Abstract:
BACKGROUND:Chronic lower back pain is still regarded as a poorly understood multifactorial condition. Recently, the thoracolumbar fascia complex has been found to be a contributing factor. Ultrasound imaging has shown that people with chronic lower back pain demonstrate both a significant decrease in shear strain, and a 25% increase in thickness of the thoracolumbar fascia. There is sparse data on whether medical practitioners agree on the level of disorganisation in ultrasound images of thoracolumbar fascia. The purpose of this study was to establish inter-rater reliability of the ranking of architectural disorganisation of thoracolumbar fascia on a scale from 'very disorganised' to 'very organised'. METHODS:An exploratory analysis was performed using a fully crossed design of inter-rater reliability. Thirty observers were recruited, consisting of 21 medical doctors, 7 physiotherapists and 2 radiologists, with an average of 13.03 ± 9.6 years of clinical experience. All 30 observers independently rated the architectural disorganisation of the thoracolumbar fascia in 30 ultrasound scans, on a Likert-type scale with rankings from 1 = very disorganised to 10 = very organised. Internal consistency was assessed using Cronbach's alpha. Krippendorff's alpha was used to calculate the overall inter-rater reliability. RESULTS:The Krippendorf's alpha was .61, indicating a modest degree of agreement between observers on the different morphologies of thoracolumbar fascia.The Cronbach's alpha (0.98), indicated that there was a high degree of consistency between observers. Experience in ultrasound image analysis did not affect constancy between observers (Cronbach's range between experienced and inexperienced raters: 0.95 and 0.96 respectively). CONCLUSIONS:Medical practitioners agree on morphological features such as levels of organisation and disorganisation in ultrasound images of thoracolumbar fascia, regardless of experience. Further analysis by an expert panel is required to develop specific classification criteria for thoracolumbar fascia.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
De Coninck K,Hambly K,Dickinson JW,Passfield Ldoi
10.1186/s12891-018-2088-5subject
Has Abstractpub_date
2018-06-01 00:00:00pages
180issue
1issn
1471-2474pii
10.1186/s12891-018-2088-5journal_volume
19pub_type
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