Howe T E, Oldham J A
University of Manchester, UK.
Physiother Res Int. 1996;1(2):112-26. doi: 10.1002/pri.6120010207.
Many therapists use thigh circumference as a measure of quadriceps size to evaluate the effect of an injury or effectiveness of an intervention. However, this technique has been shown to be unreliable, thus more accurate methods of measuring muscle size are required. The purpose of this study was to investigate the validity and reliability of measuring quadriceps cross-sectional area (CSA) with static compound B ultrasound scanning at the level of the mid-thigh. Repeated measures of known linear distances and CSAs were made with a planimetry device. Both face and criterion validity were demonstrated indicating that the device is reliable when measuring CSAs. A single rater located quadriceps muscle borders and measured CSAs on a series of ultrasound scans. A mean coefficient of variation (%CV = 1.7) was observed, signifying high intra-rater reliability. Two raters performed six scans on each of 15 subjects. Initial observation of these results suggest that the measurement of quadriceps CSA with compound B ultrasound scanning is reliable, mean %CVs = 2.8 and 1.9 for the two raters and 2.4 when their results were combined. When raters performed scans on 18 subjects on two occasions on the same day intra-class correlation coefficients (ICC) were high, 0.991 and 0.980 for raters A and B, respectively. Paired Student's t-tests revealed a significant difference (p < 0.05) for Rater B between CSAs measured for initial and relocated scans. However, this difference was calculated as 1.4-2.9% and was not of clinical importance. A significant difference (p < 0.05) was observed between measurements of CSAs made by both raters on the same subject. A calibration factor was calculated for transforming the measurements of Rater B, the use of which gave comparable values. ICCs using a fixed model for inter-rater reliability were 0.963 and 0.974 for actual and transformed values, respectively. This study observed differences between measures obtained by different raters and recommends that the calculation and employment of a calibration factor may be useful when comparing sequential measures made by different raters.
许多治疗师将大腿围度作为股四头肌大小的衡量指标，以评估损伤的影响或干预措施的效果。然而，这种技术已被证明不可靠，因此需要更准确的测量肌肉大小的方法。本研究的目的是探讨在大腿中部水平使用静态复合B超声扫描测量股四头肌横截面积（CSA）的有效性和可靠性。使用面积测量仪对已知线性距离和CSA进行重复测量。同时证明了表面效度和效标效度，表明该仪器在测量CSA时是可靠的。一名评估者确定股四头肌的肌肉边界，并在一系列超声扫描上测量CSA。观察到平均变异系数（%CV = 1.7），表明评估者内部可靠性高。两名评估者对15名受试者中的每一名进行了6次扫描。对这些结果的初步观察表明，用复合B超声扫描测量股四头肌CSA是可靠的，两名评估者的平均%CV分别为2.8和1.9，将他们的结果合并时为2.4。当评估者在同一天对18名受试者进行两次扫描时，组内相关系数（ICC）很高，评估者A和B分别为0.991和0.980。配对学生t检验显示，评估者B在初始扫描和重新定位扫描测量的CSA之间存在显著差异（p < 0.05）。然而，这种差异计算为1.4 - 2.9%，不具有临床重要性。在同一受试者上，两名评估者测量的CSA之间观察到显著差异（p < 0.05）。计算了一个校准因子来转换评估者B的测量值，使用该校准因子可得到可比的值。对于评估者间可靠性，使用固定模型的ICC在实际值和转换值时分别为0.963和0.974。本研究观察到不同评估者获得的测量结果之间存在差异，并建议在比较不同评估者进行的连续测量时计算和使用校准因子可能会有用。
