Zanesljivost merilnih orodij za ocenjevanje oblike stopala pri osnovnošolcih : magistrsko delo

Groznik, Manca (author), Vauhnik, Renata (mentor), Drobnič, Matej (co-mentor), Kovačič, Tine (reviewer)

Uvod: Stopalo ima kot ena izmed mehansko najzahtevnejših struktur v človeškem telesu izredno pomembno vlogo v biomehaniki gibanja. Razvoj stopala poteka na več ravneh, ki zajemajo strukturne in funkcionalne procese razvoja. Stopalo lahko ocenjujemo z različnimi merskimi orodji, za ocenjevanje najpogosteje uporabljamo slikovne preiskave, merilna orodja za statično obliko stopala in analizo odtisa stopala. Na področju ocenjevanja oblike stopala otrok kljub visoki prevalenci dinamičnega ploskega stopala še ni jasnega soglasja o tem, katera metoda bi bila najbolj primerna za spremljanje razvoja medialnega vzdolžnega stopalnega loka pri otrocih. Namen: Raziskati zanesljivost posameznega preiskovalca pri uporabi različnih merilnih orodij za ocenjevanje oblike stopala in s tem ugotoviti, katero merilno orodje je najbolj primerno za ocenjevanje pri osnovnošolcih. Metode dela: V raziskavo smo vključili 108 osnovnošolcev. Izvedli smo tri meritve oblike stopala – Indeks oblike stopala, Test navpičnega padca navikularne kosti in analizo odtisa stopala na papir s podografom. Ocenjevanje je bilo izvedeno dvakrat v razmiku enega tedna. Zanesljivost posameznega preiskovalca smo ocenili z intraklasnimi koeficienti korelacije. Za primerjavo rezultatov med triadami smo uporabili enosmerno analizo variance ANOVA, za primerjavo med prvo in drugo meritvijo t-test ter izračunali standardno napako meritve (SEM) in najmanjšo zaznavno spremembo (MDC). Rezultati: Med vključenimi merilnimi orodji je bila zanesljivost najvišja pri lestvici Indeks oblike stopala (FPI-6), pri vseh skupinah je bila odlična (ICC>0,9). Po zanesljivosti sta lestvici FPI-6 sledila Indeks Chippaux-Smirak (CSI) in Indeks Staheli (SI). Zanesljivost za vključeni orodji je bila odlična pri vseh skupinah, razen pri učencih 1. triade, kjer je bila zanesljivost dobra. Najnižja je bila zanesljivost testa Navpični padec navikularne kosti (NDT), ki je bila dobra. Pri primerjavi izidov meritev med triadami opažamo statistično značilne razlike (p<0,05) pri vseh merskih orodjih, razen pri NDT. Razprava in zaključek: Izsledki raziskave kažejo na lestvico FPI-6 kot na najbolj primerno za ocenjevanje oblike stopala pri osnovnošolcih. Primerno zanesljivost za klinično ocenjevanje pri otrocih kažejo tudi CSI, SI in NDT. Med triadami obstajajo statistično značilne razlike v izidih z boljšo zanesljivostjo pri starejših otrocih. V prihodnje bi bilo smiselno raziskati zanesljivost med preiskovalci ter korelacijo med izbranimi merskimi orodji. Prav tako bi lahko preverili veljavnost izbranih lestvic, predvsem veljavnost konstrukta teh lestvic ter sočasno veljavnost.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, oblika stopala, ploska stopala, zanesljivost, indeks oblike stopala, odtis stopala, test navpičnega padca navikularne kosti
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [M. Groznik Tratnjek]
• Year: 2023
• Number of pages: 45 str., [6] str. pril.
• PID: 20.500.12556/RUL-148735
• UDC: 615.8
• COBISS.SI-ID: 162803203
• Publication date in RUL: 31.08.2023

Secondary language

• Language: English
• Title: Reliability of the measurement tools for assessing foot posture among children in primary school : master thesis

Abstract

Introduction: The human foot is a complex multi-articular mechanical structure and one of the most complex structures in the human body, playing an extremely important role in the biomechanical function of the movement. The development of feet takes place on different levels which comprise structural and functional maturation processes. Foot posture can be assessed through a variety of measures including plain film radiographs, static foot posture measures and footprint analysis. No universally accepted clinical measure for assessing, evaluating and monitoring high – prevalent paediatric flat foot and the development of medial longitudinal arch was found within existing literature. Purpose: The aim of this study was to examine the intra-rater reliability of different measures for paediatric foot posture and to determine which of them is the most suitable for assessment in school children. Methods: 108 participants were included in this study. Three measures of foot posture – Foot Posture Index, Navicular Drop test and paper footprint analysis using podograph were performed twice. Testing sessions were separated by one week. Assessment of intra-rater reliability was conducted using intraclass correlation coefficients. Paired t-test was performed to compare separate measures and standard errors of measurement (SEM) and minimal detectable change (MDC) were calculated. Differences between age groups were analyzed with a one-way analysis of variance (ANOVA). Results: Intra-rater reliability of Foot Posture Index (FPI-6) was excellent in all age groups (ICC>0,9) followed by reliability of Chippaux-Smirak Index (CSI) and Staheli Index (SI). Reliability for those was excellent in all groups except in the youngest age group, where the reliability was good. Reliability of Navicular Drop Test (NDT) was good in all age groups. When comparing different age groups there are significant differences (p<0,05) in outcomes in all measures except NDT. Discussion and Conclusion: The outcomes of this study suggest that FPI-6 should be the preferred method of paediatric foot posture measurement in future research in school children. Findings suggest CSI, SI and NDT are also appropriate when assessing foot posture. There are significant differences in outcomes between age groups with higher reliability in older children. Future research should examine other measurement properties of measures - inter-rater reliability of these measures, validity (construct and concurrent) as well as examine correlation between measures.

• Keywords: master's theses, physiotherapy, foot posture, flat feet, reliability, foot posture index, navicular drop test