Roren Alexandra, Fayad Fouad, Roby-Brami Agnès, Revel Michel, Fermanian Jacques, Poiraudeau Serge, Robertson Johanna, Lefevre-Colau Marie-Martine
Department of Physical Medicine and Rehabilitation, Cochin Hospital (AP-HP), Paris Descartes University, 75679 Paris Cedex 14, France.
Man Ther. 2013 Dec;18(6):473-80. doi: 10.1016/j.math.2013.04.005. Epub 2013 May 29.
Electromagnetic devices allow the non invasive and accurate measurement of 3D scapula kinematics. The acromial method allows continuous dynamic measurement using a skin surface sensor fixed to the acromion. Inter-session intra and inter-observer repeatability of 3D scapular kinematics have only been partially assessed for analytical movements and never for functional tasks. Inter-session intra and inter-observer repeatability of 3D scapular kinematics were assessed for arm elevation in the sagittal and frontal planes and for two activities of daily living (ADL), hair combing and back washing, in both shoulders of 15 healthy subjects, using the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the small real difference (SRD) and the Bland and Altman's graphical method. Intra-observer repeatability was good to excellent for every scapular rotation for both arm elevation in isolated planes and ADL (ICC ranged from 0.64 to 0.95). Inter-observer repeatability of scapular rotations was fair to excellent for arm elevation in isolated planes (ICC ranged from 0.49 to 0.92) and poor to excellent for ADL (ICC ranged from 0.35 to 0.89). Inter-observer repeatability of scapular protraction/retraction had the lowest ICC. For both inter-session intra and inter-observer reliability, the SEM and SRD remained low and Bland and Altman's graphical method showed a good repeatability of the measurement method. Longitudinal monitoring of a subject's scapular kinematics by a trained observer is reliable. The inter-observer repeatability of scapular protraction/retraction must be improved.
电磁设备可实现对三维肩胛骨运动学的非侵入性精确测量。肩峰测量法可使用固定在肩峰上的皮肤表面传感器进行连续动态测量。三维肩胛骨运动学在不同测量时段内的观察者内及观察者间重复性，仅针对分析性动作进行了部分评估，对于功能性任务则从未进行过评估。本研究使用组内相关系数（ICC）、测量标准误差（SEM）、最小可察觉差异（SRD）以及布兰德和奥特曼图形法，对15名健康受试者双肩上举在矢状面和额状面的运动以及两项日常生活活动（ADL），即梳头和背部清洗时的三维肩胛骨运动学在不同测量时段内的观察者内及观察者间重复性进行了评估。对于孤立平面内的上举动作和ADL，观察者内重复性在各个肩胛骨旋转角度均为良好至优秀（ICC范围为0.64至0.95）。孤立平面内上举动作时肩胛骨旋转的观察者间重复性为中等至优秀（ICC范围为0.49至0.92），ADL时为差至优秀（ICC范围为0.35至0.89）。肩胛骨前伸/后缩的观察者间重复性ICC最低。对于不同测量时段内的观察者内及观察者间可靠性，SEM和SRD均保持在较低水平，布兰德和奥特曼图形法显示测量方法具有良好的重复性。由经过培训的观察者对受试者的肩胛骨运动学进行纵向监测是可靠的。肩胛骨前伸/后缩的观察者间重复性有待提高。
