慢性非特异性颈痛患者颈椎运动觉测试的信度与效度研究  

The reliability and validity of cervical movement sense measurement in patients with chronic non-specific neck pain

作　　者：谢凌锋 赵益民 郑倩 汪航 徐江[1] 黄晓琳[1] XIE Lingfeng;ZHAO Yimin;ZHENG Qian(Department of Rehabilitation,Tongji Medical College of Huazhong University of Science&Technology,Tongji Hospital,Wuhan,Hubei,430030)

机构地区：[1]华中科技大学同济医学院附属同济医院康复医学科,湖北省武汉市430030

出　　处：《中国康复医学杂志》2024年第12期1829-1833,共5页Chinese Journal of Rehabilitation Medicine

基　　金：国家卫生健康委医药卫生科技发展研究中心课题。

摘　　要：目的:探究颈椎运动觉(CMS)评估中横8图形测试及ZZ图形测试的可信性,以及在评估慢性非特异性颈痛患者中的有效性研究。方法:本研究招募受试者71例,其中慢性非特异性颈痛患者35例,健康受试者36例。两名评估人员分别对受试者进行横8图形测试及ZZ图形测试,视频录制其测试过程并通过慢速播放对受试者测试进行评分。采用组内相关系数(ICC)计算其评估者内/间信度,颈痛组和健康组进行组间对比,对差异有显著性意义的指标进行效度分析。结果:ZZ图形测试及横8图形测试的评估者内/间ICC分别为0.813/0.832和0.892/0.908,对应的评估者内/间的测量误差(SEM)分别为1.15/1.10,1.24/1.37,最小可检测变化(MDC)分别为3.18/2.73,3.44/3.05。慢性非特异性颈痛患者与健康者的ZZ图形测试及横8图形测试结果存在显著差异(P<0.05)。用于区分正常人和慢性非特异性颈痛患者的ZZ图形试验和横8图形试验的理想界值分别为10.5,16.3。结论:颈椎运动觉(CMS)评估中横8图形测试及ZZ图形测试具有较好的评估者内及评估者间信度;同时在一定程度上,可帮助区分慢性非特异性颈痛患者及健康人群,可考虑作为慢性非特异性颈痛患者的颈部运动觉评估方法。Objective:To observe the validity of the transversal 8(T8)graphs and zigzag(ZZ)graphs tests in the measurement of cervical movement sense(CMS),and to study their effectiveness in evaluating patients with chronic non-specific neck pain.Method:A total of 71 subjects were recruited,including 35 with chronic non-specific neck pain and 36 healthy subjects.Two groups of researchers separately conducted tests(T8 and ZZ)to the subjects twice,recorded the test process and scored the test by slow playback.The intra-and inter-rater reliability was quantified in terms of inter-class correlation coefficients(ICCs)and the difference in index between the two groups was also determined for validity.Result:The intra-and inter-rater ICC for ZZ graph and T8 graph tests were 0.813/0.832 and 0.892/0.908,the corresponding standard error of measurement(SEM)values were 1.15/1.10,1.24/1.37,while the minimal detectable change(MDC)values were 3.18/2.73,3.44/3.05.There was a significant difference in the results of the ZZ graphs and the T8 graphs tests between patients with chronic non-specific neck pain and healthy individuals(P<0.05).The ideal cut-off values using to distinguish normal individuals from patients with chronic nonspecific neck pain are 10.5 for ZZ graphs test and 16.3 for T8 graphs test.Conclusion:The T8 graphs and ZZ graphs tests showed good intra-and inter-raters reliability in assessing cervical movement sense,which can help distinguish patients with chronic non-specific neck pain and the healthy individuals.They can be considered as a cervical movement sense assessment method in the patients with chronic non-specific neck pain.

关 键 词：颈椎 本体感觉 信度 效度 关节运动觉 

分 类 号：R684[医药卫生—骨科学] R493[医药卫生—外科学]