Validität und Intratester-Reliabilität der Fotometrie zur Beurteilung der Position des Schultergürtels gesunder Probanden^[1]

Zusammenfassung

Hintergrund Da die Körperhaltung möglicherweise ein relevanter, beitragender als auch prognostischer Faktor bei muskuloskeletalen Problemen ist, stellt deren Beurteilung einen wichtigen Bestandteil der physiotherapeutischen Untersuchung dar. Das klinimetrische Verfahren der digitalen Fotometrie kann Parameter der Haltung objektiv erheben.

Ziel Die Studie untersuchte die Validität und die Intratester-Reliabilität eines Fotometrie-Programms zur Beurteilung der Güte seiner Anwendung in der Praxis und Forschung.

Methode In der Messgruppe wurde die Haltung des Schultergürtels von 48 Probanden im Alter von 19 bis 46 Jahren zu 2 Messzeitpunkten in 4 Ebenen gemessen, um folgende Variablen zu bestimmen: Skapula-Rotation, Pro- und Retraktion, Skapula-Kippung, kraniovertebraler Winkel, thorakale Kyphose und Schulterschiefstand. Die Intratester-Reliabilität wurde in einem Abstand von 3 Wochen untersucht. Die Bestimmung der Kriteriumsvalidität erfolgte über die Korrelation der Messwerte der Fotometrie mit denen eines digitalen Inklinometers, eines CROM und eines Zentimetermaßes.

Ergebnisse Validität: Die Korrelationskoeffizienten der gemessenen Winkel lagen zwischen r = 0,63, 95 %-Konfidenzintervall (KI) und r = 0,95, 95 %KI (p > 0,001), die Zentimetermessungen zwischen r = 0,57 und r = 0,96, 95 %KI (p < 0,0001). Intratester-Reliabilität: Die Intraklassenkorrelationskoeffizienten (ICC) der Winkelmessungen erreichten zwischen 0,77 und 0,96 CI und die ICC der Zentimetermessung zwischen 0,62 und 0,93 KI. Der Standardfehler der Messungen (SEM) betrug je nach Winkel zwischen 0,64° und 3,46° bzw. Abstand zwischen 0,35 cm und 0,98 cm.

Schlussfolgerung Die Ergebnisse lassen darauf schließen, dass die Fotometrie für die Winkel Skapula-Rotation, Skapula-Kippung und Akromioklavikulargelenk sowie für die Abstände zwischen Trigonum scapulae zur Wirbelsäule und Angulus inferior zur Wirbelsäule als valides und reliables Messinstrument zur Beurteilung des Schultergürtels bei gesunden Probanden verwendet werden kann. Insbesondere die Winkelmessungen zeigten gute Resultate.

Abstract

Background Body posture may be a relevant, contributing as well as prognostic factor in musculoskeletal problems. Therefore, its assessment is considered to be an important part of physiotherapeutic examination. Digital photometry is a clinical measuring method for objective collection of posture parameters.

Objective This study investigated the validity and intratester reliability of photometry in order to assess its qualitative application in clinical practice and research.

Method Shoulder girdle posture was measured in 19 to 46 years old 48 subjects at 2 measurement points in four levels in order to determine the following variables: scapula rotation, protraction and retraction, scapula tilt, cranio-vertebral angle, thoracic kyphosis and shoulder obliquity. Intratester reliability was examined at intervals of three weeks. The criterion validity was determined by correlating the measured photometry values with those of a digital inclinometer, CROM and centimetre tape.

Results Validity: Correlation coefficients of the measured angles were between r = 0.65 and r = 0.95, 95 % confidence interval (CI), centimetre measures were between r = 0.57 and r = 0.96, 95 % CI (p < 0.0001). Intratester Reliability: Intra-class correlation coefficients (ICC) of the measured angles were between 0.77 and and 0.96 CI an d the ICC of the centimetre measures are between 0.62 and 0.93 CI. Standard error of measurement (SEM) varied between 0.64° and 3.46° and distance measurement between 0.35 cm and 0.98 cm.

Conclusions The results of this study imply that photometry is a valid and reliable assessment tool for shoulder girdle evaluation in healthy subjects for the angles of scapula rotation, scapula tilt and acromioclavicular joint as well as for the distances between trigonum scapulae to vertebral column and inferior angle to vertebral column. Predominantly angle measurements showed good results.

Schlüsselwörter

Schultergürtel - Haltung - Reliabilität - Validität - Fotometrie

Key words

shoulder girdle - posture - reliability - validity - photometry

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