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Fiabilidade teste-reteste e erro padrão de medida da eletromiografia de superfícies na avaliação da atividade muscular do joelho
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Advisor(s)
Abstract(s)
INTRODUÇÃO: As queixas músculo-esqueléticas (ME) relacionadas com o joelho são
extremamente comuns, representando uma taxa de prevalência de 32,1% em alguns países
da Europa. As estruturas neuromusculares desempenham um papel fundamental no controlo
da articulação do joelho, predispondo a lesão quando as mesmas não funcionam em pleno.
Torna-se fundamental a existência de métodos fiáveis para medir a atividade muscular.
Apesar da eletromiografia de superfície (EMGs) ser aceite e amplamente utilizada com esse
objetivo, carece de avaliação sobre a fiabilidade teste-resteste (intra e inter-observador) e
suas variáveis, erro padrão de medida (EPM) e diferença mínima detetável (DMD) na
contração voluntária máxima (CVM) e percentagem da contração voluntária máxima
(%CVM). OBJECTIVOS: Avaliar a fiabilidade teste-reteste inter e intra-avaliador, o EPM
e a DMD de um sistema de EMGs (Physioplux) durante a contração voluntária máxima
(CVM) do joelho e a realização de tarefas funcionais, em indivíduos saudáveis.
METODOLOGIA: Foi recrutada uma amostra de 24 indivíduos saudáveis, avaliados em
dois momentos distintos e separados por uma média de 6 dias. Os dados eletromiográficos
foram normalizados pela CVM e foi calculada a %CVM durante a realização das tarefas
Wall-squat, Step-down e Step-up dos músculos Vasto Interno (VI), Vasto Externo (VE),
Bicípute Femoral (BF) e Semitendinoso (ST). Para aferir sobre a fiabilidade e concordância
foram calculados os valores de coeficiente de correlação intraclasse (CCI) e respetivos 95%
intervalo de confiança (IC), assim como os valores de EPM e respetivos 95% limites de
concordância (LDC) e a DMD. RESULTADOS: Obtiveram-se valores de CCI entre 0.52 e
0.80 para a CVM, sendo que o VE apresentou valores superiores a 0.70 nos dados inter e
intra-avaliador e o ST no inter-avaliador. Para a %CVM, os valores de CCI de inter e intra-
avaliador variaram entre 0.12 a 0.88 e 0.45 a 0.89, respetivamente. Os valores de EPM e de
DMD variaram entre 0.65% a 2.07% e 1.79% e 5.74%, respetivamente.
DISCUSSÃO E CONCLUSÃO: O EMG da Physioplux identifica-se como um sistema
moderadamente fiável, sendo necessário prudência na sua utilização em contexto de
investigação e principalmente clínico. Na grande maioria das medições, diferenças
relativamente pequenas (máximo 5%), ao longo do tempo, podem ser interpretadas como
mudanças reais no sujeito.
NTRODUCTION: Musculoskeletal (MS) complaints related to the knee are extremely common, representing a prevalence rate of 32.1% in some European countries. Neuromuscular structures play a key role in controlling the knee joint, predisposing it to injury when they are not fully functioning. Reliable methods for measuring muscle activity are essential. Although surface electromyography (EMGs) is accepted and widely used for this purpose, the test-retest reliability (intra and inter-observer), standard error of measurement (SEM) and minimum detectable change (MDC) in maximum voluntary contraction (MVC) and percentage of maximum voluntary contraction (%MVC), have not been evaluated. AIMS: To evaluate the inter and intra-rater test-retest reliability, the SEM and the MDC of an EMG system (Physioplux) during maximal voluntary contraction (MVC) and functional tasks of the knee in healthy subjects. METHODS: A sample of 24 healthy individuals was recruited and evaluated at two different time points separated by an average of 6 days. Electromyographic data were normalized by the MVC and %MVC was calculated during the performance of the Wall-squat, Step-down and Step-up tasks of the Vastus Medialis (VM), Vastus Lateralis (VL), Biceps Femoris (BF) and Semitendinosus (ST) muscles. To assess reliability and agreement, the intraclass correlation coefficient (ICC) and 95% confidence interval (CI) values were calculated, as well as the SEM and MDC values, as well as the 95% limits of agreement (LOA). RESULTS: ICC values between 0.52 and 0.80 were obtained for MVC, with VL (inter-rater and intra-rater) and ST (inter-rater) showing values higher than 0.70. For %MVC, the inter and intra-rater ICC values ranged from 0.12 to 0.88 and 0.45 to 0.89, respectively. The SEM and MDC values ranged from 0.65% to 2.07% and 1.79% to 5.74%, respectively. DISCUSSION AND CONCLUSION: Physioplux’s EMG appears to be as a moderate reliability system, however, caution is needed when using it under investigation and specially in clinical context. Relatively small changes (5% maximum) over time can be interpreted as real changes in the subject.
NTRODUCTION: Musculoskeletal (MS) complaints related to the knee are extremely common, representing a prevalence rate of 32.1% in some European countries. Neuromuscular structures play a key role in controlling the knee joint, predisposing it to injury when they are not fully functioning. Reliable methods for measuring muscle activity are essential. Although surface electromyography (EMGs) is accepted and widely used for this purpose, the test-retest reliability (intra and inter-observer), standard error of measurement (SEM) and minimum detectable change (MDC) in maximum voluntary contraction (MVC) and percentage of maximum voluntary contraction (%MVC), have not been evaluated. AIMS: To evaluate the inter and intra-rater test-retest reliability, the SEM and the MDC of an EMG system (Physioplux) during maximal voluntary contraction (MVC) and functional tasks of the knee in healthy subjects. METHODS: A sample of 24 healthy individuals was recruited and evaluated at two different time points separated by an average of 6 days. Electromyographic data were normalized by the MVC and %MVC was calculated during the performance of the Wall-squat, Step-down and Step-up tasks of the Vastus Medialis (VM), Vastus Lateralis (VL), Biceps Femoris (BF) and Semitendinosus (ST) muscles. To assess reliability and agreement, the intraclass correlation coefficient (ICC) and 95% confidence interval (CI) values were calculated, as well as the SEM and MDC values, as well as the 95% limits of agreement (LOA). RESULTS: ICC values between 0.52 and 0.80 were obtained for MVC, with VL (inter-rater and intra-rater) and ST (inter-rater) showing values higher than 0.70. For %MVC, the inter and intra-rater ICC values ranged from 0.12 to 0.88 and 0.45 to 0.89, respectively. The SEM and MDC values ranged from 0.65% to 2.07% and 1.79% to 5.74%, respectively. DISCUSSION AND CONCLUSION: Physioplux’s EMG appears to be as a moderate reliability system, however, caution is needed when using it under investigation and specially in clinical context. Relatively small changes (5% maximum) over time can be interpreted as real changes in the subject.
Description
Keywords
Fiabilidade teste-reteste EPM DMD Joelho Eletromiografia de superfície Test-retest reliability SEM MDC Knee Surface electromyography