Reliability of Two Protocols for Measuring Chest Wall Dimensions in the Transverse Plane in Individuals with Severe Motor and Intellectual Disabilities

Abstract

Abstract.[Purpose] The present study aimed to estimate the reliability of two protocols for measuring chest wall dimensions in the transverse plane in individuals (18 males, 12 females) aged 2 years 6 months to 58 years (mean age 34.7 ± 17.6) with Severe Motor and Intellectual Disabilities (SMID). [Subjects and Methods] For diagnosing pneumonia in individuals with SMID, 30 X-ray computed tomograms were taken at the level of the xiphisternal junction, scanned, and saved on a personal computer. Five therapists examined these images. Anteroposterior (AP) and laterolateral (LL) diameters were measured using two protocols. The largest AP and LL diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). Intraclass correlation coefficients (ICCs) were calculated to estimate the intrarater and interrater reliability of each protocol.[Results] ICCs were >0.85 in protocols 1 and 2 for all measurements, showing these protocols are highly reliable for measuring chest wall dimensions in the transverse plane. [Conclusions] Measurements using these protocols are easy and cheap, and can be performed retrospectively, providing an effective way for evaluating chest wall deformity in individuals with SMID.

Thoracic Deformity in the Transverse Plane among Adults with Severe Cerebral Palsy

“…Their results show that the ratio in individuals with CP was 0.53 and in those without CP was 0.72, which suggests that in individuals with severe CP, the thoracic width will become wider and the depth narrower than in those without severe CP 10) . However, their results for TD did not take into account thoracic rotation and the lateral deviation of the spine or sternum, or both 5) . In our study, the ratio of the AP to LL diameters of protocol 1 was 0.60 and that of protocol 2 was 0.82, which suggests that the thoracic width in individuals with severe CP becomes narrower and the depth wider than in individuals without severe CP.…”

“…AP view chest X-rays have been used to measure the severity of kyphoscoliosis and TD in individuals with severe CP 2,7) . Because TD is a three-dimensional thoracic deformity, it must also be measured in the transverse plane 5) . Previous studies have not measured thoracic dimensions in the transverse plane in the assessment of TD in individuals with severe CP.…”

“…We recently devised two protocols to measure TD and showed that they are highly reliable 5) . In this study, we used these two protocols to measure and compare the AP and LL diameters of the thorax in the transverse plane of adults with severe CP, because normal thoracic volume depends on adequate thoracic width and depth 4) .…”

“…Protocol 1 was designed with reference to the Japanese Body Dimension Data for Ergonomic Design, edited by the National Institute of Bioscience and Human-Technology 9) , and was used to measure the thoracic width and depth in individuals without deformities. Protocol 2 was a modified version of protocol 1 because TD in the transverse plane of individuals with severe CP shows thoracic rotation and a lateral deviation of the spine or sternum or both 5) . If the two protocols were used to measure thoracic width and depth in individuals without deformities, there would be no differences in the AP and LL diameters between them.…”

“…In conclusion, two CT protocols were used to measure and compare the AP and LL diameters of the thorax in the transverse plane of adults with severe CP. Protocol 2 was a modified version of protocol 1 that allows measurement of TD in the transverse plane, which is necessary because individuals with severe CP show thoracic rotation and lateral deviation of the spine or sternum, or both 5) . In this study, the AP diameter of protocol 1 was significantly shorter and the LL diameter significantly longer than those of protocol 2.…”