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A new device to measure adherent scar: validity, reliability, and sensitivity to change. Giorgio Ferriero , S. Vercelli, Ľ. Šalgovič, V. Stissi, F. Sartorio. Unit of Occupational Rehabilitation and Ergonomics , “Salvatore Maugeri ” Foundation , Scientific Institute of Veruno, Italy
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A new device to measure adherent scar: validity, reliability, and sensitivity to change Giorgio Ferriero, S. Vercelli, Ľ. Šalgovič, V. Stissi, F. Sartorio. Unit ofOccupationalRehabilitation and Ergonomics, “Salvatore Maugeri”Foundation, ScientificInstituteof Veruno, Italy UniverzitasvCyrila a Metoda, Trnava, Slovak Republic
Assessment of postsurgical scar adherence is crucial to plan treatment. Clinicians need tools to measure scar adhesion reliably We propose a new device to measure scar adhesion - the Adheremeter - assessing its validity, reliability, and sensitivity to change. • Ferriero G. et al, Physical Therapy, May 2010
The Adheremeter The Adheremeter measures the restriction of scar mobility, with respect to underlying tissue, of the worst adherent point. It’s an inexpensive and easy-to-use instrument with an ergonomic shape. It can be printed on flexible transparency film for copiers. The measurement procedure takes a few minutes.
The Adheremeter The nearby skin is stretched in 4 orthogonal directions. S1 R C S2 The adherent scar is compared to contralateral normal skin. 3 indices of scar mobility are calculated: SMA,SMN and AS.
Material and Methods • The SMA and SMN indices • SMA= Surface Mobility index of the Adherence • SMN= Surface Mobility index of the Normal skin • The score of both SMA and SMN • is obtained by calculating • the area of the quadrilateral: • RC X S1S2 2
Material and Methods The AS index AS= Adherence Severity index It estimates the ratio between the SMA and the SMN. AS = Its values range from 0 to 1. 0 = scar immobility 1 = scar mobility as normal skin. SMA SMN
Material and Methods 25 Patients 2 raters measured scar mobility and contralateral normal skin before and after physical therapy.
Results • The Adheremeter showed a good level of: • validity (correlation with the Vancouver Scar Scale • and its pliability subscale); • reliability (intra-rater and inter-rater); • and sensitivity to change.
Conclusions Clinicians can use the Adheremeter to measure scar adhesion reliably. It is now possible to assess changes at follow-up, and consequently to make better judgments of the effects of the treatment.
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