Concordancia entre 2 sistemas de medición de movilidad articular de rodilla en sujetos jóvenes sanos: estudio transversal / Concordance between two knee joint mobility measurement systems in healthy young subjects: Cross-sectional study

Introducción: La valoración de los arcos de movilidad articular es uno de los elementos esenciales para determinar el inicio y la progresión en los tratamientos fisioterapéuticos. Objetivo: Analizar la concordancia del goniómetro universal y el goniómetro digital para medir los movimientos de flexión y extensión de la rodilla de manera bilateral, en sujetos jóvenes sanos. Métodos: Estudio descriptivo, analítico de corte transversal, que contó con la participación de 180 jóvenes sanos, seleccionados de manera aleatoria y voluntaria, con una edad media de 21,7 años, a quienes se les midió el movimiento de flexo-extensión de la rodilla de manera pasiva. El coeficiente de correlación intraclase (ICC) de acuerdo absoluto, se utilizó para medir el grado de concordancia entre las valoraciones cuantitativas realizadas. Se presentó anormalidad en la distribución de los datos de las mediciones de flexión-extensión de la rodilla, por lo que, las comparaciones se realizaron con la mediana de los datos. Resultados: Se encontró una muy buena concordancia en la utilización del goniómetro universal y el goniómetro digital, para los movimientos de la rodilla: flexión derecha ICC: 0,956, extensión derecha ICC: 0,936, flexión izquierda ICC: 0,933, y para la extensión izquierda ICC: 0,953. Conclusiones: El goniómetro universal y el goniómetro digital obtuvieron una muy buena correlación en la medición de la flexión y extensión de la rodilla. (AU)

Introduction: The assessment of joint mobility arches is one of the essential elements to determine the onset and progression in physiotherapeutic treatments. Objective: To analyze the concordance of the universal goniometer and the digital goniometer to measure the movements of flexion and extension of the knee bilaterally, in healthy young subjects. Methods: A descriptive, analytical cross-sectional study involved 180 healthy young people, randomly selected and voluntarily, with a mean age of 21.7 years, who were measured in the knee flexo-extension movement passively. The intraclass correlation coefficient (ICC) according to absolute, was used to measure the degree of agreement between the quantitative assessments made. There was an abnormality in the distribution of data from knee flexion–extension measurements, so comparisons were made with the median of the data. Results: A very good agreement was found in the use of the universal goniometer and the digital goniometer, for knee movements: right flexion ICC 0.956, right extension ICC 0.936, left flexion ICC 0.933, and for left extension ICC 0.953. Conclusions: The universal goniometer and the digital goniometer obtained a very good correlation in the measurement of knee flexion and extension. (AU)

[Goniometry of flexion-extension ankle movement: comparative analysis between bone reference method and neutral 0 method]. / Goniometría del movimiento de flexo-extensión de tobillo: análisis comparativo entre método de referencias óseas y método 0 neutral.

Introduction: Two different methods are used in goniometry of the ankle: the neutral zero method (N0M) and the bone reference method (BRM). In addition, the N0M has a subtype (N0I), with a different technique. Purpose: To determine the average of the amplitude of flexion-extension of the ankle, measured in different body positions, using N0M, N0I and BRM, in young adults of both sexes, with the objective of providing evidence so that the ankle goniometry is more reliable. Material and methods: 190 students from the School of Kinesiology and Physiotherapy were studied, using the three methods of joint measurement in 4 different body positions; the amplitude of flex-extension in an ankle per student was evaluated. Results: In most positions, the measurements were different in the three methods compared (P<0.05). The M0 and M0I methods yielded similar results in some comparisons. The patient's position also significantly influences the result obtained. Dorsal ankle flexion was similar between men and women in most of the methods and positions; the plantar flexion that was greater in women in all cases (P<0.0001). The full flex-extension value, in most cases, was higher in women than in men (P<0.001). Conclusions: Both the method and the patient's position significantly influence the results of the goniometric measurement. Gender influences the joint width of the plantar ankle flexion, regardless of the measurement method used.

Introducción: En la goniometría de tobillo se utilizan dos métodos diferentes, el método cero neutral (M0N) y el método de referencias óseas (MRO). Además, el M0N tiene un subtipo (M0I), con una técnica diferente. Objetivo: Determinar el promedio de la amplitud de flexo-extensión de tobillo, medida en diferentes posiciones corporales, utilizando M0N, M0I y MRO, en adultos jóvenes de ambos sexos, con el objetivo de aportar evidencia para que la goniometría de tobillo sea más fiable. Materiales y Métodos: Se estudiaron 190 alumnos de la Escuela de Kinesiología y Fisioterapia, utilizando los tres métodos de medición articular en 4 posiciones corporales diferentes; se evaluó la amplitud de flexo-extensión en un tobillo por alumno. Resultados: En la mayoría de las posiciones, las mediciones fueron diferentes en los tres métodos comparados (P<0,05). Los métodos M0 y M0I arrojaron resultados similares en algunas comparaciones puntuales. La posición del paciente también influye significativamente en el resultado obtenido. La flexión dorsal de tobillo fue similar entre hombres y mujeres en la mayoría de los métodos y posiciones del paciente, no así la flexión plantar que fue mayor en las mujeres en todos los casos (P<0,0001). El valor completo de flexo-extensión, en la mayoría de los casos fue mayor en las mujeres que en los varones (P<0,001). Conclusiones: Tanto el método como la posición del paciente influyen significativamente en los resultados de la medición goniométrica. El género influye en la amplitud articular de la flexión plantar de tobillo, independientemente del método de medición utilizado.

Análise inter e intra-avaliador da abdução do ombro hemiparético pelo PhysioPlay™: software para medir a amplitude de movimento / Inter-and intra-rater analysis of hemiparetic shoulder abduction using PhysioPlay™: software for measuring range of motion

Alterações no equilíbrio são observadas em hemiparéticos após um acidente vascular encefálico (AVE), gerando impactos físicos, sociais e econômicos significativos; assim, uma avaliação foi desenvolvida para facilitar os planos de tratamento para os pacientes. A goniometria é atualmente usada como ferramenta de avaliação da amplitude de movimento (ADM); no entanto, o desenvolvimento de exergames trouxe uma nova perspectiva para a avaliação, que utiliza um mecanismo dinâmico e tem pouca subjetividade. Objetivo: Este estudo avaliou a confiabilidade inter e intraexaminadores da medida da ADM da abdução do ombro em pacientes pós-AVE usando o exergame PhysioPlay™. Método: Treze voluntários com AVE crônico, com idade de 58,23 ± 9,96 anos (homens e mulheres), participaram deste estudo. Dois fisioterapeutas avaliaram a abdução do ombro usando goniometria e o exergame PhysioPlay™. Um reteste foi realizado uma semana depois. Resultados: Os resultados das análises utilizando o coeficiente de correlação intraclasse (CCI) mostraram excelente nível de confiabilidade inter e intraexaminadores (r> 0,90; p <0,05). A correlação de Pearson entre as medidas máximas obtidas na goniometria e o software PhysioPlay™ apresentou alta correlação (r> 0,90, p = 0,001). Conclusão: O Kinect associado ao exergame PhysioPlay™ apresentou excelente confiabilidade na captura da medida da ADM em comparação à goniometria.

Changes in balance are observed in some hemiparetics following a stroke, generating significant physical, social, and economic impacts; thus, an assessment was developed to facilitate treatment plans for patients. Goniometry is currently used as an evaluation tool for range of motion (ROM); however, the development of exergames has brought a new perspective to the assessment, which uses a dynamic mechanism and has little subjectivity. Objective: This study evaluates the inter-and intra-rater reliability of ROM measurement of the shoulder abduction in post-stroke patients using the exergame PhysioPlay™. Method: Thirteen volunteer chronic stroke survivors, aged 58.23 ± 9.96 years (men and women), participated in this study. Two physiotherapists evaluated the abduction of the shoulder using goniometry and the exergame PhysioPlay™. A retest was performed one week later. Clinical trial registry number ­ RBR-55smwr. Results: The results of the analyses using intraclass correlation coeficient (ICC) showed an excellent inter- and intra-rater reliability level (r > 0.90; p < .05). The Pearson correlation between the maximum measures obtained in the goniometry and the software PhysioPlay™ showed a high correlation (r > 0.90, p= .001). Conclusion: The Kinect associated with the exergame PhysioPlay™ presented excellent reliability in capturing the ROM measure compared to the conventional goniometry.

Ankle joint mobility as a predictor of treatment prognosis in patients with chronic venous insufficiency with venous ulcers.

The present study arose from the need to improve treatment of patients with chronic venous insufficiency (CVI) who present with venous ulcers. A total of 40 lower limbs were assessed from 20 patients with healed venous ulcers (C5) or active venous ulcers (C6) who had undergone varicose vein surgery. The relationship between the range of motion of the ankle joint and presence of C5 or C6 venous ulcer was analyzed. For this purpose, normal goniometry findings for this joint were used as a predictor of venous ulcer healing, defined as the outcome. Thus, when identifying reduced ankle joint movement or immobility in these patients, new treatment options could be offered in order to increase joint mobility and prevent or delay CVI complications.

Confiabilidade de um aplicativo de goniometria para dispositivo móvel (Android): Goniôapp / Reliability of a goniometry application for mobile device (Android): Goniôapp

A goniometria é uma técnica utilizada para avaliar a amplitude de movimento (ADM) das articulações do corpo humano. O goniômetro universal (GU) é o instrumento mais utilizado pelos fisioterapeutas para avaliar a ADM. O aplicativo Goniôapp foi desenvolvido com a função de um goniômetro universal para avaliar a ADM. Objetivo: Avaliar a confiabilidade do aplicativo Goniôapp para aparelho móvel (Android) na avaliação da ADM de indivíduos saudáveis. Método: Estudo de validação de tecnologia com 44 alunos de fisioterapia da Ulbra Torres RS sendo 10 alunos do sexo masculino e 34 do sexo feminino. Foi avaliado a ADM da articulação glenoumeral do lado direito através da goniometria e do Goniôapp por três avaliadores previamente treinados com os instrumentos. Resultados: Foi verificado um nível de confiabilidade inter examinador moderado para extensão, flexão, abdução e rotação externa entre todos os avaliadores. Já na avaliação de confiabilidade intra examinador, o avaliador 1 e o 2 apresentaram um nível de confiabilidade alto para o movimento de extensão e os demais movimentos apresentaram nível moderado, porém, somente o avaliador 3 apresentou um nível alto para todos os movimentos. Conclusão: O aplicativo para dispositivo móvel (Android) Goniôapp apresenta nível de confiabilidade semelhantes a técnica do GU tanto intra quanto interavaliadores.

Goniometry is a technique used to evaluate a range of motion (ROM) of the joints of the human body. The universal goniometer is the instrument most used by physiotherapists to evaluate an ROM. The Goniôapp application was developed with a function of a universal goniometer to evaluate an ROM. Objective: To evaluate whether the goniometry application for mobile devices (Android), Goniôapp, presents results for the universal goniometer in the evaluation of healthy WMD. Method: An applied research was conducted in the technology validation modality, in physiotherapy students of Ulbra Torres RS. Primeved was signed the TCLE, and collected the demographic data. After having done an assessment of the glenohumeral joint on the right side in 10 male students and 34 female, by three evaluators who evaluate as two measures measured, universal goniometer and Goniôapp. Results: A moderate inter-examiner reliability level was verified for extension, flexion, abduction and external rotation among all the evaluators. In the intra-examiner reliability assessment, the evaluator 1 and 2 presented a high level of reliability for the movement of extension and the other movements presented moderate level, however, only the evaluator 3 presented a high level for all the movements. Conclusion: At the end of the present research, a goniometry application for mobile device (Android) was concluded, Goniôapp presents results similar to the GU technique, both results had a moderate IC both intra and between evaluators.

Mobilidade da articulação talocrural como fator preditor no prognóstico de cicatrização em portadores de insuficiência venosa crônica com úlcera venosa / Ankle joint mobility as a predictor of treatment prognosis in patients with chronic venous insufficiency with venous ulcers

O presente trabalho surgiu da necessidade de aprimorar o tratamento de pacientes com insuficiência venosa crônica (IVC) que apresentam úlcera venosa. Foram avaliados os 40 membros inferiores de 20 pacientes portadores de úlcera venosa cicatrizada (C5) ou ativa (C6) que foram submetidos ou não à cirurgia de varizes. Foi estabelecida a relação entre a amplitude de movimento da articulação talocrural e a presença de úlcera venosa C5 ou C6, sendo para isso utilizada a goniometria dessa articulação dentro da normalidade como preditor de cicatrização e tendo como desfecho a cicatrização ou não da úlcera venosa. Dessa forma, ao se identificar redução ou imobilidade talocrural em pacientes com úlcera venosa, poderão ser oferecidas novas formas terapêuticas, a fim de aumentar a mobilidade dessa articulação para prevenir ou retardar complicações da IVC

The present study arose from the need to improve treatment of patients with chronic venous insufficiency (CVI) who present with venous ulcers. A total of 40 lower limbs were assessed from 20 patients with healed venous ulcers (C5) or active venous ulcers (C6) who had undergone varicose vein surgery. The relationship between the range of motion of the ankle joint and presence of C5 or C6 venous ulcer was analyzed. For this purpose, normal goniometry findings for this joint were used as a predictor of venous ulcer healing, defined as the outcome. Thus, when identifying reduced ankle joint movement or immobility in these patients, new treatment options could be offered in order to increase joint mobility and prevent or delay CVI complications

Knee Range of Motion as a Discriminatory Tool Indicating Potential Meniscal Tears.

BACKGROUND: Primary care physicians often encounter patients with knee pain and are faced with the dilemma of whether to refer patients to a specialist. Meniscal tears are the most common intraarticular knee injury but are challenging to accurately diagnose because of a lack of quantitative, accurate, and easy-to-administer tests. We conducted a retrospective medical record review to evaluate whether measurement of knee range of motion (ROM) via goniometry could discriminate between healthy and meniscus-altered knees. METHODS: A total of 110 adult patients met the inclusion criteria: age ≥18 years; no history of contralateral knee pain, injury, or surgery; ROM data collected using a goniometer on both knees at the time of diagnosis; and a confirmed diagnosis of meniscus tear via magnetic resonance imaging. The following variables were obtained from medical records: age, sex, body mass index (BMI), ROM for both knees, surgical treatment, insurance coverage, Ahlbäck x-ray grades, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Oxford Knee Score (OKS). RESULTS: The majority of patients (96.4%) exhibited a ≥10° difference in flexion between asymptomatic and symptomatic knees. No significant relationships were observed between age, BMI, and the decision to undergo surgery and the difference in flexion or extension ROM. Both the WOMAC and the OKS were significantly correlated with the degree of loss of flexion ROM. CONCLUSION: The results suggest that knee flexion ROM may be a valuable tool for determining which patients presenting with new-onset ipsilateral knee pain should be referred to a specialist. Further investigation to determine the reliability and accuracy of knee ROM as a screening measure is warranted.

A new iPhone application for measuring active craniocervical range of motion in patients with non-specific neck pain: a reliability and validity study.

BACKGROUND CONTEXT: Measurement of cervical spine range of motion (ROM) is often considered to be an essential component of cervical spine physiotherapy assessment. PURPOSE: This study aimed to investigate the reliability and validity of an iPhone application (app) (Goniometer Pro) for measuring active craniocervical ROM (ACCROM) in patients with non-specific neck pain. STUDY DESIGN/SETTING: A cross-sectional study was conducted at the musculoskeletal biomechanics laboratory located at Iran University of Medical Sciences. PATIENT SAMPLE: Forty non-specific neck pain patients participated in this study. OUTCOME MEASURES: The outcome measure was the ACCROM, including flexion, extension, lateral flexion, and rotation. METHOD: Following the recruitment process, ACCROM was measured using a universal goniometer (UG) and iPhone 7 app. Two blinded examiners each used the UG and iPhone to measure ACCROM in the following sequences: flexion, extension, lateral flexion, and rotation. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. Intraclass correlation coefficient (ICC) models were used to determine the intra-rater and inter-rater reliability. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone app. Minimum detectable change at the 95% confidence level (MDC95) was also computed. RESULTS: Good intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥0.66 and ≥0.70 and the iPhone app with ICC values of ≥0.62 and ≥0.65, respectively. The MDC95 ranged from 2.21° to 12.50° for the intra-rater analysis and from 3.40° to 12.61° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r valuesof ≥0.63. The magnitude of the differences between the UG and iPhone app values (effect sizes) was small, with Cohen d values of ≤0.17. CONCLUSIONS: The iPhone app possesses good reliability and high validity. It seems that this app can be used for measuring ACCROM.

Reliability and concurrent validity of a new iPhone® goniometric application for measuring active wrist range of motion: a cross-sectional study in asymptomatic subjects.

Measurement of wrist range of motion (ROM) is often considered to be an essential component of wrist physical examination. The measurement can be carried out through various instruments such as goniometers and inclinometers. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for goniometric functions. This study, for the first time, aimed to evaluate the reliability and concurrent validity of a new smartphone goniometric app (Goniometer Pro©) for measuring active wrist ROM. In all, 120 wrists of 70 asymptomatic adults (38 men and 32 women; aged 18-40 years) were assessed in a physiotherapy clinic located at the School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Following the recruitment process, active wrist ROM was measured using a universal goniometer and iPhone® 5 app. Two blinded examiners each utilized the universal goniometer and iPhone® to measure active wrist ROM using a volar/dorsal alignment technique in the following sequences: flexion, extension, radial deviation, and ulnar deviation. The second (2 h later) and third (48 h later) sessions were carried out in the same manner as the first session. All the measurements were conducted three times and the mean value of three repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone® app. Good to excellent intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥ 0.82 and ≥ 0.73 and the iPhone® app with ICC values of ≥ 0.83 and ≥ 0.79, respectively. Minimum detectable change at the 95% confidence level (MDC95 ) was computed as 1.96 × standard error of measurement × âˆš2. The MDC95 ranged from 1.66° to 5.35° for the intra-rater analysis and from 1.97° to 6.15° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r values of ≥ 0.80. From the results of this cross-sectional study, it can be concluded that the iPhone® app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that this app can be used for the measurement of wrist ROM. However, further research is needed to evaluate symptomatic subjects using this app.

Reliability of the intra and inter-test measures with universal goniometer and podalic arthrometer of the active range of ankle inversion and eversion / Fiabilidad de las medidas inter y intra-ensayo con goniómetro universal y artrómetro podálico de la amplitud activa de inversión y eversión del tobillo / Fidedignidade das medidas inter e intratestes com goniômetro universal e artrômetro podálico da amplitude ativa de eversão e inversão do tornozelo

The objective this study was to evaluate intra and inter-rater and inter-instruments reliability of ankle inversion and eversion active range of motion. The study included 100 healthy individuals (71 women and 29 men; ages: 21.32±2.83 years old; body mass: 60.40±4.95 kg; height: 1.66±0.04 m; and body mass index: 21.89±2.83 kg/m2), who were submitted to measurement of ankle inversion and eversion using the universal goniometer and podalic arthrometer. We used the intra-class correlation coefficient (ICC) and Pearson's test, considering a 5% significance level. The results of this study demonstrated one very strong intra-rater ICC (0.91≥0.99; p<0.01) and a strong inter-rater (0.61≥0.9; p<0.01) in both the first and second measurements, especially when measured with the podalic arthrometer (ICC>0.8; universal goniometer: ICC<0.8). The inter-instruments correlation was proved as being regular and significant (0.31≥r≤0.6; p<0.01) for all evaluators and evaluations. Both tested instruments can be used in physical therapy practice for measurements of ankle inversion and eversion due to the high reliability presented, regardless of the evaluator's previous experience, especially the podalic arthrometer when compared to the universal goniometer, which is probably due to the lower influence that the appraiser has on the instrument during measurements.

El objetivo del estudio fue evaluar la fiabilidad de las medidas intra e inter-evaluadores e inter-instrumentos de la amplitud del movimiento activa de eversión e inversión del tobillo. Participaron de este estudio 100 sujetos sanos (71 mujeres y 29 hombres; edad: 21,32±2,83 años; masa corporal: 60,40±4,95 kg; estatura: 1,66±0,04 m e índice de masa corporal: 21,89±2,83 kg/m2), que fueron sometidos a la medición de inversión y eversión del tobillo con goniómetro universal y artrómetro podálico. Se utilizó el coeficiente de correlación intraclase (CCI) y la prueba de Pearson, teniendo en cuenta un nivel de significancia del 5%. Los resultados del estudio demostraron un CCI intra-evaluador muy fuerte (0,91≥0,99; p<0,01) y del inter-evaluador fuerte (0,61≥0,9; p<0,01), en la primera y en la segunda medición, especialmente cuando medidas con el artrómetro podálico (CCI>0,8; goniómetro universal: CCI<0,8). La correlación inter-instrumentos se mostró regular y significante (0,31≥r≤0,6; p≤0,01) para todos los evaluadores y evaluaciones. Los dos instrumentos probados pueden ser utilizados en las medidas de inversión y eversión del tobillo por su alta fiabilidad presentada, independientemente de la experiencia del evaluador. Sin embargo, las medidas del artrómetro podálico mostraron una mayor fiabilidad en comparación al goniómetro universal probablemente por la menor influencia que el evaluador ejerce sobre el instrumento durante la medición.

O objetivo deste estudo foi avaliar a confiabilidade das medidas intra- e interavaliadores e interinstrumentos da amplitude de movimento ativa de eversão e inversão do tornozelo. Participaram deste estudo 100 indivíduos saudáveis (71 mulheres e 29 homens; idade: 21,32±2,83 anos; massa corporal: 60,40±4,95 kg; estatura: 1,66±0,04 m; e índice de massa corporal de 21,89±2,83 kg/m2), os quais foram submetidos à mensuração de inversão e eversão do tornozelo com goniômetro universal e artrômetro podálico. Foram utilizados o coeficiente de correlação intraclasse (CCI) e o teste de Pearson, considerando-se um nível de significância de 5%. Os resultados deste estudo demonstraram um CCI intra-avaliador muito forte (0,91≥0,99; p<0,01) e interavaliador forte (0,61≥0,9; p<0,01), tanto na primeira quanto na segunda medida, especialmente quando mensuradas com o artrômetro podálico (CCI>0,8; goniômetro universal: CCI<0,8). A correlação interinstrumentos mostrou-se regular e significante (0,31≥r≤0,6; p<0,01) para todos os avaliadores e avaliações. Ambos os instrumentos testados podem ser utilizados na prática fisioterapêutica para as medidas de inversão e eversão do tornozelo pela alta confiabilidade apresentada, independentemente da experiência do avaliador, especialmente o artrômetro podálico comparado ao goniômetro universal, provavelmente, pela menor influência que o avaliador exerce sobre o instrumento durante a medida.

Avaliação da qualidade de vida e do tratamento fisioterapêutico em pacientes com cervicalgia crônica / Evaluation of quality of life and the physiotherapy treatment in patients with chronic neck pain

INTRODUÇÃO: Para analisar a efetividade do tratamento fisioterapêutico no paciente com dor crônica cervical, este trabalho teve como objetivo avaliar antes e após o tratamento fisioterapêutico: a qualidade de vida com o instrumento WHOQOL-100 e a melhora na amplitude de movimento usando um goniômetro. MATERIAIS E MÉTODOS: Participaram deste estudo 15 pacientes (10 mulheres e 5 homens). O nível de significância adotado foi de p < 0,05. RESULTADOS: Foi verificada melhora significativa após o tratamento fisioterapêutico no domínio I - físico (p = 0,0117); domínio II - psicológico (p = 0,004); domínio III - nível de independência (p = 0,0006); domínio IV - relações sociais (p < 0,0001); e no domínio V - ambiente (p = 0,0019); e também na amplitude articular dos movimentos de flexão cervical (p < 0,0001), extensão cervical (p = 0,0004), inclinação lateral á direita (p < 0,0001) inclinação lateral à esquerda (p < 0,0001), rotação lateral à direita (p < 0,0001) e rotação lateral à esquerda (p < 0,0001). DISCUSSÃO: Andersen et al. (17) relataram que exercícios de alongamento melhoram de forma significativa a amplitude de movimento articular em mulheres com cervicalgia crônica. Chiu et al. (20) observaram melhora na dor crônica cervical e na limitação articular após seis semanas de tratamento com TENS e exercícios. CONCLUSÃO: O presente estudo conclui que a intervenção fisioterapêutica composta de exercícios de alongamento, técnicas de relaxamento, massagens e eletroterapia foram benéficos para melhorar a qualidade de vida e a flexibilidade nos pacientes com cervicalgia crônica.

INTRODUCTION: In order to analyze the effectiveness of the physiotherapeutic treatment in patients with chronic neck pain, this work had as a goal to evaluate the period before and after the physiotherapeutic treatment: quality of life as a WHOQOL-100 tool and the improvement of the range of motion (ROM), using a goniometer. MATERIALS AND METHODS: 15 patients were members of this study (10 women and 5 men). RESULTS: Level of significance adopted was p < 0.05. It was observed significant improvement after physical therapy in the domain I - physical (p = 0.0117), in domain II - psychological (p = 0.004), the domain III - level of independence (p = 0.0006), domain IV - social relationships (p < 0.0001) and domain V - environment (p = 0.0019) and also in joint range of motion of cervical flexion (p< 0.0001), cervical extension (p = 0.0004), right head tilt (p < 0.0001), left head tilt (p < 0.0001) right lateral rotation (p < 0.0001) and left lateral rotation (p < 0.0001). DISCUSSION: Andersen et al. (17) reported that stretching exercises significantly improve the range of motion in women with chronic neck pain. Chiu et al. (20) observed improvement in chronic cervical pain and joint limitation after six weeks of treatment with TENS and exercise. CONCLUSIONS: This study concludes that the physioterapeutic intervention composed by stretching exercises, relaxation techniques, massage and electrotherapy were of positive effects for improving the quality of life and flexibility in patients with chronic neck pain.

Correlação entre fleximetria e goniometria radiológica para avaliações da amplitude articular estática do cotovelo / Correlation between fleximetry and radiological goniometryfor assessment of static elbow range of motion

Este estudo objetivou determinar o grau de confiabilidade intra e interexaminador de avaliações realizadas por meio de fleximetria,e o seu grau de correlação com avaliações realizadas porgoniometria radiológica. 10 indivíduos tiveram seu cotovelo direito estabilizado por chapas de ferro em ângulo fixo, que foi mensuradopor 04 fisioterapeutas, com o uso de um flexímetro, em 3 dias diferentes com intervalo de uma semana entre os mesmos. Após estas avaliações, os cotovelos foram radiografados, com o mesmo ângulo estabilizado, para análise pela goniometria radiológica. Estas medidas apresentaram baixa confiabilidade intraexaminador (0,23;p = 0,00) e interexaminador (0,38; p = 0,04). As medidas obtidas pela fleximetria apresentaram melhores resultados na análise da confiabilidade interexaminador do que intraexaminador, fato este que possivelmente foi influenciado pelo longo intervalo de tempo entre as avaliações (7 dias). Observou-se também baixa correlação entre afleximetria e a goniometria radiológica (r = 0,10) corroborando com inúmeros outros estudos. O teste t indicou ainda que houve uma diferença significante entre as médias obtidas pelas duas técnicas (p= 0,00). Estes resultados sugerem que o intervalo de 07 dias, pode ter dificultado a reprodutibilidade das medidas pelos examinadores e que a diferença processual entre as técnicas investigadas contribuiu para a ausência de correlação entre suas médias.

This study aimed to determinate the intra and inter-reliability of assessments using the fleximetry, and to correlate with radiologic algoniometry assessment. 10 subjects had their right elbow stabilized by fixed iron angle plates, which was measured by 4 physical therapists, using a Fleximeter, on 3 different days with one weekinterval between them. After these evaluations, the elbows were radiographed with the same angle stabilized for radiological analysis by goniometry. These measures had low reliability intra examiner(0.23, p = 0.00) and inter (0.38, p = 0.04). The measurements obtainedby fleximetry showed better results in the analysis of reliability than inter intra-examiner, a fact that was possibly influenced by the long interval between assessments (7 days). It was also observed lowcorrelation between the radiological fleximetry and goniometry(r = 0.10), which corroborates numerous other studies. The t test also indicated that there was a significant difference between themeans obtained by both techniques (p = 0.00). These results suggestthat the interval of 7 days may have hampered the reproducibility of the examiners and that the procedural difference between the research techniques contributed to the lack of correlation between their averages.

Confiabilidade inter e intraexaminadores nas mensurações angulares por fotogrametria digital e goniometria / Reliability inter and intra-tester in angular measures by photogrammetry versus goniometry

INTRODUÇÃO: A utilização da fotogrametria computadorizada em prol da goniometria, ou vice-versa, na prática clínica ainda necessita de fundamentações consistentes. OBJETIVOS: Os objetivos deste estudo foram: verificar a confiabilidade inter e intraexaminadores avaliadores na quantificação das medidas angulares obtidas a partir da fotogrametria computadorizada e a goniometria e determinar a confiabilidade paralela entre esses dois diferentes instrumentos de avaliação. MATERIAIS E MÉTODOS: 26 voluntários e 4 examinadores foram utilizados no estudo. A coleta foi realizada em 4 etapas sequenciais: demarcação dos pontos anatômicos de referência, mensuração e registro dos valores goniométricos, captação da imagem do voluntário com os marcadores fixados no corpo e avaliação do registro fotográfico no programa ImageJ. RESULTADOS: O goniômetro é um instrumento confiável na maioria das evidências, porém, a confiabilidade das medições depende principalmente da uniformização dos procedimentos. Considerações metodológicas relativas ao estabelecimento de confiabilidade e padronização da colocação dos marcadores se fazem necessárias, de modo a oferecer opções de avaliação ainda mais confiáveis para a prática clínica. CONCLUSÃO: Ambos os instrumentos são confiáveis e aceitáveis, porém, mais evidências ainda são necessárias para suportar a utilização desses instrumentos, pois poucos pesquisadores têm utilizado o mesmo desenho de estudo, e a comparação dos resultados entre eles muitas vezes são difíceis.

INTRODUCTION: The use of photogrammetry in support of goniometry or vice versa in clinical practice still requires consistent reasoning. OBJECTIVES: The objectives of this study were to verify the inter and intra-tester reliability evaluators in the quantification of angular measurements obtained from the photogrammetry and goniometry and determine the reliability parallel between these two different assessment tools. MATERIALS AND METHODS: 26 volunteers and 4 examiners were used in the study. Data collection was performed in 04 sequential steps: demarcation of anatomical reference points, measurement and recording of goniometric values, image capture volunteer with the markers attached on the body and evaluation of photographic registration in the program ImageJ. RESULTS: The goniometer is a reliable instrument in most of the evidence, but the reliability of the measurements depends mainly on the standardization of procedures. Methodological considerations regarding the establishment of reliability and standardization of the placement of markers are needed in order to offer options for further evaluation reliable for clinical practice. CONCLUSION: Both instruments are reliable and acceptable, but still needed more evidence to support their use of these instruments, because few researchers have used the same study design, and comparison of results between them, are often difficult.