非特异性腰痛的智能化康复评估系统的构建及信度检验  

Construction and reliability test of intelligent rehabilitation evaluation system for nonspecific low back pain

作　　者：邵雨薇 余达蔚 苏杭 田峻[1] 胡艳 SHAO Yuwei;YU Dawei;SU Hang;TIAN Jun;HU Yan(Department of Rehabilitation Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071)

机构地区：[1]武汉大学中南医院康复医学科,武汉430071

出　　处：《颈腰痛杂志》2025年第1期25-31,共7页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的构建针对非特异性腰痛的智能化康复评估系统(RAS-NLBP),并检验RAS-NLBP在非特异性腰痛(NLBP)患者亚型分组中的信度,为临床应用提供客观依据。方法通过查阅文献、书籍及临床经验总结,以美国物理治疗协会骨科分会发布的临床指南为依据,归纳整理与NLBP亚型密切相关的疾病特征及体格检查,并以此来构建RAS-NLBP。由不同身份、不同年资的医务人员分别对53例NLBP患者采用徒手评估和RAS-NLBP系统评估。利用ICC系数检验医师徒手测量和智能化测量的关节活动度(ROM)、治疗师徒手测量和智能化测量的ROM以及医师和治疗师分别智能化测量的ROM的重测信度。利用Kappa系数对不同身份医务人员通过RAS-NLBP评估后的分组结果信度、相同身份不同年资医务人员分别通过徒手评估和RAS-NLBP评估后的分组结果信度进行检验。结果RAS-NLBP由数据测量采集模块、存储模块、计算模块和数据库模块共同组成。系统构建后经过了由康复医师、康复治疗师和政策制定人员组成的专家团队的2轮专家论证,并得到专家的认可。不同评估者利用RAS-NLBP得出的分组结果的Kappa系数为0.856(P<0.05),不同年资的医师分别利用ICF指南和RAS-NLBP系统评估得出的分组结果的Kappa系数为0.759(P<0.05)。ROM数据采集的评估者间和评估者内的ICC系数均在0.75以上(P<0.05)。结论RAS-NLBP的构建具有实际意义,其数据采集具有较高信度,对NLBP患者的亚型分组具有较高的分类一致性。Objective To construct an intelligent rehabilitation evaluation system(RAS-NLBP)for nonspecific low back pain,and to test the reliability of RAS-NLBP in subtype grouping of patients with nonspecific low back pain(NLBP),so as to provide objective basis for clinical application.Methods By consulting literature,books and summarizing clinical experience,based on the clinical guidelines issued by the Orthopedic Branch of the American Physiotherapy Association,the characteristics of diseases and physical examinations closely related to NLBP subtypes were summarized,and RAS-NLBP was constructed.53 patients with NLBP were evaluated by bare-handed and RAS-NLBP system by medical staff with different identities.ICC coefficient was used to test the retest reliability of range of motion(ROM)measured by doctors'hands and intelligently,ROM measured by therapists hands and intelligently,and ROM measured by doctors and therapists intelligently respectively.Kappa coefficient was used to test the reliability of grouping results of medical staff with different identities after RAS-NLBP evaluation,and the reliability of grouping results of medical staff with the same identity and different seniority after RAS-NLBP evaluation respectively.Results RAS-NLBP consisted of data acquisition module,storage module,calculation module and database module.After the system was built,it passed two rounds of expert argumentation by an expert team composed of rehabilitation doctors,therapists and policy makers,and was recognized by experts.The Kappa coefficient of grouping results obtained by different appraisers using RAS-NLBP was 0.856(P<0.05),and the Kappa coefficient of grouping results obtained by doctors with different seniority using ICF guidelines and RAS-NLBP system was 0.759(P<0.05).The ICC coefficients of ROM data collection were above 0.75(P<0.05).Conclusion The construction of RAS-NLBP has practical significance,its data collection has high reliability,and it has high classification consistency for subtype grouping of NLBP patients.

关 键 词：非特异性腰痛 国际功能、残疾和健康分类 康复评估 信度 智能化 活动度 

分 类 号：R496[医药卫生—康复医学]