Measures of Skin Turgor in Humans: A Systematic Review of the Literature.

BACKGROUND: Many studies use similar methods to measure skin turgor, but there is no gold standard method that is being followed in clinics or hospitals. PURPOSE: The purpose of this systematic review was to determine if there is any consistent method to measure skin turgor in humans that is valid and reliable. METHODS: Topics of interest for turgor assessment included dehydration; skin integrity, including wounds and skin flaps; and fluid/electrolyte balance for adults 18 years and older. PubMed, ProQuest Medical, SPORTDiscus, PEDro, Web of Science Core Collection, and Cumulative Index of Nursing and Allied Health Literature complete databases were utilized. Levels of evidence were established with 2011 Oxford Centre for Evidence-Based Medicine scale. Methodological rigor was assessed with Quality Assessment of Diagnostic Accuracy Studies checklist. Two researchers graded rigor and level of evidence with a third researcher serving as a tie-breaker. RESULTS: Thirteen articles were included in the final analysis. Some researchers used skin turgor as a measure but did not give details regarding specifically how this measure was used. The pinch test was the most commonly used measure of skin turgor. There were 4 articles ranked as evidence level 2, 1 article as evidence level 3, and 8 articles as evidence level 4. Rigor scores ranged from 3 to 13/14. CONCLUSION: Skin turgor may not be the best assessment tool for some conditions or purposes in adults, such as dehydration, which could lead to a medical emergency.

Intra and inter-rater reliability of a goniometric lower trunk rotation measurement.

OBJECTIVES: Limited lower trunk rotation, which includes rotation of the lumbar spine, may hinder or even prevent functional activities. Currently, due to the lack of reliable, valid, and clinically useful tests, there is no standard objective measure of lower trunk rotation that can be easily performed in the clinic. The purpose of this study was to establish a standard protocol and to determine inter-rater and intra-rater reliability for a goniometric measurement developed to measure lower trunk rotation. METHODS: Lower trunk rotation was measured using a specific, goniometric method in 41 subjects. Each subject was measured 6 times by 2 different examiners for a total of 12 measurements. RESULTS: Pearson correlation coefficients indicate good intra-rater reliability ranging from 0.59 to 0.82 for right rotation (P< 0.001) and 0.76 to 0.82 for left rotation (P< 0.001), as well as good inter-rater reliability ranging from 0.62 to 0.83 with right rotation (P< 0.001) and 0.75 to 0.77 for left rotation (P< 0.001). CONCLUSION: This measure of trunk rotation may be useful for objectively documenting lower trunk rotation.