- 期刊
Intrarater and Interrater Reliability of the Measurement of Leg Length
腿長皮尺量法之可信度
摘要
測量雙腿長度為評估下肢各關節功能之重要步驟之一，因此臨床上，許多學者發展出各式各樣的腿長定量測量法。包括X光測量法、電腦斷層攝影測量法、骨盆水平測量法、墊高法、足跟水平法、皮尺量法等等，不勝枚舉。其中以腿長皮尺量法最為物理治療師所用，而其可信度之爭議頗眾，故本研究擬控制可能之變數，重新測量其使用之可信度。本研究之目的在於測定物理治療師對於腿長皮尺量法重複測量之可信度與測量者問之可信度。本研究之受試者共30名，每名受試者皆先接受問卷調查與下肢篩檢測驗，以確認其並無下肢關節功能障礙。測量者為2名物理治療師，其中一名為骨科專科物理治療師，具8.5年臨床經驗；而另一名為一般物理治療師，具0.5年臨床經驗。本研究採用單盲測試，亦即測量工具之皮尺均以白紙覆蓋其上之數字，以免測量者看到，因記憶而產生誤差。每一名受試者之雙腿長度皆由此2名物理治療師測量，測量時，由測量者將皮尺一端固定於腸骨之前上腸脊，再將皮尺延長，通過臏骨中央，乃至於腔骨之內髁。測量者於皮尺之白紙上做好記號，由另一名物理治療師剪開白紙，記錄下正確的數字。每一條腿皆測量3次，其順序為先測右腿再測左腿。將所得數據輸入電腦，並採用SPSS-PC軟體來分析其可信度。結果顯示，對於兩名物理治療師而言，其腿長皮尺量法均有極高之重複測量可信度，其ICC值約為0.996-0.998, 此與其臨床經驗多寡無關。比較2名物理治療師問之數據顯示，腿長皮尺量法亦具有極佳之測量者間可信度(ICC=0.975-0.991)：如採用三次測量之平均值來比較，則其可信度亦近似(ICC=0.978=0. 993)。本研究結果說明對於沒有下肢關節病變者，腿長皮尺量法仍不失為一可信賴之臨床測量法。然而由於可能造成腿長皮尺量法之誤差原因有腿骨不對稱彎曲、受測者過度肥胖、骨盆傾斜、下肢關節攣縮、大腿腿圍不等長，此皆不為本研究之受試者所具有，因此未來研究方向，應採用此類患者為研究對象，以確定腿長皮尺量法於各類病患之可信度。
並列摘要
The purposes of this study are to determine 1) the intrarater reliability of repeated leg length measurements with a tape measure and 2) the interrater reliability of leg length measurements with tape measure between two examiners. Thirty healthy subjects were measured their leg lengths in a blind method A pliable regular ruler covered with a blank sheet was used as a measurement tool. The leg length is measured from the anterior superior iliac spine to the medial malleolus. Both legs of each subject were evaluated 3 times by 2 physical therapists. Intraclass correlation coefficients (ICC) was used to analyze the data. The results of three separate trials showed that each physical therapist had significantly high intrarater reliability (ICC=.996-.998). Two examiners agreement was noted as well by highly significant intraclass correlation either in any separate trials (ICC=.975-.991) or in the mean values of the each three trials (ICC=.978-.993). These findings indicate that the leg length can be reliably measured with a tape measure from the anterior superior iliac spine to the medial malleolus in clinical use.