Dale Edgar1, Vidya Finlay, Andy Wu, Fiona Wood. 1. Western Australian Burns Service, Royal Perth Hospital, University of Western Australia, McComb Foundation of WA, Australia. dale.edgar@health.wa.gov.au
Abstract
BACKGROUND: Despite common use and theoretical construct validity, goniometry is not reported to be reliable for the measurement of burn-affected joint range of motion. Similarly, a number of simple objective measures commonly used to document hand mobility have eluded this rigour. This study aimed to examine the within sessions of intra-rater and inter-rater reliability of active joint range of motion measurement in patients with burns. METHODS: Intra-rater reliability: One physical therapist (PT) recorded duplicate measurements on each burn-affected joint after a 5-min interval in a subset of patients (n=21). Inter-rater reliability: Four qualified PTs took part in repeated measures testing of 45 patients on the same day. RESULTS: Intra-rater reliability was excellent with intraclass correlation coefficients (ICCs>.99) and 95% confidence intervals (CIs)=.99-1.0. Inter-rater reliability was also excellent with ICCs>.94 (95% CIs=.90-.99). The minimum detectable change using goniometry at the ankle was > or =5 degrees and for all other joints tested was > or =9 degrees. For linear hand measures a change of >1cm and thumb opposition > or =1/2 of one scale point indicated measurable difference. CONCLUSION: This study demonstrated excellent intra-rater and inter-rater reliability and measurement of clinically relevant change for all measurements when applied with a standardised protocol. Therefore, assessing joint range of motion (ROM) with a goniometer or hand movement with linear or scale measurements can provide accurate, objective measures in the burns population.
BACKGROUND: Despite common use and theoretical construct validity, goniometry is not reported to be reliable for the measurement of burn-affected joint range of motion. Similarly, a number of simple objective measures commonly used to document hand mobility have eluded this rigour. This study aimed to examine the within sessions of intra-rater and inter-rater reliability of active joint range of motion measurement in patients with burns. METHODS: Intra-rater reliability: One physical therapist (PT) recorded duplicate measurements on each burn-affected joint after a 5-min interval in a subset of patients (n=21). Inter-rater reliability: Four qualified PTs took part in repeated measures testing of 45 patients on the same day. RESULTS: Intra-rater reliability was excellent with intraclass correlation coefficients (ICCs>.99) and 95% confidence intervals (CIs)=.99-1.0. Inter-rater reliability was also excellent with ICCs>.94 (95% CIs=.90-.99). The minimum detectable change using goniometry at the ankle was > or =5 degrees and for all other joints tested was > or =9 degrees. For linear hand measures a change of >1cm and thumb opposition > or =1/2 of one scale point indicated measurable difference. CONCLUSION: This study demonstrated excellent intra-rater and inter-rater reliability and measurement of clinically relevant change for all measurements when applied with a standardised protocol. Therefore, assessing joint range of motion (ROM) with a goniometer or hand movement with linear or scale measurements can provide accurate, objective measures in the burns population.
Authors: Matthijs Botman; Thom C C Hendriks; Louise E M de Haas; Grayson S Mtui; Emanuel Q Nuwass; Mariëlle E H Jaspers; Anuschka S Niemeijer; Marianne K Nieuwenhuis; Henri A H Winters; Paul P M Van Zuijlen Journal: Plast Reconstr Surg Glob Open Date: 2020-07-15
Authors: Anouk M Oosterwijk; Marianne K Nieuwenhuis; Hennie J Schouten; Cees P van der Schans; Leonora J Mouton Journal: PLoS One Date: 2018-08-01 Impact factor: 3.240