Zeitschrift für Orthopädie und Unfallchirurgie
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With a life-time prevalence of 39%, low back pain (LBP) is one of the most common musculoskeletal disorders. Correct diagnosis of underlying causes is commonly seen as a prerequisite for successful therapy of LBP. Currently, there is no useful, non-invasive clinical test to diagnose painful lumbar zygapophyseal joints. Clinical tests with high diagnostic accuracy are therefore desirable. Inter-rater reliability is commonly seen as a prerequisite of test validity. The objective of this pilot study was thus to evaluate inter-rater reliability of new clinical pain provocation tests for diagnosing painful lumbar zygapophyseal joints. If a clinically significant level of inter-rater reliability were to be determined, this study could constitute a first step towards establishing the clinical utility of this new set of tests in the structural diagnosis of low back disorders. ⋯ The new pain provocation tests for lumbar zygapophyseal joints showed clinically significant levels of inter-rater reliability. Validation of these tests against fluoroscopy-guided medial branch blocks is warranted.
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Randomized Controlled Trial
Undergraduate Curricular Training in Musculoskeletal Ultrasound by Student Teachers: The Impact of Peyton's Four-Step Approach.
The aim of this study was to assess the impact of Peyton's 4-step approach on musculoskeletal ultrasound skills in a peer-teaching environment as compared to traditional "see one, do one" training and to evaluate students' acceptance of the training strategy. ⋯ Traditional teaching and Peyton's 4-step approach seem to be equally effective for teaching basic musculoskeletal ultrasound skills to undergraduate medical students. Qualitative analysis revealed high acceptance of both peer teaching strategies. Differences in course content complexity and degree of difficulty need to be addressed in future courses.