Folli Anna, Schneebeli Alessandro, Ballerini Simone, Mena Francesca, Soldini Emiliano, Fernández-de-Las-Peñas César, Barbero Marco
Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland.
Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland.
J Clin Med. 2020 Jun 23;9(6):1958. doi: 10.3390/jcm9061958.
Dry needling (DN) is a minimally invasive treatment technique widely used by physical therapists to treat myofascial trigger points (MTrP). Even if its safety has been commonly declared and the majority of adverse events are considered mild, serious adverse events cannot be excluded and DN treatments of several trunk muscles can potentially result in pneumothorax. Ultrasound imaging (US) skin-to-rib measurement could ensure the safety of this treatment procedure. Therefore, the aim of this study was to determine the inter-rater reliability of depth measurement of different trunk muscles (i.e., rhomboid, lower trapezius, iliocostalis, and pectoralis major) between an expert and two novice physiotherapists. Skin-to-rib distance of 26 asymptomatic and normal weights subjects was consecutively, independently, and randomly measured for each muscle by the three examiners (1 expert and 2 novice physical therapists) with a handheld US wireless probe. Intraclass correlation coefficient (ICC) and standard error of measurement (SEM) were used to assess inter-rater reliability. Inter-rater reliability of skin-to-rib measurements between the three examiners was good to excellent or excellent for every muscle, with an ICC ranging from 0.92 and 0.98 (95% CI 0.86-0.99). The SEM never exceeded 10% of the skin-to-rib distance. In conclusion, skin-to-rib US measurements of the trunk muscles can be reliably performed by novice physical therapists using a handheld US device. These measures could be used as an innovative and reliable technique to improve the safety of some potential dangerous DN treatments.
干针疗法（DN）是物理治疗师广泛使用的一种微创治疗技术，用于治疗肌筋膜触发点（MTrP）。即使其安全性已被普遍宣称，且大多数不良事件被认为是轻微的，但严重不良事件仍不能排除，对几块躯干肌肉进行干针治疗可能会导致气胸。超声成像（US）测量皮肤至肋骨的距离可确保该治疗程序的安全性。因此，本研究的目的是确定一名专家和两名新手物理治疗师之间对不同躯干肌肉（即菱形肌、下斜方肌、髂肋肌和胸大肌）深度测量的评分者间可靠性。三名检查者（1名专家和2名新手物理治疗师）使用手持式超声无线探头，对26名无症状且体重正常的受试者的每块肌肉连续、独立且随机地测量皮肤至肋骨的距离。组内相关系数（ICC）和测量标准误差（SEM）用于评估评分者间可靠性。三名检查者之间皮肤至肋骨测量的评分者间可靠性对于每块肌肉而言均为良好至优秀或优秀，ICC范围为0.92至0.98（95%可信区间0.86 - 0.99）。SEM从未超过皮肤至肋骨距离的10%。总之，新手物理治疗师使用手持式超声设备能够可靠地进行躯干肌肉皮肤至肋骨的超声测量。这些测量可作为一种创新且可靠的技术，以提高某些潜在危险的干针治疗的安全性。
