Establishing measurement properties in the assessment of inter-recti distance of the abdominal muscles in a postnatal women. (October 2020)

• Record Type: Journal Article
• Authors: Benjamin, Deenika R.; Frawley, Helena C.; Shields, Nora; Georgiou, Chris; Taylor, Nicholas F.
• Is Part Of: Musculoskeletal science and practice. Volume 49(2020)
• Publication Date: 2020-10
• Subjects: DRAM -- Callipers -- Validity -- Reliability -- Measurement methods; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2020.102202
• Languages: English
• ISSNs: 2468-8630

Abstract

Abstract: Background: Diastasis of the rectus abdominis muscle is often evaluated in clinical practice but it is unknown which clinical method has the best measurement properties. Objective: The aim of this study was to determine: (i) the criterion validity of the callipers, tape measure and finger-width to evaluate the inter-recti distance of the abdominal muscles compared to ultrasound; and (ii) inter-rater and retest reliability of these methods. Design: Measurement study. Methods: Two physiotherapists assessed the inter-recti distance of rectus abdominis on 50 women postnatally using the three clinical methods. These measurements were compared to ultrasound and assessed for inter-rater and retest reliability. Results: Callipers had very good positive correlations with ultrasound (r = 0.85 to 0.99) and narrow limits of agreement (LOA) (<6 mm). Finger-width and tape measure had moderate to very good correlation with ultrasound (tape measure r = 0.82 to 0.98; finger-width r = 0.75 to 0.98) with wider limits of agreement (tape measure LOA <8 mm; finger-width LOA <18 mm). Callipers demonstrated excellent inter-rater (ICC = 0.80 to 0.99) and retest (ICC = 1.00) reliability. Inter-rater reliability testing was very good for tape measure (ICC = 0.80 to 0.97) and moderate to very good (ICC = 0.44 to 0.85) for finger-width. Retest reliability demonstrated very good reliability (ICC = 0.99 to 1.00) for both finger-width and tape measure. The largest inter-recti distances, strongest correlations and reliability were found at the level of the lower umbilicus. Conclusion: Callipers, tape measure and finger-width are valid and reliable methods of measuring inter-recti distance in postnatal women. Validity, and relative and absolute reliability were found to be the strongest using the callipers. Highlights: Finger-width, tape measure and callipers have good - very good concurrent validity. Highest validity & reliability values were found with callipers in postnatal women. Callipers are recommended to screen and monitor change of inter-recti distance. Measuring recommended at level of upper and lower umbilicus in postnatal women.