra-rater-reliability of a clinical framework for spine-related neck-arm pain.
机构信息
Hochschule Osnabrueck, University of Applied Sciences, Faculty of Business, Management and Social Sciences, Department Movement and Rehabilitation Science, Osnabrueck, Germany; Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Luebeck, Germany.
Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Luebeck, Germany.
出版信息
Musculoskelet Sci Pract. 2023 Oct;67:102853. doi: 10.1016/j.msksp.2023.102853. Epub 2023 Aug 24.
OBJECTIVE
A mechanism-based clinical framework for spine-related pain differentiates (i) somatic referred pain, ii) heightened nerve mechanosensitivity, iii) radicular pain, iv) radiculopathy and mixed-pain. This study aimed to determine the reliability of proposed framework.
METHOD
Fifty-one people with unilateral spine-related neck-arm pain were assessed and categorized by examiner-1. The classifications were compared to those made by two other examiners, based on written documentation of examiner-1. Cohens kappa was calculated between examiner-pairs; Fleiss Kappa among all examiners to assess agreement in classifying subgroups and entire framework.
RESULT
Inter-rater-reliability showed moderate to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI 0.87-1.0) to 1.0 (95% CI: 1.0-1.0), radicular pain: 0.46 (95% CI: 0.19-0.69) to 0.62 (95% CI: 0.42-0.81), radiculopathy: 0.65 (95% CI: 0.43-0.84) to 0.80 (95% CI: 0.63-0.96) mixed-pain: 0.54 (95% CI: 0.21-0.81) to 0.75 (95% CI: 0.48-0.94). There was almost perfect to moderate reliability among all examiners (somatic: no variation, mechanosensitivity: 0.97 (95% CI: 0.82-1.0), radicular pain: 0.56 (95% CI: 0.40-0.71), radiculopathy: 0.74 (95% CI: 0.58-0.90), mixed-pain: 0.63 (95% CI: 0.47-0.79), entire framework: 0.64 (95% CI: 0.57-0.71)). Intra-rater-reliability showed substantial to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI: 0.87-1.0), radicular pain: 0.76 (95% CI: 0.57-0.92), radiculopathy: 0.84 (95% CI: 0.67-0.96), mixed-pain: 0.83 (95% CI: 0.60-1.0), entire framework: 0.80 (95% CI: 0.61-0.92).
CONCLUSION
Moderate to almost perfect reliability in subgrouping people with spine-related neck-arm pain and substantial reliability for entire framework support this classification's reliability.
目的
基于机制的脊柱相关疼痛临床框架可区分 (i) 躯体牵涉痛，(ii) 神经机械敏感性增高，(iii) 根性痛，(iv) 神经根病和混合性疼痛。本研究旨在确定该框架的可靠性。
方法
51 名单侧颈臂脊柱相关疼痛患者由 1 名检查者进行评估和分类。根据检查者 1 的书面记录，将这些分类与另外两名检查者的分类进行比较。计算检查者之间的 Cohen's kappa 值；计算所有检查者之间的 Fleiss Kappa 值，以评估分类亚组和整个框架的一致性。
结果
组内可靠性显示中度至近乎完美的可靠性（躯体：无变化，机械敏感性：0.96（95%CI 0.87-1.0）至 1.0（95%CI：1.0-1.0），根性疼痛：0.46（95%CI：0.19-0.69）至 0.62（95%CI：0.42-0.81），神经根病：0.65（95%CI：0.43-0.84）至 0.80（95%CI：0.63-0.96），混合性疼痛：0.54（95%CI：0.21-0.81）至 0.75（95%CI：0.48-0.94）。所有检查者之间的可靠性近乎完美至中度（躯体：无变化，机械敏感性：0.97（95%CI 0.82-1.0），根性疼痛：0.56（95%CI 0.40-0.71），神经根病：0.74（95%CI 0.58-0.90），混合性疼痛：0.63（95%CI 0.47-0.79），整个框架：0.64（95%CI 0.57-0.71））。组内可靠性显示出实质性至近乎完美的可靠性（躯体：无变化，机械敏感性：0.96（95%CI 0.87-1.0），根性疼痛：0.76（95%CI 0.57-0.92），神经根病：0.84（95%CI 0.67-0.96），混合性疼痛：0.83（95%CI 0.60-1.0），整个框架：0.80（95%CI 0.61-0.92））。
结论
对脊柱相关颈臂疼痛患者进行亚组分类的可靠性为中度至近乎完美，对整个框架的可靠性为实质性，支持该分类的可靠性。
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