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Publication
Estudo da Validade e Concordância da Classificação de McConnell na Avaliação do Posicionamento da Patela em Indivíduos Assintomáticos
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Authors
Advisor(s)
Abstract(s)
INTRODUÇÃO: A Dor Patelo-Femoral (DPF) é uma condição musculo-esquelética
caracterizada por sintomatologia dolorosa na face anterior do joelho. A sintomatologia
encontra-se geralmente associada a atividades que promovem o aumento das forças de
compressão na articulação patelo-femoral (APF). A DPF tem uma prevalência de 22.7%
na população geral e são vários os fatores que consideram estar na sua etiologia, entre as
alterações da cinemática da APF. Desta forma torna-se essencial a criação de um método
que permita uma avaliação precisa destas alterações em contexto clínico. O método
desenvolvido por Jenny McConnell (MCAPP) tem uma aceitação abrangente, no entanto
os resultados dos estudos que investigaram a sua validade são contraditórios.
OBJECTIVO: Avaliar a validade de constructo, na forma de validade convergente, do
MCAPP, e a concordância por referência ao método tridimensional de avaliação da
posição da patela (MTAPP) em indivíduos assintomáticos. METODOLOGIA: O
presente estudo utilizou uma amostra de 32 indivíduos assintomáticos. Foi composto por
um momento de avaliação único, com dois métodos distintos, o MTAPP e o MCAPP.
Realizou-se depois o Teste do X2 e Fisher Exact Test e analisou-se o Coeficiente de
correlação V de Cramer e de Spearmen, o Kappa de Fleiss e os Limites de Concordância
RESULTADOS: Desvio Interno-Externo: X2(2) =1.66; p=0.62; N=30; Coeficiente de
Correlação V de Cramer=0.24 p=0.62;Kappa de Fleiss=0.08 p=0.55; LDC a 95%: 1.87 a
-1.73. DISCUSSÃO E CONCLUSÃO: Os resultados do MTAPP e do MCAPP são
independentes e apresentam uma correlação que varia entre muito fraca e moderada.
Demonstrou-se também que a concordância entre os métodos varia entre pobre e fraca.
A validade convergente do MCAPP e a sua concordância com o MTAPP não ficaram
demonstradas.
INTRODUCTION: Patellofemoral Pain (PFP) is a common musculoskeletal condition characterized by painful symptomatology on the anterior part of the knee. Symptomatology is generally associated with activities that promote increased compression forces at the patellofemoral joint (APF). The PFP has a prevalence of 22.7% in the general population and several factors are considered to be in its etiology, among them the changes in the APF kinematics. In this way it is essential to create a method that allows an accurate evaluation of these changes in a clinical context. The method developed by Jenny McConnell (MCAPP) has a wide acceptance, however the results of studies that investigated its validity are contradictory. OBJECTIVE: To evaluate the construct validity, in the form of convergent validity, of the MCAPP, by reference to the three - dimensional method of assessment of the position of the patella (MTAPP) in asymptomatic individuals. METHODS: The present study used a sample of 32 asymptomatic individuals. It was composed of a single evaluation moment, with two different methods, the MTAPP and the MCAPP. The Chi Square Test and Fisher Exact Test were then performed as the Cramer’s V and Spearman Correlation Coefficients. Fleiss Kappa and Limits of Agreement were also analyzed. RESULTS: Internal-External Deviation: X2 (2) = 1.66; p = 0.62; N = 30; Cramer's V Correlation Coefficient= 0.24 p = 0.62; Fleiss's Kappa = 0.08 p = 0.55; 95% Limits of Agreement: 1.87 to -1.73. DISCUSSION AND CONCLUSION: The results of MTAPP and MCAPP are independent and show a correlation ranging from very weak to moderate. It has also been shown that the agreement between the methods varies between poor and weak. The convergent validity of MCAPP and its agreement with MTAPP have not been demonstrated.
INTRODUCTION: Patellofemoral Pain (PFP) is a common musculoskeletal condition characterized by painful symptomatology on the anterior part of the knee. Symptomatology is generally associated with activities that promote increased compression forces at the patellofemoral joint (APF). The PFP has a prevalence of 22.7% in the general population and several factors are considered to be in its etiology, among them the changes in the APF kinematics. In this way it is essential to create a method that allows an accurate evaluation of these changes in a clinical context. The method developed by Jenny McConnell (MCAPP) has a wide acceptance, however the results of studies that investigated its validity are contradictory. OBJECTIVE: To evaluate the construct validity, in the form of convergent validity, of the MCAPP, by reference to the three - dimensional method of assessment of the position of the patella (MTAPP) in asymptomatic individuals. METHODS: The present study used a sample of 32 asymptomatic individuals. It was composed of a single evaluation moment, with two different methods, the MTAPP and the MCAPP. The Chi Square Test and Fisher Exact Test were then performed as the Cramer’s V and Spearman Correlation Coefficients. Fleiss Kappa and Limits of Agreement were also analyzed. RESULTS: Internal-External Deviation: X2 (2) = 1.66; p = 0.62; N = 30; Cramer's V Correlation Coefficient= 0.24 p = 0.62; Fleiss's Kappa = 0.08 p = 0.55; 95% Limits of Agreement: 1.87 to -1.73. DISCUSSION AND CONCLUSION: The results of MTAPP and MCAPP are independent and show a correlation ranging from very weak to moderate. It has also been shown that the agreement between the methods varies between poor and weak. The convergent validity of MCAPP and its agreement with MTAPP have not been demonstrated.
Description
Relatório do Projeto de Investigação apresentado para cumprimento dos
requisitos necessários à obtenção do grau de mestre em Fisioterapia, área de
especialização em Fisioterapia em Condições Músculo-Esqueléticas
Keywords
Validade Concordância Dor Patelo-Femoral Avaliação Clínica McConnell Avaliação Tridimensional Validity Agreement Patello-Femoral Pain Clinical Evaluation McConnell Three-dimensional evaluation
Citation
Publisher
Instituto Politécnico de Setúbal. Escola Superior de Saúde