하지 정렬 평가를 위한 체표면 토포그래피를 이용한 측정법: 새로운 임상 및 연구 도구에 대한 검토

Surface Topographic Measurement Method for Assessing Lower Extremity Alignment: Examination on a novel clinical and research Tool

  • 임지영 (건양대학과 물리치료학과) ;
  • 임현승 (건양대학과 물리치료학과) ;
  • 박대성 (건양대학과 물리치료학과) ;
  • 이재헌 (아주대학교의료원 정형외과학교실) ;
  • 이나경 (건양대학과 물리치료학과)
  • 투고 : 2015.10.13
  • 심사 : 2015.12.28
  • 발행 : 2016.02.29

초록

이 연구의 목적은 래스터입체사진술이 적용된 ABW-mapper를 사용하여 얻은 관상면 상에서의 하지 정렬 측정에 대하여 측정자 내, 측정자 간, 측정-재측정 간 각각의 신뢰도와 타당도를 조사하고 평가하는 것이다. 열여덟 명의 대상자가 이 연구에 참여하였다. 일주일간격으로 두 번의 세션에 걸쳐서 두 사람의 측정자가 각각 ABW-mapper를 사용하여 기립자세에서의 S각(입체사진 각-래스터입체사진 촬영을 통해 측정한 관상면상의 하지 정렬 측정 각)을 측정하였고, 첫 번째 세션에서는 짧은 시간 간격으로 한 측정자가 같은 대상자에 대하여 두 번씩 측정하였다. Q각은 디지털카메라로 기립자세를 촬영한 사진에서 고니어미터로 측정하였다. HKA각은 컴퓨터 기반 디지털 방사선 영상사진 위에서 측정 소프트웨어를 사용하여 측정하였다. 급내상관계수(ICC)를 통해 신뢰도를 분석하였고, 피어슨 상관계수를 사용하여 타당도를 검사하였다. 그 결과, S각 측정은 매우 높은 측정자 내 (ICC=0.956~0.974), 측정자 간 (ICC=0.962) 검사-재검사 간 (ICC=0.945) 신뢰도를 나타냈으며, S각과 Q각, S각과 HKA각 사이에는 강한 음의 상관관계(각각 r=-0.739, -0.702)를 나타냈다. 따라서, ABW-mapper에 의한 래스터입체사진법을 통한 S각 측정은 관상면에서의 하지정렬의 측정에 대하여 Q각이나 HKA각 측정에 관련하여 예비적 또는 보완적 도구로 사용될 수 있을 것이라 생각된다.

The purpose of this study was to assess the intra-rater, inter-rater and test-retest reliability and validity of frontal plane lower extremity alignment estimated from a rasterstereographic method using ABW-Mapper. Eighteen subjects participated in this study. The S angle (stereographic angle-frontal plane lower extremity alignment estimated from a rasterstereographic method) in standing was measured throughout the two sessions with one week interval by two different readers. In the first session, a reader measured S angle twice per subject with a short break in-between. The Q-angle (quadriceps angle) was measured using a standard goniometer from a photography taken through digital camera with the participant standing in the same position as in the S angle measurement. The HKA(hip-knee-ankle) angle was measured from a computer based digital radiograph with the computerized measurement software. Reliability was tested using intraclass correlation coefficients(ICC). Validity was tested using a Pearson's correlation coefficient. Excellent intra-rater(ICC=0.956~0.974), inter-rater(ICC=0.962), test-retest reliability (ICC=0.945) were demonstrated. There were strong negative correlations between S angle and Q-angle (r=-0.739), and between S angle and HKA angle (r=-0.702). Therefore, the S angle measured using a rasterstereographic mapper may be used to as a preliminary or supplementary tool to evaluate and study LE alignment in the frontal plane in relation to HKA angle or Q-angle.

키워드

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