Confiabilidade intra e interobservador da análise cinemática angular do quadril durante o teste sentar e alcançar para mensurar o comprimento dos isquiotibiais em estudantes universitários

Abstract

Background: The sit-and-reach test (SRT) is used to measure the flexibility of the lumbar spine and hamstring muscles and is better when the hip joint angle (HJA) is measured concomitantly. Objective: To assess the intra and interobserver reliability of the SRT for measuring hamstring muscle length through angular kinematic analysis. Method: Fifty university students (X= 21.5 years; SD= 1.5) without musculoskeletal abnormalities took part. A standard SRT bench with a door (to assess the action of the gastrocnemius muscles) and a digital photographic camera positioned on a tripod were used. Skin markers were placed on the anterosuperior iliac spine and greater trochanter. Two images were recorded: one with the door closed (CD) and another with the door open (OD). To test the intra and interobserver reliability, the intraclass correlation coefficient (ICC) (random effect with one factor) and the Bland and Altman concordance test (÷ = mean difference between measurements) were used, with the respective 95% confidence intervals (95% CI). [-0.19;0.52]. Conclusion: The intra and interobserver reliability tests (CD and OD) for HJA assessment using kinematic analysis showed high reliability. The technique is easy to apply (only requiring a standard SRT bench and a photographic camera) and provides a reliable method for measuring hamstring muscles using kinematic analysis in clinical practice.

Utilização da biofotogrametria para a avaliação da flexibilidade de tronco

“…In the study by Cardoso et al 5 , an angle similar to the PW was used to evaluate the stretching of the hamstring muscles. According to the authors, in the sit and reach test only the reach of the fingers at the most distant point , rather than the angle made by the hip joint is considered, which may predict with more accuracy the length of the hamstrings.…”

“…The research by Cardoso et al 5 , as well as the present study used the angular kinemetry with the SRT; for that reason, it built a reference angle of the pelvic region made of the anatomic points antero-superior iliac crest and trochanter major. In their results, high intra and inter-observer reliability was found.…”

“…Nevertheless, some specialists recommend that the flexibility measurement of the low region of the back, hip and of the hamstrings should be included in the evaluation protocols. When these regions present low levels of flexibility biomechanical alterations which induce to patellofemoral dysfunction, low back pain, athletic pubalgia, tendinitis and posture swerves may occur 5,22,[26][27][28] .…”

“…However, Cardoso et al 5 comment that some factors may alter the test result such as disparity of proportion in the length of lower limbs compared to upper limbs, spine mobility and scapular abduction. Such components act as potential interference, since an individual may receive a high classification in the test even if he/she does not present appropriate flexibility.…”

“…In that process, cameras, camcorders and specific calculation programs which capture the image and enable their careful observation as well as comparison with other images are used 5 .…”