Primerjava občutljivosti dveh manualnih kliničnih testov za prepoznavanje poškodb sprednje križne vezi : pregled literature

Krečič, Katja (author), Divjak, Mojca (mentor)

Uvod: V našem vsakdanu je telo izpostavljeno fizičnemu stresu, ki ga zmore prenesti le do določene mere, ko pa je le ta prekoračena, nastopijo težave. Kolenski sklep je med najbolj dovzetnimi za poškodbe. Za prepoznavanje poškodbe sprednje križne vezi nam je na voljo več manualnih kliničnih testov. Med njimi izbiramo na podlagi merskih lastnosti. Občutljivost je ena od teh, pove pa, da je ob pozitivnem testu poškodba tudi prisotna. Namen: Namen diplomskega dela je primerjati občutljivost Lachman in Pivot Shift testa za prepoznavanje poškodb sprednje križne vezi, merjene v budnosti in anesteziji. Preveriti želimo tudi, ali v izbrani literaturi poročajo še o drugih dejavnikih, ki bi lahko vplivali na občutljivost navedenih manualnih kliničnih testov. Metode dela: Diplomsko delo je zastavljeno kot pregled literature. Knjižno gradivo je bilo pridobljeno s pomočjo COBISS OPAC iz knjižnice Zdravstvene fakultete. Spletni viri so bili iskani s pomočjo podatkovnih baz BioMed Central, Cinahl, Coohrane Library, MEDLINE, MedScape, PEDro, PubMed, ScienceDirect, SpringerLink in spletnima iskalnikoma DiKUL in Google Scholar. Iskanje je bilo omejeno na slovenski in angleški jezik, časovno pa na objave med leti 2012 in 2016. Rezultati: Izmed pridobljenih študij jih je petnajst ustrezalo našim kriterijem. Po obliki so bile eksperimentalne, opisno analitične, prospektivno analitične, pregledi literature, retrospektivne in metaanalize. Enajst jih je obravnavalo občutljivost Lachman in Pivot Shift testa, tri le Lachman test, ena pa le Pivot Shift test. Štiri študije so obravnavale občutljivost merjeno v budnosti in anesteziji, osem le v budnosti in trije prispevki le v anesteziji. V prispevkih so bili preiskovanci stari od 12 do 70 let, vključenih je bilo od 60 do 2502 preiskovanca. V vseh prispevkih je bilo vključenih manj žensk, od 17,4 % do 37,4 % preiskovancev. Občutljivost Lachman testa v budnem stanju je segala od 55 % do 94 %, v anesteziji pa od 89 % do 100 %, Pivot Shift testa v budnosti od OB 24 % do 79 % in v anesteziji od OB 73 % do 100 %. Razprava in sklep: Rezultati so pokazali, da je občutljivost Lachman testa višja od Pivot Shift testa, pri obeh pa se v anesteziji poviša.

• Language: Slovenian
• Keywords: Lachmna, Pivot Shift, senzitivnost, občutljivost, kolenski sklep
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-92539
• COBISS.SI-ID: 5274731
• Publication date in RUL: 09.06.2017

Secondary language

• Language: English
• Title: Comparison of the sensitivity between two manual clinical tests to detect rupture of anterior cruciate ligament : literature review

Abstract

Introduction: In our everyday life human body is being constantly exposed to physical stress, but it has only limited endurance capacity. When this is exceeded, damage to the body occurs. The knee is most susceptible part of human body to the trauma. To identify injury to the anterior cruciate ligament, we can perform several manual clinical tests. The performance of an appropriate test depends on its statistical measures. Sensitivity is of those; it tells us the proportion of injuries that are correctly identified as such. Purpose: The purpose of this thesis is to compare the sensitivity of Lachman test and Pivot Shift test for identifying injuries of the anterior cruciate ligament in awake subjects and in anaesthetized subjects. We also want to review current literature in other to identify other factors that might affect sensitivity of above mentioned manual clinical tests. Methods: The thesis is conceived as a review of current literature, accessible through COBISS OPAC of the Faculty of Health Sciences. Online sources have been searched through the databases of BioMed Central, Cinahl, Coohrane Library, MEDLINE, MedScape, PEDro, PubMed, ScienceDirect, SpringerLink, and through online search engines ikoma DiKUL and Google Scholar. The search was limited to the Slovenian and English language, and to the time frame from 2012 to 2016. Results: Among reviewed literature, fifteen articles fit selected search criteria. According to the form of these contributions they included experimental studies, descriptive studies, analytical research, prospective and retrospective studies, review articles and meta-analysis. Eleven of these articles discussed sensitivity of both Lachman and Pivot Shift tests, three only Lachman test, one article only Pivot Shift test. Four articles dealt with sensitivity measured in awake and anaesthetized subjects, eight only in awake subjects and three articles of only anaesthetized subjects. In the selected contributions, subjects were aged from 12 to 70 years. Number of participants was from 60 to 2502 with uneven distribution of demographic data ‒ female patients represented only from 17,4 % to 37,4 % of all included subjects. Sensitivity of Lachman test in awake 55 % to 94 % and anaesthetized participants ranges from 89 % to 100 %, in Pivot Shift test from 24 % to 79% in awake and from 73 % to 100 % in anaesthetized participants. Discussion and conclusions: The thesis demonstrates that upon reviewed results Lachman test has a higher sensibility that Pivot Shift test. Sensitivity is higher among anaesthetized participants for both of tests.

• Keywords: Lachman, Pivot Shift, sensitivity, knee joint