Article

Scarring after surgery can lead to a wide range of
disorders. At present, the degree of scar adhesion is assessed manually and by
ordinal scales. This article describes a new device (the Adheremeter) to measure
scar adhesion and assesses its validity, reliability, and sensitivity to change.
DESIGN: This was a reliability and validity study.
SETTING: The study was
conducted at the Scientific Institute of Veruno. Participants and METHODS: Two
independent raters, a physical therapist and a physical therapist student, used
the Adheremeter to measure scar mobility and contralateral normal skin in a
sample of 25 patients with adherent postsurgical scars before (T1) and after (T2)
physical therapy. Two indexes of scar mobility, the adherence's surface mobility
index (SM(A)) and the adherence severity index (AS), were calculated. Their
correlation with the Vancouver Scar Scale (VSS) and its pliability subscale
(PL-VSS) was assessed for the validity analysis. RESULTS: Both the SM(A) and the
AS showed good-to-excellent intrarater reliability (intraclass correlation
coefficient [ICC]=.96) and interrater reliability (SM(A): ICC=.97 and .99; AS:
ICC=.87 and .87, respectively, at T1 and T2), correlated moderately with the VSS
and PL-VSS only at T1 (r(s)=-.58 to -.66), and were able to detect changes
(physical therapist/physical therapist student): z score=-4.09/-3.88 for the
SM(A) and -4.32/-4.24 for the AS; effect size=0.6/0.4 for the SM(A) and 1.4/1.2
for the AS; standard error of measurement=4.59/4.79 mm(2) for the SM(A) and
0.05/0.06 for the AS; and minimum detectable change=12.68/13.23 mm(2) for the
SM(A) and 0.14/0.17 for the AS. LIMITATIONS: The measurement is based on the
rater's evaluation of force to stretch the skin and on the patient's judgment of
comfort. DISCUSSION AND CONCLUSION: The Adheremeter showed a good level of
reliability, validity, and sensitivity to change. Further studies are needed to
confirm these results in larger cohorts and to assess the device's validity for
other types of scars.

Langue : ANGLAIS