Daikuya Shinichi, Okayama Yumi
Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan.
PLoS One. 2025 Apr 29;20(4):e0322788. doi: 10.1371/journal.pone.0322788. eCollection 2025.
Stretching is widely used in clinical settings to maintain and enhance physical functions. Despite numerous studies investigating its effects, subjective evaluations by therapists remain common, lacking objective assessment criteria. This study aims to bridge this gap by correlating objective measures with subjective evaluations by therapists and patients. The hypotheses are: (1) significant correlation between objective measures and subjective assessments, (2) consistency in therapist judgments, and (3) identification of objective criteria. This research aims to formalize clinical knowledge and enhance stretching interventions' applicability. Sixteen physiotherapists participated, with varying clinical experience. Straight leg raising stretching was performed on a simulated patient. Objective measures included joint angle, electromyography, and posterior thigh stiffness. Subjective evaluations were made by therapists and simulated patient using numerical rating scales. Therapists' ratings correlated positively with straight leg raising angle change and stretching duration. Simulated patient's ratings correlated positively with an integral electromyographic values of semitendinosus muscle activity but negatively with joint angle change. Regression analysis did not yield significant predictive models. Subjective evaluations may deviate from objective outcomes, highlighting the need for a better understanding of their relationship. Physiotherapists detected small joint angle improvements subjectively, but no objective predictor of this change was found. Patients' subjective evaluations did not align with objective outcomes. This suggests therapists' evaluations may be more accurate. Additional investigation into subjective evaluation criteria is warranted. Therapists should be cautious in relying solely on patient feedback, emphasizing the need for objective assessment in clinical practice.
拉伸在临床环境中被广泛用于维持和增强身体功能。尽管有许多研究探讨其效果，但治疗师的主观评估仍然很常见，缺乏客观评估标准。本研究旨在通过将客观测量与治疗师和患者的主观评估相关联来弥合这一差距。假设如下：（1）客观测量与主观评估之间存在显著相关性；（2）治疗师判断的一致性；（3）确定客观标准。本研究旨在将临床知识形式化，并提高拉伸干预措施的适用性。16名物理治疗师参与了研究，他们的临床经验各不相同。在模拟患者身上进行直腿抬高拉伸。客观测量包括关节角度、肌电图和大腿后侧僵硬度。治疗师和模拟患者使用数字评分量表进行主观评估。治疗师的评分与直腿抬高角度变化和拉伸持续时间呈正相关。模拟患者的评分与半腱肌活动的肌电图积分值呈正相关，但与关节角度变化呈负相关。回归分析未得出显著的预测模型。主观评估可能与客观结果存在偏差，这凸显了更好地理解它们之间关系的必要性。物理治疗师主观上检测到关节角度有小的改善，但未发现这种变化的客观预测指标。患者的主观评估与客观结果不一致。这表明治疗师的评估可能更准确。有必要对主观评估标准进行进一步研究。治疗师在仅依赖患者反馈时应谨慎，强调在临床实践中进行客观评估的必要性。
