Abstract：
OBJECTIVE: A clinically practical tool to assess skin biomechanical properties rapidly and accurately is still lacking. Our aim was to examine the intra- and inter-observer reproducibility of a myotonometer for objective skin property assessment in systemic sclerosis (SSc), comparing it with the modified Rodnan skin score (mRSS), and distinguishing patients from healthy controls.
METHODS: Thirty-four patients (21 limited and 13 diffuse SSc), and 31 age and gender-matched healthy controls were enrolled. Skin tone and stiffness were measured at four different anatomical sites (the forearm, hand, leg, and foot) using a myotonometer. The correlation between the mRSS and skin properties was assessed. Also, hand functionality was evaluated for possible correlations between the variables. The differences in skin properties between dcSSc and lcSSc patients, and healthy controls were assessed using variance analysis.
RESULTS: Intra- and inter-examiner reproducibility were excellent (ICC = 0.70 to 0.98) for tone and stiffness except for non-dominant hand tone, which showed good reliability (ICC = 0.64 to 0.74). Stiffness and tone values of the hands, forearms, and feet significantly correlated with mRSS total score (r = 0.40 to 0.71, p < 0.05). Additionally, tone and stiffness of the hands and forearms moderately correlated with hand function (p < 0.05). Tone and stiffness values increased in patients with dcSSc compared to healthy controls, or patients with lcSSc, at the hands, forearms, and legs (p < 0.05).
CONCLUSIONS: Our findings emphasize the potential utility of the myotonometer for assessing skin properties and differentiating SSc patients from controls, demonstrating its promise as a valuable clinical evaluation tool in this context. Key Points •The myotonometer displayed excellent intra- and inter-examiner reproducibility for assessing skin properties. •Skin tone and stiffness parameters well correlated with the mRSS scores. •The myotonometer can distinguish patients with diffuse cutaneous SSc from healthy controls.
METHODS: Thirty-four patients (21 limited and 13 diffuse SSc), and 31 age and gender-matched healthy controls were enrolled. Skin tone and stiffness were measured at four different anatomical sites (the forearm, hand, leg, and foot) using a myotonometer. The correlation between the mRSS and skin properties was assessed. Also, hand functionality was evaluated for possible correlations between the variables. The differences in skin properties between dcSSc and lcSSc patients, and healthy controls were assessed using variance analysis.
RESULTS: Intra- and inter-examiner reproducibility were excellent (ICC = 0.70 to 0.98) for tone and stiffness except for non-dominant hand tone, which showed good reliability (ICC = 0.64 to 0.74). Stiffness and tone values of the hands, forearms, and feet significantly correlated with mRSS total score (r = 0.40 to 0.71, p < 0.05). Additionally, tone and stiffness of the hands and forearms moderately correlated with hand function (p < 0.05). Tone and stiffness values increased in patients with dcSSc compared to healthy controls, or patients with lcSSc, at the hands, forearms, and legs (p < 0.05).
CONCLUSIONS: Our findings emphasize the potential utility of the myotonometer for assessing skin properties and differentiating SSc patients from controls, demonstrating its promise as a valuable clinical evaluation tool in this context. Key Points •The myotonometer displayed excellent intra- and inter-examiner reproducibility for assessing skin properties. •Skin tone and stiffness parameters well correlated with the mRSS scores. •The myotonometer can distinguish patients with diffuse cutaneous SSc from healthy controls.
摘要：
目的：目前还缺乏一种快速、准确地评估皮肤生物力学特性的临床实用工具。我们的目的是检查用于系统性硬化症（SSc）中客观皮肤属性评估的肌计内和观察者间的可重复性，将其与改良的Rodnan皮肤评分（MRSS）进行比较，并将患者与健康对照区分开来。
方法：34例患者（21例局限性SSc和13例弥漫性SSc），纳入31名年龄和性别匹配的健康对照.在四个不同的解剖部位（前臂，手,腿,和脚）使用肌压计。评估mRSS和皮肤性质之间的相关性。此外，评估了手功能,以确定变量之间可能的相关性.dcSSc和lcSSc患者皮肤特性的差异，和健康对照使用方差分析进行评估。
结果：在音调和刚度方面，除了非主要的手调外，检查者之间的再现性都很好（ICC=0.70至0.98）。具有良好的可靠性(ICC=0.64~0.74)。手的刚度和音调值，前臂,和脚与mRSS总分显着相关（r=0.40至0.71，p<0.05）。此外,手和前臂的张力和僵硬度与手功能呈中度相关（p<0.05）。与健康对照组相比，dcSSc患者的音调和刚度值增加，或者lcSSc患者，在手中，前臂,和腿（p<0.05）。
结论：我们的发现强调了肌压计在评估皮肤特性和区分SSc患者与对照组方面的潜在效用。证明其作为在这方面有价值的临床评估工具的前景。关键点•肌压计显示了用于评估皮肤特性的优异的检查内和检查间再现性。•肤色和硬度参数与mRSS评分良好相关。•肌压计可以区分具有弥漫性皮肤SSc的患者与健康对照。
方法：34例患者（21例局限性SSc和13例弥漫性SSc），纳入31名年龄和性别匹配的健康对照.在四个不同的解剖部位（前臂，手,腿,和脚）使用肌压计。评估mRSS和皮肤性质之间的相关性。此外，评估了手功能,以确定变量之间可能的相关性.dcSSc和lcSSc患者皮肤特性的差异，和健康对照使用方差分析进行评估。
结果：在音调和刚度方面，除了非主要的手调外，检查者之间的再现性都很好（ICC=0.70至0.98）。具有良好的可靠性(ICC=0.64~0.74)。手的刚度和音调值，前臂,和脚与mRSS总分显着相关（r=0.40至0.71，p<0.05）。此外,手和前臂的张力和僵硬度与手功能呈中度相关（p<0.05）。与健康对照组相比，dcSSc患者的音调和刚度值增加，或者lcSSc患者，在手中，前臂,和腿（p<0.05）。
结论：我们的发现强调了肌压计在评估皮肤特性和区分SSc患者与对照组方面的潜在效用。证明其作为在这方面有价值的临床评估工具的前景。关键点•肌压计显示了用于评估皮肤特性的优异的检查内和检查间再现性。•肤色和硬度参数与mRSS评分良好相关。•肌压计可以区分具有弥漫性皮肤SSc的患者与健康对照。
