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 (TD) secondary to severe kyphoscoliosis occurs frequently in adults with severe cerebral palsy (CP) and can eventually result in pneumonia. To determine the severity of TD, we used two protocols to examine and compare the anteroposterior (AP) and laterolateral (LL) diameters of the thorax in the transverse plane among adults with severe CP. [Subjects and Method] The study examined 20 adults with severe CP. Computed tomographic scans were acquired at the level of the xiphisternal junction in each patient, and two protocols were used to measure the AP and LL diameters. The largest AP 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). The largest LL diameters were measured along the lines perpendicular to each AP diameter. The ratios of the AP to LL diameters were calculated. [Results] The AP diameter of protocol 1 was significantly shorter than that of protocol 2, and the LL diameter of protocol 1 was significantly longer than that of protocol 2. There was a significant difference in the ratio of AP to LL between the protocols. [Conclusions] Our results suggest that differences between protocols in the AP and LL diameters show the severity of TD.

[Purpose] The purpose of this study was to examine the relationship between the degree of thoracic deformity (TD) and the angle formed by a line drawn on transverse plane computed tomography (CT) images, connecting the sternum and the spinous process of the vertebrae at the level of the xiphisternum, and the perpendicular line from the floor (ANGLE), in individuals with severe motor and intellectual disorders (SMID). [Subjects] Twenty seven individuals with SMID were examined. [Methods] CT transverse images were acquired at the level of the xiphisternum of each patient. Two protocols were used to measure the anteroposterior (AP) and laterolateral (LL) diameters. The largest AP diameters were measured along a perpendicular line from the floor (protocol 1) and the line from the midline of the sternum to the spinous process of the vertebrae (protocol 2). The largest LL diameters were measured along the lines perpendicular to the AP diameters in each protocol. The ratios of the AP to LL diameters and the difference between the ratios of protocols 1 and 2 (DIFFERENCE) were calculated. [Results] Moderate to good correlation between DIFFERENCE and ANGLE was observed, and DIFFERENCE became larger with increasing ANGLE. [Conclusions] These results show that ANGLE indicates the degree of TD.