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

关键词：颈椎  本体感觉  信度  效度  关节运动觉

Keywords:cervical  proprioception  reliability  validity  joint movement sense

摘要：

      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。

Abstract:

      Abstract 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 non-specific 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.