Reprodutibilidade da cinemática da escápula, úmero e tronco em adultos saudáveis, comparando as avaliações entre os avaliadores experiente e inexperiente

Abstract

The reproducibility of scapular kinematics has already been tested intra- and inter-sessions and intra- and inter-days, however, these evaluations were only performed by experienced evaluators and the majority of studies included only one evaluator. Thus, the comparison between evaluators with different levels of experience has not yet been explored, leaving doubts as to the accuracy of the evaluation results when performed by different evaluators. The objective of the present study was to evaluate the reproducibility inter and intra-rater, experienced and inexperienced, during flexion and abduction movements of the arm for the scapula, humerus, and trunk segments. Kinematic data were captured during flexion and abduction movements of the arm using a system of 8 cameras and a sampling frequency of 120 Hz. In total, twenty healthy volunteers were evaluated (10 men and 10 women), with an average age of 25.1 (1.1) years, who underwent 6 sessions of movement analysis. Each evaluator carried out three sessions, two sessions on the first day, with a three-hour interval between them, and the third session on the second day, twenty-four hours after the first day. For each session, 5 repetitions of each movement, unilateral abduction and flexion of the arm, were performed. Statistical analysis was performed by an independent evaluator and the Shapiro-Wilk test was used for data distribution. The reproducibility of the range of motion and angular values at angles of 30º, 60º, 90º, and 120º was verified through the intraclass correlation coefficient (ICC) and standard measurement error (SEM). The values obtained for the angles 30°, 60°, 90°, and 120° intra-day ranged from 0.67-0.98 and (0.58° to 5.64°) for the inexperienced evaluator and from 0.67° to 0.98° and (0.64° to 6.17°) for the experienced evaluator in the flexion movement. During the abduction movement the values obtained at angles of 30°, 60°, 90°, and 120° intra-day ranged from 0.75° to 0.96° and (0.51° to 4.93°) for the inexperienced evaluator and from 0.62° to 0.97° and (0.66° to 6.58°) for the experienced evaluator. The model presented good to excellent intra-day reproducibility for both evaluators in the flexion and abduction movements of the arm. Inter-day values in flexion varied from 0.41° to 0.88° and (0.64° to 6.17°) for the inexperienced evaluator and 0.72° to 0.95° and (0.67° to 4.31°) for the experienced evaluator. In the inter-day abduction movement, values ranged from 0.33° to 0.91° and (0.74° to 6.60°) for the inexperienced evaluator and 0.72° to 0.98° and (0.73° to 5.01°) for the experienced evaluator. The reproducibility of the inexperienced evaluator presented from weak to excellent in the arm flexion movement and poor to excellent in abduction of the arm. The reproducibility for the experienced evaluator was good to excellent for flexion and abduction of the arm between the scapula, humerus, and trunk segments in healthy adults. The results showed that there is no difference between evaluators in the intra-day evaluations; however, on an inter-day basis the experienced evaluator obtained better reproducibility results, demonstrating that a difference in levels of experience between evaluators is of fundamental importance to obtain reproducible results on different days. However, we emphasize the importance of performing further studies, with different movements and patients, performed by two or more evaluators.