School of Physical Therapy, Anderson University, Greenville, South Carolina.
College of Business, Anderson University, Greenville, South Carolina.
J Geriatr Phys Ther. 2024;47(4):E159-E166. doi: 10.1519/JPT.0000000000000417. Epub 2024 Sep 18.
Quantitative ultrasound (QUS) performed at the distal radius shows potential as an effective tool for evaluating fracture risk, especially in postmenopausal women, but the reliability of this tool has not been reported in this patient population. This study investigated the within-day intrarater and interrater reliability of trained raters performing QUS measures at the distal radius of postmenopausal community-dwelling women.
Eighteen women between the ages of 56 and 87 years were recruited from senior centers in the Greenville area of South Carolina and consented to participate. A QUS bone sonometer was used in this study; the trained raters performed 3 repeated speed of sound (SOS) measures at the nondominant radius of each participant on the same day. Intraclass correlation coefficients (ICCs) were calculated (model 3,1 for intrarater and 2,3 for interrater reliability) to determine the reliability within and between raters. In addition, we calculated the standard error of measurement (SEM) and the minimal detectable change at 95% confidence interval (MDC 95 ).
The within-day intrarater reliability was excellent for both physical therapist raters (ICC (3,1) ranging from 0.93 to 0.91). The SEM and MDC for the within-day intrarater reliability measures were small for both raters (SEM = 36.79-38.75 or 0.92%-0.97% of the pooled mean; MDC 95 = 101.99-107.40). The interrater reliability for SOS measurements using radial QUS was good with an ICC (2,3) of 0.77 (95% CI, 0.36-0.92) for 3 averaged measures. The SEM and MDC were larger for the interrater reliability measures (SEM = 62.79 or 1.57% of the pooled mean; MDC 95 = 174.05).
Quantitative ultrasound SOS measurement at the distal radius showed excellent within-day intrarater and good interrater (when 3 measures were averaged) reliability in community-dwelling postmenopausal women. The SEM and MDC 95 were also low for interrater reliability when a mean of 3 trials was used. This study is the first to demonstrate that this particular QUS device at the radius may be a reliable fracture risk screening tool for postmenopausal women.
在桡骨远端进行定量超声（QUS）检查显示出作为评估骨折风险的有效工具的潜力，尤其是在绝经后妇女中，但该工具在该患者人群中的可靠性尚未得到报道。本研究旨在调查在格林维尔地区南卡罗来纳州的老年人中心招募的 18 名年龄在 56 至 87 岁之间的绝经后社区居住妇女中，经过培训的评估者在桡骨远端进行 QUS 测量的日内组内和组间可靠性。
本研究使用 QUS 骨超声仪；每位参与者的非优势桡骨在同一天由经过培训的评估者进行 3 次重复声速（SOS）测量。计算了组内相关系数（ICC 模型 3,1 用于组内，ICC 模型 2,3 用于组间），以确定评估者内部和之间的可靠性。此外，我们计算了测量的标准误差（SEM）和 95%置信区间的最小可检测变化（MDC 95）。
在同一天内，物理治疗师评估者的组内可靠性均为优秀（ICC（3,1）范围为 0.93 至 0.91）。对于这两个评估者，日内组内可靠性测量的 SEM 和 MDC 均较小（SEM=36.79-38.75 或总和平均值的 0.92%-0.97%；MDC 95=101.99-107.40）。使用桡骨 QUS 进行 SOS 测量的组间可靠性良好，3 次平均值的 ICC（2,3）为 0.77（95%CI，0.36-0.92）。对于组间可靠性测量，SEM 和 MDC 较大（SEM=62.79 或总和平均值的 1.57%；MDC 95=174.05）。
在社区居住的绝经后妇女中，桡骨远端 QUS SOS 测量显示出极好的日内组内和良好的组间（当平均 3 次测量时）可靠性。当使用 3 次试验的平均值时，组间可靠性的 SEM 和 MDC 95 也较低。本研究首次证明，该特定的桡骨 QUS 设备可能是绝经后妇女骨折风险筛查的可靠工具。
