Rhodes D W, Mansfield E R, Bishop P A, Smith J F
University of Alabama, USA.
J Manipulative Physiol Ther. 1995 Sep;18(7):448-52.
To assess the validity and reliability of prone and supine measurements of leg length inequality and to determine the potential use of measurements at the iliac crests and patient demographics as predictors to estimate standing leg length differential.
Repeated prone and supine measurements of leg length inequality were made by an experienced chiropractor and compared with iliac crest and femur head measurements made on X-rays of standing patients. Multiple regression analysis was performed.
Private chiropractic practice.
The first 50 new patients with low back pain that were X-rayed were included in the study.
Intraexaminer reliability was excellent for the prone measurements. The supine tests were less reliable. The prone measurements were highly correlated with the standing X-ray femur head measurement. The supine measurements were poorly correlated. Measurements of deficiency at the iliac crests on X-ray were most highly correlated with X-ray measurements of discrepancy. In multiple regression, the prone measurements and duration of problem were the only significant predictors of standing X-ray difference.
In this study, crest measurements were made on X-ray; the degree of accuracy with which millimeter differences can be measured clinically on patients is unknown. In a few cases, the supine measurements were more accurate than the prone; however, the supine test validity was poor when compared with the standing X-ray measurements, and reliability was less than expected. Supine measurements should not be used to estimate standing leg length discrepancy in new low back pain patients but perhaps can be used in other clinically meaningful ways. Intraexaminer reliability of the prone measurements was higher, but further investigations need to focus on interexaminer reliability. The prone measurement as a predictor holds promise, but new measurement tools must be developed.
评估俯卧位和仰卧位测量腿长不等的有效性和可靠性，并确定髂嵴测量值和患者人口统计学特征作为预测指标来估计站立位腿长差异的潜在用途。
由一名经验丰富的脊椎按摩师对腿长不等进行重复的俯卧位和仰卧位测量，并与站立位患者X线片上的髂嵴和股骨头测量值进行比较。进行多元回归分析。
私人脊椎按摩诊所。
纳入首批50例接受X线检查的新发腰痛患者。
检查者内俯卧位测量的可靠性极佳。仰卧位检查的可靠性较低。俯卧位测量值与站立位X线股骨头测量值高度相关。仰卧位测量值相关性较差。X线片上髂嵴缺损的测量值与X线片上差异测量值的相关性最高。在多元回归中，俯卧位测量值和问题持续时间是站立位X线差异的唯一显著预测指标。
在本研究中，X线片上进行了嵴测量；临床上在患者身上能够测量出毫米级差异的准确程度尚不清楚。在少数情况下，仰卧位测量比俯卧位测量更准确；然而，与站立位X线测量相比，仰卧位检查的有效性较差，可靠性低于预期。仰卧位测量不应用于估计新发腰痛患者站立位腿长差异，但或许可用于其他具有临床意义的方面。俯卧位测量的检查者内可靠性较高，但进一步研究需要关注检查者间可靠性。俯卧位测量作为预测指标具有前景，但必须开发新的测量工具。
