Research Report Abstracts - Gesundheit

eS302
Research Report Platform Presentation
Number: RR-PL-2928 Tuesday 21 June 09:15
RAI: Forum
INTER-RATER RELIABILITY OF
MEASUREMENTS OF NERVE LONGITUDINAL
MOVEMENT USING DYNAMIC ULTRASOUND
IMAGING IN CHRONIC WHIPLASH ASSOCIATED
DISORDERS II
Edeni K., Rushton A., Wright C.
University of Birmingham, Nursing and Physiotherapy,
Birmingham, United Kingdom
Purpose: To estimate inter-rater reliability of measurements
of median and ulnar nerve longitudinal movement during
contra-lateral neck side flexion using dynamic ultrasound
imaging [DUI] post whiplash injury.
Relevance: The presence of features suggesting neuropathic
pain in whiplash associated disorders [WAD] highlights the
importance of nerve evaluation post whiplash injury. Physiotherapists
utilise the upper limb neurodynamic test [ULNT]
during patient assessment to interpret both the mobility
and sensitivity of peripheral nerves to mechanical stress.
DUI might provide a portable, non-invasive and inexpensive
method to complement ULNT evaluation of nerve mobility
changes. Using DUI, a reduction in median nerve mobility
has been observed in patients presenting with chronic WAD
I/II. However, evidence is limited and conflicting; raising
questions regarding measurement properties of DUI, e.g. reliability.
Currently, there are few reliability studies of limited
quality [inadequate samples and data analysis or investigating
one component of measurement] for DUI evaluation of
nerve movement.
Participants: 18 participants [mean (SD) age = 35 (12)
years] with a previous history of whiplash injury [chronic
WAD II] were recruited from a university community via
email, poster and word of mouth. n ≥ 12 detects a difference
between ICC values of 0.9 and 0.7 at 80% power and 5% level
of significance using 3 raters. Ethical approval was obtained.
Methods: Cross-sectional design to evaluate inter-rater
reliability of measurements of median and ulnar nerve
longitudinal movement obtained by 3 raters. Raters
were postgraduate physiotherapy students [≥5 years postqualification],
trained and certified competent in nerve
imaging by a qualified sonographer. Nerve images of
590 × 790 pixels, 0.044 mm/pixel resolution were acquired at
10 fps using a Diasus ultrasound system [8–16 MHz; 26 mm
linear-array probe]. Median and ulnar nerve movement was
imaged at the mid-forearm and 2.5 cm above the elbow
respectively in arm starting positions utilising components
of the ULNT. Contra-lateral neck side flexion, a key sensitising
component of ULNT, was used to produce nerve
movement. A warm-up of five repetitions addressed possible
serial effects prior to imaging.
Analysis: The mean [mm] of 3 analyses of nerve images
using the cross-correlation algorithm program [Matlab ® ]was
recorded. Inter-rater reliability was assessed with intra-class
correlation coefficient [ICC2,1], standard error of measurements
[SEM] and 95% confidence intervals [95% CI] using
SPSS [version 15].
Results: ICC2,1 = 0.4 [95% CI = 0.08–0.66] and SEM = 0.38
for median nerve. ICC2,1 = 0.2 [95% CI = 0–0.55] and
SEM = 0.31 for ulnar nerve. Median and ulnar nerve longitudinal
movement demonstrated fair and poor inter-rater
reliability respectively. The DUI method involves two components,
nerve imaging followed by analysis, both of which
can individually contribute to measurement error.
Conclusions: This evidence does not support high inter-rater
reliability of DUI measurement of median and ulnar nerve
longitudinal movement in a chronic WAD II population.
Implications: Although DUI provides a potentially useful
tool for measuring nerve movement in practice, its reliability
merits further consideration. Research studies addressing
potential errors within imaging and analysis are required.
Keywords: Nerve movement; Ultrasound; Reliability
Funding acknowledgements: Unfunded. The School of
Sports and Exercise Sciences, University of Birmingham,
UK is acknowledged for providing access to the Diasus ultrasound
system used in this study.
Ethics approval: Ethical approval was obtained from ethics
committees of the Schools of Health Sciences, and Sports
Sciences, University of Birmingham, UK.
Research Report Platform Presentation
Number: RR-PL-2522 Wednesday 22 June 09:15
RAI: E106-107
ASSOCIATION BETWEEN OROFACIAL
FUNCTION, GROSS MOTOR FUNCTION AND
MANUAL ABILITY IN CHILDREN AND YOUNG
ADULTS WITH CEREBRAL PALSY
Edvinsson S. 1,2 , Lundqvist L.-O. 2
1Örebro County Council, Child and Youth Habilitation,
Örebro, Sweden, 2Örebro County Council, Centre for Rehabilitation
Research, Örebro, Sweden
Purpose: To describe orofacial dysfunction according to
Nordic Orofacial Test-Screening instrument (NOT-S) in children
and young adults with cerebral palsy (CP) and explore
the association with CP-subdiagnose, gross motor function
and manual ability.
Relevance: Orofacial function includes several actions such
as chewing and swallowing, breathing, speech and emotional
communication by facial expression all dependent on complex
integrated activities of the central nervous system and
the neuromuscular system. Oral-motor difficulties are often
present in CP and posture may have a considerable influence
on the performance. Eating and swallowing problems
are common but still under-recognised although they also can
have an impact on respiratory health. Since parents tend to