Maher C G, Latimer J, Adams R
School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.
Phys Ther. 1998 Aug;78(8):829-37. doi: 10.1093/ptj/78.8.829.
The reliability and criterion-related validity of ratings of posteroanterior (PA) spinal stiffness made using reference values for comparison have not been investigated. In this study, mechanical reference stimuli for points on an 11-point rating scale were used to determine whether using a reference scale may be feasible. Subjects. Five different raters took part in 2 studies in which they rated 40 subjects who were asymptomatic for low back pain.
The interrater reliability of ratings was evaluated with intraclass correlation coefficients (ICCs) and standard errors of the measurement (SEMs). Criterion-related validity was evaluated by correlating judgments of PA spinal stiffness assessed manually with measurements of PA spinal stiffness provided by a mechanical device, the "Stiffness Assessment Machine" (SAM).
Although the reliability indices were generally high, with ICCs reaching .77 and with SEMs as low as 0.72 points, the evidence for criterion-related validity (i.e., the ability of the examiner to judge spinal stiffness levels) was not strong, with correlations reaching only .56.
The reference-based protocol allows for more reliable measures of PA stiffness judgments than previous protocols have; however, the human ratings are not highly correlated with the SAM measures. The protocol will have clinical value if judgments made using it are shown to be reliable in clinically relevant subjects and to have validity for clinical management of patients.
使用参考值进行比较来评定后前位（PA）脊柱僵硬度的可靠性及与标准相关的效度尚未得到研究。在本研究中，使用11点量表上各点的机械参考刺激来确定使用参考量表是否可行。受试者。五名不同的评估者参与了两项研究，他们对40名无下背痛症状的受试者进行了评定。
评定者间信度通过组内相关系数（ICC）和测量标准误（SEM）进行评估。与标准相关的效度通过将手动评估的PA脊柱僵硬度判断与机械装置“僵硬度评估仪”（SAM）提供的PA脊柱僵硬度测量值进行关联来评估。
尽管信度指标总体较高，ICC达到0.77，SEM低至0.72分，但与标准相关的效度证据（即检查者判断脊柱僵硬度水平的能力）并不强，相关性仅达到0.56。
基于参考的方案比以前的方案能更可靠地测量PA僵硬度判断；然而，人工评定与SAM测量值的相关性不高。如果使用该方案做出的判断在临床相关受试者中被证明是可靠的，并且对患者的临床管理具有效度，那么该方案将具有临床价值。
