High reliability of measure of diaphragmatic mobility by radiographic method in healthy individuals.

ABSTRACT

BACKGROUND: Diaphragmatic evaluation is crucial in clinical practice, and no studies have reported the intra- and interobserver reproducibilities of the radiographic method to evaluate diaphragmatic mobility. OBJECTIVE: To analyze the reliability of radiographic measurement as a method for assessing the mobility of the left and right hemidiaphragms. METHOD: Forty-two patients, who were waiting for cholecystectomy surgery, were evaluated relative to the following parameters physical examination, pulmonary function and radiographic evaluation. The measure of mobility of each hemidiaphragm was randomly determined by two physical therapists at two different times. The intra- and interobserver reproducibilities of the measurements were determined by the intraclass correlation coefficient (ICC[2,1]) and the 95% confidence interval (CI). The Bland-Altman plot was also used. The level of significance was 5%. RESULTS: In the analysis of intra-observer reproducibility in radiographic evaluations of the left and right hemidiaphragms, ICC[2,1] indicated a "very high correlation" for both observer A (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.97, p <0.001, respectively) and observer B (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.99 p <0.001, respectively). In the analysis of interobserver reproducibility, the ICC[2,1] indicated a "very high correlation" for the 1st and 2nd radiographic evaluations of the right hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0,99, respectively, p <0.001) and left hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0.99, respectively, p <0.001). CONCLUSION: The intra and interobserver tests of the radiographic measure of mobility of the left and right hemidiaphragms showed high reliability.