Validität und Reliabilität der lumbalen PPIVM und PAIVM – Ist die Verwendung dieser Tests in der Praxis noch zeitgemäß? ^[1]

Zusammenfassung

Manualtherapeuten verwenden in der klinischen Praxis regelmäßig Gelenkmobilisationen wie PPIVM und PAIVM für die Untersuchung. Wegen ihrer widersprüchlichen Validitäts- und Reliabilitätswerte stehen sie im Fokus der wissenschaftlichen Kritik.

Dieser Review untersuchte die Praxisrelevanz der wissenschaftlichen Literatur zur Validität und Reliabilität von PPIVM sowie PAIVM und ging der Frage nach, ob diese Techniken aus dem klinischen Alltag entfernt werden sollten.

Im Allgemeinen war die Reliabilität für Symptomreproduktion höher als für intersegmentale Beweglichkeit und die Intratester- besser als die Intertester-Reliabilität. Aufgrund dieser Ergebnisse und der mangelnden Praxisrelevanz einiger Studien besteht kein Grund, lumbale PPIVM und PAIVM aus der Praxis zu entfernen. Zukünftige Untersuchungen sollten umfangreiche Test-Cluster beinhalten.

Abstract

In clinical practice manual therapists regularly use joint mobilisations such as PPIVM and PAIVM during examination. Due to their inconclusive validity and reliability performance they are in the focus of scientific criticism.

This review investigated the practical relevance of the scientific literature concerning the validity and reliability of PPIVM and PAIVM and explored the question whether these techniques should be withdrawn from clinical practice.

In general, the reliability for symptom reproduction was higher than for intersegmental mobility. The intra tester reliability was better than the inter tester reliability. Based on these results and the missing practice relevance of several studies there is no reason to withdraw lumbar PPIVM and PAIVM from practice. Future investigations should include extensive test clusters.

Schlüsselwörter

lumbale Wirbelsäule - Reliabilität - Validität - passive physiologische Bewegungen - Zusatzbewegungen

Keywords

lumbar spine - reliability - validity - passive physiological movements - passive accessory movements

1

¹ Die Arbeit wurde im Rahmen der IMTA-Instruktoren-Ausbildung durchgeführt.

• Literatur

• 1 Abbott JH, Mercer SR. Lumbar segmental hypomobility: Criterion-related validity of clinical examination items (a pilot study). NZ Journal of Physiotherapy 2003; 31: 3-9
• 2 Abbott JH, McCane B, Herbison P et al. Lumbar segmental instability: a criterion-related validity study of manual therapy assessment. BMC Musculoskelet Disord 2005; 6: 56
• 3 Abbott JH, Flynn TW, Fritz JM et al. Manual physical assessment of spinal segmental motion: intent and validity. Man Ther 2009; 14: 36-44
• 4 Binkley J, Stratford PW, Gill C. Interrater Reliability of Lumbar Accessory Motion Mobility Testing. Phys Ther 1995; 75: 786-792
• 5 Boden SD, Wiesel SW. Lumbosacral segmental motion in normal individuals. Have we been measuring instability properly? Spine 1991; 15: 571-575
• 6 Bogduk N Unpublished instruments developed in the course of the Australian National Musculoskeletal Medicine Initiative. (Personal communication 2001)
• 7 Bolton JE, Humphreys BK. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients. J Manipulative Physiol Ther 2002; 25: 141-148
• 8 CASP UK. Critical Appraisal Skills Programme – Making Sense of evidence. 2013 www.casp-uk.net (04.04.2014)
• 9 Chaitow L. The palpation reliability debate: the experts respond. Journal of Bodywork and Movement Therapies 2002; 6: 18-36
• 10 De Hertogh WJ, Vaes PH, Vijverman V et al. The clinical examination of neck pain patients: the validity of a group of tests. Man Ther 2007; 12: 50-55
• 11 Downey B, Taylor N, Niere K. Can Manipulative Physiotherapists Agree on which Lumbar Level to Treat Based on Palpation?. Physiotherapy 2003; 89: 74-81
• 12 Dvorak J, Panjabi MM, Chang DG. Functional radiographic diagnosis of the lumbar spine. Flexion – Extension and lateral bending. Spine 1991; 16: 487-602
• 13 Fritz JM, Piva SR, Childs JD. Accuracy of the clinical examination to predict radiographic instability of the lumbar spine. Eur Spine J 2005; 14: 743-750
• 14 Gonnella C, Paris SV, Kutner M. Reliability in evaluating passive intervertebral motion. Phys Ther 1982; 62: 436-444
• 15 Hayes MA, Howard TC, Gruel CR et al. Roentgenographic evaluation of the lumbar spine flexion extension in asymptomatic individuals. Spine 1989; 14: 327-331
• 16 Hicks GE, Fritz JM, Delitto A et al. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil 2003; 84: 1858-1864
• 17 Inscoe EL, Witt PL, Gross MT et al. Reliability of evaluating passive intervertebral motion of the lumbar spine. Journal of Manual and Manipulative Therapy 1995; 3: 173-143
• 18 Johansson F. Interexaminer reliability of lumbar segmental mobility tests. Man Ther 2006; 11: 331-336
• 19 Jones MA. Clinical reasoning in manual therapy. Phys Ther 1992; 72: 875-884
• 20 Jull G, Treleaven J, Versace G. Manual examination: Is pain provocation a major cue for spinal dysfunction?. Australian Journal of Physiotherapy 1994; 40: 159-165
• 21 Keating JC. Inter-Examiner Reliability of Motion Palpation of the Lumbar Spine: A Review of Quantitative Literature. Dynamic Chiropractic 1990; 8: 17
• 22 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174
• 23 Maher C, Adams R. Reliability of pain and stiffness assessments in clinical manual lumbar spine examination. Phys Ther 1994; 74: 801-811
• 24 Maitland GD. Vertebral Manipulation. London: Butterworth; 1986
• 25 Mannion A, Junge A, Fairbank JC et al. Development of a German version of the Oswestry Disability Index. Part 1: cross-cultural adaptation, reliability, and validity. Eur Spine J 2006; 15: 55-65
• 26 Margison FR, McGrath G, Barkham M et al. Measurement and Psychotherapy: Evidence-based practice and practice-based evidence. The British Journal of Psychiatry 2000; 177: 123-130
• 27 May S, Littlewood C, Bishop A. Reliability of procedures used in the physical examination of non-specific low back pain: A systematic review. Australian Journal of Physiotherapy 2006; 52: 91-102
• 28 Panzer DM. The reliability of lumbar motion palpation. J Manipulative Physiol Ther 1992; 15: 518-524
• 29 Phillips DR, Twomey LT. A comparison of manual diagnosis with a diagnosis established by a uni-level lumbar spinal block procedure. Man Ther 1996; 1: 82-87
• 30 Public Health Resource Unit England. Critical Appraisal Skills Programme (CASP) making sense of evidence. 10 questions to help you make sense of reviews. 2006 www.sph.nhs.uk/sphfiles/S.Reviews%20Appraisal%20Tool.pdf/?searchterm=review (18.02.2011)
• 31 Schneider G. The Unstable Lumbar Segment Definition and Detection. Journal of Manual & Manipulative Therapy 1993; 1: 67-72
• 32 Schreiner M. Interrater-Reliabilität passiver physiologischer intervertebraler Bewegungen in der Sagittalebene der LWS. manuelletherapie 2008; 12: 201-205
• 33 Seffinger MA, Najm WI, Adams A et al. Reliability of Spinal Palpation for Diagnosis of Back and Neck Pain: A Systematic Review of the Literature. Spine 2004; 29: E413-E425
• 34 Shields RK, Leo KC, Miller B et al. An acute care physical therapy clinical practice database for outcomes research. Physical Therapy 1994; 74: 463-470
• 35 Stochkendahl MJ, Christensen HW, Hartvigsen J et al. Manual examination of the spine: a systematic critical literature review of reproducibility. J Manip Physiol Ther 2006; 29: 475-485
• 36 Streiner DL, Norman GR. Health Measurement Scales. Oxford: Oxford University Press; 2003
• 37 Strender LE, Sjöblom AR, Sundell KR et al. Interexaminer Reliability in Physical Examination of Patients With Low Back Pain. Spine 1997; 22: 814-820
• 38 Van Trijffel E, Anderegg Q, Bossuyt PM et al. Inter-examiner reliability of passive assessment of intervertebral motion in the cervical and lumbar spine: a systematic review. Man Ther 2005; 10: 256-269
• 39 Whiting P, Rutjes AWS, Reitsma JB et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Medical Research Methodology 2003; 3: 25
• 40 Van der Wurff P, Hagmeijer RH, Meyne W. Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability. Man Ther 2000; 5: 30-36
• 41 Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther 2006; 11: 118-129