THE PITTING TEST; AN INVESTIGATION OF AN UNSTANDARDIZED ASSESSMENT OF LYMPHEDEMA.
THE PITTING TEST; AN INVESTIGATION OF AN UNSTANDARDIZED ASSESSMENT OF LYMPHEDEMA.
复制标题
点蚀测试；
作者：
J. Sanderson;N. Tuttle;R. Box;H. Reul;E. Laakso
软组织凹陷是在释放持续的拇指或手指压力后在体表上发生的暂时性凹陷。在水肿的管理中，是否存在凹陷可以有助于临床推理并指导医疗管理。然而，点蚀试验及其应用没有得到一致的描述，也不是评估的标准化部分。因此，需要进行调查，以评估结果的措施，点蚀的识别和表征的水肿组织。为了确定未来研究的有效测试参数，我们评估了6名具有不同水肿经验的治疗师，他们评估了6名水肿患者的一系列位置，这些位置代表了临床上使用的点蚀评估技术的广度。非标准化评估的结果通过观察到的测试持续时间（1.1 - 76.0秒）、压力（1.3 - 14.4 N/cm 2）和接触面积（0.2 - 6.8 cm 2）的技术差异较大得到证实。经验丰富的治疗师进行点蚀试验的技术与经验不足的同行有显著不同，包括更长的时间（p < 0.001），更高的压力（p < 0.001）和更大的接触面积（p < 0.001）。该初步研究的结果支持需要评价潜在组织对持续压力和释放的反应，以便为标准化程序的开发提供信息。
Soft tissue pitting is the occurrence of a temporary indentation on the body surface after the release of sustained thumb or finger pressure. In the management of lymphedema, presence or absence of pitting can contribute to clinical reasoning and guide healthcare management. However, the pitting test and its application has not been described consistently nor is it a standardized part of assessment. Therefore investigations are needed to assess the outcome measures of pitting identification and characterization of lymphedematous tissue. To determine valid testing parameters for a future study, we evaluated six therapists of varying lymphedema experience who assessed a range of locations on six patients with lymphedema representing the breadth of pitting assessment techniques used clinically. The consequence of an unstandardized assessment is demonstrated by the large variation in techniques observed for test duration (1.1 to 76.0 seconds), pressure (1.3 to 14.4 N/cm2) and contact area (0.2 to 6.8 cm2). Experienced therapists performed the pitting test with a significantly different technique from their inexperienced counterparts, involving a longer duration (p < 0.001), higher pressure (p < 0.001) and a larger contact area (p < 0.001). The results of this pilot study support the need for evaluation of the underlying tissue response to sustained pressure and release, in order to inform the development of a standardized procedure.