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关节角度测量四点法的临床价值
引用本文:伊文超,胡建平,励建安,蒋祥龙,宗敏,穆西虎,金鸿,赵正恩.关节角度测量四点法的临床价值[J].中华物理医学杂志,2011,33(6).
作者姓名:伊文超  胡建平  励建安  蒋祥龙  宗敏  穆西虎  金鸿  赵正恩
作者单位:伊文超,励建安,YI Wen-chao,LI Jian-an(南京医科大学附属第一医院康复医学科,南京,210029);胡建平,蒋祥龙,HU Jian-ping,JIANG Xiang-long(南京瑞海博康复医院);宗敏,穆西虎,ZONG Min,MU Xi-hu(江苏省人民医院放射科);金鸿,赵正恩,JIN Hong,ZHAO Zheng-en(绵竹市人民医院康复医学科)
摘    要:目的 比较膝关节角度三点测量法与四点测量法的信度和效度.方法 无膝关节运动障碍者25例,在膝关节处于伸直、小角度屈曲及大角度屈曲3种位置进行三点法和四点法角度测量,拍摄X线片作为金标准.采用Bland-altman法(95%一致性区间,LOA)进行信度和效度分析.结果 关节轴心随角度变化而位移.信度(95%LOA):测量者间四点法(-5.0,2.7),三点法(-6.5,4.4);测量者内四点法A(-3.6,4.0)、B(-4.1,4.8),三点法A(-5.0,6.4)、B(-6.1,5.8).效度(95%LOA):3种关节位置测量四点法分别为(3.5,2.6)、(-3.3,3.6)和(-1.9,5.7);三点法分别为(6.8,1.1)、(-4.0,7.1)和(0,8.5).结论 关节角度测量轴心随角度变化而移位,四点法的信度和效度优于传统三点法.
Abstract:
Objective To study the clinical value of using a four-point method (FP) in measuring joint angles.Method Methods Twenty-five subjects without knee dysfunction were studied.Every knee joint was tested in extension,below 90° of flexion and above 90° of flexion with the traditional three-point method (TP) and the new four-point method.X-rays were taken as a gold standard measurement.The reliability and validity were analyzed using Bland-Altman plots,which can yield 95% limits of agreement (LOA).Results (1) The joint axis centers moved with changes in joint angle.(2) The 95% LOA of inter-tester reliability was (-5.0,2.7) with the FP and (-6.5,4.4) with the TP.The 95% LOAs of intra-tester reliability were (-3.6,4.0) for tester A and (-4.1,4.8) for tester B with the FP,while (-5.0,6.4) for tester A and (-6.1,5.8) for tester B with the TP.(3) The 95% LOAs in the three positions were (3.5,2.6) in extension,(-3.3,3.6) in mild flexion and (-1.9,5.7) in greater flexion with the FP,and ( 6.8,1.1),(-4.0,7.1) and (0,8.5) with the TP.Conclusions The FP gives better reliability and validity than the TP in joint angle measurement.

关 键 词:关节角度  关节活动度  关节中心  三点法  四点法

The clinical value of using a four-point method to measure joint angles
YI Wen-chao,HU Jian-ping,LI Jian-an,JIANG Xiang-long,ZONG Min,MU Xi-hu,JIN Hong,ZHAO Zheng-en.The clinical value of using a four-point method to measure joint angles[J].Chinese Journal of Physical Medicine and Rehabilitation,2011,33(6).
Authors:YI Wen-chao  HU Jian-ping  LI Jian-an  JIANG Xiang-long  ZONG Min  MU Xi-hu  JIN Hong  ZHAO Zheng-en
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