手持式压力测痛仪的信度及效度检验

Reliability and validity of the hand-held pressure algometer as a measuring instrument of pressure pain threshold

目的检验手持式压力测痛仪在压痛阈测量中的信度和效度。方法研究分为两个阶段。第一阶段：3名施测者分别使用手持式压力测痛仪对37名健康正常受测者全身共12个部位进行压痛阈测量。第二阶段：1名施测者使用手持式压力测痛仪对10名肌筋膜痛综合征患者进行压痛阈测量，并采用目测类比评分法（VAS）进行评估。分别计算组内相关系数和Spearman相关系数以评估信度和效度。结果重测信度及施测者间信度均较高（ICC〉0．95），重测信度优于施测者间信度；根据同一施测者3次重复测量结果的均值所计算的施测者间信度高于单次测量的施测者间信度；肌筋膜痛患者激痛点与正常对照点的压痛阈差异具有统计学意义，激痛点压痛阈值与VAS评分呈显著的负相关。结论手持式压力测痛仪测量正常健康人压痛阈时具有较高信度，其可作为量化评价激痛点疼痛敏感性的有效工具。

Objective To evaluate the test-retest and inter-rater reliability of the hand-held pressure algom- eter as a measuring instrument of pressure pain threshold （PPT）. Method A total of 37 healthy subjects were re- cruited for reliability test. Three raters measured the PPT at 12 body sites of the subjects. Each rater conducted three trials on each site. In the validity test, 10 patients with active trigger points in the upper trapezius were recruited and measured by one rater using the pressure algometer for PPT, the visual analogue scale （VAS） was also used to evalu- ate the pain intensity induced by the trigger point. The intraclass correlation coefficient and Spearman correlation co- efficient were calculated to reflect the reliability and validity. Results The test-retest and inter-rater reliabilitics were both high （ ICC 〉 0.95 ） , with the measurements by one rater were more reliable than measurements by multiple raters. The inter-rater reliability of PPT measurement obtained by using the mean value of 3 trials was higher than any of the 3 trials alone. The PPT values of the trigger points were higher than those of the normal points, and there was a significantly negative correlation between the PPT values of the trigger points and the VAS scores. Conclusion The intra- and inter-rater PPT measurements in healthy subjects obtained with the hand-held pressure algometer were highly reliable. The algometer was valid for quantifying myofascial trigger point sensitivity.