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Merske lastnosti manualnih testov za prepoznavanje okvar komolčnega sklepa – pregled literature : diplomsko delo
ID Kropar, Lucija (Author), ID Hlebš, Sonja (Mentor) More about this mentor... This link opens in a new window, ID Vauhnik, Renata (Reviewer)

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Abstract
Uvod: Kompleksno gibanje komolčnega sklepa, zlasti pri ponavljajočih se gibih, poveča možnost okvar komolčnega sklepa. Med pogoste okvare komolčnega sklepa spadajo pretrganje kite mišice biceps brachii, lateralni epikondilitis in nestabilnost medialnega ter lateralnega kolateralnega ligamenta. Podatki za diagnostično natančnost manualnih testov za prepoznavanje okvar komolčnega sklepa so v literaturi nasprotujoči. Z izbiro dovolj diagnostično natančnega manualnega testa se je mogoče izogniti nepotrebnemu obremenjevanju pacienta, zamujanju z diagnozo in odvečnim stroškom pri opravljanju dodatnih diagnostičnih preiskav. Namen: Namen diplomskega dela je na podlagi pregleda literature predstaviti merske lastnosti diagnostičnih manualnih testov za prepoznavanje okvar komolčnega sklepa. Metode dela: Iskanje literature je potekalo preko spletnih virov v podatkovnih zbirkah PubMed, PEDro in Google Scholar ter s posameznim iskanjem v referencah že objavljenih pregledov literature. Kombinacije iskalnih ključnih besed v angleškem jeziku, ki so bile uporabljene so naslednje: elbow joint, physical examination of the elbow, diagnostic accuracy, testing, manual test, validity, specificity, sensitivity. Rezultati: V pregled literature je bilo vključenih devet raziskav, v katerih so avtorji proučevali lastnosti diagnostičnih manualnih testov za prepoznavanje okvar komolčnega sklepa. Diagnostična natančnost je bila ocenjena na podlagi rezultatov občutljivosti, specifičnosti, pozitivne in negativne napovedne vrednosti ter pozitivnega in negativnega razmerja verjetnosti. Pri prepoznavanju popolnih pretrganj kite mišice biceps brachii se je kot najbolj diagnostično natančen izkazal test pasivne pronacije podlakti, za delno pretrganje kite mišice biceps brachii nobeden izmed testov zaradi prenizke občutljivosti ni primeren za klinično rabo. Pri prepoznavanju lateralnega epikondilitisa ima najboljšo diagnostično natančnost dinamični test moči prijema. Kot najbolj diagnostično natančen test za prepoznavanje nestabilnosti medialnega kolateralnega ligamenta se je izkazal stresni valgus test v gibanju, za prepoznavanje nestabilnosti lateralnega kolateralnega ligamenta pa posterolateralni rotacijski predalčni test. Razprava in zaključek: Diagnostična natančnost manualnih testov je precej variirala med posameznimi okvarami komolčnega sklepa. Med vsemi analiziranimi testi je imel najboljše rezultate občutljivosti in specifičnosti posterolateralni rotacijski predalčni test. Pri nekaterih raziskavah je za vrednotenje diagnostične natančnosti manjkal podatek o specifičnosti, omejitve so bile tudi majhno število in pristranska izbira preiskovancev, precenjena pozitivna napovedna vrednost ter uporaba diagnostično nenatančnih referenčnih testov. V prihodnje bi bilo potrebno vključiti le raziskave, ki so uporabile dovolj dobre referenčne teste.

Language:Slovenian
Keywords:diplomska dela, fizioterapija, okvara komolčnega sklepa, manualni testi, občutljivost, specifičnost, diagnostična natančnost
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[L. Kropar]
Year:2024
Number of pages:28 str., [5] str. pril.
PID:20.500.12556/RUL-155091 This link opens in a new window
UDC:615.8
COBISS.SI-ID:189579267 This link opens in a new window
Publication date in RUL:20.03.2024
Views:173
Downloads:34
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Secondary language

Language:English
Title:Metric properties of manual tests for identifying defects of the elbow joint – literature review : diploma work
Abstract:
Introduction: Complex motion of the elbow joint especially in repetitive motions increases the possibility of an elbow joint defect. Common elbow injuries include biceps brachii tendon tears, lateral epicondylitis, and instability of the medial and lateral collateral ligaments. Data on the diagnostic accuracy of manual tests to identify defects of the elbow joint is contradictory in the literature. By choosing a sufficiently diagnostically accurate manual test it is possible to avoid unnecessary burden on the patient, delay in diagnosis and unnecessary cost of performing additional diagnostic tests. Purpose: The purpose of this paper is to present the metric properties of manual tests for identifying defects of the elbow joint based on a review of the literature. Methods: The literature search was carried out through online sources in PubMed, PEDro and Google Scholar databases and by individual searches in references of already published literature reviews. The keyword combinations used are elbow joint, physical examination of the elbow, diagnostic accuracy, testing, manual test, validity, specificity, sensitivity. Results: The literature review included nine articles in which the authors studied the properties of diagnostic manual tests for the identification of elbow joint defects. Diagnostic accuracy was assessed based on the results of sensitivity, specificity, positive and negative predictive values, and likelihood ratios. In the identification of total tears of the biceps brachii muscle tendon the passive forearm pronation test proved to be the most diagnostically accurate, for partial rupture of the biceps brachii muscle tendon none of the tests is suitable for clinical use due to low sensitivity. When identifying lateral epicondylitis, the dynamic grip strength test has the best diagnostic accuracy. Stress valgus test in motion proved to be the most diagnostically accurate test for identifying instability of the medial collateral ligament and posterolateral rotary drawer test for identifying instability of the lateral collateral ligament. Discussion and conclusion: The diagnostic accuracy of manual tests varied considerably between individual defects of the elbow joint. Of all the tests analysed the posterolateral rotatory drawer test had the best results in sensitivity and specificity. Some studies lacked information on specificity for the evaluation of diagnostic accuracy, other limitations were also small number and biased selection of subjects, overestimated positive predictive value and the use of diagnostically inaccurate reference tests. In future, only studies using sufficiently good reference tests should be included.

Keywords:diploma theses, physiotherapy, elbow joint defect, manual tests, sensitivity, specificity, diagnostic accuracy

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