布尺測量肢體周徑之信度及測量誤差

Reliability and Measurement Error in Using a Tape Measure to Determine Limb Circumference

王靜怡(Ching-Yi Wang) ； 謝清麟(Chin-Lin Hsieh) ； 吳昇光(Sheng-Kuang Wu) ； 張筑癸(Chu-Kuei Chang) ； 謝茜茹(Chiew-Ju Hsish) ； 林千芬(Chien-Fen Lin)

《台灣復健醫學雜誌》 33卷2期 (2005/06) Pp. 71-77

https://doi.org/10.6315/2005.33(2)02

摘要

臨床上，布尺(tape)經常被用以測量肢體周徑及其變化。然而有關布尺測量之信度及測量誤差之文獻報告，卻相當有限。本研究目的有二：(1)驗證布尺測量上下肢周徑之施測者間信度及施測者內信度及(2)計算同一施測者一週內重複測試之測量標準誤(standard error of measurement)，以判斷個案肢體的周徑變化是否超過測量誤差，並協助臨床決策之制定。
受試者為46位自願參加的年輕人（男性6位，女性40位），平均年齡為20歲。二位施測者分別測量受試者的上下肢四個部位（上臂、前臂、大腿、小腿）的周徑，以決定其施測者間信度。受試者於第一回測試後，於一週後的同一時段再安排第二回測試，以決定施測者內信度。
結果發現：以布尺測量上下肢之肢體周徑具有高度的施測者間信度(intraclass correlation coefficient, ICC≥0.74)及施測者內信度(ICC≥0.92)。施測者間信度除小腿以外，ICC均在0.95以上，施測者內信度ICC均大於0.92。在95%的信心水準下，個案上肢周徑之差距大於0.6公分，下肢周徑之差距大於1.3公分，可視為超過測量誤差的變化，代表個案肢體之周徑變化具備臨床意義。

關鍵字

布尺測量 ； 周徑 ； 信度 ； 測量誤差 ； 臨床決策

並列摘要

The purposes of this study were (1) to test the inter-rater and intra-rater reliability of using a tape measure to determine limb circumferences and (2) to report the 95% CI of standard error of measurement (SEM) of repeated measures by the same tester to determine whether a clinically important change has occurred.
Forty-six college students (6 men, 40 women) with a mean age of 20 years old volunteered to participate in this study. Subjects reported no neuro-musculo-skeletal diseases or disorders in their upper or lower extremities. To determine the inter-rater reliability, two testers measured the circumference of 4 locations on the right upper and lower limbs with a tape measure. To determine intra-rater reliability, subjects were re-tested at the same time of day one week later by the same testers.
Our results indicate that the intra-rater reliability of tape measures at the 4 sites was good (intraclass correlation coefficient, ICC≥0.92). The inter-rater reliability of the 4 sites was very good (ICC≥0.95) except in the measurement of the lower leg (ICC≥0.74). Using a tape measure to determine limb circumference was found to have high inter-rater and intra-rater reliability provided that testers followed standardized measurement procedures. The circumference changes of more than 0.6 cm and 1.3 cm for the upper and lower limbs, respectively, indicates clinically important changes.

並列關鍵字

tape measure ； circumference ； reliability ； measurement error ； clinical decision making