McCarthy Daniel A, Millis Darryl L, Levine David, Weigel Joseph P
Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States.
Department of Physical Therapy, The University of Tennessee at Chattanooga, Chattanooga, TN, United States.
Front Vet Sci. 2018 Aug 30;5:203. doi: 10.3389/fvets.2018.00203. eCollection 2018.
The purpose of the study reported here was to describe variables affecting thigh girth measurements preoperatively and 2 weeks after surgical stabilization of the stifle and to examine inter- and intra-observer reliability. Ten hound-type dogs with experimental, unilateral, cranial cruciate ligament transection, and surgical stabilization. Dogs were placed in lateral recumbency for measurements of thigh circumference after the stifle was placed in flexed (F), estimated standing (S), and extended (E) positions. Measurements were made at 50 and 70% of thigh length (TL), with hair unclipped and then clipped prior to surgery, before and 2 weeks after cruciate ligament transection and stifle stabilization, and with and without sedation. A spring tension measuring tape was used to determine thigh girth that allowed a consistent amount of end-tension to be applied to the tape. All measurements were made by two blinded individuals in triplicate, data were recorded for each set of measurements and the mean of the three measurements for each condition was used for analysis. Thigh girth was significantly greater at the more proximal site of 50% TL (36.7 ± 2.6 cm) when compared to the 70% TL (31.7 ± 2.7 cm) ( = 0.001). Sedation did not significantly affect thigh girth at any stifle position at the 70% and 50% TL. Although there were no differences in thigh circumference between the flexion and standing positions at 50% TL (F 38.2 ± 2.8 cm, S 38.1 ± 2.9 cm) and 70% TL (F 33.6 ± 1.6 cm; S 33.6 ± 1.8 cm), full extension of the stifle resulted in significantly less thigh girth (50% TL 36.6 ± 2.6 cm, = 0.006; 70% TL 31.7 ± 2.6 cm, = 0.006). Significant decreases in thigh girth were seen after surgery in all limb positions at both measurement sites. The highest correlations between Observer 1 (OB1) and Observer 2 (OB2) with least differences in measurements were with the stifle in the extended position. Agreement between two observers using standard measuring technique was significant at both the 50% (OB1: 34.10 ± 2.93 cm, OB2: 34.08 ± 2.65 cm, = 0.007, ICC = 0.984) and 70% (OB1: 29.89 ± 2.43 cm, OB2: 30.04 ± 2.30 cm, = 0.004, ICC = 0.981) TL positions with the stifle placed in extended position. Thigh girth measurement may be useful as an outcome measure when appropriate measuring technique is used. It is recommended that thigh girth be obtained at a distance of 70% thigh length, with the leg in an extended position while in lateral recumbency, and the dog relaxed or under sedation. Further studies should be performed in a variety of clinical situations.
本研究的目的是描述影响术前以及 stifle 关节手术固定后 2 周大腿围度测量的变量，并检验观察者间和观察者内的可靠性。十只猎犬型犬接受了实验性单侧颅侧交叉韧带切断术及手术固定。将犬置于侧卧位，在 stifle 关节处于屈曲（F）、估计站立（S）和伸展（E）位置时测量大腿周长。在大腿长度（TL）的 50%和 70%处进行测量，测量时毛发未剃除，然后在手术前剃除，在交叉韧带切断和 stifle 关节固定前、后 2 周进行测量，且分别在有和没有镇静的情况下进行测量。使用弹簧张力测量带确定大腿围度，该测量带能使施加在带上的终端张力保持一致。所有测量均由两名不知情的人员进行，一式三份，记录每组测量数据，并将每种情况的三次测量平均值用于分析。与 70%TL（31.7±2.7cm）相比，在 50%TL 这个更靠近近端的部位大腿围度显著更大（36.7±2.6cm）（P = 0.001）。在 70%和 50%TL 处，镇静在任何 stifle 关节位置均未显著影响大腿围度。虽然在 50%TL（F 38.2±2.8cm，S 38.1±2.9cm）和 70%TL（F 33.6±1.6cm；S 33.6±1.8cm）时，屈曲和站立位置之间的大腿周长没有差异，但 stifle 关节完全伸展时大腿围度显著减小（50%TL 36.6±2.6cm，P = 0.006；70%TL 31.7±2.6cm，P = 0.006）。在两个测量部位的所有肢体位置，术后大腿围度均显著减小。观察者 1（OB1）和观察者 2（OB2）之间相关性最高且测量差异最小的情况是 stifle 关节处于伸展位置时。使用标准测量技术时，两名观察者在 50%（OB1：34.10±2.93cm，OB2：34.08±2.65cm，P = 0.007，组内相关系数 ICC = 0.984）和 70%（OB1：29.89±2.43cm，OB2：30.04±2.30cm，P = 0.004，ICC = 0.981）TL 位置且 stifle 关节处于伸展位置时的一致性显著。当使用适当的测量技术时，大腿围度测量作为一项结果指标可能是有用的。建议在犬处于侧卧位、腿部伸展、犬放松或镇静的状态下，在大腿长度的 70%处获取大腿围度。应在各种临床情况下进行进一步研究。
