Picciano A M, Rowlands M S, Worrell T
PT Center for Sports Medicine and Family Physical Therapy, Akron, OH.
J Orthop Sports Phys Ther. 1993 Oct;18(4):553-8. doi: 10.2519/jospt.1993.18.4.553.
Subtalar joint (STJ) measurements are commonly made in the clinic to assess foot and ankle positions because of the high incidence of lower extremity dysfunctions. The purposes of this study were to investigate the intratester and intertester reliability of the open kinetic chain subtalar joint neutral (OKC STJN) and closed kinetic chain subtalar joint neutral (CKC STJN) positions and the navicular drop test (NDT). Two inexperienced testers performed repeated measurements on 15 subjects (N = 30 feet) during two testing sessions. Intratester and intertester reliability (ICC 1,1) and standard error of measurement (SEM) were determined for each dependent variable. For OKC STJN, the intratester ICC values were .06 and .27, and the intertester ICC value was .00. The intratester SEM values were 1.81 and 2.29 degrees, and the intertester was 2.51 degrees. The CKC STJN intratester ICC values were .14 and .18, with SEM values of 2.46 and 2.40 degrees. The intertester CKC ICC value was .15, with an SEM of 2.43 degrees. For the NDT, the intratester ICC values were .61 and .79, and the SEM values were 1.92 mm and 2.57 mm. The intertester ICC value was .57 and the SEM was 2.72 mm. The results reveal that both OKC and CKC STJN yield poor intratester and intertester reliability and the NDT yields poor to moderate intratester reliability and poor intertester reliability. We conclude that these foot and ankle measurements are not reliable when performed by inexperienced testers. Therefore, clinicians should practice these measurement techniques and determine their measurement error.
由于下肢功能障碍的发生率较高,临床上常用距下关节(STJ)测量来评估足踝位置。本研究的目的是调查开放动力链距下关节中立位(OKC STJN)、闭合动力链距下关节中立位(CKC STJN)以及舟骨沉降试验(NDT)在测试者内和测试者间的可靠性。两名经验不足的测试者在两个测试阶段对15名受试者(N = 30只脚)进行了重复测量。确定了每个因变量的测试者内和测试者间可靠性(ICC 1,1)以及测量标准误差(SEM)。对于OKC STJN,测试者内ICC值分别为0.06和0.27,测试者间ICC值为0.00。测试者内SEM值分别为1.81度和2.29度,测试者间为2.51度。CKC STJN测试者内ICC值分别为0.14和0.18,SEM值分别为2.46度和2.40度。测试者间CKC ICC值为0.15,SEM为2.43度。对于NDT,测试者内ICC值分别为0.61和0.79,SEM值分别为1.92毫米和2.57毫米。测试者间ICC值为0.57,SEM为2.72毫米。结果表明,OKC和CKC STJN在测试者内和测试者间的可靠性均较差,NDT在测试者内的可靠性为差到中等,在测试者间的可靠性较差。我们得出结论,当由经验不足的测试者进行这些足踝测量时,测量结果不可靠。因此,临床医生应练习这些测量技术并确定其测量误差。