Abstract
Objective
To analyse the accuracy and reproducibility of photogrammetry in detecting thoracic abnormalities in infants born prematurely.
Design
Cross-sectional study.
Setting
The Premature Clinic at the Federal University of São Paolo.
Participants
Fifty-eight infants born prematurely in their first year of life.
Outcome measures
Measurement of the manubrium/acromion/trapezius angle (degrees) and the deepest thoracic retraction (cm). Digitised photographs were analysed by two blinded physiotherapists using a computer program SAPO to detect shoulder elevation and thoracic retraction. Physical examinations performed independently by two physiotherapists were used to assess the accuracy of the new tool.
Results
Thoracic alterations were detected in 39 (67%) and in 40 (69%) infants by Physiotherapists 1 and 2, respectively (kappa coefficient=0.80). Using a receiver operating characteristic curve, measurement of the manubrium/acromion/trapezius angle and the deepest thoracic retraction indicated accuracy of 0.79 and 0.91, respectively. For measurement of the manubrium/acromion/trapezius angle, the Bland and Altman limits of agreement were −6.22 to 7.22° [mean difference (d)=0.5] for repeated measures by one physiotherapist, and −5.29 to 5.79° (d=0.75) between two physiotherapists. For thoracic retraction, the intra-rater limits of agreement were −0.14 to 0.18cm (d=0.02) and the inter-rater limits of agreement were −0.20 to −0.17cm (d=0.02).
Conclusion
SAPO provided an accurate and reliable tool for the detection of thoracic abnormalities in preterm infants.
Citation
Photogrammetry: an accurate and reliable tool to detect thoracic musculoskeletal abnormalities in preterm infants Josy Davidson, Amelia Miyashiro N. dos Santos, Kessey Maria B. Garcia, Liu C. Yi, Priscila C. João, Milton H. Miyoshi, Ana Lucia Goulart
Physiotherapy - September 2012 (Vol. 98, Issue 3, Pages 243-249, DOI: 10.1016/j.physio.2011.05.007)