Key result
The Cervical Rotation, Supine Angle of Trunk Rotation, Hip Extension, and Pelvic Obliquity tests demonstrated excellent intraobserver and interobserver reliability (ICC > 0.83) in individuals with spinal muscular atrophy.
Why the study?
Most individuals with spinal muscular atrophy experience progressive skeletal deformities affecting quality of life and mobility, but no studies had evaluated the reliability of tests assessing body posture and joint mobility in these patients.
Cross-Sectional (n=30)
Blinded to previous measurements
No
The CR, SATR, HE, and PO tests demonstrate excellent intra- and interobserver reliability for assessing musculoskeletal deformities in children and adolescents with spinal muscular atrophy.
Excellent reliability of CR/SATR/HE/PO tests in SMA supports clinical monitoring; leaves open validation for deformity progression and outcomes.
BACKGROUND: The majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to assess the reliability of Cervical Rotation test (CR), Supine Angle of Trunk Rotation test (SATR), Hip Extension test (HE) and Pelvic Obliquity test (PO) developed to evaluate the musculoskeletal system in SMA individuals. METHODS: Thirty individuals (12 girls and 18 boys) aged 4-15 with SMA type II (n = 24) and III (n = 6) confirmed by genetic examinations were qualified for the study. The participants were examined twice by three physiotherapists on the same day. The examination included four tests, i.e. CR, SATR, HE and PO tests aimed at assessing ranges of rotation in the cervical spine, chest deformities, ranges of hip extension and pelvis position while sitting. Statistical calculations were made with the use of statistical software IBM SPSS Statistics version 20. Reliability was assessed using the Intraclass Correlation Coefficient (ICC). RESULTS: Intraobserver reliability was excellent for CR (ICC range 0.839-0.911), SATR (ICC range 0.918-0.939 - the upper part of the sternum; ICC range 0.951-0.975 - the lower part of the sternum), HE (ICC range 0.988-0,991) and PO (ICC range 0.896-0.935) tests. The interobserver ICC reached the excellent values in CR (ICC range 0.912-0.920), SATR (ICC = 0.888 - the upper part of the sternum, ICC = 0.951 - the lower part of the sternum), HE (ICC range 0.922-0.923) and PO (ICC = 0.928) tests. CONCLUSIONS: CR, SATR, HE and PO tests are reliable and may be used for examining individuals with SMA. The application of these tests provides a possibility to detect early changes in the musculoskeletal system in children and adolescents and to assess the effectiveness of the implemented pharmacotherapy and rehabilitation.
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Stępień et al. (2019) conducted a cross-sectional in Spinal muscular atrophy (SMA) type II and III (n=30). Musculoskeletal assessment tests (Cervical Rotation, Supine Angle of Trunk Rotation, Hip Extension, Pelvic Obliquity) was evaluated on Intraobserver and interobserver reliability assessed using the Intraclass Correlation Coefficient (ICC). The Cervical Rotation, Supine Angle of Trunk Rotation, Hip Extension, and Pelvic Obliquity tests demonstrated excellent intraobserver and interobserver reliability (ICC > 0.83) in individuals with spinal muscular atrophy.
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