Photogrammetry: an accurate and reliable tool to detect thoracic musculoskeletal abnormalities in preterm infants.
OBJECTIVE
To analyse the accuracy and reproducibility of photogrammetry in detecting thoracic abnormalities in infants born prematurely.


METHODS
Cross-sectional study.


METHODS
The Premature Clinic at the Federal University of São Paolo.


METHODS
Fifty-eight infants born prematurely in their first year of life.


METHODS
Measurement of the manubrium/acromion/trapezius angle (degrees) and the deepest thoracic retraction (cm). Digitised photographs were analysed by two blinded physiotherapists using a computer program (SAPO; http://SAPO.incubadora.fapesp.br) to detect shoulder elevation and thoracic retraction. Physical examinations performed independently by two physiotherapists were used to assess the accuracy of the new tool.


RESULTS
Thoracic alterations were detected in 39 (67%) and in 40 (69%) infants by Physiotherapists 1 and 2, respectively (kappa coefficient=0.80). Using a receiver operating characteristic curve, measurement of the manubrium/acromion/trapezius angle and the deepest thoracic retraction indicated accuracy of 0.79 and 0.91, respectively. For measurement of the manubrium/acromion/trapezius angle, the Bland and Altman limits of agreement were -6.22 to 7.22° [mean difference (d)=0.5] for repeated measures by one physiotherapist, and -5.29 to 5.79° (d=0.75) between two physiotherapists. For thoracic retraction, the intra-rater limits of agreement were -0.14 to 0.18cm (d=0.02) and the inter-rater limits of agreement were -0.20 to -0.17cm (d=0.02).


CONCLUSIONS
SAPO provided an accurate and reliable tool for the detection of thoracic abnormalities in preterm infants.
Department of Pediatrics-Neonatal Division of Medicine, Federal University of São Paulo, Rua Dr. Diogo de Faria 764, CEP 04037-002 São Paulo, SP, Brazil.
Josy
J
Davidson
Amelia Miyashiro N
AM
dos Santos
Kessey Maria B
KM
Garcia
Liu C
LC
Yi
Priscila C
PC
João
Milton H
MH
Miyoshi
Ana Lucia
AL
Goulart
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D007234:Infant, Premature; D008297:Male; D009139:Musculoskeletal Abnormalities / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D010780:Photogrammetry / Q000379:methods* / Q000592:standards*; D026741:Physical Therapy Modalities; D011187:Posture; D015995:Prevalence; D015203:Reproducibility of Results; D013909:Thorax / Q000002:abnormalities*