Labbe David R, Hagemeister Nicola, Tremblay Mathieu, de Guise Jacques
Laboratoire de recherche en imagerie et orthopédie, Centre de recherche, Centre hospitalier de l'Université de Montréal (CHUM), 1560 rue Sherbrooke est, Montréal, Quebec, Canada.
Gait Posture. 2008 Jul;28(1):170-4. doi: 10.1016/j.gaitpost.2007.11.002. Epub 2007 Dec 21.
Different attachment systems have been proposed in an effort to reduce skin movement artifacts when recording knee bone movement during gait. One such system, called exoskeleton, has shown promising accuracy but little is known concerning its reliability. The objective of this study was to determine the intra- and inter-observer reliability of this attachment system for recording 3D knee kinematics during gait.
Two separate studies were conducted. The intra-observer study involved one observer who reinstalled the exoskeleton on 15 healthy subjects and recorded gait kinematics four times for each subject. The inter-observer study also involved 15 healthy subjects and for each of these subjects, three observers reinstalled and recorded gait kinetics three times in randomized order.
In the intra-observer setting, ICC values were 0.92, 0.94 and 0.88 for knee flexion/extension, abduction/adduction and internal/external tibial rotation, respectively. In the inter-observer setting, the corresponding values were 0.94, 0.92 and 0.89.
The high ICC values found indicate very high reliability of the exoskeleton for recording 3D knee kinematics despite reinstallation. Moreover, the values between both settings are very similar which indicates that reliability is independent of the observer who performs the installation. Therefore, evaluations may be carried out by several different clinicians without impacting reliability.
为了在步态过程中记录膝关节骨运动时减少皮肤运动伪影，人们提出了不同的附着系统。其中一种称为外骨骼的系统已显示出有前景的准确性，但关于其可靠性知之甚少。本研究的目的是确定这种附着系统在步态过程中记录三维膝关节运动学的观察者内和观察者间可靠性。
进行了两项独立研究。观察者内研究涉及一名观察者，该观察者在15名健康受试者身上重新安装外骨骼，并为每名受试者记录四次步态运动学。观察者间研究也涉及15名健康受试者，对于这些受试者中的每一名，三名观察者以随机顺序重新安装并记录三次步态动力学。
在观察者内设置中，膝关节屈伸、外展/内收和胫骨内外旋转的组内相关系数（ICC）值分别为0.92、0.94和0.88。在观察者间设置中，相应的值分别为0.94、0.92和0.89。
所发现的高ICC值表明，尽管重新安装，外骨骼在记录三维膝关节运动学时具有非常高的可靠性。此外，两种设置之间的值非常相似，这表明可靠性与进行安装的观察者无关。因此，可以由几名不同的临床医生进行评估而不影响可靠性。
