【論文摘要】Reliability of Ultrasonography in the Assessment of Thickness of Plantar Soft Tissues: A Systematic Review

【論文摘要】超音波量測足底軟組織厚度的信度之系統性回顧

陳紫琳(Chee Ling Angeline Tan) ； 王元聖(Yuan-Sheng Wang) ； 柴惠敏(Huei-Ming Chai)

《物理治療》 44卷2期 (2019/06) Pp. 101-102

https://doi.org/10.6215/FJPT.201906.O22

摘要

Background and Purpose: Plantar soft tissues, including the heel fat pad and plantar fascia, play an important role in shock attenuation for human activities. Shock attenuation capacity deteriorates if dysfunction or any pathological changes was noted in plantar soft tissues. Thickness of the heel pad or plantar fascia to determine shock attenuation capacity is routinely measured using ultrasonography in clinical practice or research purpose to discriminate between healthy and unhealthy conditions and to assess changes in progress over time. Therefore, a reliable measurement tool is essential. The objective of this systematic review was to evaluate current evidences for the intra- and inter-rater reliability of ultrasonographic measurements of thickness of the heel pad or plantar fascia. Methods: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINHAHL), and Excerpta Medica database (Embase) databases were searched using the following key search terms: heel pad, plantar fascia, ultrasonography and reliability. Studies about reliability of 2-dimensional ultrasonographic measurements of thickness of the heel pad or plantar fascia, published from 1990 to November 2018 and limited to literature written in English, were included in this study. One reviewer screened the titles and abstracts of all studies identified by the initial search strategy. Two reviewers filtered the full-text articles with the inclusion criteria and exclusion criteria. The quality appraisal tool for studies of diagnostic reliability (QAREL) was assessed first by 2 reviewers independently, and then a consensus discussion was held by all 3 reviewers. Results: A total of 40 articles were found in the initial search, but only 7 articles met the inclusion criteria in this systematic review. Results showed ultrasonographic measurements of thickness of the heel pad had excellent intra-rater (intraclass correlation coefficient [ICC] = 0.78-0.99) and fair inter-rater reliability (ICC = 0.72). The reliability of ultrasonographic measurements of thickness of plantar fascia was fair to excellent for intra-rater (ICC = 0.50-0.97) and fair to excellent for inter-rater reliability (ICC = 0.59-0.95). Conclusion: The evidences showed that ultrasound imaging had a fair to excellent intra- and inter-rater reliability in measurements of thickness of plantar soft tissues. The detail of the clinical standardized protocol and the evaluator's experience might affect the reliability and need to be verified. Clinical Relevance: The present study provided an important information that ultrasonography is reliable to evaluate the changes in plantar soft tissue dysfunction.