Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Surg Radiol Anat. 2024 Sep;46(9):1481-1489. doi: 10.1007/s00276-024-03423-9. Epub 2024 Jul 17.
The deep fascia has recently been a current topic in many medical fields, including rehabilitation. Some research has already focused on assessing deep fascia, however results of individual authors differ in certain aspects. This study focuses on the inter-rater reliability of ultrasound (US) measurement of the thickness of deep fascia and loose connective tissue (LCT). The aim was to define the causes of any discrepancies in measurement that could contribute to the unification of management of evaluating fascia.
An observational study was performed including 20 healthy individuals in whom fascia lata of the anterior thigh was examined by US imaging and then measured in Image J software. Three raters participated in this study: the first with 6 years of US imaging experience, other two were newly trained. The measurement of fascial parameters was conducted in two phases with special consultation between them resulting in an agreement of the research team on the more precise way of measurement.
Results revealed the value of inter-rater reliability ICC = 0.454 for deep fascia thickness and ICC = 0.265 for LCT thickness in the first phase and any significant difference in the second phase. This poor inter-rater reliability led to a search for possible causes of discrepancies, which authors subsequently highlighted.
The findings of the study show the main pitfalls of deep fascia measurement that should contribute to the unification of evaluation.
深筋膜最近已成为许多医学领域的热门话题，包括康复领域。一些研究已经专注于评估深筋膜，但不同作者的研究结果在某些方面存在差异。本研究重点关注超声（US）测量深筋膜和疏松结缔组织（LCT）厚度的观察者间可靠性。目的是确定测量差异的原因，这些原因可能有助于统一筋膜评估的管理。
进行了一项观察性研究，包括 20 名健康个体，通过 US 成像检查前大腿的阔筋膜，并在 Image J 软件中进行测量。三名评估者参与了这项研究：第一位有 6 年的 US 成像经验，另外两位是新培训的。在两次特殊咨询后，评估者在两次测量中进行了筋膜参数的测量，最终研究团队就更精确的测量方法达成了一致。
结果显示，在第一阶段，深筋膜厚度的观察者间可靠性 ICC = 0.454，LCT 厚度的 ICC = 0.265，而在第二阶段存在显著差异。这种观察者间可靠性较差导致了对差异原因的寻找，作者随后强调了这些原因。
研究结果表明了深筋膜测量的主要缺陷，这有助于统一评估。
