Zanesljivost med preiskovalkami za meritve diastaze preme trebušne mišice pri nosečnicah z uporabo ultrasonografa : diplomsko delo

Osredkar, Nina (author), Šćepanović, Darija (mentor), Verdenik, Ivan (co-mentor)

Uvod: Diastaza rekti abdominis je definirana kot prekomeren razmik preme trebušne mišice vzdolž bele črte. Ultrasonografija je cenovno dostopna, neinvazivna, ponovljiva in varna metoda za meritve prekomernega razmika ter uporabo v nosečnosti. Vrednosti, ki jih pridobimo s tovrstnimi meritvami, so izražene v milimetrih, takšnih sprememb pa s palpacijo ni mogoče zaznati. Namen: Ugotoviti zanesljivost posamezne preiskovalke in zanesljivost med preiskovalkami za meritve diastaze preme trebušne mišice pri nosečnicah z uporabo ultrasonografa. Metode dela: V raziskavi je sodelovalo 20 prostovoljk nosečnic. Meritve sta izvajali usposobljeni fizioterapevtki, 4,5 cm nad popkom in 4,5 cm pod popkom ter v položaju sproščene trebušne stene in ob izvedbi trebušnjaka. Za meritve smo uporabili ultrasonograf Samsung Medison UGEO H60 ter linearno ultrazvočno sondo. Za ugotavljanje zanesljivosti je bil uporabljen medrazredni korelacijski koeficient (ICC). Rezultati: Vrednost ICC je bila pri meritvah nad popkom pri sproščeni trebušni steni za prvo preiskovalko ICC = 0,976 in za drugo preiskovalko ICC = 0,924. Pri meritvah pod popkom v položaju sproščene trebušne stene je prva preiskovalka dosegla vrednost ICC = 0,599, pri drugi preiskovalki pa je bila vrednost negativna, in sicer ICC = 5,170. Za meritve nad popkom ob izvedbi trebušnjaka je bil pri prvi preiskovalki ICC = 0,918 in pri drugi preiskovalki ICC = 0,951. Vrednost ICC za meritve pod popkom ob izvedbi trebušnjaka pa so bile za prvo preiskovalko ICC = 0,535, in za drugo preiskovalko ICC = 0,907. Zanesljivost med preiskovalkami je bila za meritve diastaze nad popkom v položaju sproščene trebušne stene ICC = 0,690 in pod popkom ICC = 0,620. Za meritve ob izvedbi trebušnjaka pa je bila zanesljivost nad popkom ICC = 0,754 in pod popkom ICC = 0,753. Razprava in zaključek: Na podlagi pridobljenih rezultatov lahko zaključimo, da je bila zanesljivost posameznih preiskovalk za meritve diastaze nad popkom v obeh položajih zelo dobra. Pri meritvah pod popkom je bila zanesljivost povprečna do zelo dobra. Zanesljivost med preiskovalkami pa je bila za meritve nad popkom in pod popkom ter v obeh položajih dobra.

• Language: Slovenian
• Keywords: diastaza rekti abdominis, ultrasonograf, medrazredni korelacijski koeficient, zanesljivost, nosečnost
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-101942
• COBISS.SI-ID: 5462891
• Publication date in RUL: 14.07.2018

Secondary language

• Language: English
• Title: The reliability for measuring diastasis of the recti abdominis in pregnant women using ultrasound : diploma work

Abstract

Introduction: Diastasis recti abdominis is defined as an increased separation of the recti abdominis muscle along the linea alba. Ultrasonography is a reasonably priced, non-invasive, repeatable and safe method for measuring the excessive separation and use in pregnancy. The obtained values are in millimetres; however, such changes cannot be detected by palpation. Purpose: To determine the intra-rater and the inter-rater reliability in measuring diastasis recti abdominis in pregnant women with the use of an ultrasound machine. Methods: The research included 20 pregnant volunteers. Two qualified physiotherapists performed measurements 4.5 cm above the superior border of the umbilicus and 4.5 cm below the inferior border of the umbilicus, as well as in the position of a relaxed abdominal wall and in performing a crunch. Measurements were made using an ultrasound machine Samsung Medison UGEO H60 and linear ultrasound probe. The reliability was assessed by the intraclass correlation coefficient (ICC). Results: ICC value in measurements above the umbilicus and in position of a relaxed abdominal wall, was ICC = 0.976 for the first rater and for the second rater it was ICC = 0.924. In measurements below the umbilicus and in the position of a relaxed abdominal wall, the first rater reached the value of ICC = 0.599, for the second rater the value was negative, ICC = - 5.170. In measurements above the umbilicus in performing a crunch, for the first rater it was ICC = 0.918 and for the second rater it was ICC = 0.951. The ICC value in measurements below the umbilicus in performing a crunch, for the first rater was ICC = 0.535, and for the second one ICC = 0.907. The reliability among raters for measurements in position of a relaxed abdominal wall above the umbilicus was ICC = 0.690 and below the umbilicus, ICC = 0.620. In measurements in performing a crunch above the umbilicus, it was ICC = 0.754 and below the umbilicus, it was ICC = 0.753. Discussion and conclusion: Based on acquired results, we can conclude that the intra-rater reliability above the umbilicus in both positions was very good. In measurements below the umbilicus, the reliability was average to very good. Reliability among raters in measurements above and below the umbilicus and in both positions was good.

• Keywords: diastasis recti abdominis, ultrasound machine, intraclass correlation coefficient, reliability, pregnancy