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Theophanous RG, Vissoci JRN, Wen FH, Griffin SM, Anderson VE, Mullins ME, Brandehoff NP, Quackenbush EB, Bush SP, Toschlog EA, Greene SC, Sharma K, Kleinschmidt K, Charlton NP, Rose SR, Schwartz R, Lewis B, Lavonas EJ, Gerardo CJ. Validity and reliability of telephone administration of the patient-specific functional scale for the assessment of recovery from snakebite envenomation. PLoS Negl Trop Dis 2019; 13:e0007935. [PMID: 31834923 PMCID: PMC6934321 DOI: 10.1371/journal.pntd.0007935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/27/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives Although more than 1.8 million people survive snakebite envenomation each year, their recovery is understudied. Obtaining long-term follow-up is challenging in both high- and low-resource settings. The Patient-Specific Functional Scale (PSFS) is an easily administered, well-accepted patient-reported outcome that is validated for assessing limb recovery from snakebite envenomation. We studied whether the PSFS is valid and reliable when administered by telephone. Methods This is a secondary analysis of data from a randomized clinical trial. We analyzed the results of PSFS collected in-person on days 3, 7, 14, 21, and 28 and by telephone on days 10, 17, and 24. We assessed the following scale psychometric properties: (a) content validity (ceiling and floor effects), (b) internal structure and consistency (Cronbach’s alpha), and (c) temporal and external validity using Intraclass Correlation Coefficient (ICC). Temporal stability was assessed using Spearman’s correlation coefficient and agreement between adjacent in-person and telephonic assessments with Cohen’s kappa. Bland Altman analysis was used to assess differential bias in low and high score results. Results Data from 74 patients were available for analysis. Floor effects were seen in the early post-injury time points (median: 3 (IQR: 0, 5) at 3 days post-enrollment) and ceiling effects in the late time points (median: 9 (IQR: 8, 10). Internal consistency was good to excellent with both in-person (Cronbach α: 0.91 (95%CI 0.88, 0.95)) and telephone administration (0.81 (0.73, 0.89). Temporal stability was also good (ICC: 0.83 (0.72, 0.89) in-person, 0.80 (0.68, 0.88) telephone). A strong linear correlation was found between in-person and telephone administration (Spearman’s ρ: 0.83 (CI: 0.78, 0.84), consistency was assessed as excellent (Cohen’s κ 0.81 (CI: 0.78, 0.84), and Bland Altman analysis showed no systematic bias. Conclusions Telephone administration of the PSFS provides valid, reliable, and consistent data for the assessment of recovery from snakebite envenomation. Snakebite envenomation is an important but neglected tropical disease that impacts millions of people worldwide each year. These bites lead to both death and permanent disability. As they occur in tropical and subtropical regions, they primarily impact people from low-income areas of the world. As potential new treatments are being developed, we must understand their potential benefit in humans before they can be widely disseminated. Performing these human studies requires the ability to determine how patients recovered with these treatments. Having people return for evaluation during recovery is difficult in these low-income regions. We evaluated the ability to use a telephone version of an already accepted measurement of recovery in snakebite, the Patient-Specific Functional Scale. This study demonstrates that using this telephone-administered measure is feasible, valid, and reliable. With the results of this study, we now have an important tool to easily measure recovery in areas where snakebite predominates. This tool will help snakebite envenomation researchers evaluate the potential benefit of new treatments and accelerate the process of bringing new effective treatments to those snakebite patients in the most need.
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Affiliation(s)
- Rebecca G. Theophanous
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Joao Ricardo Nickenig Vissoci
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Fan Hui Wen
- Hospital Vital, Instituto Butantan, São Paulo, Brazil
| | - S. Michelle Griffin
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
| | - Victoria E. Anderson
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, United States of America
| | - Michael E. Mullins
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Nicklaus P. Brandehoff
- Department of Emergency Medicine, University of California San Francisco Fresno, Fresno, CA, United States of America
| | - Eugenia B. Quackenbush
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Sean P. Bush
- Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, NC, United States of America
| | - Eric A. Toschlog
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC, United States of America
| | - Spencer C. Greene
- Henry J. N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Kapil Sharma
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Kurt Kleinschmidt
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Nathan P. Charlton
- Division of Medical Toxicology, University of Virginia, Charlottesville, VA, United States of America
| | - S. Rutherfoord Rose
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Richard Schwartz
- Department of Emergency Medicine and Hospital Services, Medical College of Georgia, Augusta, GA, United States of America
| | - Brandon Lewis
- Texas A&M Health Science Center, College Station, TX, United States of America
| | - Eric J. Lavonas
- Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, United States of America
- Department of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO, United States of America
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Charles J. Gerardo
- Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- * E-mail:
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Montaguti E, Cariello L, Dodaro MG, Rizzo N, Pilu G, Youssef A. The role of a new three‐dimensional ultrasound technique in the diagnosis of levator ani muscle avulsion. Neurourol Urodyn 2019; 39:455-463. [DOI: 10.1002/nau.24236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 11/09/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Elisa Montaguti
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
| | - Luisa Cariello
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
| | - Maria Gaia Dodaro
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
| | - Nicola Rizzo
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
| | - Gianluigi Pilu
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
| | - Aly Youssef
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital University of Bologna Bologna Italy
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103
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Lo WLA, Yu Q, Mao Y, Li W, Hu C, Li L. Lumbar muscles biomechanical characteristics in young people with chronic spinal pain. BMC Musculoskelet Disord 2019; 20:559. [PMID: 31759390 PMCID: PMC6875033 DOI: 10.1186/s12891-019-2935-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/07/2019] [Indexed: 11/15/2022] Open
Abstract
Background The prevalence of low back pain is rising among the young adult population. Altered lumbar muscle tone was suggested to be associated with underlying pathologies and symptoms. To date, there is minimum information available on the repeatability of lumbar spine muscle mechanical properties in the young adults who experienced low back pain. This study aimed to assess the reproducibility of mechanical properties of lumbar spinal muscle in young adults with spinal pain by myotonometer and explored the difference in reproducibility when different number of indentations was used. Methods Participants who aged between 18 to 25 and reported chronic LBP were recruited. Lumbar muscle tone (Hz) and stiffness (N/m) were assessed by myotonometer on one occasion by two assessors. Parameters were recorded by triple scans and 5-scans mode. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Bland and Altman analysis were used to assess agreement between two measurements. The relationship between muscle mechanical properties and pain score and disability level were assessed by Spearman’s rank correlation coefficient. Results The results of ICCs indicated excellent repeatability in triple scans and 5-scans mode for each lumbar level bilaterally (ICC > 0.75). SEM and SRD were smaller in triple scans than 5-scans mode for most levels. Bland and Altman analysis revealed no systematic bias. Spearman’s rank correlation analysis indicated significant high correlations between muscle tone and disability level (r = 0.80, p < 0.05), and between muscle stiffness and disability level (r = 0.81, p < 0.05). Conclusions This study found that lumbar spinal muscle tone and stiffness were repeatable parameters when measured by myotonometer. The reproducibility of muscle mechanical parameters did not appear to differ between the two scanning modes with different number of indentations. Muscle tone and stiffness measured by myotonometer may therefore be reliable as outcome measures to assess intervention induced changes. The lack of significant association between intensity of pain and mechanical properties of paraspinal muscles may suggest that muscle properties measured at rest might not be related to pain level at rest but more related to pain elicited during movement.
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Affiliation(s)
- Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yurong Mao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wenfeng Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chengpeng Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Le Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China. .,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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O'Sullivan M, Fitzsimons S, Ramos SDS, Oddy M, Glorney E, Sterr A. Utility of the Brain Injury Screening Index in Identifying Female Prisoners With a Traumatic Brain Injury and Associated Cognitive Impairment. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:313-327. [PMID: 31742464 DOI: 10.1177/1078345819879898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is a high prevalence of traumatic brain injury (TBI) in prisoners, but screening tools for identifying TBI in female prisoners are not readily available. Using a cross-sectional design, the psychometric properties of the Brain Injury Screening Index (BISI) were investigated in a closed United Kingdom female prison. Purposive sampling comprised 56 females. Assessment included clinical interview, the BISI, self-report measures of mood, and a battery of measures of cognitive functioning. Seven of the 10 clinical indicators on the BISI met test-retest reliability criteria. Two of the three BISI summary variables demonstrated correlations with questionnaires in the hypothesized directions; however, only two BISI variables were associated with cognitive functioning. Findings support further investigation into the validity and reliability of the BISI with a larger sample.
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Affiliation(s)
- Michelle O'Sullivan
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom.,Rail Safety and Standards Board, London, United Kingdom
| | - Steven Fitzsimons
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Sara da Silva Ramos
- Brain Injury Rehabilitation Trust, The Disabilities Trust Foundation, Horsham, West Sussex, United Kingdom
| | - Michael Oddy
- Brain Injury Rehabilitation Trust, The Disabilities Trust Foundation, Horsham, West Sussex, United Kingdom
| | - Emily Glorney
- School of Law, Royal Holloway, University of London, Egham, Surrey, United Kingdom
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
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105
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McGee C. Measuring intrinsic hand strength in healthy adults: The accuracy intrarater and inter-rater reliability of the Rotterdam Intrinsic Hand Myometer. J Hand Ther 2019; 31:530-537. [PMID: 28457691 DOI: 10.1016/j.jht.2017.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 01/11/2017] [Accepted: 03/20/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement study. INTRODUCTION Measuring the isometric strength generated during isolated hand joint motions is a challenging feat. The Rotterdam Intrinsic Hand Myometer (RIHM; med.engineers, Rotterdam, Netherlands) permits measurement of isolated movements of the hand. To date, there is limited evidence on the inter-rater reliability and limited adult normative data of RIHM. Given that multiple raters, often with varying degrees of experience, are needed to collect normative data, inter-rater reliability testing and a comparison of novice and experienced raters are needed. PURPOSES OF THE STUDY The purposes of this study were to test the accuracy, intrarater reliability, and inter-rater reliability of the RIHM in healthy-handed adults. METHODS RIHM accuracy was tested through use of precision class F weights. Adults 18 years or older without upper limb dysfunction were recruited. Each participant was tested by 4 raters, 3 occupational therapy graduate students, and an experienced certified hand therapist, through use of a calibrated RIHM. Five strength measures were tested bilaterally (ie, thumb carpometacarpal palmar abduction, index finger metacarpophalangeal [MP] abduction, index finger MP flexion, thumb MP flexion, and small finger MP abduction) 3 times per a standardized protocol. Statistical methods were used to test accuracy, inter-rater reliability, and intrarater/response stability. RESULTS The accuracy of RIHM device error was 5% or less. Reliability testing included the participation of 19 women and 10 men (n = 29). All raters were in excellent agreement across all muscles (intraclass correlation coefficient, ≥0.81). Low standard error of measurement values of ≤8.3 N (1.9 lb) across raters were found. The response stability and/or intrarater reliability of the novice and certified hand therapist raters were not statistically different. DISCUSSION The RIHM has an acceptable instrument error; the RIHM and its standardized procedure have excellent inter-rater reliability and response stability when testing those without hand limitations; and the response stability and/or intrarater reliability of expert and novice raters were consistent. CONCLUSIONS The use of the RIHM is justified when multiple raters of varying expertise collect normative data or conduct cohort studies on persons with healthy hands. Future research is warranted. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Corey McGee
- Program in Occupational Therapy, University of Minnesota, Minneapolis, MN, USA.
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106
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Dos'Santos T, Lake J, Comfort P. Comment on: 'Reliability of a commercially available and algorithm-based kinetic analysis software compared to manual-based software'. Sports Biomech 2019; 21:666-668. [PMID: 31707920 DOI: 10.1080/14763141.2019.1666911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Thomas Dos'Santos
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK,
| | - Jason Lake
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Paul Comfort
- Human Performance Laboratory, Directorate of Sport, Exercise, and Physiotherapy, University of Salford, Greater Manchester, UK
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107
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Kennedy DL, Kemp HI, Wu C, Ridout DA, Rice ASC. Determining Real Change in Conditioned Pain Modulation: A Repeated Measures Study in Healthy Volunteers. THE JOURNAL OF PAIN 2019; 21:708-721. [PMID: 31715262 DOI: 10.1016/j.jpain.2019.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/29/2019] [Accepted: 09/19/2019] [Indexed: 11/17/2022]
Abstract
Conditioned pain modulation (CPM) is a potentially useful biomarker in pain populations; however, a statistically robust interpretation of change scores is required. Currently, reporting of CPM does not consider measurement error. Hence, the magnitude of change representing a "true" CPM effect is unknown. This study determined the standard error of measurement (SEM) and proportion of healthy participants showing a "true" CPM effect with a standard CPM paradigm. Fifty healthy volunteers participated in an intersession reliability study using pressure pain threshold (PPT) test stimulus and contact heat, cold water, and sham conditioning stimuli. Baseline PPTs were used to calculate SEM and >±2 × SEM to determine CPM effect. SEM for PPT was .21 kg/cm2. An inhibitory CPM effect (>+2 SEM) was elicited in 59% of subjects in response to cold stimulus; in 44% to heat. Intrasession and intersession reliability of within-subject CPM response was poor (kappa coefficient <.36). Measurement error is important in determining CPM effect and change over time. Even when using reliable test stimuli, and incorporating measures to limit bias and error, CPM intersession reliability was fair and demonstrated a large degree of within-subject variation. Determining "true" change in CPM will underpin future interrogations of intraindividual differences in CPM. PERSPECTIVE: This study used a distribution-based statistical approach to identify real change in CPM, based on the SEM for the test stimulus. Healthy volunteers demonstrate substantial within-subject variation; CPM effect was paradigm dependent at intrasession testing and unstable to the same paradigm at intersession testing.
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Affiliation(s)
- Donna L Kennedy
- Pain Research Group, Department of Surgery & Cancer, Imperial College London, United Kingdom.
| | - Harriet I Kemp
- Pain Research Group, Department of Surgery & Cancer, Imperial College London, United Kingdom
| | - Chenxian Wu
- Imperial College London School of Medicine, United Kingdom
| | - Deborah A Ridout
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - Andrew S C Rice
- Pain Research Group, Department of Surgery & Cancer, Imperial College London, United Kingdom
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108
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Estrella EP, Orillaza NS, Castillo-Carandang NT, Cordero CP, Juban NR. The Validity, Reliability and Internal Consistency of the Cross-Cultural Adaptation of the FIL-DASH (Filipino Version of the Disability of the Arm, Shoulder and Hand) Questionnaire in Patients with Traumatic Brachial Plexus Injuries. J Hand Surg Asian Pac Vol 2019; 24:456-461. [PMID: 31690189 DOI: 10.1142/s2424835519500590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The objective of this paper was to determine the validity, reliability and internal consistency of the translated FILIPINO DASH (FIL-DASH) questionnaire in patients with traumatic brachial plexus injuries. Methods: Thirty-five adult patients with traumatic brachial plexus injury were enrolled in the validation stage. The same questionnaire was given to the patient between 7 to 14 days for the test-retest reliability. The validated Filipino version of the SF-36 was used as the gold standard to determine the construct validity of the translated DASH. We also compared the DASH score with the SF-36 total and subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Acuity Scale (VAS) for Pain. Results: The internal consistency was adequate, with Cronbach's Alpha for the 30 items of 0.93 and an average inter-item covariance of 0.399. The test-retest reliability was 0.87 (p < 0.001). There was no significant difference in establising the validity of the translated DASH against SF-36 total and Subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Analogue Scale (VAS). Conclusions: The translated DASH (FIL-DASH) questionnaire was internally consistent and showed no difference in testing for test-retest reliability and validity against functional outcome measures and pain scales validated for adult Filipinos.
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Affiliation(s)
- Emmanuel P Estrella
- ASTRO (Advanced Study and Research in Orthopedics) Study Group, Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines.,Section of Hand & Reconstructive Microsurgery, Department of Orthopedics, Philippine General Hospital, Manila, Philippines
| | - Nathaniel S Orillaza
- ASTRO (Advanced Study and Research in Orthopedics) Study Group, Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines.,Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines.,Section of Hand & Reconstructive Microsurgery, Department of Orthopedics, Philippine General Hospital, Manila, Philippines
| | - Nina T Castillo-Carandang
- ASTRO (Advanced Study and Research in Orthopedics) Study Group, Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines.,Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
| | - Cynthia P Cordero
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
| | - Noel R Juban
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
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de Araujo Barbosa PHF, de Menezes LT, Costa AS, Paz CCSC, Martins HR, Fachin-Martins E. Reliability of upright weight-bearing distribution measures obtained by computed baropodometry for participants with and without post-stroke hemiparesis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2018.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Measurements from force platforms and digital scales have been applied to classify weight-bearing distribution in post-stroke hemiparesis. However, an intermediate tool – computed baropodometry – is breaking new ground in this field of diagnosis, with a need to report its reliability. Intra-test and test/retest reliabilities of the percentage of total body weight borne by the predominantly used hemibody calculated from computed baropodometry in participants with and without chronic hemiparesis was investigated in this study. Methods A total of 40 participants were evaluated and combined for age and sex in two different groups. Repeated measures were taken to analyse differences among records obtained from averages during 5, 10 or 20 seconds (intra-test reliability) and between the test and 1-week retest (test/retest reliability) for both groups. The analysis of variance, intra-class correlation coefficient and data plotted by Bland-Altman method were administrated. Results The intra-test analysis did not show differences among records obtained from different time durations (5, 10 and 20 seconds). Excellent to moderate intra-class correlation coefficient values (0.794 to 0.644) between test and retest were observed in the hemiparesis group from the records obtained by short to the longer lasting time durations, while for control groups, intra-class correlation coefficient values (0.661 to 0.748) were classified as moderate. Conclusions Acceptable reliability was found for all participants. Moreover, improved repeatability was reported when the measures were obtained by shorter time periods for both groups.
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Affiliation(s)
| | - Lidiane Teles de Menezes
- Physiotherapist, Center for Assistive Technology, Accessibility and Innovation, University of Brasilia, Brasilia, Brazil
| | - Abraão Souza Costa
- Professor, Graduate Program in Health Science and Technology, Ceilândia Campus, University of Brasilia, Brasilia, Brazil
| | | | - Henrique Resende Martins
- Professor, Graduate Program in Electrical Engineering, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Emerson Fachin-Martins
- Professor, Graduate Program in Health Science and Technology, Ceilândia Campus, University of Brasilia, Brasilia, Brazil
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Kamel R, Negm S, Montaguti E, Dodaro MG, Brunelli E, Di Donna G, Soliman E, Sharaf MF, ElHarty AS, Youssef A. Reliability of transperineal ultrasound for the assessment of the angle of progression in labor using parasagittal approach versus midsagittal approach. J Matern Fetal Neonatal Med 2019; 34:3175-3180. [PMID: 31640437 DOI: 10.1080/14767058.2019.1678143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the inter-method agreement between midsagittal (msAoP) and parasagittal (psAoP) measurements of the angle of progression (AoP) during labor. In addition, we aimed to evaluate the correlation between AoP measurements by both midsagittal and parasagittal approaches with the mode of delivery. METHODS We recruited a nonconsecutive series of women in active labor with a singleton uncomplicated term pregnancy with fetuses in vertex presentation. Women underwent transperineal ultrasound in the absence of uterine contractions or maternal pushing to measure both msAoP and psAoP. The inter-method agreement between the two acquisitions was then assessed. Lastly, both measurements were compared between women who had a vaginal delivery versus those who underwent cesarean section (CS). RESULTS Overall, 151 women were included in the study. We found an excellent agreement between msAoP and psAoP (ICC 0.935; 95% CI 0.912-0.953, p < .001). On the other hand, psAoP overestimated the measurements in comparison with msAoP (101.2 ± 15.6 versus 98.2 ± 16.0, p < .001). There was a significant correlation between both methods of AoP assessment and duration of the active second stage of labor and AoP measured by either method was significantly wider in patients who delivered vaginally compared to those who had a CS. CONCLUSIONS Our data showed a significant difference in the measured angle between the psAoP and the originally described msAoP. The automated measurements of AoP that have been introduced are designed using the parasagittal visualization of the more echogenic pubic arch, rather than the hypoechogenic pubic symphysis. We think that in the light of our data, care should be taken before applying data from midsagittal measurement in centers using the parasagittal automated approach.
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Affiliation(s)
- Rasha Kamel
- Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, Cairo, Egypt
| | - Sherif Negm
- Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, Cairo, Egypt
| | - Elisa Montaguti
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Maria Gaia Dodaro
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Elena Brunelli
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Gaetana Di Donna
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Ehab Soliman
- Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, Cairo, Egypt
| | - Marwa Fouad Sharaf
- Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, Cairo, Egypt
| | - Ahmed Salah ElHarty
- Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, Cairo, Egypt
| | - Aly Youssef
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy
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Pini A, Markström JL, Schelin L. Test–retest reliability measures for curve data: an overview with recommendations and supplementary code. Sports Biomech 2019; 21:179-200. [DOI: 10.1080/14763141.2019.1655089] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alessia Pini
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
- Department of Statistical Sciences, Catholic University of the Sacred Heart, Milan, Italy
| | - Jonas L Markström
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Lina Schelin
- Department of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
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112
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Histological age-at-death estimation in white South Africans using stereology. Int J Legal Med 2019; 133:1957-1965. [PMID: 31468135 DOI: 10.1007/s00414-019-02152-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
Various methods are available for estimating age from skeletal remains, amongst them the use of histomorphometry. It is generally argued that age estimation standards are population specific, but this in itself creates problems as the reference samples used are often not large enough and/or lack substantial representation of all age cohorts. Traditional age methods have been shown to suffer from problems such as age mimicry. This paper aims at establishing histological age-at-death standards for the white South African population by supplementing the available sample (lacking an adequate number of young adults) with another sample of European descent to avoid over-estimation of age in younger individuals caused by age mimicry. Bone microstructures related to the number of osteons and fragments, osteon size and Haversian canal size that change with advancing age were used for the development of regression formulae. A histomorphometric assessment of the anterior cortex of the femur was done using stereology for the estimation of age at death. All sections were analysed using the optical fractionator and nucleator probes. A sample of 94 bone sections (n = 50 male, n = 44 females) of white South African individuals were used. A sample of Danish individuals (n = 14 males, n = 16 females) was combined with the South African sample to create a normal age distribution for the reference sample. Single and multiple regression equations were developed after randomly selecting a hold-out sample (n = 14) for validation. Osteon size (average length, surface area and volume) showed the highest correlation with age, followed by the number of osteons and fragments per grid area. Haversian canal size showed inconsistent changes with advancing age. Using the regression equations, predicted ages were obtained for the 14 individuals. RMSE values ranged between 14 and 17 years, which we deemed acceptable.
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113
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Johnson EC, Huffman AE, Yoder H, Dolci A, Perrier ET, Larson-Meyer DE, Armstrong LE. Urinary markers of hydration during 3-day water restriction and graded rehydration. Eur J Nutr 2019; 59:2171-2181. [PMID: 31428854 PMCID: PMC7351875 DOI: 10.1007/s00394-019-02065-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This investigation had three purposes: (a) to evaluate changes in hydration biomarkers in response to a graded rehydration intervention (GRHI) following 3 days of water restriction (WR), (b) assess within-day variation in urine concentrations, and (c) quantify the volume of fluid needed to return to euhydration as demonstrated by change in Ucol. METHODS 115 adult males and females were observed during 1 week of habitual fluid intake, 3 days of fluid restriction (1000 mL day-1), and a fourth day in which the sample was randomized into five different GRHI groups: no additional water, CON; additional 500 mL, G+0.50; additional 1000 mL, G+1.00; additional 1500 mL, G+1.50; additional 2250 mL, G+2.25. All urine was collected on 1 day of the baseline week, during the final 2 days of the WR, and during the day of GRHI, and evaluated for urine osmolality, color, and specific gravity. RESULTS Following the GRHI, only G+1.50 and G+2.25 resulted in all urinary values being significantly different from CON. The mean volume of water increase was significantly greater for those whose Ucol changed from > 4 to < 4 (+ 1435 ± 812 mL) than those whose Ucol remained ≥ 4 (+ 667 ± 722 mL, p < 0.001). CONCLUSIONS An additional 500 mL of water is not sufficient, while approximately 1500 mL of additional water (for a total intake between 2990 and 3515 mL day-1) is required to return to a urine color associated with adequate water intake, following 3 days of WR.
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Affiliation(s)
- Evan C Johnson
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.
| | - Ainsley E Huffman
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.,University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Hillary Yoder
- Human Integrated Physiology Laboratory, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA.,Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
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114
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Cherni Y, Ballaz L, Girardin-Vignola G, Begon M. Intra- and inter-tester reliability of spasticity assessment in standing position in children and adolescents with cerebral palsy using a paediatric exoskeleton. Disabil Rehabil 2019; 43:1001-1007. [PMID: 31368379 DOI: 10.1080/09638288.2019.1646814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The L-STIFF tool of the Lokomat evaluates the hip and knee flexors and extensors spasticity in a standing position. It moves the lower limb at a controlled velocity, measuring joint resistance to passive movements. Since its reliability in children with cerebral palsy remains unknown, our goal was to evaluate the relative and absolute reliability of L-STIFF in children with cerebral palsy. METHODS Reliability was determined in 16 children with cerebral palsy by two experienced therapists. The changes in resistive torque in hip and knee in both flexion and extension were measured. Relative and absolute reliability were estimated using the intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Reliability was assessed on three levels: (1) intra- and (2) inter-tester within session, and (3) intra-tester between sessions. RESULTS Intraclass correlation coefficients were moderate to excellent for intra-tester reliability (all p ≤ 0.01). The standard error of measurement ranged from 0.005 to 0.021 Nm/° (i.e., 7-16%) and minimal detectable change from 0.014 to 0.059 Nm/°. Inter-tester intraclass correlation coefficients ranged from 0.32 to 0.70 (all p ≤ 0.01), standard error of measurement ranged from 0.012 to 0.029 Nm/° (i.e., 6-39%), and minimal detectable change ranged from 0.033 to 0.082 Nm/°. L-STIFF reliability was better during fast and medium movement speeds compared to slow speeds. CONCLUSIONS The assessment tool L-STIFF is a promising tool for quantifying lower limb spasticity in children with cerebral palsy in a standing position. However, the results should be interpreted carefully.Implications for RehabilitationL-STIFF is a promising tool for evaluating lower limb spasticity in standing position.A special care must be given to the installation and alignment of the participant into the Lokomat to minimize erroneous spasticity measurement.Relative standard error of measurement and minimal detectable change should be used to analyze changes spasticity.
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Affiliation(s)
- Yosra Cherni
- École de kinésiologie et des sciences de l'activité physique, Faculté de Médecine, Université de Montréal, Montréal, Canada.,Centre de réadaptation Marie-Enfant, CHU Sainte-Justine, Montréal, Canada
| | - Laurent Ballaz
- Centre de réadaptation Marie-Enfant, CHU Sainte-Justine, Montréal, Canada.,Département des sciences de l'activité physique, Université de Québec à Montréal, Montréal, Canada
| | | | - Mickael Begon
- École de kinésiologie et des sciences de l'activité physique, Faculté de Médecine, Université de Montréal, Montréal, Canada.,Centre de réadaptation Marie-Enfant, CHU Sainte-Justine, Montréal, Canada
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115
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Linek P, Wolny T, Sikora D, Klepek A. Supersonic Shear Imaging for Quantification of Lateral Abdominal Muscle Shear Modulus in Pediatric Population with Scoliosis: A Reliability and Agreement Study. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1551-1561. [PMID: 31031032 DOI: 10.1016/j.ultrasmedbio.2019.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/16/2019] [Accepted: 03/02/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to assess the intra- and inter-rater reliability/agreement of the lateral abdominal muscle (LAM) stiffness and thickness measurements at rest and during contraction and to determine the relationship between the superficial fat thickness and the LAM stiffness measurements. LAM stiffness and thickness were measured using supersonic shear wave elastography (SSI) in pediatric participants. The reliability of LAM stiffness and thickness measurements ranged from moderate to excellent. There was an inverse correlation between fat thickness and between-rater difference in the resting external oblique stiffness (r > -0.37) and the contracted external and internal oblique stiffness (r > -0.40). SSI is a reliable method for assessing LAM stiffness and thickness in pediatric populations. To remove potential systematic errors: (i) the first round of measurements should be performed to familiarize patients with procedures; (ii) the examiner should pay more attention while performing LAM measurements on the opposite side of the body.
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Affiliation(s)
- Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
| | - Tomasz Wolny
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Damian Sikora
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Anna Klepek
- Rehabilitation Department, Stokrotka Health Resort, Goczałkowice-Zdrój, Poland
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116
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Cavuoto LA, Pajoutan M, Mehta RK. Reliability analyses and values of isometric shoulder flexion and trunk extension strengths stratified by body mass index. PLoS One 2019; 14:e0219090. [PMID: 31260477 PMCID: PMC6602192 DOI: 10.1371/journal.pone.0219090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022] Open
Abstract
The main goal of this study was to investigate the reliability of muscle strength across different levels of obesity. A sample of 142 healthy subjects performed maximum voluntary isometric contractions for shoulder flexion and trunk extension on each of four days. Subjects were recruited into one of three groups, non-obese, overweight, or obese, based on body mass index (BMI). Reliability of the strength measurements within each session and across the four sessions was determined from the intraclass correlation coefficient, coefficient of repeatability, coefficient of variation, and standard error of measurement. For the shoulder flexion measures, the coefficient of variation was < 10% and intraclass correlation coefficient was > 0.75. The absolute reliability of trunk extension strength measurement was rejected due to a high variability across sessions. For both tasks, comparable strengths across the BMI groups were found.
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Affiliation(s)
- Lora A. Cavuoto
- Industrial and Systems Engineering, University at Buffalo, Buffalo, New York, United States of America
- * E-mail:
| | - Mojdeh Pajoutan
- Industrial and Systems Engineering, University at Buffalo, Buffalo, New York, United States of America
| | - Ranjana K. Mehta
- Industrial and Systems Engineering, Texas A&M University, College Station, Texas, United States of America
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117
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Development and validation of models to predict respiratory function in persons with long-term spinal cord injury. Spinal Cord 2019; 57:1064-1075. [PMID: 31217518 DOI: 10.1038/s41393-019-0313-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 01/01/2023]
Abstract
STUDY DESIGN Multicenter, cross-sectional study. OBJECTIVES To validate previously developed respiratory function prediction models for persons with long-term spinal cord injury (SCI) and if necessary develop and validate new models. SETTING Ten SCI rehabilitation centers. METHODS Five respiratory function parameters were measured in adults with chronic, traumatic, motor complete SCI (C4-T12). First, the models published in 2012 were validated using Bland-Altman plots. Then, new models were calculated using 80% of the dataset by multiple regression analysis with the candidate predictors gender, age, height, weight, time post injury (TPI), lesion level, and smoking. In a third step, the new models were validated using the other 20% of the dataset by Bland-Altman plots. RESULTS In total 613 participants were included. For persons with long-term SCI, the 2012 models were poorly predictive, especially for respiratory muscle strength (R2 = 0.4). Significant predictors for all respiratory function parameters in the new models (R2 = 0.7-0.8) were lesion level, gender and weight. Small effects on single outcome parameters were observed for TPI and age whereas smoking had no effect. For the new models the mean differences between measured and predicted values for respiratory muscle strength were 4.0 ± 36.0 cm H2O and for lung function parameters -0.5 ± 1.2 L (FVC), -0.3 ± 0.9 L (FEV1) and -0.5 ± 2.0 L/s (PEF). CONCLUSION We did not find better models for lung function in long-term SCI but those for respiratory muscle strength showed better accuracy. SPONSORSHIP The content of this publication was developed under grant from Wings for Life, grant number WFL-CH-017/14.
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118
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Hu B, Zhang X, Mu J, Wu M, Zhu Z, Liu Z, Wang Y. Spasticity Measurement Based on the HHT Marginal Spectrum Entropy of sEMG Using a Portable System: A Preliminary Study. IEEE Trans Neural Syst Rehabil Eng 2019; 26:1424-1434. [PMID: 29985152 DOI: 10.1109/tnsre.2018.2838767] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To facilitate stretch reflex onset (SRO) detection and improve accuracy and reliability of spasticity assessment in clinical settings, a new method to measure dynamic stretch reflex threshold (DSRT) based on Hilbert-Huang transform marginal spectrum entropy (HMSEN) of surface electromyography (sEMG) signals and a portable system to quantify modified Ashworth scale (MAS) for spasticity assessment were developed. The sEMG signals were divided into frames using a fixed-length sliding window, and the HMSEN of each frame was calculated. An adaptive threshold was set to measure the DSRT. The HMSEN based method can quantify muscle activity through time-frequency and nonlinear dynamics analysis, therefore providing deeper insight about the spastic muscle mechanisms during stretching and a reliable SRO detection method. Experimental results revealed that the HMSEN based method could reliably detect the SRO and measure the DSRT (recognition rate: 95.45%), and could achieve improved performance over the time-domain based method. There was a strong correlation ( to -0.900) between the MAS scores and the DSRT index, and the test-retest reliability was high. Additionally, limitations of the MAS were analyzed. This paper indicates that the presented framework can provide a promising tool to measure DSRT and a clinical quantitative approach for spasticity assessment.
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119
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Torrance E, Hallam L, Walton MJ, Monga P, Watts AC, Funk L. The combined shoulder assessment: a convenient method for obtaining equivalent outcome scores. Shoulder Elbow 2019; 11:182-190. [PMID: 31210789 PMCID: PMC6555105 DOI: 10.1177/1758573217736748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 06/08/2017] [Accepted: 09/21/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Outcome scores are useful tools with respect to quantifying how pain and limitations in strength and movement affect the patient's functionality and lifestyle. Three shoulder outcome methods [Oxford, Constant and QuickDASH (Disability of the Arm, Shoulder and Hand)] are commonly used in practice but collectively consist of 34 questions, taking approximately 7 min to complete. We have developed a concise shoulder assessment to derive three equivalent outcome scores in a 12-item patient-reporting questionnaire. METHODS Outcome scores from 1285 outpatients of an upper limb clinic were collected. The patient cohort consisted of 462 females and 823 males with a mean (SD) age of 47.2 (16.79) years (range 13 years to 90 years). Using a correlation matrix, a 12-item questionnaire was drafted. The combined shoulder assessment was validated by 227 patients; consisting of 101 females and 126 males with a mean (SD) age of 47.91 (16.63) years (range 13 years to 88 years). RESULTS Agreement was achieved between the two methods, with an equivalent Oxford Shoulder Score intraclass correlation (ICC) of 0.930, equivalent Constant Shoulder Score ICC of 0.942 and equivalent QuickDASH ICC of 0.869. Bland-Altman analyses showed no systematic differences. Large effect sizes highlighted the responsiveness to change. CONCLUSIONS The new combined shoulder assessment is a more convenient and patient-friendly method to obtain equivalent Oxford, Constant and QuickDASH shoulder outcome scores.
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Affiliation(s)
| | | | - Michael J. Walton
- The Wilmslow Hospital, Wilmslow,
UK,Wrightington Hospital, Wigan, UK,University of Salford, Manchester,
UK
| | - Puneet Monga
- The Wilmslow Hospital, Wilmslow,
UK,Wrightington Hospital, Wigan, UK,University of Salford, Manchester,
UK
| | - Adam C. Watts
- The Wilmslow Hospital, Wilmslow,
UK,Wrightington Hospital, Wigan, UK,University of Manchester, Manchester,
UK
| | - Lennard Funk
- The Wilmslow Hospital, Wilmslow,
UK,Wrightington Hospital, Wigan, UK,University of Salford, Manchester,
UK,Lennard Funk, Wrightington Hospital Hall
Lane Appley Bridge Wigan WN6 9EP, UK.
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120
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Liu TW, Ng SSM. Assessing the fall risks of community-dwelling stroke survivors using the Short-form Physiological Profile Assessment (S-PPA). PLoS One 2019; 14:e0216769. [PMID: 31112580 PMCID: PMC6528978 DOI: 10.1371/journal.pone.0216769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 04/30/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction Fall is common after stroke. The Short-form Physiological Profile Assessment (S-PPA) was developed to assess the fall risks and underlying physiological factors, and it has been used in healthy older adults and older adults with stroke. This study aimed to establish the psychometric properties of the S-PPA among cognitively intact and ambulant community-dwelling older adults with stroke. Methods The S-PPA, Chinese version of the Activities-specific Balance Confidence (ABC-C) scale and 3 balance measures, namely the Berg Balance Scale (BBS), Timed “Up & Go” (TUG) and Functional Reach Test (FRT), were administered. Inter- and intra-rater reliability were assessed at baseline and after a 1-week interval, respectively. The validity of the S-PPA was assessed through correlations with balance measures and the ABC-C and by comparing the S-PPA scores between the stroke and healthy groups and between fallers and non-fallers in the stroke group. A receiver operating characteristic (ROC) curve analysis was used to assess the ability of balance measures to distinguish fall status in the stroke group. Results The S-PPA yielded good inter-rater (intraclass correlation coefficient (ICC) = 0.83) and moderate intra-rater reliability (ICC = 0.74), correlated significantly with the 3 balance measures (rho = 0.49–0.70) and ABC-C (rho = 0.35) and revealed significant differences between stroke survivors and controls and between stroke survivors with and without a fall history. However, the ROC analysis revealed that the S-PPA had a poor ability to distinguish the fall statuses of community-dwelling stroke survivors. Conclusions The S-PPA is reliable and valid for evaluating fall risks but cannot adequately distinguish the fall statuses of stroke survivors.
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Affiliation(s)
- Tai-Wa Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR)
- School of Nursing & Health Studies, The Open University of Hong Kong, Ho Man Tin, Hong Kong (SAR)
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR)
- * E-mail:
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121
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Baghel P, Walia S, Noohu MM. Reliability and validity of transfer assessment instrument version 3.0 in individuals with acute spinal cord injury in early rehabilitation phase. Hong Kong Physiother J 2019; 38:115-123. [PMID: 30930583 PMCID: PMC6405354 DOI: 10.1142/s1013702518500099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 07/28/2017] [Indexed: 11/18/2022] Open
Abstract
Background Transfers are very important in functional activities of subjects with spinal cord injury (SCI). The transfer assessment instrument (TAI) was the first tool to standardize the assessment of transfer technique. Objective The purpose of this study was to establish the reliability and validity of TAI 3.0 in people with SCI in early rehabilitation phase. Methods Thirty subjects with acute traumatic SCI were recruited from a tertiary care center for SCI management. Four raters assessed the quality of transfer using TAI 3.0 and a fifth rater used global assessment of transfer scale (VAS). TAI 3.0's intraclass correlation coefficient (ICC) for intrarater and interrater reliability, standard error of measurement (SEM), minimal detectable change (MDC), limits of agreement and concurrent validity was determined. Results The intrarater ICC was 0.93 to 0.98 and interrater ICC was 0.99, indicating high levels of reliability. The SEMs among the raters for TAI 3.0 total was from 0.23 to 0.28. The MDC among the raters TAI 3.0 total was from 0.54 to 0.86. Correlation for different raters between the TAI 3.0 and VAS ranged between 0.88 and 0.90. Conclusion TAI 3.0 is a reliable and valid tool to assess the transfer skill in individuals with SCI in early rehabilitation phase.
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Affiliation(s)
- Preeti Baghel
- ISIC Institute of Rehabilitation Sciences, New Delhi, India
| | - Shefali Walia
- ISIC Institute of Rehabilitation Sciences, New Delhi, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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122
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O'Hara S, Zelesco M, Sun Z. Shear Wave Elastography on the Uterine Cervix: Technical Development for the Transvaginal Approach. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1049-1060. [PMID: 30208228 DOI: 10.1002/jum.14793] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This research aimed to identify biological and technical confounders in the nonpregnant cervix when applying shear wave elastography with an endovaginal transducer. METHODS Cervical speed measurements were obtained at the internal and external os in the anterior and posterior portions of the cervix using a transvaginal approach in 69 nongravid patients. RESULTS Reliable measurements were obtained at the external os and internal os, anteriorly and posteriorly, in 63, 55, 55, and 26 patients, respectively. The mean speed obtained at the external os, anteriorly and posteriorly, was 2.52 ± 0.49 m/s and 2.87 ± 0.63 m/s, respectively, and at the internal os, anteriorly and posteriorly, 3.29 ± 0.79 m/s and 4.10 ± 1.11 m/s, respectively. The difference in speed between all regions was statistically significant (P < .05). CONCLUSION Ultrasound-induced artifacts appear to affect the transmission of the elastographic main pulse, with cervical position contributing to suboptimal shear wave production in the posterior cervix. Reliable shear wave propagation can be achieved in the anterior cervix in most patients.
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Affiliation(s)
- Sandra O'Hara
- SKG Radiology, West Perth, Perth, Western Australia
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia
| | - Marilyn Zelesco
- Department of Medical Imaging, Fiona Stanley Hospital, Murdoch, Western Australia
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia
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123
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Manzi L, Villafañe JH, Indino C, Tamini J, Berjano P, Usuelli FG. Reliability of the Phi angle to assess rotational alignment of the talar component in total ankle replacement. Foot Ankle Surg 2019; 25:169-173. [PMID: 29409284 DOI: 10.1016/j.fas.2017.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/15/2017] [Accepted: 10/10/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to investigate the test-retest reliability of the Phi angle in patients undergoing total ankle replacement (TAR) for end stage ankle osteoarthritis (OA) to assess the rotational alignment of the talar component. METHODS Retrospective observational cross-sectional study of prospectively collected data. Post-operative anteroposterior radiographs of the foot of 170 patients who underwent TAR for the ankle OA were evaluated. Three physicians measured Phi on the 170 randomly sorted and anonymized radiographs on two occasions, one week apart (test and retest conditions), inter and intra-observer agreement were evaluated. RESULTS Test-retest reliability of Phi angle measurement was excellent for patients with Hintegra TAR (ICC=0.995; p<0.001) and Zimmer TAR (ICC=0.995; p<0.001) on radiographs of subjects with ankle OA. There were no significant differences in the reliability of the Phi angle measurement between patients with Hintegra vs. Zimmer implants (p>0.05). CONCLUSIONS Measurement of Phi angle on weight-bearing dorsoplantar radiograph showed an excellent reliability among orthopaedic surgeons in determining the position of the talar component in the axial plane. LEVEL OF EVIDENCE Level II, cross sectional study.
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Affiliation(s)
- Luigi Manzi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
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124
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Interrater reliability of three-dimensional reconstruction of the spine. DER ORTHOPADE 2019; 49:350-358. [DOI: 10.1007/s00132-019-03712-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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125
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Lee P, Lu WS, Liu CH, Lin HY, Hsieh CL. Test-Retest Reliability and Minimal Detectable Change of the D2 Test of Attention in Patients with Schizophrenia. Arch Clin Neuropsychol 2019; 33:1060-1068. [PMID: 29228100 DOI: 10.1093/arclin/acx123] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/23/2017] [Indexed: 12/12/2022] Open
Abstract
Objective The d2 Test of Attention (D2) is a commonly used measure of selective attention for patients with schizophrenia. However, its test-retest reliability and minimal detectable change (MDC) are unknown in patients with schizophrenia, limiting its utility in both clinical and research settings. The aim of the present study was to examine the test-retest reliability and MDC of the D2 in patients with schizophrenia. Method A rater administered the D2 on 108 patients with schizophrenia twice at a 1-month interval. Test-retest reliability was determined through the calculation of the intra-class correlation coefficient (ICC). We also carried out Bland-Altman analysis, which included a scatter plot of the differences between test and retest against their mean. Systematic biases were evaluated by use of a paired t-test. Results The ICCs for the D2 ranged from 0.78 to 0.94. The MDCs (MDC%) of the seven subscores were 102.3 (29.7), 19.4 (85.0), 7.2 (94.6), 21.0 (69.0), 104.0 (33.1), 105.0 (35.8), and 7.8 (47.8), which represented limited-to-acceptable random measurement error. Trends in the Bland-Altman plots of the omissions (E1), commissions (E2), and errors (E) were noted, presenting that the data had heteroscedasticity. Conclusions According to the results, the D2 had good test-retest reliability, especially in the scores of TN, TN-E, and CP. For the further research, finding a way to improve the administration procedure to reduce random measurement error would be important for the E1, E2, E, and FR subscores.
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Affiliation(s)
- Posen Lee
- Department of Occupational Therapy, I-Shou University, Kaohsiung City 82445, Taiwan
| | - Wen-Shian Lu
- School of Occupational Therapy, Chung Shan Medical University and Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chin-Hsuan Liu
- Department of Occupational Rehabilitation, Kai-Suan Psychiatric Hospital, Kaohsiung City 80276, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung 41354, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City 100, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei City 10048, Taiwan
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Marei A, Doi K, Hattori Y, Sakamot S. Quantitative assessment of elbow flexion by handheld dynamometry in brachial plexus palsy. J Hand Surg Eur Vol 2019; 44:256-262. [PMID: 30509149 DOI: 10.1177/1753193418814430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to assess the relative and absolute reliability of a handheld dynamometer when used for examining elbow flexion power in patients with brachial plexus palsy. The assessment of the intra-rater and inter-rater reliability coefficients for the handheld dynamometer was done using the stationary Kin-Com® dynamometer as the reference standard. We determined the measurement errors and checked the systematic biases of the handheld dynamometer. The inter-rater and intra-rater reliabilities of the handheld dynamometer had a very high intraclass correlation coefficient. The values of handheld dynamometer readings had a high correlation to Kin-Com® readings. The Medical Research Council grading was a comparatively inaccurate method for quantitative assessment of motor power. We conclude that a handheld dynamometer measurement is more precise and reliable than the Medical Research Council grading for measuring recovery of elbow flexion in patients with brachial plexus palsy. Level of evidence: III.
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Affiliation(s)
- Abdelhakim Marei
- 1 Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi City, Japan.,2 Tanta University Hospitals, Orthopedic Surgery Department, Tanta, El- Gharbia Governorate, Egypt
| | - Kazuteru Doi
- 1 Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi City, Japan
| | - Yasunori Hattori
- 1 Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi City, Japan
| | - Soutetsu Sakamot
- 1 Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi City, Japan
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The validity of spatiotemporal gait analysis using dual laser range sensors: a cross-sectional study. Arch Physiother 2019; 9:3. [PMID: 30820352 PMCID: PMC6381722 DOI: 10.1186/s40945-019-0055-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 02/08/2019] [Indexed: 11/14/2022] Open
Abstract
Background The spatiotemporal parameters were used for sophisticated gait analysis in widespread clinical use. Recently, a laser range sensor has been proposed as a new device for the spatiotemporal gait measurement. However, measurement using a single laser range sensor can only be used for short-range gait measurements because the device irradiates participants with lasers in a radial manner. For long-range gait measurement, the present study uses a modified method using dual laser range sensors installed at opposite ends of the walking path. The aim of present study was to investigate the concurrent validity of the proposed method for spatiotemporal gait measurement by comparison to a computer-based instrumented walkway system. Methods Ten healthy participants were enrolled in this study. Ten-meter walking tests at 100, 75, and 50% of the comfortable speed were conducted to determine the concurrent validity of the proposed method compared to instrumented walkway measurements. Frequency distributions of errors for foot-contact (FC) and foot-off (FO) estimated times between the two systems were also calculated to determine the adequacy of estimation of FC and FO from three perspectives: accuracy (smallness of mean error), precision (smallness of variability), and unambiguity (monomodality of histogram). Intra-class correlation coefficient (2,1) was used to determine the concurrent validity of spatiotemporal parameters between the two systems. Result The results indicate that the detection times for FC and FO estimated by the proposed method did not differ from those measured by the instrumented walkway reference system. In addition, histogram for FC and FO showed monomodality. Intra-class correlation coefficients of the spatiotemporal parameters (stance time: 0.74; double support time: 0.56; stride time: 0.89; stride length: 0.83; step length: 0.71; swing time: 0.23) were not high enough. The mean errors of all spatiotemporal parameters were small. Conclusions These results suggest that the proposed lacks sufficient concurrent validity for spatiotemporal gait measurement. Further improvement of this proposed system seems necessary. Trial registration UMIN000032710. Registered 24 May 2018. Retrospectively registered.
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128
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Spanou A, Mamais I, Lamnisos D, Stasinopoulos D. Reliability and validity of the Greek shoulder pain and disability index in patients with shoulder pain. Disabil Rehabil 2019; 42:1299-1304. [PMID: 30653385 DOI: 10.1080/09638288.2018.1519728] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The Shoulder Pain and Disability Index is one of the most common questionnaire to evaluate the impact of shoulder disorders on function. There is no valid and reliable Greek version of the Shoulder Pain and Disability Index available at present for all shoulder disorders. Therefore, the aim of the current study was to test the reliability and validity of the Shoulder Pain and Disability Index in patients with shoulder pain for at least four weeks.Methods: The validation study was conducted in clinical settings by questionnaires comprising the Greek Shoulder Pain and Disability Index and Disability of the Arm, Shoulder, and Hand questionnaire. 130 (68 women and 62 men) Greek reading patients over 18 years old with shoulder pain for at least four weeks were recruited from physical therapy clinics. Internal consistency of the translated instrument was measured using Cronbach's α. to establish test-retest reliability, the patients without any change in their condition after 2-3 days from their initial visit were asked to complete the Shoulder Pain and Disability Index for a second time. An intraclass correlation coefficient was used to assess the test-retest reliability of the Shoulder Pain and Disability Index. The Greek version of the Shoulder Pain and Disability Index and Disability of the Arm, Shoulder, and Hand questionnaire was also administered in both visits. Concurrent validity was measured by correlating the Shoulder Pain and Disability Index with the Greek Shoulder Pain and Disability Index and Disability of the Arm, Shoulder and Hand scale using Pearson's correlation coefficient.Results: The results showed that the Greek Shoulder Pain and Disability Index has good internal consistency (Cronbach α = 0.947), test-retest reliability (ICC =0.926) and concurrent validity (r > 0.7). The standard error of measurement (SEM) and the smallest detectable change (SDC) of the Greek SPADI total score were 4.77 and 13.18.Conclusions: The Greek version of the Shoulder Pain and Disability Index is a reliable and valid measure when administered to patients aged over 18 years old with shoulder pain for at least four weeks.Implications for RehabilitationThe Greek version of the Shoulder Pain and Disability Index has been found to be reliable and valid when used in patients with shoulder pain for at least four weeks.The results of the psychometric characteristics were compatible with those of the original English version.The Shoulder Pain and Disability Index could be applied to a Greek-speaking population to assess functional limitations and symptoms in patients over 18 years old with shoulder pain for at least four weeks.
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Affiliation(s)
- Alexia Spanou
- Physiotherapy Program, Department of Health Sciences School of Sciences, European University of Cyprus, Nicosia, Cyprus
| | - Ioannis Mamais
- Physiotherapy Program, Department of Health Sciences School of Sciences, European University of Cyprus, Nicosia, Cyprus
| | - Dimitrios Lamnisos
- Physiotherapy Program, Department of Health Sciences School of Sciences, European University of Cyprus, Nicosia, Cyprus
| | - Dimitrios Stasinopoulos
- Physiotherapy Program, Department of Health Sciences School of Sciences, European University of Cyprus, Nicosia, Cyprus
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Ophey MJ, Bosch K, Khalfallah FZ, Wijnands AMMP, van den Berg RB, Bernards NTM, Kerkhoffs GMMJ, Tak IJR. The decline step-down test measuring the maximum pain-free flexion angle: A reliable and valid performance test in patients with patellofemoral pain. Phys Ther Sport 2019; 36:43-50. [PMID: 30641448 DOI: 10.1016/j.ptsp.2018.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Patients with patellofemoral pain (PFP) experience pain while descending stairs. To date no reliable and valid performance-test exists to assess the maximum pain-free knee flexion angle (MPFFA) as outcome measure during a step-down task. Therefore, the intra- and inter-observer reliability and construct validity of the decline step-down test (DSDT) measuring the MPFFA in patients with PFP were evaluated. DESIGN Reliability and construct validity. SETTING Private practices in Nijmegen and Utrecht, the Netherlands. PARTICIPANTS Patients with PFP. MAIN OUTCOME MEASURES The reliability was assessed by repeated measurements of the MPFFA during the DSDT. The construct validity was assessed by correlating the measurements on the DSDT with the Anterior Knee Pain Scale Dutch Version (AKPS-DV) based on a pre-set hypothesis. RESULTS Thirty-two participants (forty-eight knees) were eligible for inclusion. The intraclass correlation coefficient (ICC) for intra-observer reliability was ICC2,1 = 0.83 and ICC2,1 = 0.85 for inter-observer reliability. The 95% limits of agreement (LoA) showed a width of 27.56° for intra-observer reliability and a width of 24.42° for inter-observer reliability. There was an average positive correlation between the DSDT and the total score on the AKPS-DV (rs = 0.31, p = 0.030). CONCLUSION The DSDT measuring the MPFFA is reliable and valid in patients with PFP.
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Affiliation(s)
- Martin J Ophey
- Nexus - Institute for Physical Therapy Education, Gennep, the Netherlands; IJsveldFysio - Private Practice for Physical Therapy, Nijmegen, the Netherlands; European Sports Physical Therapy Education Network, Vienna, Austria.
| | - Karlijn Bosch
- HAN - University of Applied Sciences, Physical Therapy Department, Nijmegen, the Netherlands
| | - Fatos Z Khalfallah
- HAN - University of Applied Sciences, Physical Therapy Department, Nijmegen, the Netherlands
| | - Ap M M P Wijnands
- HAN - University of Applied Sciences, Physical Therapy Department, Nijmegen, the Netherlands
| | | | - Nol T M Bernards
- HAN - University of Applied Sciences, Physical Therapy Department, Nijmegen, the Netherlands
| | - Gino M M J Kerkhoffs
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands
| | - Igor J R Tak
- European Sports Physical Therapy Education Network, Vienna, Austria; Physiotherapy Utrecht Oost - Sports Rehabilitation and Manual Therapy, Utrecht, the Netherlands; Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands
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130
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Porto AB, Okazaki VHA. Thoracic Kyphosis and Lumbar Lordosis Assessment by Radiography and Photogrammetry: A Review of Normative Values and Reliability. J Manipulative Physiol Ther 2019; 41:712-723. [PMID: 30612716 DOI: 10.1016/j.jmpt.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 03/23/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study was to review referential values for thoracic kyphosis and lumbar lordosis for radiography and photogrammetry analysis and search for information about the interrater and intrarater reliability. METHODS The databases PubMed/Medline and LILACS were searched using the following keywords: radiograph and posture, postural alignment, and photogrammetry or photometry or biophotogrammetry. Studies containing values of thoracic kyphosis and lumbar lordosis or a reliability test assessed by radiography and photogrammetry were selected. Random numbers were generated in MATLAB from each study individually to establish normative values for the thoracic kyphosis and lumbar lordosis for both methods. After that, frequencies (median, first quartile, and third quartile) were obtained in SPSS 20.0 (IBM Corp, Armonk, New York). RESULTS Twenty-six articles were selected, of which 23 studies contained values for thoracic kyphosis and lumbar lordosis and 10 tested the intra- and interrater reliability of both methods. For the studies with radiography that calculated the angle by the same method of assessment, the mean was 44.07° (4.75) for L1 to L5 and 58.01° (5.75) for L1 to S1, and for T1 to T12 the mean was 48.33° (6.24). Most studies used the intraclass correlation coefficient test, showing strong reliability. CONCLUSION No concordance among the results for both methods was shown. Also, it was not possible to perform the same procedure with the photogrammetry studies because of the great discrepancy in procedures and angle calculations. To assess the reliability, it is necessary to use the proper statistical test.
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Viveiro LAPD, Ferreira AFL, Pompeu JE. Cross-cultural adaptation, reliability, and validity of the St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY). FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Falls are an important adverse event among older adults. The St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY) is a tool to assess the risk of falls; however, it is not translated and adapted to Portuguese. Objective: To translate and perform a cross-cultural adaptation of STRATIFY in Brazilian Portuguese, as well as to test the reliability and validity of the instrument. Method: The cross-cultural adaptation process was carried out in six stages: A) T1 and T2 translations; B) synthesis of translations (T12); C) T12 back translations (RT1 and RT2); D) expert committee review; E) pretesting of the version approved by the committee; F) adapted version of STRATIFY for Brazilian Portuguese. Inter-rater and test-retest reliability were performed using the intraclass correlation coefficient (ICC) and 95% confidence interval (CI). Validity was assessed by the Spearman’s correlation coefficient of the STRATIFY with the Morse Fall Scale (MFS). Data analysis was performed by the Microsoft Office Excel 2016 (translation and adaptation) and by the IBM SPSS Statistics 20.0 (reliability and validity). We used a level of significance of p<0.05. Results: Data were presented about the perception of 33 health professionals on the adapted version of STRATIFY. The following ICC and CI were found for inter-rater and test-retest reliability, respectively: ICC=0.729; CI=0.525-0.845 and ICC=0.876; CI=0.781-0.929. STRATIFY and MFS showed a moderate but significant correlation (ρ=0.50, p<0.001). Conclusion: The translated and adapted version of the STRATIFY presented moderate inter-rater reliability and good test-retest reliability, in addition to a moderate correlation to the MFS.
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Bohman T, Tegern M, Halvarsson A, Broman L, Larsson H. Reliability and agreement of the IsoKai isokinetic lift test - A test used for admission to the Swedish Armed Forces. PLoS One 2018; 13:e0209419. [PMID: 30566536 PMCID: PMC6300333 DOI: 10.1371/journal.pone.0209419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/05/2018] [Indexed: 12/13/2022] Open
Abstract
This study was performed to evaluate the reliability and agreement of the IsoKai isokinetic lift test as it is currently administered in admission to the Swedish Armed Forces. The study included an intrarater (n = 534) and interrater reliability sample (n = 137), of Swedish male conscripts who performed the test on two test occasions about two hours apart. Two-to-four lifts were performed at each occasion, and the highest mean (IsoKaiMF) and peak force (IsoKaiPF) produced (N) were used for evaluation. All intraclass coefficients showed excellent reliability. The interrater analyses resulted in intraclass coefficients of 0.942 (95% CI; 0.920–0.959) and 0.858 (95% CI; 0.806–0.896) for the IsoKaiMF and IsoKaiPF, respectively, while the corresponding coefficients for the intrarater analyses were 0.935 (95% CI; 0.923–0.946) and 0.865 (95% CI; 0.842–0.886). Agreement, the capability of a test to detect changes, was assessed by the standard error of measurement (SEM/SEM%) and the smallest real difference (SRD/SRD%). These estimate indicated that it is possible to achieve measurements relevant to use in real practice with the IsoKai isokinetic lift test. Bland and Altman analyses revealed no systematic errors in either sample. Based on these findings, the IsoKai isokinetic lift test is suggested to be a highly reliable test for maximal dynamic muscular strength. The test could be of use in selection procedures in order to accurately evaluate maximal dynamic muscular strength, and for evaluating longitudinal changes in strength.
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Affiliation(s)
- Tony Bohman
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Matthias Tegern
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Alexandra Halvarsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Lisbet Broman
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Helena Larsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Swedish Armed Forces, Headquarters, Medical Services, Stockholm, Sweden
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Kuring JK, Mathias JL, Ward L. Prevalence of Depression, Anxiety and PTSD in People with Dementia: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:393-416. [PMID: 30536144 DOI: 10.1007/s11065-018-9396-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
There appears to be a link between depression/anxiety/PTSD and dementia, although the evidence is incomplete and the reason is unclear. Mental illness may cause dementia or may be prodromal or comorbid with dementia, or dementia may trigger a relapse of symptoms in individuals with a history of mental illness. This study examined the link between depression/anxiety/PTSD and dementia by evaluating the prevalence of these disorders in people with dementia, relative to their healthy peers. Existing meta-analyses have examined the prevalence of clinically-significant depression and anxiety in Alzheimer's disease (AD), and depression in frontotemporal dementia (FTD), but have not considered vascular dementia (VaD), dementia with Lewy bodies (DLB), PTSD, or anxiety in FTD. The current meta-analysis compared the prevalence of clinically-significant depression, anxiety and PTSD in the four most common types of dementia (AD, VaD, DLB, FTD) and in unspecified dementia to that of healthy controls (PROSPERO number: CRD42017082086). PubMed, EMBASE, PsycINFO and CINAHL database searches identified 120 eligible studies. Prevalence rates were calculated for depression and anxiety in AD, VaD, DLB, FTD, unspecified dementia, and controls. PTSD data were only available for unspecified dementia. Subgroup analyses indicated that depression, but not anxiety, was more prevalent in people with dementia compared to controls; however, the anxiety analyses were probably under-powered. The results support a link between depression and dementia; however, the link between anxiety or PTSD and dementia remains unclear due to insufficient data. Longitudinal data is now needed to clarify whether depression/anxiety/PTSD may be risk factors for dementia.
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Affiliation(s)
- J K Kuring
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - J L Mathias
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - L Ward
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, 5005, Australia
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Taha AA, El Noman A, Mahboub TA, Zaki AA, Abd El-Rahman RW, El Essawy M, Ismail AT. Pre-operative predictive estimation of abdominal flap volume for breast reconstruction using ultrasound and an anthropometric method. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-018-1412-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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135
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Models for temporal-spatial parameters in walking with cadence ratio as the independent variable. Med Biol Eng Comput 2018; 57:877-886. [PMID: 30465322 PMCID: PMC6449492 DOI: 10.1007/s11517-018-1919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/21/2018] [Indexed: 11/17/2022]
Abstract
Accurate models that describe temporal-spatial parameters are desirable in gait estimation and rehabilitation. This study aimed to explore simple but relatively accurate models to describe stride length (SL), speed (SP) and walk ratio (WR) at various cadences. Twenty-four able-bodied participants (16 in a test group and 8 in a validation group) walked at seven cadence ratios (CRs). The individual and group mean SL, SP and WR were studied. Suitable temporal-spatial model structures were proposed and used to approximate the individual SL, SP and WR at various CRs. After the temporal-spatial model structures were found to be feasible, the general temporal-spatial models were analysed using the test group mean SL, SP and WR. Accuracy was assessed using the validation group mean values. Individual approximation accuracies showed that the proposed model structure deduced from the linear SL model was suitable for WR approximation. The linear, deduced quadratic and power functions approximated the individual SL, SP and WR, respectively, with high accuracy. Based on the test group mean SL, SP and WR, the general temporal-spatial models were obtained and produced comparable approximation accuracies in the validation group. The general temporal-spatial models predicted well the individual gait parameters with similar individual errors for both groups. These temporal-spatial models clearly describe SL, SP and especially WR at various cadences. They provide accurate reference data for gait estimation and have potential to guide speed modulation in robot-assisted gait rehabilitation. Twenty-four able-bodied participants (16 in test group and 8 in validation group) walked at seven cadence ratios (CRs), with the individual and group mean stride length (SL), speed (SP) and walk ratio (WR) studied. This work selected the cadence ratio as the independent variable and yielded general temporal-spatial models based on the test group data, which were a linear model for SL, a quadratic function for SP and a power function for WR. The general temporal-spatial model produced comparable approximation accuracies in the validation group. Clearly describing SL, SP and especially WR at various cadences, these temporal-spatial models provide accurate references for gait estimation and have the potential to guide speed modulation in robot-assisted gait rehabilitation. Approximation of the group mean temporal-spatial parameters at seven cadences. Solid lines in parts (a, b): the general linear SL model. Solid lines in (c, d): the general quadratic SP model. Solid lines in (e, f): the general WR model. Dots and stars in (a, c, e): the individual and group mean values for the test group. Dots and stars in (b, d, f): the individual and group mean values for the validation group. ![]()
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Côté C, Germain I, Dufresne T, Gagnon C. Comparison of two methods to categorize thickened liquids for dysphagia management in a clinical care setting context: The Bostwick consistometer and the IDDSI Flow Test. Are we talking about the same concept? J Texture Stud 2018; 50:95-103. [PMID: 30370530 DOI: 10.1111/jtxs.12377] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/09/2018] [Accepted: 10/25/2018] [Indexed: 11/28/2022]
Abstract
The Bostwick consistometer and the International Dysphagia Diet Standardization Initiative (IDDSI) Flow Test are both proposed methods to measure and categorize thickened liquids for dysphagia management. The objectives were to: (a) compare the Bostwick consistometer reference values used in clinical settings and the IDDSI reference values of thickened liquids suggested for nutrition care plans in the management of dysphagia when measuring commercially available preprepared thickened liquids; (b) explore the relationship between the two methods; (c) assess the interchangeability; (d) document the intra-rater reliability. Preprepared thickened liquids (n = 32) were measured twice with the Bostwick consistometer and 3 times with the IDDSI Flow Test, using a rigorous methodology. A registered dietitian nutritionist and a registered nutrition and dietetic technician performed the measurements. The Pearson's correlation coefficient was calculated to explore the relationship between the two methods. Using a linear regression equation, back-calculations of the IDDSI Flow Test values were done, based on the experimental Bostwick results. Interchangeability was assessed by documenting the level of agreement between the results with a Bland and Altman graphical analysis. Intraclass correlation coefficients calculation and a Bland and Altman graphical analysis were performed to assess reliability. The strong correlation (r = -.93, p < .001) between the IDDSI Flow Test and the Bostwick consistometer measurements suggests that they measure flow rate in a similar manner, but not exactly the same, as confirmed with the Bland and Altman graphical analysis. Thus, they produced results that are not interchangeable. However, both tests show excellent intra-rater reliability (ICC ≥ 0.99) when using a rigorous methodology. PRACTICAL APPLICATIONS: Thickened liquids are used to manage oropharyngeal dysphagia. Clinicians need to provide quality assurance/quality control (QA/QC) support in the selection or production of thickened liquids as well as staff training or patient education regarding these products. Methods and classification have been proposed to measure and categorize thickened liquids for dysphagia management, such as the line spread test, the Bostwick consistometer method, and the IDDSI Flow Test. Although empirical, these methods are more accessible to clinicians than viscometer or rheometer assessments. Clinicians need to understand the limitations of these techniques as neither appear to capture the full extent of consistency for potential beverages available on the market or produced in-house. In this article, we compare the Bostwick consistometer and the IDDSI Flow Test methods and classifications and propose a standard operating procedure in order to maximize the quality of results. We point out the large variations in consistency levels of commercial preprepared thickened liquids in light of the absence of evidence of clinical outcomes associated with either proposed methods or consistency classifications.
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Affiliation(s)
- Claudia Côté
- Centre de recherche Charles-Le-Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean/Neuromuscular Clinic, Jonquière, Québec, Canada
| | - Isabelle Germain
- Association des nutritionnistes experts en dysphagie, Montréal, Québec, Canada
| | | | - Cynthia Gagnon
- Centre de recherche Charles-Le-Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean/Neuromuscular Clinic, Jonquière, Québec, Canada
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Devos H, Ranchet M, Bollinger K, Conn A, Akinwuntan AE. Performance-based visual field testing for drivers with glaucoma: A pilot study. TRAFFIC INJURY PREVENTION 2018; 19:715-721. [PMID: 30407083 DOI: 10.1080/15389588.2018.1508834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Conventional visual field (VF) tests are limited in predicting on-road driving performance of individuals with glaucoma. We developed a new performance-based VF test in a driving simulator for individuals with glaucoma. The aim was to evaluate the psychometric properties of the newly developed test. METHODS In this pilot study, 17 drivers with glaucoma aged 65.24 ± 9.69 and 13 control drivers aged 61.27 ± 11.45 completed the performance-based VF task. Construct validity was determined by comparing performance on the new task with results on conventional visual and perimetry tests including Humphrey Visual Field Analyzer, Keystone Vision Screener, and Useful Field of View (UFOV). Concurrent validity was evaluated by comparing performance on the new task with on-road driving performance, scored using the Test Ride for Investigating Practical fitness-to-drive (TRIP). Ten individuals (7 with glaucoma and 3 controls) participated in the test-retest reliability assessment. RESULTS Drivers with glaucoma identified fewer symbols (P = .047) and took longer to respond to the symbols (P = .048) compared to controls. In the glaucoma group, correct responses on the performance-based VF test correlated strongly (r = -0.51, P = .046) with UFOV divided attention. Both glaucoma and control groups achieved submaximal to maximal scores on the TRIP (median [Q1-Q3], glaucoma: 193 [191-196]; controls: 196 [195-196]; P = .16). No strong correlations were found between scores on the performance-based VF test and on-road driving performance in glaucoma. The intraclass correlation coefficients ranged between 0.77 for response time and 0.92 for correct responses, indicating good to excellent test-retest reliability. CONCLUSIONS We established the construct validity and test-retest reliability of the performance-based VF test. Future studies should include a larger sample with more severe driving difficulties to demonstrate the concurrent validity between performance-based VF testing and on-road driving performance in glaucoma.
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Affiliation(s)
- Hannes Devos
- a Department of Physical Therapy and Rehabilitation Science, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
| | | | - Kathryn Bollinger
- c Department of Ophthalmology, Medical College of Georgia , Augusta University , Augusta , Georgia
- d Culver Vision Discovery Institute, Medical College of Georgia, Augusta University , Augusta , Georgia
| | - Amber Conn
- a Department of Physical Therapy and Rehabilitation Science, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
| | - Abiodun E Akinwuntan
- e Dean's Office, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
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138
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Kadry M, Tawfik A, Abdallah N, Badawi A, Shokeir H. Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study. Clin Cosmet Investig Dermatol 2018; 11:551-559. [PMID: 30510437 PMCID: PMC6231433 DOI: 10.2147/ccid.s178817] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose The aim of this study was to assess the efficacy of platelet-rich plasma (PRP) vs combined fractional CO2 (Fr: CO2) laser with PRP in the treatment of stable nonsegmental vitiligo (NSV) lesions. Patients and methods This prospective, randomized, intrapatient, comparative controlled study was conducted between June 2014 and June 2016 at National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt. Thirty NSV patients were treated with PRP, Fr: CO2 laser, and combined Fr: CO2 laser with PRP. Intrapatient lesions were divide randomly into four groups. Each group was treated by one modality. The fourth group served as a control.Patients received six treatment sessions with 2-week interval for 3 months and were followed up after 3 months. Results A highly significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in the combined Fr: CO2 laser with PRP and in the PRP only groups than other groups. These results were confirmed by mean improvement score by physician (MISP) and by VAS with no statistical difference between them. The combined Fr: CO2 laser with PRP group showed minimal side effects. Regardless of the modalities, better improvement was seen in the trunk than the face, extremities, and acral lesions with significant reduction in all regions. Face showed maximum response with combined Fr: CO2 laser with PRP. Trunk showed higher response with PRP. Upper limbs showed highest response with combined Fr: CO2 laser with PRP. Lower limbs showed the highest improvement with Fr: CO2 laser. Conclusion According to our study, combined Fr: CO2 laser with PRP achieved superior repigmentation than intradermal (ID) PRP. However, Fr: CO2 alone showed poor improvement. Combined ablative Fr: CO2 laser and PRP therapy followed by sun exposure could be used effectively and safely to treat refractory NSV.
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Affiliation(s)
- Mostafa Kadry
- Faculty of Medicine, Dermatology Department, Helwan University Cairo, Helwan, Egypt
| | - Abeer Tawfik
- Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt,
| | - Noha Abdallah
- Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt,
| | - Ashraf Badawi
- Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt, .,Department of Allergology and Dermatology, Szeged University, Hungary,
| | - Hisham Shokeir
- Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt,
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139
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Ultrasound-based measurements of testicular volume in 6- to 16-year-old boys - intra- and interobserver agreement and comparison with Prader orchidometry. Pediatr Radiol 2018; 48:1771-1778. [PMID: 29980860 DOI: 10.1007/s00247-018-4195-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/01/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Prader orchidometry has been the standard method for evaluating testicular size. As this technique is subjective and tends to overestimate the testicular volume, ultrasound (US) has been proposed as more reliable. OBJECTIVE To evaluate the intra- and interobserver agreement of US measurements of testicular volume and to compare US with the Prader orchidometer. MATERIALS AND METHODS Dimensions of the right testicle were measured using US in 57 boys ages 6.5 to 16.4 years (mean: 12.0 years). The measurements were performed twice by one main observer and once by a second observer. A third observer estimated testicular volume using a Prader orchidometer. Agreement was investigated with Bland-Altman plots, summarized as the mean and standard deviation (SD) of differences, 95% limits of agreement and technical error of measurement. RESULTS Mean intra-observer difference of testicular volume was 2.2%, SD=9.2% (limits of agreement: -20.3 to 15.9%) and technical error of measurement 6.5%. The mean interobserver difference was 4.8%, SD=20.7% (limits of agreement: -35.7 to 45.3%) and technical error of measurement 14.6%. Comparing US and orchidometer volumes required conversion that was nonlinear and volume dependent, estimated as VolOM = 1.96×VolUS0.71. The mean difference after transformation was 0.7% with an SD of 18.0% (limits of agreement: -34.5 to 35.9%). CONCLUSION Our results showed a small mean intra- and interobserver difference that indicates the potential of US for measurement of testicular volume at group level. The intra-observer error was limited, which justifies its use in longitudinal follow-up of testicular development in an individual child, but the larger interobserver variability indicates the need for good standardization of methods. Agreement between the two methods requires a power transformation.
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140
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Hessler M, Arnemann PH, Zamit F, Seidel L, Kampmeier TG, Kathöfer U, Morelli A, Ince C, Rehberg SW, Ertmer C. A new complimentary web-based tool for manual analysis of microcirculation videos: Validation of the Capillary Mapper against the current gold standard AVA 3.2. Microcirculation 2018; 25:e12505. [PMID: 30192423 DOI: 10.1111/micc.12505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/17/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the current study was to compare a newly developed web-based freely accessible software program for manual analysis of the microcirculation, the Capillary Mapper (CM), with AVA 3.2 software (AVA; MicroVision Medical B.V., Amsterdam, The Netherlands), which is the current gold standard for analysis of microcirculation videos. METHODS A web-based software program was developed, which enables manual analysis of videos of the microcirculation to be carried out according to recommendations of the 2018 consensus conference. A set of 50 high quality microcirculation videos was analyzed with AVA and CM with respect to total vessel density, perfused vessel density, proportion of perfused vessels, and the microvascular flow index. RESULTS Comparison of the mean values derived from manual analysis with CM and AVA revealed no significant differences in microcirculatory variables. Analysis according to Bland and Altman revealed an acceptable bias between manual analysis with the CM and AVA for all variables tested with sufficient limits of agreement. The analysis of intraclass correlation showed "excellent" agreement for all microcirculatory variables analyzed. CONCLUSIONS The newly developed CM was successfully validated for manual analyses of microcirculation videos against the current gold standard, the software AVA 3.2.
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Affiliation(s)
- Michael Hessler
- Department of Anesthesiology, Intensive Care and Pain Therapy, University of Muenster Medical Centre, Muenster, Germany
| | - Philip-Helge Arnemann
- Department of Anesthesiology, Intensive Care and Pain Therapy, University of Muenster Medical Centre, Muenster, Germany
| | - Frédéric Zamit
- IT-Center Research and Education, Medical Faculty of Muenster, University of Muenster, Muenster, Germany
| | - Laura Seidel
- Department of Anesthesiology, Intensive Care and Pain Therapy, University of Muenster Medical Centre, Muenster, Germany
| | - Tim-Gerald Kampmeier
- Department of Anesthesiology, Intensive Care and Pain Therapy, University of Muenster Medical Centre, Muenster, Germany
| | - Ulrich Kathöfer
- IT-Center Research and Education, Medical Faculty of Muenster, University of Muenster, Muenster, Germany
| | - Andrea Morelli
- Department of Anesthesiology and Intensive Care, University of Rome "La Sapienza", Rome, Italy
| | - Can Ince
- Department of Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sebastian W Rehberg
- Department of Anesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, Protestant Hospital of the Bethel Foundation, Bielefeld, Germany
| | - Christian Ertmer
- Department of Anesthesiology, Intensive Care and Pain Therapy, University of Muenster Medical Centre, Muenster, Germany
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Korakakis V, O’Sullivan K, Sotiralis Y, Karanasios S, Sideris V, Sideris A, Sakellariou K, Giakas G. Evaluation of the within- and between-day intra-tester and inter-tester reliability of positioning subjects into neutral and lordotic sitting postures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1503719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Vasileios Korakakis
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | - Kieran O’Sullivan
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Education and Health Sciences, University of Limerick, School of Allied Health, Limerick, Ireland
| | - Yiannis Sotiralis
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | | | - Vasilis Sideris
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Alexandros Sideris
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | | | - Giannis Giakas
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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142
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Ramos SDS, Liddement J, Addicott C, Fortescue D, Oddy M. The development of the Brain Injury Screening Index (BISI): A self-report measure. Neuropsychol Rehabil 2018; 30:948-960. [PMID: 30272531 DOI: 10.1080/09602011.2018.1526692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to investigate the psychometric properties and screening accuracy of the Brain Injury Screening Index (BISI), a self-report questionnaire designed to identify a history of acquired brain injury. The study was conducted in a closed male prison in the UK. The purposive sample comprised 55 male prisoners who arrived at the establishment during the study. A repeated measures design was used, where the Brain Injury Screening Index (BISI) was administered on three occasions. Inter-rater reliability was poor to moderate, but test retest reliability was moderate to good. Medical records were not available for all participants, but the limited number obtained resulted in a sensitivity of .38 to .71 and specificity of .47 to .70 across the three screening administrations of the BISI. The limitations of the present findings are discussed in the context of the use of the tool in custodial environments. It is argued that these results suggest that, when used as recommended, the BISI has acceptable reliability and validity as an initial screen for identifying individuals who should receive support and a comprehensive neuropsychological assessment, and it merits further investigation and development.
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Affiliation(s)
- Sara da Silva Ramos
- The Disabilities Trust, Burgess Hill, UK.,The Disabilities Trust Foundation, Burgess Hill, UK.,Brain Injury Rehabilitation Trust, Burgess Hill, UK
| | | | | | - Deborah Fortescue
- The Disabilities Trust, Burgess Hill, UK.,The Disabilities Trust Foundation, Burgess Hill, UK
| | - Michael Oddy
- The Disabilities Trust Foundation, Burgess Hill, UK.,Brain Injury Rehabilitation Trust, Burgess Hill, UK
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143
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Shiel F, Persson C, Furness J, Simas V, Pope R, Climstein M, Hing W, Schram B. Dual energy X-ray absorptiometry positioning protocols in assessing body composition: A systematic review of the literature. J Sci Med Sport 2018; 21:1038-1044. [PMID: 29588115 DOI: 10.1016/j.jsams.2018.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 03/08/2018] [Accepted: 03/11/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To systematically identify and assess methods and protocols used to reduce technical and biological errors in published studies that have investigated reliability of dual energy X-ray absorptiometry (DXA) for assessing body composition. DESIGN Systematic review. METHODS Systematic searches of five databases were used to identify studies of DXA reliability. Two independent reviewers used a modified critical appraisal tool to assess their methodological quality. Data was extracted and synthesised using a level of evidence approach. Further analysis was then undertaken of methods used to decrease DXA errors (technical and biological) and so enhance DXA reliability. RESULTS Twelve studies met eligibility criteria. Four of the articles were deemed high quality. Quality articles considered biological and technical errors when preparing participants for DXA scanning. The Nana positioning protocol was assessed to have a strong level of evidence. The studies providing this evidence indicated very high test-retest reliability (ICC 0.90-1.00 or less than 1% change in mean) of the Nana positioning protocol. The National Health and Nutrition Examination Survey (NHANES) positioning protocol was deemed to have a moderate level of evidence due to lack of high quality studies. However, the available studies found the NHANES positioning protocol had very high test-retest reliability. Evidence is limited and reported reliability has varied in papers where no specific positioning protocol was used or reported. CONCLUSIONS Due to the strong level of evidence of excellent test-retest reliability that supports use of the Nana positioning protocol, it is recommended as the first choice for clinicians when using DXA to assess body composition.
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Affiliation(s)
- Flinn Shiel
- Physiotherapy Program, Faculty of Health Sciences and Medicine, Bond University, Australia
| | - Carl Persson
- Physiotherapy Program, Faculty of Health Sciences and Medicine, Bond University, Australia
| | - James Furness
- Physiotherapy Program, Faculty of Health Sciences and Medicine, Bond University, Australia; Water Based Research Unit, Faculty of Health Science and Medicine, Bond University, Australia.
| | - Vini Simas
- Water Based Research Unit, Faculty of Health Science and Medicine, Bond University, Australia
| | - Rodney Pope
- Physiotherapy Program, School of Community Health, Charles Sturt University, Australia
| | - Mike Climstein
- Water Based Research Unit, Faculty of Health Science and Medicine, Bond University, Australia; Exercise Health & Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, Australia
| | - Wayne Hing
- Physiotherapy Program, Faculty of Health Sciences and Medicine, Bond University, Australia; Water Based Research Unit, Faculty of Health Science and Medicine, Bond University, Australia
| | - Ben Schram
- Physiotherapy Program, Faculty of Health Sciences and Medicine, Bond University, Australia; Water Based Research Unit, Faculty of Health Science and Medicine, Bond University, Australia
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144
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Hu X, Lei D, Li L, Leng Y, Yu Q, Wei X, Lo WLA. Quantifying paraspinal muscle tone and stiffness in young adults with chronic low back pain: a reliability study. Sci Rep 2018; 8:14343. [PMID: 30254233 PMCID: PMC6156595 DOI: 10.1038/s41598-018-32418-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/23/2018] [Indexed: 11/09/2022] Open
Abstract
The reliability of a handheld myotonometer when used in a clinical setting to assess paraspinal muscle mechanical properties is unclear. This study aimed to investigate the between-session intra-rater reliability of a handheld myotonometer in young adults with low back pain (LBP) in a clinical environment. One assessor recorded lumbar paraspinal muscle tone and stiffness in an outpatient department on two occasions. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD) and Bland-Altman analysis were conducted to assess reliability. The results indicated acceptable between-days intra-rater reliability (ICC > 0.75) for all measurements. The SEM of the muscle tone and stiffness measurements ranged between 0.20–0.66 Hz and 7.91–16.51 N/m, respectively. The SRD was 0.44–1.83 Hz for muscle tone and 21.93–52.87 N/m for muscle stiffness. SEM and SRD at L1-L2 were higher than those at other levels. The magnitude of agreement appeared to decrease as muscle tone and stiffness increased. The myotonometer demonstrated acceptable reliability when used in a clinical setting in young adults with chronic LBP. Measurements of the upper lumbar levels were not as reliable as those of the lower lumbar levels. The crural attachment of the diaphragm at L1 and L2 may affect paraspinal muscle tone and stiffness during respiratory cycles.
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Affiliation(s)
- Xiaoqian Hu
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Di Lei
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Le Li
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yan Leng
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiaoyu Wei
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China. .,Department of Electronic and Electrical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.
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145
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Roberts A, Post D. Information Content and Efficiency in the Spoken Discourse of Individuals With Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2259-2274. [PMID: 30208482 DOI: 10.1044/2018_jslhr-l-17-0338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 05/04/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE This study compared the information content and information efficiency of spoken language in individuals with Parkinson's disease (PD) to a healthy comparator group. METHOD Nineteen participants with PD and 19 healthy older adults completed the prospective, cross-sectional study. In the primary analysis, 2 language samples elicited by standardized protocols were analyzed for group differences using standard discourse informativeness measures including main events (MEs; Wright, Capilouto, Wagovich, Cranfill, & Davis, 2005) analyzed as %MEs and correct information units (CIUs; Nicholas & Brookshire, 1993) analyzed as %CIUs and CIUs/min. In exploratory analyses, the following were examined: (a) associations among conceptual (%MEs) and lexical (%CIUs and CIUs/min) measures and (b) associations among informativeness measures and age, education, disease severity/duration, global cognition, speech intelligibility, and a verb confrontation naming measure. RESULTS In the primary analysis, the PD group differed significantly from the control group on conceptual (%MEs) and lexical measures of content (%CIUs) and efficiency (CIUs/min). In exploratory analyses, for the control group %MEs were significantly correlated with CIUs/min. Significant associations among conceptual and lexical measures of informativeness were not found in the PD group. For controls, there were no significant correlations between informativeness measures and any of the demographic or speech/cognitive/language variables. In the PD group, there was a significant and positive association between CIUs/min and Dementia Rating Scale-Second Edition scores (Mattis, 2001). A significant but negative correlation was found between CIUs/min and motor severity scores. However, %MEs and verb naming were significantly and positively correlated. CONCLUSIONS Individuals with PD without dementia demonstrated reduced discourse informativeness that reflects disruptions to both conceptual and lexical discourse processes. In exploratory analyses, reduced efficiency of information content was associated with global cognition and motor severity. Clinical and research implications are discussed within a Cognitivist framework of discourse production (Sheratt, 2007).
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Affiliation(s)
- Angela Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Danielle Post
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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146
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Saito A, Minagawa H, Watanabe H, Kawasaki T, Okada K. Elasticity of the pronator teres muscle in youth baseball players with elbow injuries: evaluation using ultrasound strain elastography. J Shoulder Elbow Surg 2018; 27:1642-1649. [PMID: 29941303 DOI: 10.1016/j.jse.2018.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although the pronator teres muscle, a major dynamic stabilizer of elbow valgus stress during throwing, frequently presents stiffness, its relationship with elbow injuries in youth baseball players is unknown. This study investigated the relationship between the elasticity of the pronator teres muscle and elbow injuries in youth baseball players. METHODS The strain ratio (SR) of 15 individuals with osteochondritis dissecans of the humeral capitellum (OCD group), 67 individuals with medial epicondylar fragmentation (medial injury group), and 115 healthy individuals (control group) was measured as the index of the elasticity of the pronator teres muscle using ultrasound strain elastography. In addition, the forearm and glenohumeral joint rotation range of motion was measured. RESULTS The SR of the throwing arm was significantly higher in the OCD and medial injury groups than in the control group (both P <.001). In the OCD group, the SR was significantly higher in the throwing arm than in the nonthrowing arm (P <.001), whereas in the medial injury group, there was no significant difference between both arms. The glenohumeral joint external rotation range of motion of the throwing arm was moderately negatively correlated with the SR (r = -0.478, P <.001). CONCLUSIONS Stiffness of the pronator teres muscle was exhibited only in the throwing arm of individuals with OCD and in both arms in individuals with medial elbow injury. These findings may contribute to an accurate evaluation and prevention of elbow injuries in youth baseball players.
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Affiliation(s)
- Akira Saito
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan.
| | | | | | | | - Kyoji Okada
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
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147
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Worsley PR, Conington C, Stuart H, Patterson A, Bader DL. A randomised cross over study to evaluate the performance of a novel ankle dorsiflexion measurement device for novice users. J Foot Ankle Res 2018; 11:45. [PMID: 30083236 PMCID: PMC6069889 DOI: 10.1186/s13047-018-0286-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background The ankle joint is a common site of musculoskeletal pathology. Measurement of its functional range of motion is a primary indicator for rehabilitation outcomes in therapy settings. The present study was designed to assess reliability and validity of a new standardised method using a D-Flex device to assess ankle range of motion. Methods A cohort of 20 healthy volunteers were recruited to measure the weight-bearing ankle range of motion using three assessment tools, namely, a goniometer, inclinometer and the D-Flex measurement devices. Repeated measures were performed both between and within observers for each device over a 48 h period. Performance evaluation of each device and their reliability was assessed using intra-class correlation coefficients and Bland and Altman plots. Results Although significant correlations (p < 0.05) were observed between devices, there were large mean differences in ankle range of motion values ranging from 4.3°-15.7°. The D-flex produced the highest inter- and intra-rater reliability (ICCs 0.76–0.95), compared to values of 0.55–0.85 and 0.32–0.71 for the goniometer and inclinometer, respectively. The Bland and Altman plots revealed a low mean observer difference for the D-Flex (mean difference = 0.7°), with the vast majority of data coincident within the 95% confidence intervals. For both the goniometer and inclinometer mean differences were higher, with values of 3.1° and 5.7° respectively. Conclusion The results of the present study provide evidence to support the use of the D-Flex system as a valid, portable, and easy to use alternative to the weight-bearing lunge test when assessing ankle dorsiflexion ROM in healthy participants.
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Affiliation(s)
- Peter R Worsley
- Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Caitlan Conington
- Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Holly Stuart
- Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Alice Patterson
- Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Dan L Bader
- Clinical Academic Facility, Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
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148
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Trefan L, Harris C, Evans S, Nuttall D, Maguire S, Kemp AM. A comparison of four different imaging modalities - Conventional, cross polarized, infra-red and ultra-violet in the assessment of childhood bruising. J Forensic Leg Med 2018; 59:30-35. [PMID: 30096460 PMCID: PMC6125673 DOI: 10.1016/j.jflm.2018.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/23/2018] [Accepted: 07/31/2018] [Indexed: 01/24/2023]
Abstract
Background It is standard practice to image concerning bruises in children. We aim to compare the clarity and measurements of bruises using cross polarized, infra-red (IR) and ultra-violet (UV) images to conventional images. Methods Children aged <11 years with incidental bruising were recruited. Demographics, skin and bruise details were recorded. Bruises were imaged by standard protocols in conventional, cross-polarized, IR and UV lights. Bruises were assessed in vivo for contrast, uniformity and diffuseness, and these characteristics were then compared across image modalities. Color images (conventional, cross polarized) were segmented and measured by ImageJ. Bruises of grey scale images (IR, UV) were measured by a ‘plug in’ of ImageJ. The maximum and minimum Feret's diameter, area and aspect ratio, were determined. Comparison of measurements across imaging modalities was conducted using Wilcoxon rank sum tests and modified Bland-Altman graphs. Significance was set at p < 0.05. Results Twenty five children had 39 bruises. Bruises that were of low contrast, i.e. difficult to distinguish from surrounding skin, were also more diffuse, and less uniformity in vivo. Low contrast bruises were best seen on conventional and cross-polarized images and less distinctive on IR and UV images. Of the 19 bruises visible in all modalities, the only significant difference was maximum and minimum Feret's diameters and area were smaller on IR compared to conventional images. Aspect ratios were not affected by the modality. Conclusions Conventional and cross-polarized imaging provides the most consistent bruise measurement, particularly in bruises that are not easily distinguished from surrounding skin visually. Diffuse bruises may be measured on conventional & cross polarized imaging. Infrared or ultraviolet imaging may not show bruises which are difficult to see in vivo. Measurements of bruises using infrared imaging may be smaller than other modalities.
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Affiliation(s)
- L Trefan
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK.
| | - C Harris
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK.
| | - S Evans
- Chief Clinical Photographer, Dental Photography, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
| | - D Nuttall
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK.
| | - S Maguire
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK.
| | - A M Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK.
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Hu A, Arnold JB, Causby R, Jones S. The identification and reliability of static and dynamic barefoot impression measurements: A systematic review. Forensic Sci Int 2018; 289:156-164. [DOI: 10.1016/j.forsciint.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/11/2018] [Accepted: 05/03/2018] [Indexed: 10/16/2022]
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150
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Masteling M, Ashton-Miller JA, DeLancey JOL. Technique development and measurement of cross-sectional area of the pubovisceral muscle on MRI scans of living women. Int Urogynecol J 2018; 30:1305-1312. [PMID: 29974138 DOI: 10.1007/s00192-018-3704-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/18/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Measurements of the anatomic cross-sectional area (CSA) of the pubovisceral muscle (PVM) in women are confounded by the difficulty of separating the muscle from the adjacent puborectal (PRM) and iliococcygeal (ICM) muscles when visualized in a plane orthogonal to the fiber direction. We tested the hypothesis that it might be possible to measure the PVM CSA within a defined region of interest based on magnetic resonance images (MRI). METHODS MRI scans of 11 women with unilateral PVM tears and seven primiparous women with intact muscles following elective C-section were used to identify the PVM injury zone defined by the mean location of its boundaries with the adjacent intact PRM and ICM from existing anatomic reference points using 3D Slicer and ImageJ software. Then, from the 15 or more 2-mm transverse slices available, the slice with the maximum anatomic CSA of the left and right PVM was found in 24 primiparous women with bilaterally intact muscles who had delivered via C-section. RESULTS Mean [± standard deviation (SD)] of the maximum left or right PVM cross-section areas for the 24 women, measured by two different raters, was 1.25 ± 0.29 cm2 (range 0.75-1.86). The 5th, 50th, and 95th percentile values were 0.77, 1.23, and 1.80 cm2, respectively. Inter- and intrarater measurement repeatability intraclass correlation coefficients exceeded 0.89 and 0.90, respectively. CONCLUSIONS It is possible to use MRI to identify the volume of interest with the maximum anatomic cross section of the PVM belly while minimizing the inadvertent inclusion of adjacent PRM or ICM in that measurement.
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Affiliation(s)
- Mariana Masteling
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward St, Ann Arbor, MI, 48109, USA.
| | - James A Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward St, Ann Arbor, MI, 48109, USA
| | - John O L DeLancey
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48109, USA
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