Visual feedback increases chest wall mobility measure: A cross-sectional study

Abstract

This method depends on patient understanding; the operator and measurement variability must also be considered. Several studies have assessed the reliability of chest wall mobility. Malaguti et al. (9) found a substantial intraclass correlation coeffi cient (ICC: 0.89 [95% confi dence interval, CI, 0.75 -0.95]) between two chest wall mobility measurements in chronic obstructive pulmonary disease (COPD) patients. Similar ICC values were reported in other studies of healthy volunteers (10,11).External stimuli can infl uence tests reliant on patient cooperation. AbstractBackground: Visual feedback could optimize the evaluation of chest wall mobility. Objective: To compare chest wall mobility performed with and without visual feedback. Methods: Cross-sectional study, 64 healthy volunteers, average age 24 years old. The thorax circumference was measured at two locations, the axillary and xiphisternum regions, by a tape placed at the anterior axillary line and at the xiphoid process. The evaluations were performed: (i) after verbal explanation (without visual feedback), (ii) after verbal explanation plus visual feedback (with visual feedback); for this evaluation the volunteer remained in front of the computer, which provides visual feedback. Results: There was no difference between axillary measurement with vs. without feedback (7.5 Ϯ 2.4 cm vs. 7.9 Ϯ 3.3 cm, respectively, p ϭ 0.215), but signifi cant difference between xiphisternum measurement 7.1 Ϯ 2.7cm with feedback vs. 6.5 Ϯ 2.3cm without feedback, p ϭ 0.043. Low intraclass correlation coeffi cients were observed for the axillary measurement [0.51 (0.19 -0.72, p ϭ 0.003) and for xiphisternum measurement [0.60 (0.35 -0.76, p Ͻ 0.001) performed with and without feedback, respectively. Conclusion: Thoracic mobility presents great variability when compared with and without feedback, so the visual stimulus must be taken into account in this evaluation.