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Betz JW, Lightstone DF, Oakley PA, Haas JW, Moustafa IM, Harrison DE. Reliability of the Biomechanical Assessment of the Sagittal Lumbar Spine and Pelvis on Radiographs Used in Clinical Practice: A Systematic Review of the Literature. J Clin Med 2024; 13:4650. [PMID: 39200793 PMCID: PMC11355792 DOI: 10.3390/jcm13164650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/27/2024] [Accepted: 08/06/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Biomechanical analysis of the sagittal alignment of the lumbar spine and pelvis on radiographs is common in clinical practices including chiropractic, physical therapy, scoliosis-related thoraco-lumbo-sacral orthosis (TLSO) management, orthopedics, and neurosurgery. Of specific interest is the assessment of pelvic morphology and the relationship between angle of pelvic incidence, sacral slope, and lumbar lordosis to pain, disability, and clinical treatment of spine conditions. The current state of the literature on the reliability of common methods quantifying these parameters on radiographs is limited. Methods: The objective of this systematic review is to identify and review the available studies on the reliability of different methods of biomechanical analysis of sagittal lumbo-pelvic parameters used in clinical practice. Our review followed the recommendations of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The design of this systematic review was registered with PROSPERO (CRD42023379873). Results: The search strategy yielded a total of 2387 articles. A total of 1539 articles were screened after deduplication and exclusion by automation tools, leaving 473 full-text articles that were retrieved. After exclusion, 64 articles met the inclusion criteria. The preponderance of the evidence showed good to excellent reliability for biomechanical assessment of sagittal lumbo-pelvic spine alignment. Conclusions: The results of this systematic review of the literature show that sagittal radiographic analysis of spinal biomechanics and alignment of the human lumbo-pelvic spine is a reliable tool for aiding diagnosis and management in clinical settings.
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Affiliation(s)
| | | | - Paul A. Oakley
- Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada;
| | - Jason W. Haas
- Chiropractic Biophysics NonProfit, Inc., Eagle, ID 83616, USA;
| | - Ibrahim M. Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS—Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
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Oh D, To D, Corso M, Murnaghan K, Yu H, Cancelliere C. Agreement and concurrent validity between telehealth and in-person diagnosis of musculoskeletal conditions: a systematic review. Chiropr Man Therap 2024; 32:21. [PMID: 38872176 DOI: 10.1186/s12998-024-00542-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/17/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVES To assess the concurrent validity and inter-rater agreement of the diagnosis of musculoskeletal (MSK) conditions using synchronous telehealth compared to standard in-person clinical diagnosis. METHODS We searched five electronic databases for cross-sectional studies published in English in peer-reviewed journals from inception to 28 September 2023. We included studies of participants presenting to a healthcare provider with an undiagnosed MSK complaint. Eligible studies were critically appraised using the QUADAS-2 and QAREL criteria. Studies rated as overall low risk of bias were synthesized descriptively following best-evidence synthesis principles. RESULTS We retrieved 6835 records and 16 full-text articles. Nine studies and 321 patients were included. Participants had MSK conditions involving the shoulder, elbow, low back, knee, lower limb, ankle, and multiple conditions. Comparing telehealth versus in-person clinical assessments, inter-rater agreement ranged from 40.7% agreement for people with shoulder pain to 100% agreement for people with lower limb MSK disorders. Concurrent validity ranged from 36% agreement for people with elbow pain to 95.1% agreement for people with lower limb MSK conditions. DISCUSSION In cases when access to in-person care is constrained, our study implies that telehealth might be a feasible approach for the diagnosis of MSK conditions. These conclusions are based on small cross-sectional studies carried out by similar research teams with similar participant demographics. Additional research is required to improve the diagnostic precision of telehealth evaluations across a larger range of patient groups, MSK conditions, and diagnostic accuracy statistics.
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Affiliation(s)
- David Oh
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
| | - Daphne To
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - Melissa Corso
- Faculty of Health Sciences, Institute for Disability and Rehabilitation Research, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Kent Murnaghan
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - Hainan Yu
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
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Adriani M, Saccomanno MF, Motta M, Galli S, Milano G. Reliability of Magnetic Resonance Imaging Criteria for the Preoperative Assessment of Rotator Cuff Tears: A Systematic Review. Am J Sports Med 2024; 52:845-858. [PMID: 37183988 DOI: 10.1177/03635465231166077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Magnetic resonance (MR) imaging is the most common modality for assessment of the rotator cuff before and after surgery. Several classifications have been described aiming to define main tear characteristics. However, there is still confusion when it comes to the reliability of those classifications. PURPOSE (1) To identify all MR classifications available in the literature for preoperative assessment of rotator cuff tears, (2) to summarize available data on the reliability of identified classifications, and (3) to assess the methodological quality of reliability studies. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All studies reporting MR assessment in patients with a superior or posterosuperior rotator cuff tear were included. After identification of the available MR criteria, reliability studies were analyzed. Descriptive statistics were used to summarize findings. Methodological quality was assessed using the Quality Appraisal of Reliability Studies checklist. RESULTS A total of 75 studies were included in this review. Eight categories of outcomes could be identified. Of the total, 62 studies reported interobserver reliability whereas 32 reported intraobserver reliability of some of the identified criteria. Each category reflected a variety of reliability, ranging from poor to excellent agreement. MR proved to be a reliable imaging modality to detect the structural integrity of the posterosuperior cuff, especially in cases of full-thickness tear; it was also reliable in terms of tear width and length and muscle atrophy based on a tangent sign or Thomazeau classification. All other classifications did not prove acceptable reliability. Methodological quality was high for 23 articles and moderate for 14. CONCLUSION Preoperative MR is a reliable imaging modality to identify full-thickness tears, measure tear size and morphology, and identify muscle atrophy with tangent sign or Thomazeau classification. All other outcomes and classifications did not show acceptable reliability; therefore, caution is needed when using them for preoperative evaluation of a rotator cuff tear.
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Affiliation(s)
- Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Maristella Francesca Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Galli
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Staibano P, Ham J, Chen J, Zhang H, Gupta MK. Inter-Rater Reliability of Thyroid Ultrasound Risk Criteria: A Systematic Review and Meta-Analysis. Laryngoscope 2023; 133:485-493. [PMID: 36039947 DOI: 10.1002/lary.30347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/05/2022] [Accepted: 07/29/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The most commonly employed diagnostic criteria for identifying thyroid nodules include Thyroid Imaging and Reporting Data System (TI-RADS) and American Thyroid Association (ATA) guidelines. The purpose of this systematic review and meta-analysis is to determine the inter-rater reliability of thyroid ultrasound criteria. METHODS We performed a library search of MEDLINE (Ovid), EMBASE (Ovid), and Web of Science for full-text articles published from January 2005 to June 2022. We included full-text primary research articles that used TI-RADS and/or ATA guidelines to evaluate thyroid nodules in adults. These included studies must have calculated inter-rater reliability using any validated metric. The Quality Appraisal for Reliability Studies (QAREL) was used to assess study quality. We planned for a random-effects meta-analysis, in addition to covariate and publication bias analyses. This study was performed in accordance with Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines and registered prior to conduction (International prospective register of systematic reviews-PROSPERO: CRD42021275072). RESULTS Of the 951 articles identified via the database search, 35 met eligibility criteria. All studies were observational. The most commonly utilized criteria were ACR Thyroid Imaging and Reporting Data System (TI-RADS) and/or ATA criteria, while the majority of studies employed Κ statistics. For ACR TI-RADS, the pooled Κ was 0.51 (95% confidence interval [CI]: 0.42, 0.57; n = 7) while for ATA, the pooled Κ was 0.52 (95% CI: 0.37, 0.67; n = 3). Due to the small number of studies, covariate or publication bias analyses were not performed. CONCLUSION Ultrasound criteria demonstrate moderate inter-rater reliability, but these findings are impacted by poor study quality and a lack of standardization. Laryngoscope, 133:485-493, 2023.
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Affiliation(s)
- Phillip Staibano
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Ham
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Chen
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Han Zhang
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael K Gupta
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Lombardi AF, Ma YJ, Jang H, Jerban S, Du J, Chang EY, Chung CB. Synthetic CT in Musculoskeletal Disorders: A Systematic Review. Invest Radiol 2023; 58:43-59. [PMID: 36070535 PMCID: PMC9742139 DOI: 10.1097/rli.0000000000000916] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Repeated computed tomography (CT) examinations increase patients' ionizing radiation exposure and health costs, making an alternative method desirable. Cortical and trabecular bone, however, have short T2 relaxation times, causing low signal intensity on conventional magnetic resonance (MR) sequences. Different techniques are available to create a "CT-like" contrast of bone, such as ultrashort echo time, zero echo time, gradient-echo, and susceptibility-weighted image MR sequences, and artificial intelligence. This systematic review summarizes the essential technical background and developments of ultrashort echo time, zero echo time, gradient-echo, susceptibility-weighted image MR imaging sequences and artificial intelligence; presents studies on research and clinical applications of "CT-like" MR imaging; and describes their main advantages and limitations. We also discuss future opportunities in research, which patients would benefit the most, the most appropriate situations for using the technique, and the potential to replace CT in the clinical workflow.
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Affiliation(s)
- Alecio F Lombardi
- From the Department of Radiology, University of California San Diego, La Jolla, and the Research Service, Veterans Affairs San Diego Healthcare System, California
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Bogduk N. On understanding reliability for diagnostic tests. INTERVENTIONAL PAIN MEDICINE 2022; 1:100124. [PMID: 39239130 PMCID: PMC11372993 DOI: 10.1016/j.inpm.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 09/07/2024]
Abstract
For professional practice to be responsible, any diagnostic tests used must be reliable. Therefore, the reliability of any diagnostic test needs to have been measured. The classical statistic for quantifying reliability is Kappa. Although Kappa can be promptly determined using a programmed calculator, using an algorithm to derive Kappa provides greater insight into what it is actually measuring and why. Kappa scores can be graded, with verbal descriptor applied to different grades. However, those descriptors do not necessarily reflect the degree of skill required to achieve different grades of Kappa. High levels of skill attract high Kappa scores, but Kappa scores described as fair or moderate are not necessarily flattering because they can be achieved with questionable levels of skill. Various corrections can be applied to the calculation of Kappa scores in order to raise their value, and to improve the verbal descriptors of their grade, but these may not be legitimate or necessary. Low Kappa scores do not condemn tests but they serve to raise questions about their reliability.
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Affiliation(s)
- Nikolai Bogduk
- The University of Newcastle, PO Box 431, East Maitland, NSW, 2323, Australia
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Habberfield J, Schneider G, Schneider K, Katuli S, Olson L. A clinical test to assess isometric cervical strength in chronic whiplash associated disorder (WAD): a reliability study. BMC Musculoskelet Disord 2022; 23:736. [PMID: 35915421 PMCID: PMC9341054 DOI: 10.1186/s12891-022-05703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cervical spine muscle weakness is well demonstrated in individuals with chronic neck pain. There is a lack of literature evaluating clinically applicable means of assessing isometric cervical strength in chronic whiplash associated disorder (WAD). This study assessed the reliability of self-resisted isometric cervical strength testing using a handheld dynamometer. The relationship between strength and neck pain-related disability and kinesiophobia was also investigated. Methods Twenty subjects with chronic WAD performed maximum-effort isometric cervical flexion, extension, side flexion, and rotation against a hand held dynamometer. The dynamometer was held by the subject, who provided self-resistance. Subjects completed two sessions of testing on one day with two different examiners, and one session on a subsequent day with one of the original examiners. Subjects completed the Neck Disability Index (NDI) and Tampa Scale for Kinesiophobia (TSK) prior to the first testing session. Results Intraclass correlation coefficients (ICC) for directional strength measures were fair to high (0.71–0.88 for intra-rater and 0.79–0.91 for inter-rater). Total strength (sum of all directional strengths) ICCs were high for both intra-rater (ICC = 0.91) and inter-rater (ICC = 0.94) measures. All statistical tests for ICCs demonstrated significance (α < 0.05). Agreement was assessed using Bland Altman (BA) analysis with 95% limits of agreement. BA analysis demonstrated difference scores between the two testing sessions that ranged from 3.0—17.3% and 4.5—28.5% of the mean score for intra and inter-rater measures, respectively. Most measures did not meet the a priori standard for agreement. A moderate to good inverse relationship was demonstrated between kinesiophobia (TSK score) and six out of seven strength measures (α < .05). No significant correlation was found between neck disability (NDI) and cervical strength in any direction. Conclusion This study demonstrated fair to high reliability of self resisted isometric cervical strength testing in the chronic WAD population. All directional strength measures except flexion demonstrated a significant inverse relationship with kinesiophobia. No cervical strength measures were correlated with neck disability. These results support testing cervical strength in this manner to reliably assess change over time within individual patients. The value of such measurement requires further consideration given the lack of correlation between cervical strength and disability. Further research is required to establish normative values and enhance clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05703-0.
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Affiliation(s)
- Jeff Habberfield
- Evidence Sport and Spinal Therapy, 2000 Veterans Place NW, T3B 4N2, Calgary, AB, Canada. .,Andrews University School of Rehabilitation Sciences. School of Rehabilitation Sciences Building 131, 8515 East Campus Circle Drive, 49104-0420, Berrien Springs, MI, USA.
| | - Geoff Schneider
- Evidence Sport and Spinal Therapy, 2000 Veterans Place NW, T3B 4N2, Calgary, AB, Canada.,Andrews University School of Rehabilitation Sciences. School of Rehabilitation Sciences Building 131, 8515 East Campus Circle Drive, 49104-0420, Berrien Springs, MI, USA.,University of Calgary Cumming School of Medicine, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada
| | - Kathryn Schneider
- Evidence Sport and Spinal Therapy, 2000 Veterans Place NW, T3B 4N2, Calgary, AB, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada
| | - Sozina Katuli
- Andrews University School of Rehabilitation Sciences. School of Rehabilitation Sciences Building 131, 8515 East Campus Circle Drive, 49104-0420, Berrien Springs, MI, USA
| | - Lee Olson
- Andrews University School of Rehabilitation Sciences. School of Rehabilitation Sciences Building 131, 8515 East Campus Circle Drive, 49104-0420, Berrien Springs, MI, USA
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Romeo A, Baccini M, Carreras G, Sagripanti M, Ruggeri M, Pillastrini P, Di Bari M. Reliability, Validity, and Responsiveness of the Craniocervical Flexion Test in People Who Are Asymptomatic and Patients With Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. Phys Ther 2022; 102:6585158. [PMID: 35554598 DOI: 10.1093/ptj/pzac054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/08/2021] [Accepted: 06/06/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Among the tests designed to evaluate neck neuromuscular function, the craniocervical flexion test (CCFT) assesses the function of the deep cervical flexor muscles (DCFs). The purpose of this study was to conduct a review and meta-analysis of published articles about all measurement properties of the different CCFT versions (CCFT Activation Score [CCFT-AS], CCFT Performance Index [CCFT-PI], CCFT Cumulative Performance Index [CCFT-CPI], and CCFT alternative procedures for measuring activation level (CCFT1) or endurance (CCFT2) in people who were asymptomatic and people with nonspecific neck pain. METHODS PubMed Central, MEDLINE, CINAHL, Scopus, Web of Science, and Google Scholar were searched from inception to June 30, 2020. Studies were selected if they reported data on reliability, validity, and/or responsiveness of the CCFT in adults who were asymptomatic or who had nonspecific neck pain. Two reviewers independently selected the studies, conducted quality assessment, and extracted the results. All meta-analyses used a random-effects model. RESULTS Twenty-one studies met the inclusion criteria. The rating of interrater reliability (assessed for CCFT-AS and CCFT-CPI) was positive only for using the test at a group level. The same rating was ascribed to the intrarater reliability of CCFT-AS, CCFT1, and CCFT2, whereas CCFT-PI and CCFT-CPI showed positive intrarater reliability for assessment of individuals as well. CCFT validity was rated as positive for expressly assessing DCF action when measuring DCF activation through electromyography-not through ultrasonography-or craniocervical flexion motion as well as for differentiating patients who were asymptomatic and patients who had nonspecific neck pain (only the AS version). CCFT validity was rated as negative for investigating the CCFT performance correlation with the severity of nonspecific neck pain. CCFT responsiveness was rated as negative. CONCLUSIONS The CCFT is a potentially useful tool for detecting impairment in DCF control and identifying patients who have nonspecific neck pain and who would benefit from a targeted intervention. However, the limited reliability affects its suitability for that purpose. Further research on the reliability of different CCFT versions in which the raters are thoroughly trained is strongly recommended. IMPACT The CCFT might help to detect impairment in DCF control and identify patients who have nonspecific neck pain and who would benefit from a targeted intervention. However, the poor reliability of most versions of the test greatly limits its application in clinical practice. Only CCFT-PI and CCFT-CPI seem reliable enough to help in clinical decision-making at the individual level.
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Affiliation(s)
- Antonio Romeo
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Marco Baccini
- PROMISE Lab, IRCCS Fondazione Don Gnocchi Firenze, Florence, Italy
| | - Giulia Carreras
- Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Sagripanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Martina Ruggeri
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Mauro Di Bari
- Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Nee RJ, Coppieters MW, Boyd BS. Reliability of the straight leg raise test for suspected lumbar radicular pain: A systematic review with meta-analysis. Musculoskelet Sci Pract 2022; 59:102529. [PMID: 35245880 DOI: 10.1016/j.msksp.2022.102529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The passive straight leg raise (SLR) and crossed SLR are recommended tests for lumbar radicular pain. There are no recent reviews of test reliability. OBJECTIVES To summarize SLR and crossed SLR reliability in patients with suspected lumbar radicular pain. DESIGN Systematic review with meta-analysis. METHOD MEDLINE and CINAHL were searched for studies published before April 2021 that reported SLR or crossed SLR reliability in patients with low back-related leg pain. Supplemental analyses also included patients with low back pain only. Study selection, risk of bias assessment (QAREL), and data extraction were performed in duplicate. Kappa, intraclass correlation coefficients, and smallest detectable difference (SDD95) quantified reliability. Meta-analysis was performed when appropriate. Confidence in the evidence was determined by applying GRADE principles. RESULTS/FINDINGS Fifteen studies met selection criteria. One-hundred-eighty-nine participants had low back-related leg pain. Four-hundred-thirty-nine were included in supplemental analyses. Meta-analyses showed at least fair inter-rater reliability when a positive SLR required provocation of lower extremity symptoms or pain. SLR reliability was at least moderate when testing included structural differentiation (e.g., ankle dorsiflexion). A low prevalence of positive crossed SLR tests led to wide-ranging reliability estimates. Confidence in the evidence for identifying a positive SLR or crossed SLR was moderate to very low. SDD95 values for different raters measuring SLR range of motion ranged from 13 to 20°. CONCLUSIONS Reliability data support testing SLR with structural differentiation manoeuvres. Crossed SLR reliability data are inconclusive. Measurement error likely prohibits using SLR range of motion for clinical decision-making.
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Affiliation(s)
- Robert J Nee
- Department of Physical Therapy, Samuel Merritt University, Oakland, CA, USA.
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia; Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Benjamin S Boyd
- Department of Physical Therapy, Samuel Merritt University, Oakland, CA, USA
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Gushikem A, Gomes Costa RR, Lima Cabral AL, Lopes Bomtempo LF, de Mendonça Cardoso M. Validity of range of motion, muscle strength, sensitivity, and Tinel sign tele-assessment in adults with traumatic brachial plexus injury. Acta Neurochir (Wien) 2022; 164:1317-1328. [PMID: 35348897 PMCID: PMC8960665 DOI: 10.1007/s00701-022-05164-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Abstract
Background The COVID-19 pandemic and the need for social distancing created challenges for accessing and providing health services. Telemedicine enables prompt evaluation of patients with traumatic brachial plexus injury, even at a distance, without prejudice to the prognosis. The present study aimed to verify the validity of range of motion, muscle strength, sensitivity, and Tinel sign tele-assessment in adults with traumatic brachial plexus injury (TBPI). Methods A cross-sectional study of twenty-one men and women with TBPI admitted for treatment at a Rehabilitation Hospital Network was conducted. The participants were assessed for range of motion, muscle strength, sensitivity, and Tinel sign at two moments: in-person assessment (IPA) and tele-assessment (TA). Results The TA muscle strength tests presented significant and excellent correlations with the IPA (the intra-rater intraclass correlation coefficient, ICC ranged between 0.79 and 1.00 depending on the muscle tested). The agreement between the TA and IPA range of motion tests ranged from substantial to moderate (weighted kappa coefficient of 0.47–0.76 (p < 0.05) depending on the joint), and the kappa coefficient did not indicate a statistically significant agreement in the range of motion tests of supination, wrist flexors, shoulder flexors, and shoulder external rotators. The agreement between the IPA andTA sensitivity tests of all innervations ranged from substantial to almost perfect (weighted kappa coefficient 0.61–0.83, p < 0.05) except for the C5 innervation, where the kappa coefficient did not indicate a statistically significant agreement. The IPA versus TA Tinel sign test showed a moderate agreement (weighted kappa coefficient of 0.57, p < 0.05). Conclusions The present study demonstrated that muscle strength tele-assessment is valid in adults with TBPI and presented a strong agreement for many components of TA range of motion, sensitivity, and Tinel sign tests.
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Affiliation(s)
- Andreia Gushikem
- Physiotherapy Department, SARAH Network of Rehabilitation Hospitals, Brasilia, DF, Brazil.
| | | | - Ana Lucia Lima Cabral
- Physiotherapy Department, SARAH Network of Rehabilitation Hospitals, Brasilia, DF, Brazil
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Mine K, Ono K, Tanpo N. The reliability of palpatory examinations for pelvic landmarks to determine pelvic asymmetry: a systematic review and meta-analysis. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.2019368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Koya Mine
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Kenta Ono
- Department of Rehabilitation, Kuwano Kyoritsu Hospital, Fukushima, Japan
| | - Nobuhito Tanpo
- Department of Rehabilitation, Takeda General Hospital, Fukushima, Japan
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12
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Alfuth M, Fichter P, Knicker A. Leg length discrepancy: A systematic review on the validity and reliability of clinical assessments and imaging diagnostics used in clinical practice. PLoS One 2021; 16:e0261457. [PMID: 34928991 PMCID: PMC8687568 DOI: 10.1371/journal.pone.0261457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A variety of assessments to determine leg length discrepancy (LLD) is used in clinical practice and evidence about validity and reliability may differ. OBJECTIVE The objective of this systematic review was to identify and describe the validity and reliability of different assessments and imaging diagnostics for the determination of LLD. MATERIALS AND METHODS The review was conducted following the recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The databases Medline (PubMed) and Index to Chiropractic Literature were systematically searched. Studies regarding clinical assessments and imaging diagnostics for the diagnosis of LLD, which reported the clinimetric properties for assessment of LLD, were included and screened for methodological quality using the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) tool for validity studies and the Quality Appraisal of Diagnostic Reliability (QAREL) tool for reliability studies. RESULTS Thirty-seven articles on clinical assessments and 15 studies on imaging diagnostics met the eligibility criteria. Thirteen studies on the validity of clinical assessments and six studies on the validity of imaging diagnostics had a low risk of bias and low concerns regarding applicability for all domains. One study on the reliability of clinical assessments and one study on the reliability of imaging diagnostics had a low risk of bias. Main limitations were, that an analysis of sensitivity and specificity was only performed in a few studies and that a valid reference standard was lacking in numerous studies on clinical assessments. CONCLUSIONS For the clinical assessment of LLD, the block test appears to be the most useful method. Full-length standing anteroposterior radiography seems to be the most valid and reliable method and may be used as global reference standard to measure the anatomic LLD when comparing clinical methods and imaging diagnostics.
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Affiliation(s)
- Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
- Department of Further Education, M.Sc. Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
- * E-mail:
| | - Patrick Fichter
- Department of Further Education, M.Sc. Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
| | - Axel Knicker
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Visual assessment of movement quality: a study on intra- and interrater reliability of a multi-segmental single leg squat test. BMC Sports Sci Med Rehabil 2021; 13:66. [PMID: 34099021 PMCID: PMC8186063 DOI: 10.1186/s13102-021-00289-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022]
Abstract
Background The Single Leg Squat test (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but there is not one established SLS test used in the clinic. Based on previous scientific findings on the reliability of the SLS test and with a methodological rigorous setup, the aim of the present study was to investigate the intra- and interrater reliability of a standardised multi-segmental SLS test. Methods We performed a study of measurement properties to investigate the intra- and interrater reliability of a standardised multi-segmental SLS test including the assessment of the foot, knee, pelvis, and trunk. Novice and experienced physiotherapists rated 65 video recorded SLS tests from 34 test persons. We followed the Quality Appraisal for Reliability Studies checklist. Results Regardless of the raters experience, the interrater reliability varied between “moderate” for the knee variable (ĸ = 0.41, 95% CI 0.10–0.72) and “almost perfect” for the foot (ĸ = 1.00, 95% CI 1.00–1.00). The intrarater reliability varied between “slight” (pelvic variable; ĸ = 0.17, 95% CI -0.22-0.55) to “almost perfect” (foot variable; ĸ = 1.00, 95% CI 1.00–1.00; trunk variable; ĸ = 0.82, 95% CI 0.66–0.97). A generalised kappa coefficient including the values from all raters and segments reached “moderate” interrater reliability (ĸ = 0.52, 95% CI 0.43–0.61), the corresponding value for the intrarater reliability reached “almost perfect” (ĸ = 0.82, 95% CI 0.77–0.86). Conclusions The present study shows a “moderate” interrater reliability and an “almost perfect” intrarater reliability for the variable all segments regardless of the raters experience. Thus, we conclude that the proposed standardised multi-segmental SLS test is reliable enough to be used in an active population. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00289-x.
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14
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Cahyanti RD, Widyawati W, Hakimi M. The reliability of maternal audit instruments to assign cause of death in maternal deaths review process: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:380. [PMID: 34001025 PMCID: PMC8127245 DOI: 10.1186/s12884-021-03840-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal Death Reviews (MDR) can assist in formulating prevention strategies to reduce maternal mortality. To support MDR, an adequate MDR instrument is required to accurately identify the underlying causes of maternal deaths. We conducted a systematic review and meta-analysis to determine the reliability of maternal death instruments for conducting the MDR process. METHOD Three databases: PubMed, ProQuest and EBSCO were systematically searched to identify related research articles published between January 2004 and July 2019. The review and meta-analysis involved identification of measurement tools to conduct MDR in all or part of maternal audit. Eligibiliy and quality of studies were evaluated using the Modified Quality Appraisal of Diagnostic Reliability (QAREL) Checklist: Reliability Studies. RESULTS Overall, 242 articles were identified. Six articles examining the instrument used for MDR in 4 countries (4 articles on verbal autopsy (VA) and 2 articles on facility-based MDR) were included. None of studies identified reliability in evaluation instruments assessing maternal audit cycle as a comprehensive approach. The pooled kappa for the MDR instruments was 0.72 (95%CI:0.43-0.99; p < 0.001) with considerable heterogeneity (I2 = 96.19%; p < 0.001). Subgroup analysis of MDR instruments showed pooled kappa in VA of 0.89 (95%CI:0.52-1.25) and facility-based MDR of 0.48 (95%CI:0.15-0.82). Meta-regression analysis tended to show the high heterogeneity was likely associated with sample sizes, regions, and year of publications. CONCLUSIONS The MDR instruments appear feasible. Variation of the instruments suggest the need for judicious selection of MDR instruments by considering the study population and assessment during the target periods.
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Affiliation(s)
- Ratnasari D Cahyanti
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Obstetrics and Gynecology Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Widyawati Widyawati
- Pediatric and Maternity Nursing Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Mohammad Hakimi
- Obstetrics and Gynecology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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15
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Gross motor skill development is similar in children post Ponseti casting for congenital talipes equinovarus compared to typically developing children: a systematic review. J Pediatr Orthop B 2021; 30:264-272. [PMID: 33767125 DOI: 10.1097/bpb.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This review aimed to investigate gross motor skill development in children with congenital talipes equinovarus (CTEV) following the Ponseti method of casting and bracing. Summary of evidence revealed through a systematic search of electronic databases completed in May 2019. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to report and conduct the study. The McMaster Critical Review Form was used to critically appraise included studies and a descriptive synthesis of the results is reported. Inclusion criteria for studies included participants aged above 4 years, with a diagnosis of CTEV, treated via the Ponseti method and followed up with valid gross motor outcome measures. The comparator was a control group of typically developing children, or reference data. The searches resulted in 619 unique articles. Eight studies (retrospective cohort/case control studies) met inclusion criteria. There were nine different outcome measures used with 29 domains being relevant to this review. Synthesis of the findings found no significant difference between the gross motor skills of children with CTEV treated with Ponseti and typically developing children. The balance domains of three measures were consistently lower for the CTEV group versus controls/normative data. Yet, it is still demonstrated that most gross motor skills are within the typically developing range. It must be considered, however, that there is a spectrum of severity of CTEV and overall gross motor function should be monitored.
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16
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Gore S, Chindam T, Goldberg A, Huang MH, Shoemaker M, Blackwood J. Reliability and Validity of Patient-Reported, Rater-Based, and Hybrid Physical Activity Assessments in COPD: A Systematic Review. COPD 2020; 17:721-731. [PMID: 33054418 DOI: 10.1080/15412555.2020.1830963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Selecting valid and reliable PA assessments in chronic obstructive pulmonary disease (COPD) is crucial to ensure that the information obtained is accurate, valuable, and meaningful. The purpose of this systematic review was to compare the validity and reliability among PA assessments in COPD. An electronic database search of PubMed and CINAHL was completed in December 2019 using MeSH terms on physical activity, COPD, validation, and questionnaires. Transparency in reporting was assessed with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist while methodological quality was assessed with the modified Quality Appraisal tool for Reliability studies (QAREL) for reliability studies and the Quality Appraisal of Validity Studies (QAVALS) for validity studies. The search yielded fifteen different measures. The Stanford 7-day recall (PAR) demonstrated the strongest correlations with SenseWear Armband on energy expenditure (r = 0.83; p < 0.001) and moderate correlations for time spent in activity over 3 METs (r = 0.54, p < 0.001). The Multimedia Activity Recall (MARCA) also demonstrated moderate to good correlations with both SenseWear and Actigraph GT3X + accelerometers (r = 0.66-0.74). Assisted and computerized PRO measures (PAR and MARCA) and hybrid measures (C-PPAC and D-PPAC) demonstrate better psychometric properties as compared to other subjective measures and may be considered for quantification of PA in COPD. However, observations drawn from single validation studies limit strength of recommendations and further research is needed to replicate the findings.
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Affiliation(s)
- Shweta Gore
- School of Health and Rehabilitation Sciences, Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Tirupathi Chindam
- Department of Rehabilitation, Genesis Rehabilitation Services, Richmond, VA, USA
| | - Allon Goldberg
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
| | - Min H Huang
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
| | - Michael Shoemaker
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Jennifer Blackwood
- Physical Therapy Department, University of Michigan-Flint, Flint, MI, USA
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17
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Kulage KM, Goldberg J, Usseglio J, Romero D, Bain JM, Smaldone AM. How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis. J Autism Dev Disord 2020; 50:2102-2127. [PMID: 30852784 DOI: 10.1007/s10803-019-03967-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0-26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2-16.0), p < 0.001], and Asperger's [23.3% (12.9-38.5), p = 0.001]; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6-58.0), p = 0.52]. Less than one-third [28.8% (13.9-50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.
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Affiliation(s)
- Kristine M Kulage
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.
| | - Johanna Goldberg
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, 701 West 168th Street, New York, NY, 10032, USA
| | - Danielle Romero
- Lucile Packard Children's Hospital at Stanford, 770 Welch Road, Palo Alto, CA, 94304, USA
| | - Jennifer M Bain
- Department of Neurology, Division of Child Neurology, Columbia University Vagelos College of Physicians and Surgeons, 180 Fort Washington Avenue, 5th Floor, New York, NY, 10032, USA
| | - Arlene M Smaldone
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA
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18
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Rohlin M, Horner K, Lindh C, Wenzel A. Through the quality kaleidoscope: reflections on research in dentomaxillofacial imaging. Dentomaxillofac Radiol 2020; 49:20190484. [PMID: 31971827 PMCID: PMC7461737 DOI: 10.1259/dmfr.20190484] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/10/2020] [Accepted: 01/17/2020] [Indexed: 12/13/2022] Open
Abstract
The REduce research Waste And Reward Diligence statement has highlighted how weaknesses in health research can produce misleading results and waste valuable resources. Research on diagnostic efficacy in the field of dentomaxillofacial radiology (DMFR) is no exception to these criticisms and could be strengthened by more robust study designs, consistent use of a core set of outcome measures and completeness in reporting. Furthermore, we advocate that everyone participating in collaborative research on clinical interventions subscribes to the importance of methodological quality in how imaging methods are used. The aim of this paper, therefore, is to present a guide to conducting high-quality research on diagnostic efficacy in DMFR.We initially propose a framework inspired by the hierarchical model of efficacy of Fryback and Thornbury, highlighting study designs, measures of analysis, completeness of reporting and established guidelines to assist in these aspects of research. Bias in research, and measures to prevent or limit it, are then described.It is desirable to climb the Fryback and Thornbury "ladder" from technical efficacy, via accuracy and clinical efficacy, to societal efficacy of imaging methods. Efficacy studies on the higher steps of the ladder may be difficult to perform, but we must strive to answer questions of how useful our methods are in patient management and assess benefits, risks, costs, ethical and social issues. With the framework of six efficacy levels as the structure and based on our experience, we present information that may facilitate quality enhancement of diagnostic efficacy research in DMFR.
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Affiliation(s)
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
| | | | - Ann Wenzel
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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19
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Corso M, Cancelliere C, Mior S, Kumar V, Smith A, Côté P. The clinical utility of routine spinal radiographs by chiropractors: a rapid review of the literature. Chiropr Man Therap 2020; 28:33. [PMID: 32641135 PMCID: PMC7346665 DOI: 10.1186/s12998-020-00323-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/24/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION When indicated by signs or symptoms of potentially serious underlying pathology (red flags), chiropractors can use radiographs to inform their diagnosis. In the absence of red flags, the clinical utility of routine or repeat radiographs to assess the structure and function of the spine is controversial. OBJECTIVES To determine the diagnostic and therapeutic utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. Investigate whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. The research objectives required that we determine the validity, diagnostic accuracy and reliability of radiographs for the structural and functional evaluation of the spine. EVIDENCE REVIEW We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from inception to November 25, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (cross-sectional, case-control, cohort, randomized controlled trials, diagnostic and reliability) were critically appraised. Studies of acceptable quality were included in our synthesis. The lead author extracted data and a second reviewer independently validated the data extraction. We conducted a qualitative synthesis of the evidence. FINDINGS We identified 959 citations, screened 176 full text articles and critically appraised 23. No relevant studies assessed the clinical utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. No studies investigated whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. Nine low risk of bias studies investigated the validity (n = 2) and reliability (n = 8) of routine or repeat radiographs. These studies provide no evidence of clinical utility. CONCLUSION We found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.
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Affiliation(s)
- Melissa Corso
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - Carol Cancelliere
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - Silvano Mior
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Varsha Kumar
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Ali Smith
- Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada.
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20
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Baker J, de Laat D, Kruger E, McRae S, Trung S, Zottola C, Omaña H, Hunter SW. Reliable and valid measures for the clinical assessment of balance and gait in older adults with dementia: a systematic review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1788638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jacqueline Baker
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Danielle de Laat
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Emily Kruger
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Sarah McRae
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Sabrina Trung
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Carly Zottola
- School of Physical Therapy, University of Western Ontario, London, Canada
| | - Humberto Omaña
- Faculty of Health Sciences, University of Western Ontario, London, Canada
| | - Susan W. Hunter
- School of Physical Therapy, University of Western Ontario, London, Canada
- Faculty of Health Sciences, University of Western Ontario, London, Canada
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21
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Nuwailati R, Curatolo M, LeResche L, Ramsay DS, Spiekerman C, Drangsholt M. Reliability of the conditioned pain modulation paradigm across three anatomical sites. Scand J Pain 2020; 20:283-296. [PMID: 31812949 DOI: 10.1515/sjpain-2019-0080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/24/2019] [Indexed: 01/08/2023]
Abstract
Background and aims Conditioned Pain Modulation (CPM) is a measure of pain inhibition-facilitation in humans that may elucidate pain mechanisms and potentially serve as a diagnostic test. In laboratory settings, the difference between two pain measures [painful test stimulus (TS) without and with the conditioning stimulus (CS) application] reflects the CPM magnitude. Before the CPM test can be used as a diagnostic tool, its reliability on the same day (intra-session) and across multiple days (inter-session) needs to be known. Furthermore, it is important to determine the most reliable anatomical sites for both the TS and the CS. This study aimed to measure the intra-session and inter-session reliability of the CPM test paradigm in healthy subjects with the TS (pressure pain threshold-PPT) applied to three test sites: the face, hand, and dorsum of the foot, and the CS (cold pressor test-CPT) applied to the contralateral hand. Methods Sixty healthy participants aged 18-65 were tested by the same examiner on 3 separate days, with an interval of 2-7 days. On each day, testing was comprised of two identical experimental sessions in which the PPT test was performed on each of the three dominant anatomical sites in randomized order followed by the CPM test (repeating the PPT with CPT on the non-dominant hand). CPM magnitude was calculated as the percent change in PPT. The Intraclass Correlation Coefficient (ICC), Coefficient of Variation (CV), and Bland-Altman analyses were used to assess reliability. Results PPT relative reliability ranged from good to excellent at all three sites; the hand showed an intra-session ICC of 0.90 (0.84, 0.94) before CPT and ICC of 0.89 (0.83, 0.92) during CPT. The PPT absolute reliability was also high, showing a low bias and small variability when performed on all three sites; for example, CV of the hand intra-session was 8.0 before CPT and 8.1 during CPT. The relative reliability of the CPM test, although only fair, was most reliable when performed during the intra-session visits on the hand; ICC of 0.57 (0.37, 0.71) vs. 0.20 (0.03, 0.39) for the face, and 0.22 (0.01, 0.46) for the foot. The inter-session reliability was lower in all three anatomical sites, with the best reliability on the hand with an ICC of 0.40 (0.23, 0.55). The pattern of absolute reliability of CPM was similar to the relative reliability findings, with the reliability best on the hand, showing lower intra-session and inter-session variability (CV% = 43.5 and 51.5, vs. 70.1 and 73.1 for the face, and 75.9 and 78.9 for the foot). The CPM test was more reliable in women than in men, and in older vs. younger participants. Discussion The CPM test was most reliable when the TS was applied to the dominant hand and CS performed on the contralateral hand. These data indicate that using the CS and TS in the same but contralateral dermatome in CPM testing may create the most reliable results.
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Affiliation(s)
- Rania Nuwailati
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Michele Curatolo
- Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA.,Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Linda LeResche
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.,Department of Oral Medicine, University of Washington, Seattle, WA, USA
| | - Douglas S Ramsay
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.,Department of Orthodontics, University of Washington, Seattle, WA, USA.,Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA
| | - Charles Spiekerman
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.,Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Mark Drangsholt
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.,Department of Oral Medicine, University of Washington, Seattle, WA, USA
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22
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Abstract
OBJECTIVES (A) To investigate the specialty of observers involved in imaging-based assessment of bone fracture union in recent orthopaedic trials and (B) to provide a general overview of observer differences (in terms of interobserver reliability) in radiologic fracture union assessment that have been reported between surgeons and radiologists. DATA SOURCES Two separate systematic reviews (A, B) of English-, German-, and French-language articles in MEDLINE and Embase databases using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were done, with the following time frames: (A) January 2016-August 2017 and (B) through November 2017. STUDY SELECTION (A) Clinical trials of surgical fracture treatment evaluating radiologic (non) union. (B) Interobserver studies reporting kappa-values or intraclass correlation coefficients as reliability coefficient for radiologic fracture union assessment. Inclusion criteria for both reviews were fractures of the appendicular skeleton and the use of radiographs or computed tomography. DATA EXTRACTION Data were independently retrieved by 2 reviewers. DATA SYNTHESIS Descriptive statistics and percentages were reported. RESULTS (A) Forty-eight trials were included, whereof 33 (68%) did not report the observer's specialty. Six trials (13%) reported surgeon observers only, and 6 (13%) reported radiologist observers only. The median number of observers is 1 (interquartile range, 1-2). (B) Thirty-one interobserver studies were included, whereof 11 (35%) included at least 1 surgeon and 1 radiologist. Interobserver reliability varied considerably across the various fracture types studied and outcome scale used and was often unsatisfactory (kappa or intraclass correlation coefficients of <0.7). CONCLUSIONS In most trials providing observer's characteristics, radiologic fracture union was either rated by 1 surgeon or 1 radiologist. As interobserver reliability can be unsatisfactory, we recommend surgeons and radiologists to further intensify collaboration and trials to include at least 2 observers and associated reliability statistics.
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Gore S, Blackwood J, Guyette M, Alsalaheen B. Validity and Reliability of Accelerometers in Patients With COPD: A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev 2019; 38:147-158. [PMID: 29120966 DOI: 10.1097/hcr.0000000000000284] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Reduced physical activity is associated with poor prognosis in chronic obstructive pulmonary disease (COPD). Accelerometers have greatly improved quantification of physical activity by providing information on step counts, body positions, energy expenditure, and magnitude of force. The purpose of this systematic review was to compare the validity and reliability of accelerometers used in patients with COPD. METHODS An electronic database search of MEDLINE and CINAHL was performed. Study quality was assessed with the Strengthening the Reporting of Observational Studies in Epidemiology checklist while methodological quality was assessed using the modified Quality Appraisal Tool for Reliability Studies. RESULTS The search yielded 5392 studies; 25 met inclusion criteria. The SenseWear Pro armband reported high criterion validity under controlled conditions (r = 0.75-0.93) and high reliability (ICC = 0.84-0.86) for step counts. The DynaPort MiniMod demonstrated highest concurrent validity for step count using both video and manual methods. DISCUSSION Validity of the SenseWear Pro armband varied between studies especially in free-living conditions, slower walking speeds, and with addition of weights during gait. A high degree of variability was found in the outcomes used and statistical analyses performed between studies, indicating a need for further studies to measure reliability and validity of accelerometers in COPD. CONCLUSION The SenseWear Pro armband is the most commonly used accelerometer in COPD, but measurement properties are limited by gait speed variability and assistive device use. DynaPort MiniMod and Stepwatch accelerometers demonstrated high validity in patients with COPD but lack reliability data.
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Affiliation(s)
- Shweta Gore
- Department of Physical Therapy, University of Michigan-Flint, Flint
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Powden CJ, Dodds TK, Gabriel EH. THE RELIABILITY OF THE STAR EXCURSION BALANCE TEST AND LOWER QUARTER Y-BALANCE TEST IN HEALTHY ADULTS: A SYSTEMATIC REVIEW. Int J Sports Phys Ther 2019; 14:683-694. [PMID: 31598406 PMCID: PMC6769278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Dynamic balance is often an important criterion used during lower extremity musculoskeletal injury prediction, prevention, and rehabilitation processes. Methods to assess lower extremity dynamic balance include the Star Excursion Balance Test (SEBT) and Lower Quarter Y-Balance Test (YBT). Due to the importance of dynamic balance it is imperative to establish reliable quantification techniques. PURPOSE To conduct a systematic review to assess the reliability and responsiveness of the SEBT/YBT. STUDY DESIGN Systematic Review. METHODS Electronic databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus) were searched from inception to August 2018. Included studies examined the intra- and inter-rater reliability of the SEBT/YBT in healthy adults. Two investigators independently assessed methodological quality, level of evidence and strength of recommendation with the Qualtiy Appraisal of Reliability Studies (QAREL) scale. Relative intra and inter-rater reliability was examined through intraclass correlation coefficients (ICC) and responsiveness was evaluated through minimal detectable change (MDC). Data was analyzed based on reach direction (Anterior, Posteromedial, and Posterolateral) and normalization (normalized and non-normalized). Additionally, data were then synthesized using the strength of recommendation taxonomy to provide a grade of recommendation. RESULTS A total of nine studies were included in this review. Six studies examined the inter-rater reliability and seven assessed intra-rater reliability. The included studies had a median QAREL score of 66.89% (range = 55.56% to 75.00%) and 59.03% (range = 33.33 to 66.67%) for inter and intra-rater reliability respectively. Median ICC values for inter-rater reliability were 0.88 (Range = 0.83 - 0.96), 0.87 (range = 0.80 - 1.00), and 0.88 (range = 0.73 - 1.00) for the anterior, posteromedial, and posterolateral directions respectively. Median ICC values for intra-rater reliability were 0.88 (Range = 0.84 - 0.93), 0.88 (Range = 0.85 - 0.94), and 0.90 (Range = 0.68 - 0.94) for the anterior, posteromedial, and posterolateral directions, respectively. CONCLUSIONS There is grade A evidence to support that the SEBT/YBT have excellent inter and intra-rater reliability when used in healthy adults. Furthermore, minimal detectable change values have been provided that can be used in practice to aid clinical decision making. Future research is needed to assess the reliability, responsiveness, and validity of the SEBT/YBT in pathologic populations. LEVEL OF EVIDENCE 1a.
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Affiliation(s)
- Cameron J. Powden
- Department of Athletic Training, University of Indianapolis, Indianapolis, IN, USA
| | - Teralyn K. Dodds
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terra Haute, IN, USA
| | - Emily H. Gabriel
- Department of Athletic Training, Mercer University, Macon, GA, USA
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Lohr C, Schmidt T, Medina-Porqueres I, Braumann KM, Reer R, Porthun J. Diagnostic accuracy, validity, and reliability of Tensiomyography to assess muscle function and exercise-induced fatigue in healthy participants. A systematic review with meta-analysis. J Electromyogr Kinesiol 2019; 47:65-87. [DOI: 10.1016/j.jelekin.2019.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/16/2019] [Accepted: 05/03/2019] [Indexed: 02/04/2023] Open
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Lemeunier N, Suri-Chilana M, Welsh P, Shearer HM, Nordin M, Wong JJ, Torres P, Oolup-da Silva S, D’Silva C, Jeoun EB, Stern P, Yu H, Murnaghan K, Sutton D, Côté P. Reliability and validity of clinical tests to assess the function of the cervical spine in adults with neck pain and its associated disorders: part 5. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) collaboration. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1626906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nadège Lemeunier
- Department of Research, Institut Franco-Européen de Chiropraxie (IFEC), Toulouse, France
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
| | - Minisha Suri-Chilana
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Patrick Welsh
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Heather M. Shearer
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Margareta Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Centre (OIOC), New York, NY, USA
| | - Jessica J. Wong
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Paola Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago, Chile
| | - Sophia Oolup-da Silva
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Chelsea D’Silva
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Eun Been Jeoun
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Paula Stern
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Kent Murnaghan
- Librarian, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Deborah Sutton
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Canada
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Gore S, Goldberg A, Huang MH, Shoemaker M, Blackwood J. Development and validation of a quality appraisal tool for validity studies (QAVALS). Physiother Theory Pract 2019; 37:646-654. [PMID: 31246154 DOI: 10.1080/09593985.2019.1636435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Appraisal of methodological quality of included studies is an important component of conducting systematic reviews. Although several quality appraisal tools are available for intervention studies, fewer tools are available for non-randomized designs, especially for studies of measurement properties.Objectives: The purpose of this study was to develop a quality appraisal tool specific to validity studies (QAVALS) and to examine its reliability and validity.Methods: Following identification of key concepts, an initial list of 34 possible items was developed. Content experts rated each item as either 'essential', 'useful but not essential', and 'not necessary'. The content validity ratio (CVR) and content validity index (CVI) were calculated to establish content validity following two rounds of review. Inter-rater and test-retest reliability were assessed by two external reviewers using weighted kappa coefficients.Results: Items below a CVR of 0.50 were eliminated resulting in the modified version with 27 items. Following the second round, the final tool with 24 items was developed. The content validity index of QAVALS was 0.90. QAVALS demonstrated excellent test-retest reliability (k = 0.80-0.84, 95% CI = 0.76-0.90) and good overall inter-rater reliability (k = 0.70, 95% CI = 0.61-0.79).Limitations: Individual item reliability was low for four items. Further research is warranted to examine reliability using larger number of studies and raters with different experience levels.Conclusion: QAVALS is the first quality appraisal tool specifically designed to address common types of validity. The QAVALS demonstrates strong content validity, good overall inter-rater and excellent test-retest reliability.
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Affiliation(s)
- Shweta Gore
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - Allon Goldberg
- Department of Physical Therapy, School of Health Professions and Studies, University of Michigan-Flint, Flint, MI, USA
| | - Min H Huang
- Department of Physical Therapy, School of Health Professions and Studies, University of Michigan-Flint, Flint, MI, USA
| | - Michael Shoemaker
- Department of Physical Therapy, College of Health Professions, Grand Valley State University, 1 Campus Dr, Allendale, MI, USA
| | - Jennifer Blackwood
- Department of Physical Therapy, School of Health Professions and Studies, University of Michigan-Flint, Flint, MI, USA
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Ressman J, Grooten WJA, Rasmussen Barr E. Visual assessment of movement quality in the single leg squat test: a review and meta-analysis of inter-rater and intrarater reliability. BMJ Open Sport Exerc Med 2019; 5:e000541. [PMID: 31275606 PMCID: PMC6579566 DOI: 10.1136/bmjsem-2019-000541] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2019] [Indexed: 01/05/2023] Open
Abstract
Single leg squat (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but also to assess lower extremity function in active people.
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Affiliation(s)
- John Ressman
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wilhelmus Johannes Andreas Grooten
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals Function, Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Rasmussen Barr
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Armitage L, Kark L, Czerniec S, Kwah LK. Reliability and Validity of Measurement Tools for Residual Limb Volume in People With Limb Amputations: A Systematic Review. Phys Ther 2019; 99:612-626. [PMID: 30722026 DOI: 10.1093/ptj/pzz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 09/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Measurements of residual limb volume often guide decisions on the type and timing of prosthetic prescription. To help inform these decisions, it is important that clinicians use measurement tools that are reliable and valid. PURPOSE The aim of this systematic review was to investigate the reliability and validity of measurement tools for residual limb volume in people with limb amputations. DATA SOURCES A comprehensive search on MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science was performed on July 11, 2016. STUDY SELECTION Studies were included if they examined the reliability or validity of measurement tools for residual limb volume, were conducted on humans, and were published in English. DATA EXTRACTION Data were extracted from 11 reliability and 4 validity studies and included study characteristics, volumetric estimates, and reliability and validity estimates. The quality of the studies was also rated. DATA SYNTHESIS Data from 2 studies (38 participants) indicated good to excellent intrarater (intraclass correlation coefficient [ICC] ≥0.88) and interrater (ICC ≥0.88) reliability and high between-session reliability (coefficient of variation [CV] = 10%) for water displacement volumetry. One study (28 participants) reported excellent intrarater and interrater reliability (ICC ≥0.93) for the circumferential method, and data from 2 studies (19 participants) indicated high between-session reliability for the optical surface scanner (CV ≤9.8%). Three studies (26 participants) indicated good to excellent between-session reliability results for computed tomography (CV = 9.2%-10.9%). One study (7 participants) showed moderate within-session reliability (CV = 50%). Using water displacement volumetry as the gold standard, 2 studies (79 participants) indicated excellent validity for the circumferential method ( r ≥0.92; ICC ≥0.92). All studies reporting measures of reliability or validity were performed with people who had transtibial amputations. LIMITATIONS Only studies published in English and in which water displacement volumetry was used as the gold standard were included in this review. The reliability and validity of the quality rating scale used in this review have not been tested. CONCLUSIONS On the basis of a limited number of moderate- to high-quality studies with small sample sizes, circumferential and water displacement methods were found to be reliable, and the circumferential method was found to be valid in people with transtibial amputations. There are inadequate data for drawing conclusions about volume measurement methods in people with other types of limb amputations.
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Affiliation(s)
- Lucy Armitage
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, New South Wales, Australia 2052
| | - Lauren Kark
- Graduate School of Biomedical Engineering, UNSW Sydney
| | - Sharon Czerniec
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Li Khim Kwah
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Lemeunier N, da Silva-Oolup S, Olesen K, Shearer H, Carroll LJ, Brady O, Côté E, Stern P, Tuff T, Suri-Chilana M, Torres P, Wong JJ, Sutton D, Murnaghan K, Côté P. Reliability and validity of self-reported questionnaires to measure pain and disability in adults with neck pain and its associated disorders: part 3-a systematic review from the CADRE Collaboration. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:1156-1179. [PMID: 30879185 DOI: 10.1007/s00586-019-05949-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/10/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the reliability and validity of self-reported questionnaires to measure pain and disability in adults with grades I-IV neck pain and its associated disorders (NAD). METHODS We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and systematically searched databases from 2005 to 2017. Independent reviewers screened and critically appraised studies using standardized tools. Evidence from low-risk-of-bias studies was synthesized according to best evidence synthesis principles. Validity studies were ranked according to the Sackett and Haynes classification. RESULTS We screened 2823 articles, and 26 were eligible for critical appraisal; 18 were low risk of bias. Preliminary evidence suggests that the Neck Disability Index (original and short versions), Whiplash Disability Questionnaire, Neck Pain Driving Index, and ProFitMap-Neck may be valid and reliable to measure disability in patients with NAD. We found preliminary evidence for the validity and reliability of pain measurements including the Body Pain Diagram, Visual Analogue Scale, the Numeric Rating Scale and the Pain-DETECT Questionnaire. CONCLUSION The evidence supporting the validity and reliability of instruments used to measure pain and disability is preliminary. Further validity studies are needed to confirm the clinical utility of self-reported questionnaires to assess pain and disability in patients with NAD. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie (IFEC), 72 chemin de la Flambère, 31300, Toulouse, France.
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
| | - S da Silva-Oolup
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - K Olesen
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - H Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - L J Carroll
- School of Public Health, University of Alberta, 4075 Research Transition Facility, 8308 - 114 St., Edmonton, AB, T6G 2E1, Canada
| | - O Brady
- School of Physical Therapy and Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher Ave, Tampa, FL, USA
| | - E Côté
- Department of Ophthalmology and Vision Sciences, University of Toronto, 340 College St., Toronto, ON, M5T 3A9, Canada
| | - P Stern
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - T Tuff
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - M Suri-Chilana
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - J J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - D Sutton
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - K Murnaghan
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - P Côté
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
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Lemeunier N, Jeoun EB, Suri M, Tuff T, Shearer H, Mior S, Wong JJ, da Silva-Oolup S, Torres P, D'Silva C, Stern P, Yu H, Millan M, Sutton D, Murnaghan K, Cȏté P. Reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with neck pain and its associated disorders: Part 4. A systematic review from the cervical assessment and diagnosis research evaluation (CADRE) collaboration. Musculoskelet Sci Pract 2018; 38:128-147. [PMID: 30455032 DOI: 10.1016/j.msksp.2018.09.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the reliability and validity of clinical tests to assess posture, pain location, and cervical spine mobility in adults with grades I-IV neck pain and associated disorders (NAD). METHODS We systematically searched electronic databases to update the systematic review of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Eligible reliability and validity studies were critically appraised using modified versions of the QAREL and QUADAS-2 instruments, respectively. Evidence from low risk of bias studies were synthesized following best evidence synthesis principles. RESULTS We screened 14302 articles, critically appraised 46 studies, and found 32 low risk of bias articles (14 reliability and 18 validity studies). We found preliminary evidence of: 1) reliability of visual inspection, aided with devices (CROM and digital caliper) to assess head posture; 2) reliability and validity of soft tissue palpation to locate tender/trigger points in muscles; 3) reliability and validity of joint motion palpation to assess stiffness and pain provocation in combination; and 4) range of motion tests using visual estimation (in cervical extension only) or devices (digital caliper, goniometer, inclinometer) to assess cervical mobility. CONCLUSIONS We found little evidence to support the reliability and validity of clinical tests to assess head posture, pain location and cervical mobility in adults with NAD grades I-III. More advanced validity studies are needed to inform the clinical utility of tests used to evaluate patients with NAD.
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Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France; UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada.
| | - E B Jeoun
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - M Suri
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - T Tuff
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - C D'Silva
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
| | - P Stern
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - H Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - M Millan
- Cabinet d'expertise médicale, Castres, France
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada
| | - K Murnaghan
- Librarian, Canadian Memorial Chiropractic College (CMCC), 6100, Leslie Street, Toronto, Ontario, Canada
| | - P Cȏté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000, Simcoe St. N., Oshawa, Ontario, L1H 7K4, Canada
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Thoirs KA, Childs J. Are Ultrasound Measurements of Achilles Tendon Size Reliable? A Systematic Review of Rater Reliability. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2476-2491. [PMID: 30154035 DOI: 10.1016/j.ultrasmedbio.2018.07.011] [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: 04/08/2018] [Revised: 07/04/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
Ultrasound measurements of Achilles tendon size are used to assess the tendon's response to exercise, aging, rehabilitation, tendon loading and healing. It is important to understand and minimise the measurement error that occurs with these measurements. This review identified and synthesised studies reporting on intra- and inter-rater reliability of ultrasound measurements of Achilles tendon size. Analysis of 21 studies revealed that good to excellent intra- and inter-rater reliability can be achieved for ultrasound measurements of Achilles tendon size. Reliability can be optimised by using one experienced operator, standardising transducer pressure and orientation and averaging two or three measurements. There was a high risk of methodological bias across the included studies. Reporting of reliability studies needs to be improved by the use of existing reporting guidelines and expansion of these guidelines to include important elements of ultrasound imaging.
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Affiliation(s)
- Kerry A Thoirs
- International Centre of Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia 5001, Australia.
| | - Jessie Childs
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001, Australia
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Reliability of the Mechanical Diagnosis and Therapy System in Patients With Spinal Pain: A Systematic Review. J Orthop Sports Phys Ther 2018; 48:923-933. [PMID: 29932871 DOI: 10.2519/jospt.2018.7876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND An updated summary of the evidence for the reliability of the Mechanical Diagnosis and Therapy (MDT) system in patients with spinal pain is needed. OBJECTIVE To investigate the evidence on the intrarater and interrater reliability of MDT in patients with spinal pain. METHODS Searches in MEDLINE, CINAHL, Embase, PEDro, and Scopus were conducted for this systematic review. We included any study design as long as reliability of the MDT method was tested in patients with spinal pain. We collected data on the reliability of MDT to identify main and subsyndromes, directional preference, the centralization phenomenon, and lateral shift. The methodological quality of studies was assessed using the Quality Appraisal of Diagnostic Reliability and the Guidelines for Reporting Reliability and Agreement Studies checklists. RESULTS Twelve studies were included (8 studies on back pain, pooled n = 2160 patients; 3 studies on neck pain, pooled n = 45 patients; and 3 studies recruited mixed spinal conditions, pooled n = 389 patients). Studies investigating patients with back pain reported kappa estimates ranging from 0.26 to 1.00 (main and subsyndromes), 0.27 to 0.90 (directional preference), and 0.11 to 0.70 (centralization phenomenon). Kappa estimates for studies investigating neck pain ranged from 0.47 to 0.84 (main and subsyndromes) and 0.46 (directional preference). In mixed populations, kappa estimates ranged from 0.56 to 0.96 (main and subsyndromes). CONCLUSION The MDT system appears to have acceptable interrater reliability for classifying patients with back pain into main and subsyndromes when applied by therapists who have completed the credentialing examination, but unacceptable reliability in other therapists. We found conflicting evidence regarding the reliability of the MDT system in patients with neck pain or mixed pain locations. J Orthop Sports Phys Ther 2018;48(12):923-933. Epub 22 Jun 2018. doi:10.2519/jospt.2018.7876.
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Alqarni A, Manlapaz D, Baxter D, Tumilty S, Mani R. Test procedures to assess somatosensory abnormalities in individuals with neck pain: a systematic review of psychometric properties. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1512737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Abdullah Alqarni
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Donald Manlapaz
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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van Rijn SF, Zwerus EL, Koenraadt KLM, Jacobs WCH, van den Bekerom MPJ, Eygendaal D. The reliability and validity of goniometric elbow measurements in adults: A systematic review of the literature. Shoulder Elbow 2018; 10:274-284. [PMID: 30214494 PMCID: PMC6134535 DOI: 10.1177/1758573218774326] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 04/08/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The universal goniometer is a simple measuring tool. With this review we aimed to investigate the reliability and validity of the universal goniometer in measurements of the adults' elbow. METHODS Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed and our study protocol was published online at PROSPERO. A literature search was conducted on relevant studies. Methodological quality was assessed using the Quality Appraisal of Diagnostic Reliability (QAREL) scoring system. RESULTS Out of 697 studies yielded from our literature search, 12 were included. Six studies were rated as high quality. The intrarater reliability intraclass correlation coefficient ranged from 0.45 to 0.99, the interrater reliability ranged from intraclass correlation coefficient 0.53-0.97. One study providing instructions on goniometric alignment did not find a difference in expert versus non-expert examiners. Another study in which examiners were not instructed found a higher interrater reliability in expert examiners. One study investigating the validity of the goniometer in elbow measurements found a maximum standard error of the mean of 11.5° for total range of motion. DISCUSSION Overall, the studies showed high intra- and interrater reliability of the universal goniometer. The reliability of the universal goniometer in non-expert examiners can be increased by clear instructions on goniometric alignment.
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Affiliation(s)
| | - Elisa L Zwerus
- Department of Orthopedic Surgery, Academic Medical Centre, Amsterdam, the Netherlands
| | - Koen LM Koenraadt
- Orthopedic Surgery Department, Amphia Hospital, Breda, the Netherlands
| | - Wilco CH Jacobs
- Orthopedic Surgery Department, Amphia Hospital, Breda, the Netherlands
| | - Michel PJ van den Bekerom
- Department of Orthopedic Surgery, Shoulder and Elbow Unit, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Denise Eygendaal
- Orthopedic Surgery Department, Amphia Hospital, Breda, the Netherlands
- Department of Orthopedic Surgery, Academic Medical Centre, Amsterdam, the Netherlands
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Reliability and Validity of Frontal Plane Kinematics of the Trunk and Lower Extremity Measured With 2-Dimensional Cameras During Athletic Tasks: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2018; 48:812-822. [PMID: 29895235 DOI: 10.2519/jospt.2018.8006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Two-dimensional (2-D) analysis is commonly used to quantify frontal plane kinematics of the trunk and lower extremity. However, there are conflicting results regarding the reliability and validity of these measurements. OBJECTIVE To synthesize the current literature to determine whether 2-D analysis is a reliable and valid method of measuring frontal plane kinematics of the trunk and lower extremity during squatting, landing, and cutting tasks. METHODS For this systematic review with meta-analysis, MEDLINE, CINAHL, Embase, Scopus, and SPORTDiscus databases were searched from inception until March 2017. The authors included 16 studies that evaluated the reliability and/or validity of 2-D measurements of frontal plane trunk and/or lower extremity kinematics when compared to 3-D measurements during any of the following tasks: squatting, landing, or cutting. RESULTS Intrarater reliability (intraday and interday) and interrater reliability of the 2-D video measurements varied from moderate to excellent. In terms of validity, there was poor agreement between the 2-D and 3-D methods, with no correlation between 2-D knee frontal plane projection angle and 3-D knee frontal plane angles (r = 0.127, P = .094) for the single-leg squat, but a moderate to good relationship (r = 0.619, P<.001) for the landing task. CONCLUSION Two-dimensional video analysis of frontal plane trunk and lower extremity kinematics is reliable, but this appears to be dependent on the task and the type of reliability evaluated. The current evidence does not support the use of 2-D video analysis for measuring trunk and lower extremity frontal plane kinematics when accurate measures are required. LEVEL OF EVIDENCE Diagnosis, level 3. J Orthop Sports Phys Ther 2018;48(10):812-822. Epub 12 Jun 2018. doi:10.2519/jospt.2018.8006.
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van Kooij YE, Fink A, Nijhuis-van der Sanden MW, Speksnijder CM. The reliability and measurement error of protractor-based goniometry of the fingers: A systematic review. J Hand Ther 2018; 30:457-467. [PMID: 28389132 DOI: 10.1016/j.jht.2017.02.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review PURPOSE OF THE STUDY: The purpose was to review the available literature for evidence on the reliability and measurement error of protractor-based goniometry assessment of the finger joints. METHODS Databases were searched for articles with key words "hand," "goniometry," "reliability," and derivatives of these terms. Assessment of the methodological quality was carried out using the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Two independent reviewers performed a best evidence synthesis based on criteria proposed by Terwee et al (2007). RESULTS Fifteen articles were included. One article was of fair methodological quality, and 14 articles were of poor methodological quality. An acceptable level for reliability (intraclass correlation coefficient > 0.70 or Pearson's correlation > 0.80) was reported in 1 study of fair methodological quality and in 8 articles of low methodological quality. Because the minimal important change was not calculated in the articles, there was an unknown level of evidence for the measurement error. DISCUSSION Further research with adequate sample sizes should focus on reference outcomes for different patient groups. For valid therapy evaluation, it is important to know if the change in range of motion reflects a real change of the patient or if this is due to the measurement error of the goniometer. Until now, there is insufficient evidence to establish this cut-off point (the smallest detectable change). CONCLUSION Following the Consensus-Based Standards for the Selection of Health Measurement Instruments criteria, there was limited level of evidence for an acceptable reliability in the dorsal measurement method and unknown level of evidence for the measurement error. LEVEL OF EVIDENCE 2a.
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Affiliation(s)
| | | | - Maria W Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Caroline M Speksnijder
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands; Physical Therapy Science, University Medical Center Utrecht, Program in Clinical Health Sciences, Utrecht, The Netherlands; Department of Oral-Maxillofacial Surgery, University Medical Center Utrecht, Prosthodontics and Special Dental Care, Utrecht, The Netherlands
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Banwell HA, Paris ME, Mackintosh S, Williams CM. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review. J Foot Ankle Res 2018; 11:21. [PMID: 29854006 PMCID: PMC5975578 DOI: 10.1186/s13047-018-0264-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/11/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Flexible flat foot is a normal observation in typically developing children, however, some children with flat feet present with pain and impaired lower limb function. The challenge for health professionals is to identify when foot posture is outside of expected findings and may warrant intervention. Diagnoses of flexible flat foot is often based on radiographic or clinical measures, yet the validity and reliability of these measures for a paediatric population is not clearly understood. The aim of this systematic review was to investigate how paediatric foot posture is defined and measured within the literature, and if the psychometric properties of these measures support any given diagnoses. METHODS Electronic databases (MEDLINE, CINAHL, EMBASE, Cochrane, AMED, SportDiscus, PsycINFO, and Web of Science) were systematically searched in January 2017 for empirical studies where participants had diagnosed flexible flat foot and were aged 18 years or younger. Outcomes of interest were the foot posture measures and definitions used. Further articles were sought where cited in relation to the psychometric properties of the measures used. RESULTS Of the 1101 unique records identified by the searches, 27 studies met the inclusion criteria involving 20 foot posture measures and 40 definitions of paediatric flexible flat foot. A further 18 citations were sought in relation to the psychometric properties of these measures. Three measures were deemed valid and reliable, the FPI-6 > + 6 for children aged three to 15 years, a Staheli arch index of > 1.07 for children aged three to six and ≥ 1.28 for children six to nine, and a Chippaux-Smirak index of > 62.7% in three to seven year olds, > 59% in six to nine year olds and ≥ 40% for children aged nine to 16 years. No further measures were found to be valid for the paediatric population. CONCLUSION No universally accepted criteria for diagnosing paediatric flat foot was found within existing literature, and psychometric data for foot posture measures and definitions used was limited. The outcomes of this review indicate that the FPI - 6, Staheli arch index or Chippaux-Smirak index should be the preferred method of paediatric foot posture measurement in future research.
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Affiliation(s)
- Helen A. Banwell
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia 5001 Australia
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Maisie E. Paris
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Shylie Mackintosh
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
| | - Cylie M. Williams
- School of Health Sciences, University of South Australia, Adelaide, South Australia 5001 Australia
- Allied Health, Peninsula Health, Frankston, VIC 3199 Australia
- School of Primary and Allied Health, Monash University, Frankston, VIC 3199 Australia
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Alqarni AM, Manlapaz D, Baxter D, Tumilty S, Mani R. Test Procedures to Assess Somatosensory Abnormalities in Individuals with Peripheral Joint Pain: A Systematic Review of Psychometric Properties. Pain Pract 2018; 18:895-924. [PMID: 29350873 DOI: 10.1111/papr.12680] [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: 10/02/2017] [Accepted: 01/11/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Test procedures that were developed to assess somatosensory abnormalities should possess optimal psychometric properties (PMPs) to be used in clinical practice. The aim of this systematic review was to evaluate the literature to assess the level of evidence for PMPs of test procedures investigated in individuals with peripheral joint pain (PJP). METHODS A comprehensive electronic literature search was conducted in 7 databases from inception to March 2016. The Quality Appraisal for Reliability Studies (QAREL) checklist and the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) tool were used to assess risk for bias of the included studies. Level of evidence was evaluated based on the methodological quality and the quality of the measurement properties. RESULTS Forty-one studies related to PJP were included. The majority of included studies were considered to be of insufficient methodological quality, and the level of evidence for PMPs varied across different test procedures. The level of evidence for PMPs varied across different test procedures in different types of PJP. Hand-held pressure algometry is the only test procedure that showed moderate positive evidence of intrarater reliability, agreement, and responsiveness, simultaneously, when it was investigated in patients with chronic knee osteoarthritis. CONCLUSIONS This systematic review identified that the level of evidence for PMPs varied across different testing procedures to assess somatosensory abnormalities for different PJP populations. Further research with standardized protocols is recommended to further investigate the predictive ability and responsiveness of reported test procedures in order to warrant their extended utility in clinical practice.
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Affiliation(s)
- Abdullah Mohammad Alqarni
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Donald Manlapaz
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Swaine JM, Moe A, Breidahl W, Bader DL, Oomens CWJ, Lester L, O'Loughlin E, Santamaria N, Stacey MC. Adaptation of a MR imaging protocol into a real-time clinical biometric ultrasound protocol for persons with spinal cord injury at risk for deep tissue injury: A reliability study. J Tissue Viability 2017; 27:32-41. [PMID: 28864351 DOI: 10.1016/j.jtv.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND High strain in soft tissues that overly bony prominences are considered a risk factor for pressure ulcers (PUs) following spinal cord impairment (SCI) and have been computed using Finite Element methods (FEM). The aim of this study was to translate a MRI protocol into ultrasound (US) and determine between-operator reliability of expert sonographers measuring diameter of the inferior curvature of the ischial tuberosity (IT) and the thickness of the overlying soft tissue layers on able-bodied (AB) and SCI using real-time ultrasound. MATERIAL AND METHODS Part 1: Fourteen AB participants with a mean age of 36.7 ± 12.09 years with 7 males and 7 females had their 3 soft tissue layers in loaded and unloaded sitting measured independently by 2 sonographers: tendon/muscle, skin/fat and total soft tissue and the diameter of the IT in its short and long axis. Part 2: Nineteen participants with SCI were screened, three were excluded due to abnormal skin signs, and eight participants (42%) were excluded for abnormal US signs with normal skin. Eight SCI participants with a mean age of 31.6 ± 13.6 years and all male with 4 paraplegics and 4 tetraplegics were measured by the same sonographers for skin, fat, tendon, muscle and total. Skin/fat and tendon/muscle were computed. RESULTS AB between-operator reliability was good (ICC = 0.81-0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC = -0.028 and -0.01). SCI between-operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC = 0.75-0.97) and poor for tendon (ICC = 0.26 unloaded and ICC = -0.71 loaded) and skin (ICC = 0.37 unloaded and ICC = 0.10). CONCLUSION A MRI protocol was successfully adapted for a reliable 3 soft tissue layer model and could be used in a 2-D FEM model designed to estimate soft tissue strain as a novel risk factor for the development of a PU.
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Affiliation(s)
- Jillian M Swaine
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Institute for Health Research, The University of Notre Dame Australia, 19 Mouat Street (PO Box 1225), Fremantle, Western Australia, 6959, Australia; Fiona Stanley Hospital, State Rehabilitation Service, Spinal Service, South Metropolitan Health Service Fiona Stanley Fremantle Hospitals Group, Locked Bag 100, Palmyra DC, Western Australia, 6961, Australia.
| | - Andrew Moe
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Fiona Stanley Hospital, South Metropolitan Health Service Fiona Stanley Fremantle Hospitals Group, Locked Bag 100, Palmyra DC, Western Australia, 6961, Australia
| | - William Breidahl
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Perth Radiological Clinic, PO Box 99, Mirrabooka, Western Australia, 6941, Australia
| | - Daniel L Bader
- Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK; Biomedical Engineering Department, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Cees W J Oomens
- Biomedical Engineering Department, Eindhoven University of Technology, PO Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Leanne Lester
- Health Evaluation Promotion Unit, School of Human Sciences, The University of Western Australia M408, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia
| | - Edmond O'Loughlin
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Fiona Stanley Hospital, South Metropolitan Health Service Fiona Stanley Fremantle Hospitals Group, Locked Bag 100, Palmyra DC, Western Australia, 6961, Australia
| | - Nick Santamaria
- Melbourne School of Health Sciences, University of Melbourne, Parkville, Victoria, 2010, Australia
| | - Michael C Stacey
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia, 6009, Australia; Department of Surgery, McMaster University, 1280 Main St W, Hamilton, Ontario, L8S 4L8, Canada
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Lange T, Struyf F, Schmitt J, Lützner J, Kopkow C. The reliability of physical examination tests for the clinical assessment of scapular dyskinesis in subjects with shoulder complaints: A systematic review. Phys Ther Sport 2017; 26:64-89. [DOI: 10.1016/j.ptsp.2016.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/01/2016] [Accepted: 10/31/2016] [Indexed: 12/19/2022]
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Levenhagen K, Davies C, Perdomo M, Ryans K, Gilchrist L. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association. Phys Ther 2017; 97:729-745. [PMID: 28838217 PMCID: PMC5803775 DOI: 10.1093/ptj/pzx050] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/01/2017] [Indexed: 01/20/2023]
Abstract
The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema.
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Affiliation(s)
- Kimberly Levenhagen
- Saint Louis University, Doisy College of Health Sciences, Department of Physical Therapy & Athletic Training, St Louis, Missouri
| | - Claire Davies
- Rehabilitation Services Baptist Health Lexington, Lexington, Kentucky
| | - Marisa Perdomo
- University of Southern California, Division of Biokinesiology and Physical Therapy, Los Angeles, California
| | - Kathryn Ryans
- Doctor of Physical Therapy Program, Mercy College, Dobbs Ferry, New York
| | - Laura Gilchrist
- St Catherine University, Doctor of Physical Therapy Program, 601 25th Avenue South, Minneapolis, MN 55454
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Levenhagen K, Davies C, Perdomo M, Ryans K, Gilchrist L. Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA. REHABILITATION ONCOLOGY 2017; 35:E1-E18. [PMID: 28748128 PMCID: PMC5497787 DOI: 10.1097/01.reo.0000000000000073] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. METHODS Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. RECOMMENDATIONS In an effort to make these clinically applicable, recommendations were based on the characteristics as to the location and stage of a patient's upper-quadrant lymphedema.
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Affiliation(s)
- Kimberly Levenhagen
- Department of Physical Therapy & Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO
| | - Claire Davies
- Certified Lymphedema Therapist-Lymphology Association of North America (CLT-LANA), Rehabilitation Services, Baptist Health Lexington, Lexington, KY
| | - Marisa Perdomo
- Certified Lymphedema Therapist-Foldi (CLT-Foldi), Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA
| | - Kathryn Ryans
- Doctor of Physical Therapy Program, Mercy College, Dobbs Ferry, NY
| | - Laura Gilchrist
- Doctor of Physical Therapy Program, St Catherine University, Minneapolis, MN
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Lemeunier N, da Silva-Oolup S, Chow N, Southerst D, Carroll L, Wong JJ, Shearer H, Mastragostino P, Cox J, Côté E, Murnaghan K, Sutton D, Côté P. Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1-A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:2225-2241. [PMID: 28608175 DOI: 10.1007/s00586-017-5153-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/24/2017] [Accepted: 05/20/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. METHODS We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes. RESULTS We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II-III studies). Preliminary evidence suggests that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling's and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry. CONCLUSIONS Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension-rotation test, neurological examination, Spurling's and the upper limb neurodynamic tests.
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Affiliation(s)
- Nadège Lemeunier
- Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France. .,UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
| | - S da Silva-Oolup
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - N Chow
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada.,Michael G. DeGroote Institute for Pain Research and Care, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
| | - D Southerst
- Occupational and Industrial Orthopaedic Centre, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 63 Downing Street, New York, NY, 10014, USA
| | - L Carroll
- School of Public Health, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - J J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
| | - H Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.,Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - P Mastragostino
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - J Cox
- Division of Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - E Côté
- Faculty of Medicine, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 1A1, Canada
| | - K Murnaghan
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - D Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
| | - P Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.,Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, Canada
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Cavaleri R, Schabrun SM, Chipchase LS. The number of stimuli required to reliably assess corticomotor excitability and primary motor cortical representations using transcranial magnetic stimulation (TMS): a systematic review and meta-analysis. Syst Rev 2017; 6:48. [PMID: 28264713 PMCID: PMC5340029 DOI: 10.1186/s13643-017-0440-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 02/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is a non-invasive means by which to assess the structure and function of the central nervous system. Current practices involve the administration of multiple stimuli over target areas of a participant's scalp. Decreasing the number of stimuli delivered during TMS assessments would improve time efficiency and decrease participant demand. However, doing so may also compromise the within- or between-session reliability of the technique. The aim of this review was therefore to determine the minimum number of TMS stimuli required to reliably measure (i) corticomotor excitability of a target muscle at a single cranial site and (ii) topography of the primary motor cortical representation of a target muscle across multiple cranial sites. METHODS Database searches were performed to identify diagnostic reliability studies published before May 2015. Two independent reviewers extracted data from studies employing single-pulse TMS to measure (i) the corticomotor excitability at a single cranial site or (ii) the topographic cortical organisation of a target muscle across a number of cranial sites. Outcome measures included motor evoked potential amplitude, map volume, number of active map sites and location of the map centre of gravity. RESULTS Only studies comparing the reliability of varying numbers of stimuli delivered to a single cranial site were identified. Five was the lowest number of stimuli that could be delivered to produce excellent within-session motor evoked potential (MEP) amplitude reliability (intraclass correlation coefficient (ICC) = 0.92, 95% CI 0.87 to 0.95). Ten stimuli were required to achieve consistent between-session MEP amplitudes among healthy participants (ICC = 0.89, 95% CI 0.76 to 0.95). However, between-session reliability was influenced by participant characteristics, intersession intervals and target musculature. CONCLUSIONS Further exploration of the reliability of multi-site TMS mapping is required. Five stimuli produce reliable MEP recordings during single-site TMS investigations involving one session. For single-site analyses involving multiple sessions, ten stimuli are recommended when investigating corticomotor excitability in healthy participants or the upper limb musculature. However, greater numbers of stimuli may be required for clinical populations or assessments involving the lower limb. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015024579.
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Affiliation(s)
- Rocco Cavaleri
- Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, Western Sydney University, Sydney, NSW, 2560, Australia
| | - Siobhan M Schabrun
- Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, Western Sydney University, Sydney, NSW, 2560, Australia
| | - Lucy S Chipchase
- Brain Rehabilitation and Neuroplasticity Unit, School of Science and Health, Western Sydney University, Sydney, NSW, 2560, Australia.
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Tang ZM, Ling ZG, Wang CM, Wu YB, Kong JL. Serum tumor-associated autoantibodies as diagnostic biomarkers for lung cancer: A systematic review and meta-analysis. PLoS One 2017; 12:e0182117. [PMID: 28750095 PMCID: PMC5547718 DOI: 10.1371/journal.pone.0182117] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 07/12/2017] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We performed a comprehensive review and meta-analysis to evaluate the diagnostic values of serum single and multiplex tumor-associated autoantibodies (TAAbs) in patients with lung cancer (LC). METHODS We searched the MEDLINE and EMBASE databases for relevant studies investigating serum TAAbs for the diagnosis of LC. The primary outcomes included sensitivity, specificity and accuracy of the test. RESULTS The systematic review and meta-analysis included 31 articles with single autoantibody and 39 with multiplex autoantibodies. Enzyme-linked immunosorbent assay (ELISA) was the most common detection method. For the diagnosis of patients with all stages and early-stage LC, different single or combinations of TAAbs demonstrated different diagnostic values. Although individual TAAbs showed low diagnostic sensitivity, the combination of multiplex autoantibodies offered relatively high sensitivity. For the meta-analysis of a same panel of autoantibodies in patients at all stages of LC, the pooled results of the panel of 6 TAAbs (p53, NY-ESO-1, CAGE, GBU4-5, Annexin 1 and SOX2) were: sensitivity 38% (95% CI 0.35-0.40), specificity 89% (95% CI 0.86-0.91), diagnostic accuracy 65.9% (range 62.5-81.8%), AUC 0.52 (0.48-0.57), while the summary estimates of 7 TAAbs (p53, CAGE, NY-ESO-1, GBU4-5, SOX2, MAGE A4 and Hu-D) were: sensitivity 47% (95% CI 0.34-0.60), specificity 90% (95% CI 0.89-0.92), diagnostic accuracy 78.4% (range 67.5-88.8%), AUC 0.90 (0.87-0.93). For the meta-analysis of the same panel of autoantibodies in patients at early-stage of LC, the sensitivities of both panels of 7 TAAbs and 6 TAAbs were 40% and 29.7%, while their specificities were 91% and 87%, respectively. CONCLUSIONS Serum single or combinations of multiplex autoantibodies can be used as a tool for the diagnosis of LC patients at all stages or early-stage, but the combination of multiplex autoantibodies shows a higher detection capacity; the diagnostic value of the panel of 7 TAAbs is higher than the panel of 6 TAAbs, which may be used as potential biomarkers for the early detection of LC.
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Affiliation(s)
- Zhen-Ming Tang
- Department of Respiratory Medicine, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Zhou-Gui Ling
- Department of Respiratory Medicine, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
- * E-mail: (ZGL); (JLK)
| | - Chun-Mei Wang
- Department of Respiratory Medicine, the People's Hospital of Shenzhen Guangming New District, Shenzhen, China
| | - Yan-Bin Wu
- Institute of Respiratory Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jin-Liang Kong
- Institute of Respiratory Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
- * E-mail: (ZGL); (JLK)
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Lange T, Matthijs O, Jain NB, Schmitt J, Lützner J, Kopkow C. Reliability of specific physical examination tests for the diagnosis of shoulder pathologies: a systematic review and meta-analysis. Br J Sports Med 2016; 51:511-518. [DOI: 10.1136/bjsports-2016-096558] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/03/2022]
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Marks D, Comans T, Bisset L, Scuffham PA. Substitution of doctors with physiotherapists in the management of common musculoskeletal disorders: a systematic review. Physiotherapy 2016; 103:341-351. [PMID: 28801031 DOI: 10.1016/j.physio.2016.11.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 11/19/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is large variation in models-of-care involving the professional substitution of doctors with physiotherapists. OBJECTIVE To establish the impact upon patients and health services, of substituting doctors with physiotherapists in the management of common musculoskeletal disorders. DATA SOURCES Medline, CINAHL and ABI Complete databases, and hand-searching of related studies. STUDY SELECTION Randomised and non-randomised clinical trials, inter-rater reliability and comparative studies comparing the outcomes of usual care from doctors, with outcomes when the doctor was substituted with a physiotherapist. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers evaluated all studies using the Downs and Black Instrument. Meta-analysis was not possible due to study heterogeneity. A descriptive review was undertaken. RESULTS 14 studies of moderate to low quality met the inclusion criteria. Professional substitution with a physiotherapist causes no significant change to health outcomes and inconsistent variation in the use of healthcare resources. There is insufficient health economic data to determine overall efficiency. In the selected presentations studied, physiotherapists made similar diagnostic and management decisions to orthopaedic surgeons and patients are as, or more satisfied with a physiotherapist. LIMITATIONS Further high quality health and economic research is needed, in less selective patient populations, to determine the optimal role for physiotherapists. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS Physiotherapists provide a professional alternative to doctors for musculoskeletal disorders but the health economic implications of this model are presently unclear. Systematic Review Registration Number PROSPERO (Registration number CRD42015027671).
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Affiliation(s)
- Darryn Marks
- Gold Cost Hospital and Health Service, Gold Coast University Hospital, 1 Hospital Boulevard, Southport 4215, Gold Coast, Australia; Menzies Health Institute Queensland, Griffith University, Australia.
| | - Tracy Comans
- Menzies Health Institute Queensland, Griffith University, Australia; Metro North Hospital Health Service, Brisbane, Australia.
| | - Leanne Bisset
- Menzies Health Institute Queensland, Griffith University, Australia.
| | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Australia.
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Décary S, Ouellet P, Vendittoli PA, Desmeules F. Reliability of physical examination tests for the diagnosis of knee disorders: Evidence from a systematic review. ACTA ACUST UNITED AC 2016; 26:172-182. [PMID: 27697691 DOI: 10.1016/j.math.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/12/2016] [Accepted: 09/15/2016] [Indexed: 10/21/2022]
Abstract
Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests.
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Affiliation(s)
- Simon Décary
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada.
| | - Philippe Ouellet
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada.
| | - Pascal-André Vendittoli
- Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada; Department of Surgery, Maisonneuve-Rosemont Hospital, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, University of Montreal Affiliated Hospital, Montreal, Quebec, Canada.
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada.
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Mani S, Sharma S, Omar B, Paungmali A, Joseph L. Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: a systematic review. J Telemed Telecare 2016; 23:379-391. [PMID: 27036879 DOI: 10.1177/1357633x16642369] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose The purpose of this review is to systematically explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders. Method A comprehensive systematic literature review was conducted using a number of electronic databases: PubMed, EMBASE, PsycINFO, Cochrane Library and CINAHL, published between January 2000 and May 2015. The studies examined the validity, inter- and intra-rater reliabilities of TR-based physiotherapy assessment for musculoskeletal conditions were included. Two independent reviewers used the Quality Appraisal Tool for studies of diagnostic Reliability (QAREL) and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool to assess the methodological quality of reliability and validity studies respectively. Results A total of 898 hits were achieved, of which 11 articles based on inclusion criteria were reviewed. Nine studies explored the concurrent validity, inter- and intra-rater reliabilities, while two studies examined only the concurrent validity. Reviewed studies were moderate to good in methodological quality. The physiotherapy assessments such as pain, swelling, range of motion, muscle strength, balance, gait and functional assessment demonstrated good concurrent validity. However, the reported concurrent validity of lumbar spine posture, special orthopaedic tests, neurodynamic tests and scar assessments ranged from low to moderate. Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability, except for lumbar spine posture, orthopaedic special tests, neurodynamic testa and scar assessment.
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Affiliation(s)
- Suresh Mani
- 1 Physiotherapy Program, Universiti Kebangsaan Malaysia, Malaysia
| | - Shobha Sharma
- 2 Speech Sciences Program, Universiti Kebangsaan Malaysia, Malaysia
| | - Baharudin Omar
- 3 Department of Biomedical Science, Universiti Kebangsaan Malaysia, Malaysia
| | - Aatit Paungmali
- 4 School of Physical Therapy, Chiang Mai University, Thailand
| | - Leonard Joseph
- 1 Physiotherapy Program, Universiti Kebangsaan Malaysia, Malaysia
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