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manuelletherapie 2015; 19(04): 167-179
DOI: 10.1055/s-0035-1564335
Originalia
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Ist das Messen von Widerständen während passiver Bewegung ein zuverlässiges Assessment-Tool?

Systematischer ReviewIs the Measurement of Resistance during Passive Movements a Reliable Assessment Tool?Systematic Review
Harry von Piekartz
1   Fakultät Wirtschafts- und Sozialwissenschaften, Hochschule Osnabrück, Caprivistr. 30; 49076 Osnabrück
,
T. Szikszay
› Institutsangaben
Weitere Informationen

Publikationsverlauf

30. Juni 2014

01. September 2014

Publikationsdatum:
16. September 2015 (online)

    Lizenzen und Reprints

Zusammenfassung

Passive manuelle Bewegungen von Gelenk- und Neuralstrukturen werden häufig mit einem ersten (R 1 = erster fühlbarer Widerstand innerhalb einer passiven Bewegung) und zweiten Widerstand (R2 = fühlbarer Widerstand am Bewegungsende) gemessen.

Die vorliegende Arbeit gibt einen Überblick über die Zuverlässigkeit der Messung von R1 und R2. In den Datenbanken PubMed (Medline), The Cochrane Database, CINAHL und Web of Science wurde in einer systematischen Literaturrecherche nach Diagnostikstudien zu R1 und R2 gesucht und die eingeschlossenen Studien mit dem Quality Appraisal of Reliability Studies Tool (QAREL) bewertet.

Die Ergebnisse zeigten widersprüchliche Reliabilität bei neurodynamischen Tests. Passive Außenrotationen bei Schulterpathologien erzielten eine gute, passive akzessorische intervertebrale Bewegungen (PAIVM) eher eine geringere Reliabilität.

R2 scheint eine höhere Reliabilität als R1 aufzuweisen, und die Intrarater-Reliabilität bei neurodynamischen Tests besser zu sein als die Interrater-Reliabilität. Für die geringe Reliabilität werden verschiedene Ursachen diskutiert. Trotz der methodischen Mängel in einigen Studien scheinen Tests mit größerem Hebel eine höhere Reliabilität zu erreichen als PAIVM.

Abstract

Passive manual movements of articular and neural structures are often assessed using a first (R1 = first perceptible resistance during a passive movement) and second resistance (R2 = perceptible end of range resistance).

This article reviews the reliability of the measurement of R1 and R2. A systematic literature research in the databases PubMed (medline), The Cochrane Database, CINAHL and Web of Science searched for diagnostic studies on R1 and R2. The included studies were evaluated using the Quality Appraisal of Reliability Studies Tool (QAREL).

The results showed inconclusive reliability of neurodynamic tests. Passive external rotation in shoulder pathologies produced good, passive accessory intervertebral movements (PAIVM) rather low reliability.

R2 seems to have a higher reliability than R1, and the intrarater reliability in neurodynamic tests seems to be better than the interrater reliability. Different sources of the poor reliability are discussed. In spite of the methodological deficits in some studies the tests with a larger lever seem to attain better reliability than PAIVM.

Schlüsselwörter

Manuelle Therapie - R1 - R2 - Reliabilität - Assessment - Gelenkbewegung - Neurodynamik

Keywords

manual therapy - R1 - R2 - reliability - assessment - articular movement - neurodynamic
 

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