Jadehkenari Alieh Zendehdel, Haghighatkhah Hamid Reza, Sarrafzadeh Javad, Takamjani Ismail Ebrahimi, Arab Amir Massoud, Ziaeifar Maryam
Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Radiology Department of Diagnosis Imaging, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Chiropr Med. 2022 Jun;21(2):116-123. doi: 10.1016/j.jcm.2022.02.006. Epub 2022 Jun 18.
This study aimed to determine within-day intra-rater reliability of ultrasound measurements of the right and left hemidiaphragm thickness and contractility (quantified by percentage thickness change) in supine position during deep breathing in individuals with nonspecific chronic neck pain.
Seventeen volunteers (20-55 years of age) participated in this observational study. Bilateral diaphragm muscle thickness and contractility (percentage thickness change) were compared between 2 measurement sessions administered by a radiologist using B-mode real-time ultrasound (30 minutes apart). Intraclass correlation coefficient (ICC [3, 3]) as well as the standard error of measurement (SEM), minimal detectable change (MDC), and the coefficient of variation (CV) were used to determine the intra-rater reliability.
The right and left hemidiaphragm thickness showed good to excellent reliability at the end of deep inspiration (ICC, 0.90; 95% confidence interval [CI], 0.72-0.96; and ICC, 0. 93; 95% CI, 0.81-0.97, respectively) as well as at the end of deep expiration (ICC, 0.91; 95% CI, 0.75-0.96; ICC, 0.91; 95% CI, 0.77-0.97; SEM, 0.19; MDC, 0.54; and CV, 7.84%, respectively) and the percentage thickness change (ICC, 0.83; 95% CI, 0.54-0.94; and ICC, 0.93; 95% CI, 0.82-0.97, respectively).
This study found that diagnostic ultrasound measurements of the right and left hemidiaphragm thickness and contractility in supine position during deep breathing in individuals with nonspecific chronic neck pain was reliable. The SEM, MDC, and CV reported may allow for accurate interpretation of diaphragm assessment in a clinical research setting.
本研究旨在确定非特异性慢性颈部疼痛患者在仰卧位深呼吸时，超声测量左右半膈肌厚度及收缩性（以厚度变化百分比量化）的日内评分者内信度。
17名志愿者（年龄20 - 55岁）参与了这项观察性研究。由一名放射科医生使用B型实时超声在两个测量时段（间隔30分钟）测量双侧膈肌厚度及收缩性（厚度变化百分比）。组内相关系数（ICC[3, 3]）以及测量标准误差（SEM）、最小可检测变化（MDC）和变异系数（CV）用于确定评分者内信度。
在深吸气末，左右半膈肌厚度显示出良好至极好的信度（ICC分别为0.90；95%置信区间[CI]，0.72 - 0.96；以及ICC为0.93；95% CI，0.81 - 0.97），在深呼气末也是如此（ICC分别为0.91；95% CI，0.75 - 0.96；ICC为0.91；95% CI，0.77 - 0.97；SEM为0.19；MDC为0.54；CV分别为7.84%），厚度变化百分比的信度也较好（ICC分别为0.83；95% CI，0.54 - 0.94；以及ICC为0.93；95% CI，0.82 - 0.97）。
本研究发现，对非特异性慢性颈部疼痛患者在仰卧位深呼吸时进行的左右半膈肌厚度及收缩性的诊断性超声测量是可靠的。所报告的SEM、MDC和CV可能有助于在临床研究环境中对膈肌评估进行准确解读。
