Reproducibility of the durometer and myoton devices for skin stiffness measurement in healthy subjects

Abstract

Background: Clinical assessment of skin stiffness is unreliable in many applications. The durometer, an industrial device to measure hardness, has previously been applied in scleroderma. The Myoton is a noninvasive handheld device for assessing soft tissue biomechanical parameters.

Materials and methods: We evaluated the reproducibility of both devices in six healthy subjects in the volar forearm, dorsal forearm, upper arm, shin, and calf bilaterally. The intraclass correlation coefficient (ICC) was used as a measure of reproducibility among three observers.

Results: The interobserver intraclass correlation coefficient (ICC) of overall stiffness for the Myoton was 0.74 [95% confidence interval (CI) 0.45-1.00] and 0.71 [0.39-1.00] for the durometer. Coefficient of variation (CV) for the Myoton was 6.4% [range 1.3-12.1] and 7.6% [range 4.4-13.8] for the durometer. Myoton and durometer values had a Pearson correlation of 0.69. The intraobserver Myoton ICC was 0.89 [0.74-1.00] and CV 3.1% [range 1.6-5.0]. The 95% confidence minimal detectable change by the Myoton for a single observer is 32.4 N/m, which is 7.6% of the average subject's overall stiffness.

Conclusion: The Myoton demonstrated high reproducibility, particularly in the overall stiffness parameter, and merits further investigation to assess disease progression and treatment efficacy.

Keywords: durometer; intraclass correlation coefficient; myoton; sclerosis; stiffness.

Published 2018. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Figures

Figure 1:

Myoton, a noninvasive handheld device modified to isolate cutaneous tissue, and the Rex gauge OO durometer

Figure 2.. Inter- and Intra-Observer Repeatability of Myoton and Inter-Observer Repeatability of Durometer Measurements in Healthy Subjects

Scatter plot with error bars showing the inter- and intra-observer Myoton and inter-observer durometer ICCs per site across six healthy subjects. Error bars represent 95% confidence interval.