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动态光栅立体摄影术可提高对健康受试者肩胛胸壁运动学中运动延迟和动态不对称的检测能力。

Dynamic rasterstereography improves the detection of movement delays and dynamic asymmetries in the scapulothoracic kinematic of healthy subjects.

作者信息

Freytag Richard Julius, Moss Jonas Wilhelm, Piana Jacquot Filippo Maria, Zapatka Jakob, Herrmann Rebecca, Ragab Mahmoud, Scheidt Sebastian, Cucchi Davide

机构信息

Department of Orthopaedics and Trauma Surgery University Hospital Bonn Bonn Germany.

U.O.C. 1° Clinica Ortopedica ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO Milano Italy.

出版信息

J Exp Orthop. 2024 Dec 18;11(4):e70115. doi: 10.1002/jeo2.70115. eCollection 2024 Oct.

Abstract

PURPOSE

Assessing scapulothoracic kinematics typically involves visually observing patients during movement, which has limited inter- and intraobserver reliability. Dynamic rasterstereography (DRS) records, measures and visualizes surface structures in real time, using a curvature map to colour-code convex, concave and saddle-shaped structures on the body surface. This study aimed to evaluate the diagnostic efficacy of DRS-assisted observation in identifying dyskinetic scapulothoracic patterns.

METHODS

Thirty-seven healthy participants performed shoulder abduction/adduction and flexion/extension cycles without additional weight, recorded using both DRS and a conventional video camera. A metronome ensured consistent timing, and for DRS a grid of parallel light rays projected onto the back surface was captured using indirect optical measurement techniques. The mean surface curvature was converted into a colour scale. The diagnostic performance of conventional and DRS videos in detecting dyskinetic patterns, including static asymmetries, dynamic asymmetries, motion delays and rapid compensatory movements, were compared. Two investigators independently evaluated the videos twice in a blinded and randomized sequence to assess intra- and interrater reproducibility.

RESULTS

Analysis of 118 videos showed good-to-excellent intrarater and interrater reproducibility for both techniques (ICCs 0.727-0.949). Movement delays and dynamic asymmetries were observed more frequently when evaluating DRS videos rather than conventional videos ( = 0.0008 and  = 0.0016). However, no differences were found in static asymmetry and rapid compensatory movement detection.

CONCLUSIONS

DRS can create a real-time model of the trunk surface and allows observers to evaluate the scapular movements with good-to-excellent intrarater and interrater reproducibility; compared to clinical observation, some specific scapular motion alterations can be observed more frequently. Part of the DRKS00022334 trial.

LEVEL OF EVIDENCE

Level II, prospective cohort study.

摘要

目的

评估肩胛胸壁关节的运动学通常需要在患者运动过程中进行视觉观察,而这种方法在观察者间和观察者内的可靠性有限。动态光栅立体摄影术(DRS)可实时记录、测量并可视化体表结构,利用曲率图对体表的凸面、凹面和鞍形结构进行颜色编码。本研究旨在评估DRS辅助观察在识别肩胛胸壁关节运动障碍模式方面的诊断效能。

方法

37名健康参与者在无额外负重的情况下进行肩部外展/内收和前屈/后伸循环,同时使用DRS和传统摄像机进行记录。节拍器确保时间一致,对于DRS,使用间接光学测量技术捕捉投射到背部表面的平行光线网格。平均表面曲率被转换为颜色标度。比较传统视频和DRS视频在检测运动障碍模式(包括静态不对称、动态不对称、运动延迟和快速代偿运动)方面的诊断性能。两名研究者以盲法和随机顺序对视频进行两次独立评估,以评估观察者内和观察者间的可重复性。

结果

对118个视频的分析表明,两种技术在观察者内和观察者间均具有良好至优秀的可重复性(组内相关系数为0.727 - 0.949)。与传统视频相比,在评估DRS视频时更频繁地观察到运动延迟和动态不对称(P = 0.0008和P = 0.0016)。然而,在静态不对称和快速代偿运动检测方面未发现差异。

结论

DRS可以创建躯干表面的实时模型,使观察者能够以良好至优秀的观察者内和观察者间可重复性评估肩胛骨运动;与临床观察相比,可以更频繁地观察到一些特定的肩胛骨运动改变。DRKS00022334试验的一部分。

证据水平

II级,前瞻性队列研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0366/11653215/f5cf5f016c40/JEO2-11-e70115-g005.jpg

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