Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, University College Copenhagen, Denmark.
Department of Physio- and Occupational Therapy, Holbaek Hospital, Denmark.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420903801. doi: 10.1177/1534735420903801.
The purpose of this study is to determine the interrater reliability of dynamic muscle tests in the early rehabilitation phase in women after breast cancer surgery with axillary lymph node dissection (ALND) based on the "preventive intervention against lymphedema after breast cancer" (LYCA) randomised controlled trial. Fifteen women treated with breast cancer surgery including ALND were recruited from participants in the LYCA trial. In this interrater reliability study, women were tested in 4 dynamic muscle tests by 2 physiotherapists at a Capital Hospital in Denmark. Intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs) was used to assess the relative reliability between raters. A Bland-Altman plot and limits of agreement were calculated to describe the absolute reliability. All 6 subtests displayed high interrater reliability. ICC values were: leg press 0.96 (95% CI = 0.87-0.99), elbow flexion (contralateral) 0.94 (0.83-0.98), elbow flexion (affected arm) 0.93 (0.80-0.98), elbow extension 0.80 (0.41-0.93), shoulder abduction (contralateral) 0.89 (0.68-0.96), and shoulder abduction (affected arm) 0.91 (0.74-0.97). Cumulated interrater reliability for the test battery was very high (ICC = 0.99, 95% CI = 0.990-1.0). The absolute reliability of this study was considered high, and the absence of large shifts between mean and the line of 0 difference suggest no systematic bias that could influence clinical interpretation. The dynamic muscle tests evaluated in this study had high interrater reliability and can be used reliably in women in the postoperative phase after breast cancer surgery with ALND.
本研究旨在基于“乳腺癌预防性淋巴水肿干预（LYCA）”随机对照试验，确定乳腺癌术后腋窝淋巴结清扫（ALND）女性早期康复阶段动态肌肉测试的评分者间信度。 从 LYCA 试验的参与者中招募了 15 名接受乳腺癌手术（包括 ALND）治疗的女性。在这项评分者间信度研究中，女性在丹麦一家首都医院由 2 名物理治疗师进行了 4 项动态肌肉测试。使用组内相关系数（ICC）和 95%置信区间（CI）评估评分者间的相对可靠性。计算 Bland-Altman 图和可接受范围以描述绝对可靠性。 所有 6 项分测验均显示出高度的评分者间可靠性。ICC 值为：腿推 0.96（95%CI=0.87-0.99），对侧肘弯曲（肘弯曲）0.94（0.83-0.98），患侧肘弯曲（肘弯曲）0.93（0.80-0.98），肘伸展 0.80（0.41-0.93），对侧肩部外展（肩部外展）0.89（0.68-0.96），患侧肩部外展（肩部外展）0.91（0.74-0.97）。测试组合的累积评分者间可靠性非常高（ICC=0.99，95%CI=0.990-1.0）。本研究的绝对可靠性被认为是高的，且均值与 0 差值线之间不存在较大的变化，表明没有可能影响临床解释的系统偏差。 在这项研究中评估的动态肌肉测试具有很高的评分者间可靠性，可在乳腺癌术后腋窝淋巴结清扫的女性术后阶段可靠使用。
