The purpose of this study was to clarify the reliability of employing different joint angles when evaluating tibiofibular separation using ultrasound (US).
Two physiotherapists measured both feet of ten healthy participants (five males and five females with a mean age of 25.9 years) with no history of ankle problems.
Participants slightly flexed their knee in supine position with the ankle fixed at either 35° plantar flexion (PF), 0° (NP), or 20° dorsiflexion (DF).
During US, the probe was vertically aligned with the axis of the lower thigh, with the outer side of the tibia was the most protruding part on the side of the fibula and the fibula being aligned horizontally.
Imaging and measurement were randomly performed twice by the two examiners using a US.
The images recorded were analyzed only by physiotherapist A using the ImageJ.
The interclass correlation coefficient (ICC) 1.1, 2.1, and 3.1; Bland–Altman analysis; and minimal detectable change (MDC) 95 were applied to determine statistical significance. ICC statistical analyses were performed with R 2.8.1.
According to examiner A, ICC 1.1 was greater than 0.9 in all image analyses. Additionally, (ICC) 1.1, 2.1, and 3.1 values in the PF, NP, and DF conditions were greater than 0.9.
As a result of Bland–Altman analysis, there was no addition / /proportional error.
MDC 95 values were as follows: 0.49–0.63 mm for PF, 0.39–0.67 mm for NP, and 0.58–0.69 mm for DF in intra-rater reliability.
MDC 95 values were as follows: 0.55–0.62 mm for PF, 0.57–0.67 mm NP, and 0.53–0.64 mm DF in inter-rater reliability.
The measuring method used in this study showed a high level of reliability, with no addition/proportional errors. Additionally, MDC 95 successfully clarified the error range.
The method used in this study appears to be a clinically viable and reliable method for evaluating tibiofibular separation.
Kazuki Aoki– Chief / Certificated physical therapist in Orthopedic disorders, Matsui Orthopeaedics department Ansyokai medical corporaition / Department of Rehabilitation
Mitsutoshi Shinoda– Chief, Yoshida Orthopaedic Hospital / Department of Rehabilitation
Yoshinari Oda– vice-chief, Matsui Orthopeaedics department Ansyokai medical corporaition / Department of Rehabilitation
keishiro Yamashita– reader, Matsui Orthopeaedics department Ansyokai medical corporaition / Department of Rehabilitation
Jyunichi Matsui– Director of Matsui Orthopeaedics department, Matsui Orthopeaedics department Ansyokai medical corporaition
Makoto Nishio– President of Ansyokai Medical Corporation, Ansyokai medical corporaition