Reliability of an analysis method for measuring diaphragm excursion by means of direct visualization with videofluoroscopy.

OBJECTIVE The purpose of this study was to verify the reproducibility between two different observers of an analysis method for diaphragmatic displacement measurements using direct visualization with videofluoroscopy. PATIENTS AND METHODS 29 mouth breathing children aged 5 to 12 years from both genders were analyzed. The diaphragmatic displacement evaluation was divided in three parts: videofluoroscopy with VHS recording in standing, sitting, and dorsal positions; digitalization of the images; and measurement of the distance between diaphragmatic domes during a breathing cycle using Adobe Photoshop 5.5 and Adobe Premiere PRO 6.5 software. RESULTS The intraclass correlation coefficients presented excellent reproducibility in all positions, with coefficients always above 0.94. Mean of the measurements of the diaphagramatic domes displacement done by the two observers were similar (P<.05), with the exception of right diaphragmatic displacement in the seated position and left diaphragmatic displacement in the standing position (P<.05). CONCLUSION This study demonstrated that the evaluation of diaphragmatic displacement via videofluoroscopy is a reproducible measurement when two trained investigators are compared. This fact indicates that the present technique can be disseminated and performed by other healthcare professionals.