常见的测试和测量时关节疾病的可靠性和最小可检测的变化
Ovidio Olivencia1, Kelby B Kaplan1,2, Ashley Graham1
1Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, USA.
Physiotherapy theory and practice
|July 9, 2024
概括
这项研究发现,活跃运动范围 (AROM) 和闭塞测量对于评估关节障碍是可靠的. 然而,关节的移动性和侧面状骨区域的触摸显示出不良一致性,需要更大的变化来确认真正的进展.
科学领域:
- 牙科 牙科是指牙科的专业.
- 矯正牙科 矯正牙科是一種矯正牙科.
- 物理疗法物理治疗
背景情况:
- 部疾病 (TMD) 是 orofacial 疼痛的一个重要原因.
- 了解评估程序的临床特征对于评估TMD损伤和治疗有效性至关重要.
研究的目的:
- 为了调查时关节 (TMJ) 检查程序的可靠性,最小可检测变化 (MDC95) 和95%的协议限制.
- 为了确定特定的TMJ评估技术的临床特征.
主要方法:
- 在50个无症状的成年人中评估了闭塞,下动力学 (最大切口口,后部突出,突出活动运动范围 - - AROM),听觉,敏感性和关节运动.
- 在单个会议内评估评价者之间的可靠性,并在24-48小时内评估评价者内的可靠性.
- 使用类内相关系数 (ICC) 和卡帕值来确定测量可重复性.
主要成果:
- 对于闭塞和AROM.发现了高的内部评价可靠性 (ICC ≥ 0.75) 和良好的内部评价可靠性 (ICC ≥ 0.68).
- 关节移动性 (Kappa = 0.18) 和侧面状骨触摸 (Kappa ≥ 0.48) 的评价者间协议显示了局限性.
- 最小可检测的变化 (MDC95) 为闭塞1毫米,AROM为3-6毫米.
结论:
- 活动运动范围 (AROM) 和闭塞测量显示出足够可靠的临床使用.
- 临床医生应该承认关节移动性和侧面状骨触摸测量的差异很大.
- 需要3-6毫米的AROM变化或1毫米的遮变化才能自信地检测出超出测量误差的真实变化.
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