Sarro Karine J, Mombrini Camila L, Tonole Thais B
a Faculty of Physical Education , University of Campinas - UNICAMP , Campinas , SP , Brazil.
b Health Sciences Center , Federal University of Espírito Santo - UFES , Vitória , ES , Brazil.
Physiother Theory Pract. 2018 Sep;34(9):730-739. doi: 10.1080/09593985.2017.1423525. Epub 2018 Jan 16.
The knowledge about measurement errors of the measuring tool is important before its use, as clinical decisions are going to be made based on its results. Here we investigate intrarater and interrater reliability and the minimal detectable change (MDC) of thoracoabdominal mobility measurements using photogrammetry, considering novice and experienced raters. Thoracoabdominal mobility of 17 healthy participants was assessed; photographs during apnea in maximal inspiration and expiration were used to calculate latero-lateral and anteroposterior diameters of the thorax (at axillary and xiphoid level) and abdomen. One novice and one experienced rater measured the same photographs three times. We found good reliability for the experienced rater (average Intraclass Correlation Coefficient (ICC): 0.98; average MDC: 0.3) and for interrater comparison (average ICC: 0.97; average MDC: 0.35) for all measures, with poorer results for latero-lateral mobility of abdomen. The novice rater presented moderate reliability for latero-lateral mobility of the thorax at axillary level and abdomen (ICC: 0.52 and 0.61; MDC: 1.42 and 2.05, respectively) and good reliability for the other measures (average ICC: 0.81; average MDC: 1.52). The photogrammetric analysis of thoracoabdominal mobility presented itself as a reliable method when used by an experienced professional. However, considering that the measurement of latero-lateral mobility is more subjected to errors, it should be used with caution. The MDC presented should be taken into account as a threshold to be certain that the measure is not under the measurement error due to rater variability.
在使用测量工具之前，了解其测量误差很重要，因为临床决策将基于其结果做出。在此，我们研究了使用摄影测量法测量胸腹部活动度时的评分者内和评分者间可靠性以及最小可检测变化（MDC），同时考虑了新手和经验丰富的评分者。评估了17名健康参与者的胸腹部活动度；使用最大吸气和呼气时屏气期间的照片来计算胸部（腋窝和剑突水平）和腹部的左右径和前后径。一名新手和一名经验丰富的评分者对相同的照片进行了三次测量。我们发现，对于所有测量指标，经验丰富的评分者具有良好的可靠性（平均组内相关系数（ICC）：0.98；平均MDC：0.3），评分者间比较也具有良好的可靠性（平均ICC：0.97；平均MDC：0.35），腹部左右活动度的结果较差。新手评分者在腋窝水平的胸部和腹部左右活动度方面表现出中等可靠性（ICC分别为0.52和0.61；MDC分别为1.42和2.05），而其他测量指标具有良好的可靠性（平均ICC：0.81；平均MDC：1.52）。胸腹部活动度的摄影测量分析在由经验丰富的专业人员使用时是一种可靠的方法。然而，考虑到左右活动度的测量更容易出现误差，应谨慎使用。应将给出的MDC作为一个阈值，以确保测量结果不在评分者变异性导致的测量误差范围内。
