Harrison A L, Barry-Greb T, Wojtowicz G
Division of Physical Therapy, College of Allied Health Professions, University of Kentucky, Albert Chandler Medical Center, Lexington 40536-0079, USA.
J Orthop Sports Phys Ther. 1996 Jun;23(6):353-61. doi: 10.2519/jospt.1996.23.6.353.
A reliable method that is practical for clinical use for measuring head posture in standing has not been demonstrated in the literature. The purposes of this study were: 1) to produce a reliable method for measuring sagittal plane head and shoulder posture that is practical for clinical use and 2) to perform a pilot study to compare means between a nonpatient sample and a sample of people who have a history of recurring cervical pain. A method of measuring sagittal plane postural alignment of the head and shoulder in relationship to the lateral malleolus was developed using a carpenter's tri-square with a line level attached to the horizontal arm and a goniometer with a line level attached to the horizontal arm. Horizontal measures were taken with the tri-square from a vertical reference point to the tragus of the ear, to the shoulder axis, and to the lateral malleolus. Angular measures were taken with the goniometer of C7-tragus with the horizontal and tragus-corner of the eye with the horizontal. A reliability study was performed by two therapists with 15 non-patient subjects. Intraclass correlation coefficients measuring interrater reliability for horizontal and angular measures were as follows: 1) tragus to lateral malleolus: R = .87; 2) shoulder to lateral malleolus: R = .91;3) tragus to shoulder: R = .7;4) angle tragus-eye-horizon: R = .68; and 5) angle C7-tragus-horizon: R = .34. In the pilot study, 41 nonpatient subjects (11 males and 30 females, 20-45 years) and 10 patient subjects with cervical pain (one male and nine females, 23-43 years) were measured. Means calculated for horizontal distances (in cm) were: 1) tragus to lateral malleolus (nonpatients: 8.14; patients: 6.65);2) shoulder to lateral malleolus (nonpatients: 5.47; patients: 5.98); and 3) tragus to shoulder (nonpatients: 2.78; patients: .56). Means calculated for angular measures were: 1) tragus-eye-horizon (nonpatients: 18.78 degrees; patients: 21.57 degrees) and 2) C7-tragus-horizon (nonpatients: 49.34 degrees; patients: 49.43 degrees). No statistically significant differences were found between the two samples in this pilot study using an independent two-sample t test. This study demonstrates a reliable and practical method for taking postural measurements in the clinic and describes a pilot study for comparing a patient and a nonpatient sample.
文献中尚未证明有可靠且适用于临床测量站立时头部姿势的实用方法。本研究的目的是：1）制定一种可靠且适用于临床的测量矢状面头部和肩部姿势的方法；2）进行一项初步研究，比较非患者样本和有复发性颈部疼痛病史的人群样本之间的均值。利用一个在水平臂上附有水准仪的木工直角尺和一个在水平臂上附有水准仪的测角仪，开发了一种测量头部和肩部矢状面姿势与外踝关系的方法。使用直角尺从垂直参考点到耳屏、到肩轴、再到外踝进行水平测量。使用测角仪测量C7与耳屏之间以及耳屏与眼角之间相对于水平方向的角度。两名治疗师对15名非患者受试者进行了可靠性研究。测量水平和角度测量者间可靠性的组内相关系数如下：1）耳屏到外踝：R = 0.87；2）肩部到外踝：R = 0.91；3）耳屏到肩部：R = 0.7；4）耳屏 - 眼角 - 水平角度：R = 0.68；5）C7 - 耳屏 - 水平角度：R = 0.34。在初步研究中，对41名非患者受试者（11名男性和30名女性，年龄20 - 45岁）和10名有颈部疼痛的患者受试者（1名男性和9名女性，年龄23 - 43岁）进行了测量。计算得到的水平距离（单位：厘米）均值为：1）耳屏到外踝（非患者：8.14；患者：6.65）；2）肩部到外踝（非患者：5.47；患者：5.98）；3）耳屏到肩部（非患者：2.78；患者：0.56）。计算得到的角度测量均值为：1）耳屏 - 眼角 - 水平角度（非患者：18.78度；患者：21.57度）和2）C7 - 耳屏 - 水平角度（非患者：49.34度；患者：49.43度）。在这项初步研究中，使用独立两样本t检验未发现两个样本之间存在统计学上的显著差异。本研究展示了一种在临床中进行姿势测量的可靠且实用的方法，并描述了一项比较患者和非患者样本的初步研究。
