Talbott Nancy R, Witt Dexter W
Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH 45267-0394, USA.
Clin Physiol Funct Imaging. 2013 May;33(3):192-200. doi: 10.1111/cpf.12012. Epub 2012 Dec 10.
The purpose of this study is to describe a clinically feasible method for measuring the thickness of the serratus anterior (SA) muscle using rehabilitative ultrasound imaging (RUSI) and to determine the reliability of repeated measures of that method. An exploratory clinical measurement study using a test-retest methodology was utilized to determine the reliability of the measurements in a sample of 20 healthy subjects. While sitting with the arm flexed 120°, the SA of each subject was imaged at rest, during an active hold and while holding a three pound weight. On Day 1, images were repeated three times for each condition by the same examiner. On Day 2, Examiner 1 and Examiner 2 repeated the scans. Images were examined offline by Examiner 1 with SA thickness measured superior to the most distal rib in the image. Reliability was evaluated using intraclass correlation coefficients (ICCs) and Bland-Altman plots. The intra-examiner reliability (same day) during rest, active hold and active hold with resistance was ICC3,3 = 0·892; ICC3,3 = 0·951; and ICC3,3 = 0·869-0·971, respectively. Intra-examiner reliability between days ranged from ICC3,2 = 0·613 at rest to ICC3,2 = 0·736 during active hold with resistance. Interexaminer reliability was moderate during active hold (ICC2,2 = 0·526) and active hold with resistance (ICC2,2 = 0·535) and poor during rest (ICC2,2 = 0·425). This study demonstrates that SA thickness can be measured reliably using RUSI by the same examiner and suggests that active movements may increase that reliability.
本研究的目的是描述一种使用康复超声成像（RUSI）测量前锯肌（SA）厚度的临床可行方法，并确定该方法重复测量的可靠性。采用重测法进行探索性临床测量研究，以确定20名健康受试者样本中测量的可靠性。当手臂屈曲120°坐着时，对每个受试者的SA在静息状态、主动保持期间以及手持三磅重物时进行成像。在第1天，由同一名检查者对每种情况重复成像三次。在第2天，检查者1和检查者2重复扫描。检查者1离线检查图像，测量SA厚度，测量位置在图像中最远端肋骨上方。使用组内相关系数（ICC）和Bland-Altman图评估可靠性。静息、主动保持和抗阻主动保持期间的检查者内可靠性（同一天）分别为ICC3,3 = 0·892；ICC3,3 = 0·951；以及ICC3,3 = 0·869 - 0·971。不同日期之间的检查者内可靠性范围从静息时的ICC3,2 = 0·613到抗阻主动保持时的ICC3,2 = 0·736。主动保持期间（ICC2,2 = 0·526）和抗阻主动保持期间（ICC2,2 = 0·535）的检查者间可靠性为中等，静息期间（ICC2,2 = 0·425）较差。本研究表明，同一名检查者使用RUSI能够可靠地测量SA厚度，并表明主动运动可能会提高这种可靠性。
