Objective: To evaluate inter- and intra-observer variability, influence of hair clipping and laser guidance on canine thigh circumference (TC) measurements amongst observers.
Background: It was our goal to further study the reliability of canine TC measurements as currently performed. For this purpose we designed a cadaveric model that allows for controlled inflation of the thigh resembling increase of muscle mass. We also investigated the impact of novel technologies (laser guidance) and hair clipping on TC measurements in this model.
Evidentiary value: Phase 1 cadaveric study - five long-haired, large breed canine cadavers; Phase 2 clinical study - eight clinically healthy Golden Retrievers. This study should impact clinical research and practice.
Methods: Phase 1 - Canine cadaveric thigh girth was manually expanded to three different levels using a custom, submuscular inflation system before and after hair clipping; Phase 2 - TC of Golden Retrievers was measured with and without laser guidance. TC measurements for both phases were performed by four observers in triplicate resulting in a total of 552 measurements.
Results: Phase 1 - TC measurements before and after hair clipping were significantly different (3.44cm difference, p<0.001). Overall inter-observer and intra-observer variability were 2.26±1.18cm and 0.90±0.61cm, respectively. Phase 2 - Laser guidance nominally improved inter-observer variability (3.34 ±1.09cm versus 4.78 ±2.60cm) but did not affect intra-observer variability (1.14 ±0.66cm versus 1.13 ±0.77cm).
Conclusion: TC measurement is a low fidelity outcome measure with a large inter- and intra-observer variability even under controlled conditions in a cadaveric setting. Current methods of canine TC measurement may not produce a valid outcome measurement. If utilised, hair coat clipping status should be considered and an intra-observer variability of at least 1cm should be assumed when comparing repeated TC measurements. Laser guidance may be helpful to nominally reduce inter-observer variability in settings with multiple observers. Further investigation of alternative methods for canine TC measurement should be pursued.
Application: This information should be considered by everyone utilizing TC measurements as an outcome assessment for clinical or research purposes.
Baker, S. G. et al. (2010) Comparison of four commercial devices to measure limb circumference in dogs. Veterinary and Comparative Orthopaedics and Traumatology, 23 (6), pp. 406-10 http://dx.doi.org/10.3415/VCOT-10-03-0032
Berard, A. et al. (2002) Validity of the Leg-O-Meter, an instrument to measure leg circumference. Angiology, 53 (1), pp. 21-8 http://dx.doi.org/10.1177/000331970205300104
Berard, A. et al. (1998) Reliability study of the Leg-O-Meter, an improved tape measure device, in patients with chronic venous insufficiency of the leg. Angiology, 49 (3), pp.169-73 http://dx.doi.org/10.1177/000331979804900301
Berard, A. and Zuccarelli, F. (2000) Test-retest reliability study of a new improved Leg-O-meter, the Leg-O-meter II, in patients suffering from venous insufficiency of the lower limbs. Angiology, 51, 711-7 http://dx.doi.org/10.1007/978-1-4471-3095-6_135
Doxey, G. (1987) Assessing Quadriceps Femoris Muscle Bulk with-Girth Measurements in Subjects with Patellofemoral Pain. Journal of Orthopaedic & Sports Physical Therapy, 9 (5), pp. 177-83 http://dx.doi.org/10.2519/jospt.1918.104.22.168
Doxey, G. (1987) The Association of Anthropometric Measurements of Thigh Size and B-mode Ultrasound Scanning of Muscle Thickness. Journal of Orthopaedic & Sports Physical Therapy, 8 (9), pp. 462-8 http://dx.doi.org/10.2519/jospt.1922.214.171.1242
Eskelinen, E. V. et al. (2012) Canine total knee replacement performed due to osteoarthritis subsequent to distal femur fracture osteosynthesis: two-year objective outcome. Veterinary and Comparative Orthopaedics and Traumatology, 25 (5), pp. 427-32 http://dx.doi.org/10.3415/VCOT-11-01-0012
Gordon-Evans, W. J.et al. ( 2010) Randomised controlled clinical trial for the use of deracoxib during intense rehabilitation exercises after tibial plateau levelling osteotomy. Veterinary and Comparative Orthopaedics and Traumatology. 23 (5), pp. 332-5 http://dx.doi.org/10.3415/vcot-09-11-0121
Gordon-Evans, W. J. et al. (2011) Effect of the use of carprofen in dogs undergoing intense rehabilitation after lateral fabellar suture stabilization. Journal of the American Veterinary Medical Association, 239 (1), pp. 75-80 http://dx.doi.org/10.2460/javma.239.1.75
Gordon-Evans, W. J. et al. (2013) Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. Journal of the American Veterinary Medical Association, 243 (5), 675-80 http://dx.doi.org/10.2460/javma.243.5.675
Innes, J. F. and Barr, A. R. (1998) Clinical natural history of the postsurgical cruciate deficient canine stifle joint: year 1. Journal of Small Animal Practice, 39 (7), pp. 325-32 http://dx.doi.org/10.1111/j.1748-5827.1998.tb03723.x
Jarvela, T. et al. (2002) Simple measurements in assessing muscle performance after an ACL reconstruction. International Journal of Sports Medicine, 23 (3), pp. 196-201 http://dx.doi.org/10.1055/s-2002-23171
Johnson, J. M. et al. (1997) Rehabilitation of dogs with surgically treated cranial cruciate ligament-deficient stifles by use of electrical stimulation of muscles. American Journal of Veterinary Research, 58 (12), pp. 1473-8
Kalis, R. H. Liska, W. D. and Jankovits, D. A. 2012. Total hip replacement as a treatment option for capital physeal fractures in dogs and cats. Veterinary Surgery, 41 (1), pp.148-55 http://dx.doi.org/10.1111/j.1532-950X.2011.00919.x
Kim, S. E. et al. (2008) Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Veterinary Surgery, 37 (2), pp.111-25 http://dx.doi.org/10.1111/j.1532-950X.2007.00361.x
Lauer, S. et al. (2008) In vivo comparison of two hinged transarticular external skeletal fixators for multiple ligamentous injuries of the canine stifle. Veterinary and Comparative Orthopaedics and Traumatology, 21 (1), pp. 25-35 http://dx.doi.org/10.3415/VCOT-06-11-0090
Millis, D. L. (2004) Assessing and Measuring Outcomes. In: Mills, D.L., Levine, D. and Taylor, R.A. (eds) Canine Rehabilitation & Physical Therapy, London: WB Saunders. pp. 211-227 http://dx.doi.org/10.1016/B978-0-7216-9555-6.50016-4
Millis, D. L. Scroggs, L. and Levine, D. (1999) Variables affecting thigh circumference measurements in dogs. In Blythe, L.J., McCubbin, J.A. and Riebold, T.W. (eds) Proceedings First International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine, Oregon State University. August 7-11 Oregon: Oregon State University p, 157.
Moeller, E. M. et al. (2010) Long-term outcomes of thigh circumference, stifle range-of-motion, and lameness after unilateral tibial plateau levelling osteotomy. Veterinary and Comparative Orthopaedics and Traumatology, 23, pp. 37-42 http://dx.doi.org/10.3415/VCOT-09-04-0043
Monk, M. L. Preston, C. A. and McGowan, C. M. (2006) Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. American Journal of Veterinary Research, 67 (3), pp. 529-36 http://dx.doi.org/10.2460/ajvr.67.3.529
Mourtzakis, M. and Wischmeyer, P. (2014) Bedside ultrasound measurement of skeletal muscle. Current Opinion in Clinical Nutrition and Metabolic Care, 17 (5) pp. 389-95 http://dx.doi.org/10.1097/MCO.0000000000000088
Slocum, B. and Slocum, T. D. (1993) Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Veterinary Clinics of North America: Small Animal Practice, 23 (4), pp. 777-95 http://dx.doi.org/10.1016/S0195-5616(93)50082-7
Smith, T. J. (2013) Inter- and intratester reliability of anthropometric assessment of limb circumference in labrador retrievers. Veterinary Surgery, 42 (3), pp. 316-21 http://dx.doi.org/10.1111/j.1532-950X.2013.01102.x
Soderberg, G. L. Ballantyne, B. T. and Kestel, L. L. (1996) Reliability of lower extremity girth measurements after anterior cruciate ligament reconstruction. Physiotherapy Research International, 1 (1), pp. 7-16 http://dx.doi.org/10.1002/pri.43
Thomaes, T. et al. (2012) Reliability and validity of the ultrasound technique to measure the rectus femoris muscle diameter in older CAD-patients. BMC Medical Imaging, 12:7 http://dx.doi.org/10.1186/1471-2342-12-7
Weiss, L. W., Coney, H. D. and Clark, F. C. (2000) Gross measures of exercise-induced muscular hypertrophy. Journal of Orthopaedic & Sports Physical Therapy, 30 (3), pp. 143-8 http://dx.doi.org/10.2519/jospt.2000.30.3.143
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