Peterson D E, Blankenship K R, Robb J B, Walker M J, Bryan J M, Stetts D M, Mincey L M, Simmons G E
US Army-Baylor University, Army Medical Department Center and School, Fort Sam Houston, TX 78234, USA.
J Orthop Sports Phys Ther. 1997 Jan;25(1):34-42. doi: 10.2519/jospt.1997.25.1.34.
Clinicians often rely on visual inspection and descriptive terms to documents a patient's forward shoulder posture. The purpose of this study was to assess the validity and intrarater reliability of four objective techniques to measure forward shoulder posture. Subjects were 25 males and 24 females. Subjects had a lateral cervical spine radiograph taken, from which the horizontal distance from the C7 spinous process to the anterior tip of the left anterior acromion process was measured. Subjects then proceeded twice through a random order of four measurements: the Baylor square, the double square, the Sahrmann technique, and scapular position. These results were then used to determine the intrarater reliability of each technique. Multiple regression analyses were performed on each measure's mean scores to determine both the correlation with and the predictive value for the radiographic measurement. The intraclass correlation coefficients for intrarater reliability ranged from .89 to .91. The correlation coefficients ranged from -.33 to .77, and the coefficients of determination ranged from .10 to .59 (N = 49). The researchers demonstrated clinical reliability for each technique; however, validity compared with the radiographic measurement could not be established. These techniques may have clinical value in objectively measuring change in a patient's shoulder posture as a result of a treatment program. Before any of these measures could be universally recommended in clinical practice, future research is necessary to establish interrater reliability and assess each technique's ability to detect postural changes over time.
临床医生常常依靠目视检查和描述性术语来记录患者的肩部前伸姿势。本研究的目的是评估四种测量肩部前伸姿势的客观技术的有效性和评分者内信度。受试者包括25名男性和24名女性。为受试者拍摄颈椎侧位X线片，测量C7棘突到左前肩峰前尖端的水平距离。然后，受试者按照随机顺序对四种测量方法各进行两次测量：贝勒方块法、双方块法、萨尔曼技术和肩胛骨位置测量法。这些结果随后被用于确定每种技术的评分者内信度。对每种测量方法的平均得分进行多元回归分析，以确定与X线测量的相关性和预测价值。评分者内信度的组内相关系数范围为0.89至0.91。相关系数范围为-0.33至0.77，决定系数范围为0.10至0.59（N = 49）。研究人员证明了每种技术的临床信度；然而，与X线测量相比的有效性未能确立。这些技术在客观测量患者因治疗方案导致的肩部姿势变化方面可能具有临床价值。在临床实践中普遍推荐使用这些测量方法之前，有必要进行进一步研究以确立评分者间信度，并评估每种技术检测随时间变化的姿势改变的能力。
