Repeatability and clinical utility in stereophotogrammetric measurements of wounds.

OBJECTIVE: To investigate the hypothesis that stereophotogrammetric wound size monitoring shows suitable inter-observer reliability and user acceptance for clinical practice use. METHOD: Veterans admitted for conservative management of severe pressure ulcers were eligible for inclusion in the study. Three-dimensional (3D) digital wound images were independently captured by two expert and two non-expert nurse-observers using a commercially available stereophotogrammetry system,weekly for 6 weeks.A double-blinded analyst generated 3D wound reconstructions, using software to determine geometry. Clinical opinion of wound progression was provided by an expert physician. RESULTS: Thirteen wounds were assessed with more than 80% of all images being readable. Interclass correlation of 0.9867 (p < 0.000 I) was observed. Compared with clinical opinion, 3D wound measurement was sensitive between improving and static wounds for wound perimeter, volume, depth and length. CONCLUSION: These preliminary findings suggest that 3D wound measurement minimises differences in wound measurement between expert and non-expert observers, suggesting it could be implemented with high reliability in health-care settings where several observers are involved in wound care management.

Efeito da reeducação postural global e do isostretchingem portadores de lombalgia crônica inespecífica atravésda biofotogrametria computadorizada / Effects of global posture re-education and isostretching in patients with chronic non-specific low back pain assessed by the computerized biophotogrametry method

O objetivo deste estudo foi quantificar os efeitos da ReeducaçãoPostural Global (RPG) e do Isostretching em portadoresde lombalgia crônica inespecífica (LCI) através do método daBiofotogrametria Computadorizada. 30 portadores de LCI foramacompanhados no Instituto Ortopédico de Palmas (IOP). Ospacientes foram submetidos a procedimentos como: avaliação fisioterápicaatravés do Instrumento de Avaliação da Coluna Vertebral,Escala Visual Analógica de Dor (EVA), Avaliação pelo método daBiofotogrametria Computadorizada antes da 1ª sessão e após trêsmeses de tratamento (2ª avaliação), e reavaliados após dois mesespós-tratamento (3ª avaliação). Os resultados obtidos através dotratamento com base na avaliação da Biofotogrametria Computadorizadaforam que não houve efeito estatisticamente significativodo fator Grupo, nem do fator Tempo, nem da interação entre osdois fatores (valor de p > 0,05) sobre as medidas de concavidadelombar ou convexidade torácica. Conclui-se que o método doRPG aumentou a concavidade lombar e diminuiu a convexidadetorácica quando os pacientes foram submetidos ao método daBiofotogrametria Computadorizada através da quantificação dascurvas fisiológicas da coluna vertebral. O método do Iso não alterouas curvas fisiológicas da coluna vertebral. Quando os dois métodosforam associados (Iso + RPG), a concavidade lombar diminuiu e aconvexidade torácica se manteve.

This study aimed at quantifying the effects of Global PostureRe-education (GPR) and Isostretching (Iso) in patients withchronic non-specific low back pain using the ComputerizedBiophotogrametry method. This research was performed in 30patients followed at the Orthopedic Institute of Palmas (IOP). Thepatients were submitted to Iso or GPR and to the following treatmentassessment procedures: physical therapy evaluation using theVertebral Column Instrument, Visual Analogic Pain Scale (EVA).The subjects were evaluated by Computerized Biophotogrametrybefore the 1st session and after three months of treatment, andre-evaluated two months after the final interventions. Treatmentresults, as judged from Computerized Biophotogrametry data, andconcerning lumbar concavity or thoracic convexity measurements,were not statistically significant with regard to the Group factor,the Time factor, or the interaction between these factors (value p >0.05). Thus we conclude that the GPR method tended to increaselumbar concavity and decreased thoracic convexity, according toComputerized Biophotogrametric data. The Iso method did notchange the physiologic curves of the vertebral column. When thetwo methods were associated (Iso + GPR), lumbar concavity decreasedand thoracic convexity was maintained. These different results,however, did not reach statistical significance.