Intra- und Intertester-Reliabilität klinischer Tests zur Untersuchung der Bewegungskontrolle bei Patienten mit Nackenschmerzen

Zusammenfassung

Hintergrund Nackenschmerzen sind weltweit eine häufig auftretende Gesundheitseinschränkung. Der große Anteil von Patienten mit unspezifischen Nackenschmerzen kann in Subgruppen eingeteilt werden. Eine dieser Subgruppen sind Patienten mit Bewegungskontrollproblemen. Für eine eindeutige Identifizierung dieser Gruppe sind zuverlässige Messverfahren notwendig. Es gibt eine Vielzahl verschiedener Tests zur Überprüfung der Bewegungskontrolle. Bisher liegt kein Review über den aktuellen Forschungsstand zur Intertester- und Intratester-Reliabilität der vielen Bewegungskontrolltests ohne technische Geräte bei Patienten mit Nackenschmerzen vor.

Ziel Das Ziel der Arbeit ist es, die aktuell vorhandene Evidenz zur Intratester- und Intertester-Reliabilität von Bewegungskontrolltests bei Patienten mit Nackenschmerzen zu untersuchen.

Methode Die Recherche fand im April 2017 bei Medline, Cochrane und PEDro unter anderem mit den Suchbegriffen „neck pain“ [Mesh], „reproducibility of results“ [Mesh], „reliability“ und „movement control impairment“ sowie einer Vielzahl von Synonymen statt. Um das Bias-Risiko der eingeschlossenen Studien zu ermitteln, wurde die QAREL-Checkliste verwendet [17]. Eine Autorin extrahierte die Studien- und Patientencharakteristika.

Ergebnisse 4 Studien mit einem geringen (8/11) bis moderaten (7/11) Bias-Risiko wurden eingeschlossen. Die Intertester-Reliabilität der 26 Tests lag zwischen ausreichend und sehr gut (k = 0,32 – 1,0), die Intratester-Reliabilität der 11 Tests war moderat bis sehr gut (k = 0,59 – 0,92). Lediglich 3 Tests wurden von je 2 Studien, alle anderen Tests jeweils nur von 1 Studie überprüft. Der am besten untersuchte und beurteilte Test zur Einschätzung der Bewegungskontrolle der HWS war der Test „Blickstabilität“.

Schlussfolgerung Weitere Studien sollten neben der Untersuchung der Validität einzelner Tests eine Testbatterie zur zuverlässigen Beurteilung der Bewegungskontrolle der HWS entwickeln.

Abstract

Background Neck pain is worldwide a common health restriction. The high proportion of patients with unspecific neck pain can be allocated into subgroups. One of these is subgroups are patients with movement control problems. For a distinct identification of this group reliable assessment methods are required. There are many different tests used to examine movement control. To date there exist no reviews regarding the current state of evidence of the intertester and intratester reliability of multiple movement control tests without technical devices in patients with neck pain.

Objective The aim of this study is to evaluate the current state of evidence of the intertester and intratester reliability of movement control tests in patients with neck pain.

Method The literature research in April 2017 in Medline, Cochrane and PEDro used among others the terms “neck pain” [Mesh], “reproducibility of results” [Mesh], “reliability” and “movement control impairment” as well as multiple synonyms. In order to evaluate the included studies’ risk of bias the QAREL checklist was employed [17]. One of the authors extracted the study and patient characteristics.

Results 4 studies with poor (8/11) to moderate (7/11) risk of bias were included. The intertester reliability of the 26 tests ranged from fair to very good (k = 0.32 – 1.0), the intratester reliability of the eleven tests ranged from moderate to very good (k = 0.59 – 0.92). Only 3 tests were evaluated in 2 studies, the others were merely evaluated in 1 study. The best investigated test for the evaluation of the cervical spine’s movement control was the test “Blickstabilität”.

Conclusion Future studies should in addition to the evaluation of the validity of single tests develop a reliable test battery for the assessment of the cervical spine’s movement control.

Schlüsselwörter

Nackenschmerzen - Reproduzierbarkeit der Ergebnisse - Assessments - Bewegungskontrolle

Key words

neck pain - reproducibility of results - assessments - movement control

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