腱板損傷の身体所見の感度, 特異度を評価したMeta-analysis
身体所見は以下の通り
|
疼痛誘発試験
|
感度(%)
|
特異度(%)
|
LR+
|
LR-
|
|
Painful arc
|
71[60-83]
|
81[68-93]
|
3.7[1.9-7.0]
|
0.36[0.23-0.54]
|
|
Cross-body adduction
|
75[64-85]
|
61[46-76]
|
1.9[1.3-2.9]
|
0.42[0.26-0.68]
|
|
Hawkins
|
76[56-89]
|
48[23-74]
|
1.5[1.1-2.0]
|
0.51[0.39-0.66]
|
|
Neer
|
64-68
|
30-61
|
0.98-1.6
|
0.60-1.1
|
|
Yocum
|
79[61-97]
|
40[10-70]
|
1.3[0.75-2.3]
|
0.53[0.17-1.7]
|
|
Passive abduction
|
74[54-93]
|
10[0-29]
|
0.82[0.58-1.1]
|
2.6[0.35-20]
|
|
筋力テスト
|
感度(%)
|
特異度(%)
|
LR+
|
LR-
|
|
External rotation lag
|
47[21-71]
|
94[85-100]
|
7.2[1.7-31]
|
0.57[0.35-0.92]
|
|
Internal rotation lag
|
97[88-100]
|
83[70-96]
|
5.6[2.6-12]
|
0.04[0.0-0.58]
|
|
Drop arm
|
24[13-34]
|
93[85-100]
|
3.3[1.0-11]
|
0.82[0.70-0.97]
|
|
Dropping sign
|
73[51-95]
|
77[62-92]
|
3.2[1.6-6.5]
|
0.35[0.15-0.83]
|
|
Gerber (lift-off test)
|
34-68
|
50-77
|
1.4-1.5
|
0.63-0.85
|
|
疼痛, 筋力低下試験
|
感度(%)
|
特異度(%)
|
LR+
|
LR-
|
|
External rotation resistance
|
63[49-77]
|
75[69-82]
|
2.6[1.8-3.6]
|
0.49[0.33-0.72]
|
|
Full can
|
75[64-85]
|
68[54-83]
|
2.4[1.5-3.8]
|
0.37[0.23-0.60]
|
|
Patte
|
58[36-80]
|
60[30-90]
|
1.4[0.62-3.4]
|
0.70[0.34-1.5]
|
|
Empty can
|
71[49-86]
|
49[42-56]
|
1.3[0.97-1.6]
|
0.64[0.33-1.3]
|
|
Resisted abduction
|
58[36-80]
|
20[0-45]
|
0.72[0.55-8.1]
|
2.1[0.55-8.1]
|
|
Combination
|
感度(%)
|
特異度(%)
|
LR+
|
LR-
|
|
Hawkins and Neer
|
78[66-90]
|
50[22-78]
|
1.6[0.87-2.8]
|
0.43[0.20-0.96]
|
腱板損傷の評価に有用な所見は,
Painful arc, External rotation lag, Internal rotation lag, Drop arm, Dropping signの5つ
"腱板損傷の所見"で記載した, Empty can testのLR-はMetaでは大したことありませんでした.
それ以外の有用な所見は今回のMetaでも同様で, これら5つの所見はやはり押さえておくべきでしょう.
