Chesworth B M, MacDermid J C, Roth J H, Patterson S D
London Health Sciences Centre-Victoria Campus, Ontario, Canada.
Phys Ther. 1998 Jun;78(6):593-601. doi: 10.1093/ptj/78.6.593.
Findings related to joint function can be recorded with movement diagrams or by characterizing the "end-feel" according to the procedure described by Cyriax. Because both methods are used to classify pain and resistance in relation to joint range of motion (ROM), the purpose of this study was to simultaneously evaluate the reliability of these categorizations in a patient sample.
Two physical therapists performed 2 assessments of passive lateral rotation of the shoulder in 34 patients.
Pain and resistance findings were recorded using movement diagrams and end-feel categories. Intraclass correlation coefficients (ICC[2,1]) were used to analyze the ratio (movement diagram) data, and kappa statistics (kappa) were used to analyze the categorical (end-feel) data.
Intrarater ICCs varied from .58 to .89. Interrater ICCs for locating maximum pain and resistance in joint ROM varied from .85 to .91. Other interrater ICCs were lower (ICC = .34-.88). Intrarater kappa values for end-feel were moderate (kappa = .48-.59), and interrater kappa values were substantial (kappa = .62-.76).
Movement diagram measures conceptually related to the end of joint ROM and end-feel were highly reliable. This finding and the fact that additional end-feel categories were introduced in the study may partially explain the end-feel reliability findings. Consideration of their use in future studies may help to determine their clinical utility.
与关节功能相关的发现可以通过运动图记录，或者按照西里克斯所描述的方法对“终末感觉”进行特征描述。由于这两种方法都用于根据关节活动范围（ROM）对疼痛和阻力进行分类，本研究的目的是在患者样本中同时评估这些分类的可靠性。
两名物理治疗师对34例患者的肩部被动外旋进行了两次评估。
使用运动图和终末感觉类别记录疼痛和阻力发现。组内相关系数（ICC[2,1]）用于分析比率（运动图）数据，kappa统计量（kappa）用于分析分类（终末感觉）数据。
评定者内ICC值在0.58至0.89之间。评定者间在关节ROM中定位最大疼痛和阻力的ICC值在0.85至0.91之间。其他评定者间ICC值较低（ICC = 0.34 - 0.88）。评定者内终末感觉的kappa值为中等（kappa = 0.48 - 0.59），评定者间kappa值为实质性（kappa = 0.62 - 0.76）。
与关节ROM终点和终末感觉概念相关的运动图测量具有高度可靠性。这一发现以及研究中引入了额外的终末感觉类别这一事实，可能部分解释了终末感觉可靠性的结果。考虑在未来研究中使用它们可能有助于确定其临床效用。
