Variables Affecting Thigh Girth Measurement and Observer Reliability in Dogs

Abstract

Objective: The purpose of the study reported here was to describe variables affecting thigh girth measurements preoperatively and 2 weeks after surgical stabilization of the stifle and to examine inter- and intra-observer reliability.Animals: Ten hound-type dogs with experimental, unilateral, cranial cruciate ligament transection, and surgical stabilization.Procedures: Dogs were placed in lateral recumbency for measurements of thigh circumference after the stifle was placed in flexed (F), estimated standing (S), and extended (E) positions. Measurements were made at 50 and 70% of thigh length (TL), with hair unclipped and then clipped prior to surgery, before and 2 weeks after cruciate ligament transection and stifle stabilization, and with and without sedation. A spring tension measuring tape was used to determine thigh girth that allowed a consistent amount of end-tension to be applied to the tape. All measurements were made by two blinded individuals in triplicate, data were recorded for each set of measurements and the mean of the three measurements for each condition was used for analysis.Results: Thigh girth was significantly greater at the more proximal site of 50% TL (36.7 ± 2.6 cm) when compared to the 70% TL (31.7 ± 2.7 cm) (P = 0.001). Sedation did not significantly affect thigh girth at any stifle position at the 70% and 50% TL. Although there were no differences in thigh circumference between the flexion and standing positions at 50% TL (F 38.2 ± 2.8 cm, S 38.1 ± 2.9 cm) and 70% TL (F 33.6 ± 1.6 cm; S 33.6 ± 1.8 cm), full extension of the stifle resulted in significantly less thigh girth (50% TL 36.6 ± 2.6 cm, P = 0.006; 70% TL 31.7 ± 2.6 cm, P = 0.006). Significant decreases in thigh girth were seen after surgery in all limb positions at both measurement sites. The highest correlations between Observer 1 (OB1) and Observer 2 (OB2) with least differences in measurements were with the stifle in the extended position. Agreement between two observers using standard measuring technique was significant at both the 50% (OB1: 34.10 ± 2.93 cm, OB2: 34.08 ± 2.65 cm, P = 0.007, ICC = 0.984) and 70% (OB1: 29.89 ± 2.43 cm, OB2: 30.04 ± 2.30 cm, P = 0.004, ICC = 0.981) TL positions with the stifle placed in extended position.Conclusion and Clinical Importance: Thigh girth measurement may be useful as an outcome measure when appropriate measuring technique is used. It is recommended that thigh girth be obtained at a distance of 70% thigh length, with the leg in an extended position while in lateral recumbency, and the dog relaxed or under sedation. Further studies should be performed in a variety of clinical situations.

Diagnostic Ultrasound Detection of Changes in Femoral Muscle Mass Recovery after Tibial Plateau Levelling Osteotomy in Dogs

“…The 2-to 8-week time point comparison was defined as the clinically relevant outcome measure based on previous studies suggesting that the 2-week time point represents the time point with the least muscle mass. 5,6,10 Changes over time across all datasets (CT, US, manual TC and gait analysis) were evaluated using linear effect mixed models and Tukey post-hoc tests where the dog was considered as the random effect and time was the fixed effect. Similarly, a marginal pseudo-R 2 was calculated to evaluate the strength of the relationships between the various measures using a linear mixed effects models where both the dog and week were entered as random effects.…”

“…Manual TC is a simple, frequently used outcome measure. [3][4][5][6] In the study population, this measurement method did not detect significant changes in muscle mass at any time point. Potential limitations associated with manual TC measurements that may explain this finding include the variability in the location of the measuring tape, the degree of limb extension and tension applied to the tape, positioning, hair regrowth and lack of sedation.…”

“…Potential limitations associated with manual TC measurements that may explain this finding include the variability in the location of the measuring tape, the degree of limb extension and tension applied to the tape, positioning, hair regrowth and lack of sedation. [6][7][8] The strong relation of manual TC with CT in this study is easily explained by the fact that both measure the perimeter of the thigh (i.e. TSA and TC).…”

“…Manual TC measurements (in mm) at each location were acquired in triplicate by a single observer (IF) using a Gulick II measuring tape (Country Technology, Inc., Gays Mills, Wisconsin, United States) as previously described. 6,8 The measurements were performed prior to sedation and hair clipping, while the dog was laying in lateral recumbency with the stifle joint at a 135°angle.…”

“…1,2 Manual thigh circumference (TC) has been used as an objective outcome measure for detecting changes in muscle mass. [3][4][5][6] However, the accuracy of this measurement in dogs has recently been questioned. 7,8 Muscle mass measurement with advanced imaging computed tomography (CT), magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DEXA) has been advocated as a more objective and reliable outcome measure.…”