改良式趾節量尺之效度研究

Validity of Modified First Ray Ruler to Measure First Ray Mobility

蔡於儒(Yu-Ju Tsai) ； 戴瑞敏(Jui-Min Tai) ； 楊卿潔(Ching-Zye Yang) ； 許瑞祈(Jui-Chi Hsu) ； 柴惠敏(Huei-Ming Chai)

《物理治療》 36卷3期 (2011/09) Pp. 233-240

摘要

背景和目的：良好的足掌功能端賴第一趾節活動度與穩定度，但臨床上缺乏有效可信的評估工具。本研究團隊改良信度較低的趾節量尺，並將量測姿勢標準化，發現可提高趾節量尺的信度，但未曾檢測其效度。因此本研究進一步以X光影像為金標準，評估改良式趾節量尺的效度。方法：以改良式趾節量尺評估5名年輕健康男性的第一趾節活動度，共進行背屈與蹠屈測試各5次，取第5次量測值與平均值分析；在第5次量測後，使用X光拍攝當時的位置。所獲得X光片均由同一名分析者以醫療影像管理系統量測第一趾節活動度，共量測3次，取其平均值分析。以皮爾森相關係數分析改良式趾節量尺與X光置測結果之相關性，代表其效度。結果：無論是背屈、蹠屈、總活動度，使用改良式趾節量尺與X光影像所測得的數據，其r值皆大於0.85，表示具有極高效度。結論：由於改良式趾節量尺效度佳，具有低科技設計、簡易操作、價位便宜、方便繃帶、即時讀取數值等優點，故值得推廣。

關鍵字

第一趾節 ； 趾節量尺 ； 活動度

並列摘要

Background and Purpose: Normal functions of the foot depend on the mobility and stability of the first ray; but, there is lack of a valid and reliable tool to measure its motion in clinical settings. Previous literatures have implicated that the first ray ruler, the only quantitative tool in clinical setting, had a poor intra- and inter-rater reliability. In a recent study, the use of a modified first ray ruler and standardization of the testing position improved the reliability to an excellent level. However, its validity has not been established yet. The purpose of this study, therefore, was to determine the validity of measuring first ray mobility using a modified first ray ruler as compared to the results from X-ray imaging. Methods: Five young healthy male adults participated in this study. Five trials of the first ray mobility test were performed and dorsal and plantar mobility of the first ray was measured using a modified first ray ruler. The fifth and the averaged data were used for analyses. X-ray images were taken at the end of the 5(subscript th) trial as the gold standard for first ray mobility variables, which were measured 3 times by the same rater using the Picture Archiving and Communication System. The averaged data from the X-ray measures were used for analyses. Pearson correlation coefficient analysis was performed for two measurements to determine the validity. Results: The results suggest that measurements of first ray mobility using the modified first ray ruler arc highly correlated with the gold standard X-ray method (r greater than 0.85). indicating good validity of measures. Conclusion: Since the modified first ray ruler has the advantages of high-validity. low-tech-design, easy-application, inexpensive, portable, and reading data immediately, this study provides support for the use of this simple-designed ruler as a quantitative measure for the purpose of evaluating first ray problems in clinical or laboratory settings.

並列關鍵字

First ray ； First ray ruler ； Mobility