Horsak Brian, Pobatschnig Barbara, Baca Arnold, Greber-Platzer Susanne, Kreissl Alexandra, Nehrer Stefan, Wondrasch Barbara, Crevenna Richard, Keilani Mohammad, Kranzl Andreas
St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria.
Orthopedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Austria.
Gait Posture. 2017 May;54:112-118. doi: 10.1016/j.gaitpost.2017.02.028. Epub 2017 Mar 2.
Three-dimensional gait analysis (3DGA) in obese populations is a difficult task due to a great amount of subcutaneous fat. This makes it more challenging to identify anatomical landmarks, thus leading to inconsistent marker placement. Therefore, the purpose of this study was to investigate the test-retest reliability for kinematic measurements of obese children and adolescents.
Nine males and two females with an age-based BMI above the 97th percentile (age: 14.6±2.6years, BMI: 33.4±4.4kg/m) were administered to two 3DGA sessions. To quantify reliability of discrete parameters the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. To quantify waveform similarity, the coefficient of multiple correlation (CMC) and the linear fit method (LFM) were used.
From 28 kinematic parameters, 23 showed acceptable ICCs (≥0.70) and the remaining parameters demonstrated moderate values. These were peak hip extension during stance (0.58), mean pelvis rotation (0.60), mean anterior pelvic tilt (0.64), peak knee flexion during swing (0.67) and peak hip abduction during swing (0.69). The SEM was below 5° for all parameters. The MDC for the sagittal, frontal, and transversal plane were on average 7.5°±2.2, 4.6°±1.3 and 6.0°±0.9 respectively. Both the LFM and CMC showed, in general, moderate to good reliability except for pelvis tilt and hip rotation.
Data demonstrated acceptable error margins especially for the sagittal and frontal plane. Low reliability for the pelvis tilt indicates that great effort is necessary to position the pelvic markers consistently during repeated sessions.
由于肥胖人群皮下脂肪过多,对其进行三维步态分析(3DGA)是一项艰巨的任务。这使得识别解剖标志点更具挑战性,从而导致标记物放置不一致。因此,本研究的目的是调查肥胖儿童和青少年运动学测量的重测信度。
对9名男性和2名女性进行两次3DGA测试,他们基于年龄的BMI均高于第97百分位数(年龄:14.6±2.6岁,BMI:33.4±4.4kg/m²)。为了量化离散参数的信度,计算了组内相关系数(ICC)、测量标准误差(SEM)和最小可检测变化(MDC)。为了量化波形相似性,使用了多重相关系数(CMC)和线性拟合方法(LFM)。
在28个运动学参数中,23个显示出可接受的ICC(≥0.70),其余参数显示为中等值。这些参数包括站立期髋关节伸展峰值(0.58)、骨盆平均旋转(0.60)、骨盆前倾平均值(0.64)、摆动期膝关节屈曲峰值(0.67)和摆动期髋关节外展峰值(0.69)。所有参数的SEM均低于5°。矢状面、额状面和横断面的MDC平均分别为7.5°±2.2、4.6°±1.3和6.0°±0.9。除骨盆倾斜和髋关节旋转外,LFM和CMC总体上显示出中等至良好的信度。
数据显示误差范围可接受,特别是在矢状面和额状面。骨盆倾斜的低信度表明,在重复测试过程中,需要付出很大努力才能始终如一地放置骨盆标记物。