J W H Custers1, H G M Arets, R H H Engelbert, F T C Kooijmans, C K van der Ent, P J M Helders. 1. Department of Paediatric Physiotherapy and Paediatric Exercise Physiology, University Medical Centre/Wilhelmina Children's Hospital Utrecht, Room KB 02.056.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands. j.custers@umcutrecht.nl
Abstract
BACKGROUND: Measurement of thoracic excursion (TEM) during maximal ventilation is part of the physiotherapy assessment in children with cystic fibrosis (CF). OBJECTIVES: The purpose of our study was to examine the reliability of TEM and its relation with pulmonary function. METHODS: Thoracic excursions were measured using a measuring tape. Thirty children participated in an intra-observer and inter-observer reliability study. Reliability was determined by calculating the typical error in repeated measurement, limits of agreement and correlation coefficients. Cross-sectional data from the annual check-ups were used to measure the relation between TEM and pulmonary function. RESULTS: In the intra-observer reliability study the typical error was 0.31 cm, the limits of agreement were +/-0.86 cm. Pearson's r and ICC were 0.96 and 0.95, respectively. In the inter-observer reliability study these values were 0.56 cm, +/-1.55 cm, 0.85 and 0.85, respectively. TEM correlated significantly with height (0.31, P<0.001), FVC (0.44, P<0.001), FEV1 (0.41, P<0.001) and TLC (0.19, P<0.05), and there was a significant inverse correlation with RV%TLC (-0.45, P<0.001). CONCLUSIONS: TEM is a reliable assessment tool. Thoracic excursion is significantly, although moderately correlated with pulmonary function.
BACKGROUND: Measurement of thoracic excursion (TEM) during maximal ventilation is part of the physiotherapy assessment in children with cystic fibrosis (CF). OBJECTIVES: The purpose of our study was to examine the reliability of TEM and its relation with pulmonary function. METHODS: Thoracic excursions were measured using a measuring tape. Thirty children participated in an intra-observer and inter-observer reliability study. Reliability was determined by calculating the typical error in repeated measurement, limits of agreement and correlation coefficients. Cross-sectional data from the annual check-ups were used to measure the relation between TEM and pulmonary function. RESULTS: In the intra-observer reliability study the typical error was 0.31 cm, the limits of agreement were +/-0.86 cm. Pearson's r and ICC were 0.96 and 0.95, respectively. In the inter-observer reliability study these values were 0.56 cm, +/-1.55 cm, 0.85 and 0.85, respectively. TEM correlated significantly with height (0.31, P<0.001), FVC (0.44, P<0.001), FEV1 (0.41, P<0.001) and TLC (0.19, P<0.05), and there was a significant inverse correlation with RV%TLC (-0.45, P<0.001). CONCLUSIONS:TEM is a reliable assessment tool. Thoracic excursion is significantly, although moderately correlated with pulmonary function.