Zanesljivost merjenja obsega gibljivosti dorzalne fleksije s tremi merilnimi inštrumenti pri preiskovancih po lateralnem zvinu skočnega sklepa : diplomsko delo

Škerl, Filip (author), Hlebš, Sonja (mentor), Vauhnik, Renata (reviewer)

Uvod: Merjenje obsega gibljivosti skočnega sklepa se izvaja za oceno funkcijskega stanja sklepa, pri prepoznavanju in diagnosticiranju okvar in poškodb ter za spremljanje napredka zdravljenja z različnimi merilnimi inštrumenti v položaju leže ali stoje. Namen: Namen diplomskega dela je bil ugotoviti zanesljivost posameznega preiskovalca meritve obsega gibljivosti dorzalne fleksije v skočnem sklepu s tremi merilnimi inštrumenti v položaju stoje, z univerzalnim goniometrom, aplikacijo na pametnem telefonu in centimetrskim trakom pri preiskovancih po lateralnem zvinu skočnega sklepa, ali obstaja asimetrija v obsegu gibljivosti med predhodno poškodovanim in nepoškodovanim skočnim sklepom in ali izkušenost preiskovalca vpliva na zanesljivost meritev. Metode: Sodelovalo je 20 preiskovancev (10 moških, 10 žensk; starost 22,2 ± 3,21 let; telesna masa 76,45 ± 17,66 kg; telesna višina 73,9 ± 10,25 cm; indeks telesne mase 25,14 ± 4,61; čas od poškodbe 36 ± 30,12 mesecev). Izračunan je bil intraklasni koeficient korelacije, standardna napaka merjenja in najmanjša zaznavna sprememba za vsak merilni inštrument. Rezultati: Ugotovili smo dobro zanesljivost posameznega preiskovalca z vsemi tremi merilnimi inštrumenti (ICC = 0,973 centimetrski trak; 0,977 aplikacija; 0,990 univerzalni goniometer). Ugotovljena je bila statistično značilna razlika obsega gibljivosti med poškodovanim in nepoškodovanim skočnim sklepom, in sicer z univerzalnim goniometrom (p < 0,007) in z aplikacijo (p < 0,018). Rezultati t-testa za odvisne vzorce so pokazali statistično značilno razliko (p = 0,01) med meritvama z goniometrom in aplikacijo za nepoškodovan skočni sklep, statistično značilnih razlik med meritvami z goniometrom in aplikacijo za poškodovani skočni sklep ni bilo (p = 0,666). Standardne napake merjenja za univerzalni goniometer in za aplikacijo so bile od 1,390° do 2,129° in najmanjše zaznavne spremembe od 3,853° do 6,515°. Standardna napaka merjenja za centimetrski trak je bila od 1,090 cm do 1,145 cm in najmanjša zaznavna sprememba od 3,022 cm do 3,175 cm. Razprava in zaključek: Koeficienti zanesljivosti za goniometer in aplikacijo so bili višji v primerjavi z merilnim trakom, pri čemer smo za univerzalni goniometer izmerili najnižjo vrednost najmanjše zaznavne spremembe, zato bi univerzalni goniometer lahko bil boljša izbira od aplikacije in merilnega traka za merjenje obsega gibljivosti dorzalne fleksije skočnega sklepa. Rezultati naše raziskave so pokazali, da lahko preiskovalec brez izkušenj zanesljivo izmeri obseg gibljivosti dorzalne fleksije z uporabo treh različnih merilnih inštrumentov.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, gleženj, dorzalna fleksija, mobilna aplikacija, univerzalni goniometer
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [F. Škerl]
• Year: 2024
• Number of pages: 33 str.
• PID: 20.500.12556/RUL-155914
• UDC: 615.8
• COBISS.SI-ID: 193648131
• Publication date in RUL: 24.04.2024

Secondary language

• Language: English
• Title: Reliability of measuring ankle dorsiflexion range of motion with three measuring instruments after lateral ankle sprain : diploma work

Abstract

Introduction: Measurement of the range of motion of the ankle joint is performed to assess the functional status of the joint, to detect impairments and injuries and to monitor the progress of treatment using various measuring instruments in supine or standing position. Purpose: The study aimed to determine the intra-rater reliability of ankle dorsiflexion range of motion using three measuring instruments in the standing position – a universal goniometer, a smartphone application, and a tape measure - in subjects with a lateral ankle sprain. In addition, to investigate whether there is an asymmetry in the range of motion between the previously injured and uninjured ankle and whether the examiner's experience influences the reliability of the measurement. Methods: Twenty participants (10 men, 10 women; mean age 22.2 ± 3.21 years; mean body weight 76.45 ± 17.66 kg; mean height 73.9 ± 10.25 cm; mean body mass index 25.14 ± 4.61; mean time since injury 36 ± 30.12 months) were included. Intra-rater reliability was determined using an intraclass correlation coefficient, standard error of measurement and the minimal detectable change for each measurement technique were also calculated. Results: Good intra-rater reliability was found for the measurements all three measuring instruments (ICC = 0.973 for tape measure; 0.977 for the application; 0.990 for the universal goniometer). A statistically significant difference in range of motion was found between the injured and uninjured ankle, with the universal goniometer (p < 0.007) and the application (p < 0.018). The results of the dependent t-test showed a statistically significant difference (p = 0.01) between the measurements with the goniometer and the application for the uninjured ankle, while no statistically significant differences were found between the measurements with the goniometer and the application for the injured ankle (p = 0.666). The standard errors of measurement for the universal goniometer and application ranged from 1.390° to 2.129°, and the minimum detectable changes ranged from 3.853° to 6.515°. The standard error of measurement for the tape measure ranged from 1.090 cm to 1.145 cm, and the minimum detectable changes ranged from 3.022 cm to 3.175 cm. Discussion and conclusion: Reliability coefficients for the goniometer and the application were higher compared to the tape measure, with the universal goniometer having the lowest values for minimum detectable change. Therefore, the universal goniometer may be preferred over the application and tape measure for measuring ankle dorsiflexion range of motion. The results of our study show that unexperienced examiner can reliably measure ankle dorsiflexion range of motion with three different measuring instruments.

• Keywords: diploma theses, physiotherapy, ankle, dorsiflexion, mobile application, universal goniometer