Article

Prospective cohort study. PURPOSE OF THE STUDY: To compare the
inter-rater reliability of using a modified finger goniometer (MFG) for the
measurement of isolated forearm rotation for patients with distal radius
fractures to the currently accepted technique for isolated forearm measurement.
INTRODUCTION: The currently accepted method of forearm measurement requires the
assessor to visually estimate vertical for the stationary arm and placement of
the moveable arm while placing a straight edge along a curved surface.
Inter-rater reliability may be limited as assessors may estimate the placement of
the goniometer arms differently depending on their experience, posture, and even
their positioning relative to the patient. Rather than continue to place a
straight edge on a round surface, we evaluate a new technique using an MFG for
measuring isolated forearm rotation. METHODS: Patients with clinically healed
distal radius fractures were enrolled in the study. Measurement of active forearm
pronation and supination was recorded using 2 separate measurement techniques.
These measurements were taken by 2 separate hand therapists with more than 10
years of clinical experience in a tertiary care setting at the beginning and end
of hand therapy sessions for 3 consecutive weekly visits. Intraclass correlation
coefficients (ICCs), standard error of measurement, and minimal detectable change
were calculated for each technique. RESULTS: The point estimates for the MFG
method demonstrated a slightly higher ICC than the standard method for pronation
(0.86 vs 0.82). For supination, both measurement techniques displayed equally
high pooled ICCs (0.95). The standard error of measurements for the MFG were 2.1
for pronation and 1.2 for supination compared with 2.9 (pronation) and 1.2
(supination) for the standard technique. These translate into 90% minimal
detectable changes of 5 degrees and 3 degrees for the MFG pronation/supination
compared with 7 degrees (pronation) and 3 degrees (supination) for the standard
technique, respectively. DISCUSSION: Although the point estimates for the ICCs of
the MFG method are equal or higher than the standard method, the confidence
intervals for the ICCs overlap, indicating that the MFG is at least equivalent to
the standard method in terms of inter-rater reliability. LEVEL OF EVIDENCE: 2b.
CI - Copyright (c) 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS