Fiabilité et changement minimal détectable de mesures obtenues à partir d'images enregistrées par ultrasonographie afin de caractériser l'intégrité du tendon d'Achille
Background: Quantifying the integrity of the Achilles tendon (AT) represents a challenge in rehabilitation. The adoption of quantitative measurements of the AT, extracted from an ultrasound image (QUS) could remedy this shortcoming. Objectives: 1) To assess the test-retest reliability and accuracy of QUS measurements of the AT; 2) To determine the best protocol of QUS measurements to use in clinical practice. Methods: A total of 23 ATs with symptoms of mid-portion Achilles tendinopathy and 63 asymptomatic ATs were evaluated. For each AT, 8 images were recorded (2visits* 2 evaluators* 2 images). Different types of QUS measurements were taken: geometric (thickness, width, area), derived from a gray-level histogram and derived from a co-occurrence marix. A generalizability study quantified the reliability and accuracy of each QUS measurement whereas a decision study highlighted the best protocols for measuring use. Results: The geometric measurements showed excellent reliability and accuracy. The measures derived from the gray-level histogram showed poor reliability and accuracy. The measurements derived from a co-occurrence matrix have shown moderate to excellent reliability and a variable precision. In clinical practice, it is recommended averaging the results of three images collected by an assessor during a single visit. Conclusions: The use of geometric QUS measures allows to quantify the integrity of the AT in clinical practice and in research. Further studies on QUS measurements derived from a matrix of co-occurrence are needed.
Mesure quantitative Achilles tendon Musculoskeletal Physiotherapy Precision Quantitative Measurement Rehabilitation Reliability Tendinopathy Ultrasound