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Rider JV, Valdes KA. Test-retest reliability of joint position sense in the elbow among healthy adults. J Hand Ther 2024; 37:243-249. [PMID: 37783630 DOI: 10.1016/j.jht.2023.08.015] [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] [Received: 08/11/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Proprioception of the elbow is necessary for daily activities. Proprioception can be impaired with injury or pathology, and rehabilitation efforts seek to improve proprioception for improved upper extremity functioning. In clinical practice, joint position sense (JPS) testing is often utilized to assess conscious proprioception; however, varying methods exist with little evidence of psychometric properties, especially for the elbow. PURPOSE The primary aim of this study was to create a standardized elbow JPS test protocol using goniometry measurement to determine the most reliable testing position. The secondary aim was to determine if the elbow JPS test had acceptable test-retest reliability in healthy adults. STUDY DESIGN This was a cross-sectional study using a convenience sample of healthy adults. METHODS Three elbow positions (45°, 60°, and 75° of elbow flexion) were measured twice on the same day by a single rater using a universal goniometer. We calculated the absolute error in degrees between each position and reposition and the intraclass correlation coefficient (3,1) for relative reliability. We also calculated the standard error of the measurement and visually inspected Bland-Altman plots for absolute reliability. RESULTS Sixty-eight healthy adults (mean age 27.9 years, standard deviation 8.59) were assessed. The mean absolute error for all positions for test and retest was 5.7°. The intraclass correlation coefficients were moderate to good (0.57-0.75), and the standard error of the measurement was 2° (rounded) for all positions. The limits of agreement were moderately narrow, and the Bland-Altman plots showed a random distribution of errors for each position, indicating clinically acceptable measurement error. CONCLUSIONS The joint position reproduction test for JPS using goniometry demonstrated moderate to good test-retest reliability and acceptable measurement error in healthy adults. The elbow joint angle of 60° flexion was the most reliable for JPS testing, providing insight for JPS assessment in clinical practice.
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Affiliation(s)
- John V Rider
- Touro University Nevada, School of Occupational Therapy, Henderson, NV, USA.
| | - Kristin A Valdes
- Touro University Nevada, School of Occupational Therapy, Henderson, NV, USA
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Valdes KA, Rider JV. Test-retest reliability of joint position sense in the carpometacarpal joint among healthy adults. J Hand Ther 2024; 37:238-242. [PMID: 37775433 DOI: 10.1016/j.jht.2023.08.014] [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] [Received: 08/07/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Accurate proprioception in the thumb carpometacarpal (CMC) joint is necessary during activities such as performing fine manipulative tasks, such as coin handling, opening doors, using keys, and pressing control buttons. PURPOSE The primary aim of the present study was to examine the test-retest reliability of CMC joint position sense (JPS) in healthy subjects. The secondary aim was to determine the most reliable JPS testing position for the thumb CMC joint. STUDY DESIGN This was a cross-sectional study of a convenience sample of healthy adults. METHODS Three thumb positions (20°, 30°, and 40° of thumb abduction) were measured twice on the same day by a single rater using a universal goniometer. The absolute error in degrees between each position and reposition was calculated. The intraclass correlation coefficient (2,1) was calculated for relative reliability. The standard error of the measurement was calculated. RESULTS Sixty-four healthy adults (mean age 27.8 years, standard deviation = 8.7) were assessed. The intraclass correlation coefficients were poor (-0.08 to 0.22), and the standard error of the measurement was 1.4° for all positions. CONCLUSIONS The joint position reproduction test for JPS using goniometry demonstrated poor test-retest reliability and acceptable measurement error in healthy adults.
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Affiliation(s)
- Kristin A Valdes
- Touro University Nevada, School of Occupational Therapy, Henderson, NV, USA.
| | - John V Rider
- Touro University Nevada, School of Occupational Therapy, Henderson, NV, USA
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Nazari N, Ansari NN, Naghdi S, Gallego PH, Honarpisheh R. A Clinical Trial Protocol to Compare the Effect of Dry Needling and Acupoint Dry Needling on Wrist Flexor Spasticity after Stroke. J Acupunct Meridian Stud 2022; 15:273-278. [DOI: 10.51507/j.jams.2022.15.4.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/05/2021] [Accepted: 05/05/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Najmeh Nazari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Pablo Herrero Gallego
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Roshanak Honarpisheh
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Tekin F, Can-Akman T, Kitiş A. Evaluation of the validity and reliability of the KFORCE Sens® electrogoniometer in evaluation of wrist proprioception. HAND SURGERY & REHABILITATION 2021; 41:183-188. [PMID: 34974162 DOI: 10.1016/j.hansur.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/11/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the validity and reliability of the KFORCE Sens® electrogoniometer in the evaluation of wrist proprioception. Wrist position sense was assessed on a Baseline® 360° universal goniometer and a KFORCE Sens® device. The validity and reliability of the KFORCE Sens® device for wrist position sense evaluation were investigated by comparing the two data sets. Fifty-three healthy volunteers (39 female, 14 male) with a mean age of 22.83 ± 1.28 years (range, 21-27 years) were included. Joint position sense test-retest reliability (intra-class correlation coefficient) on KFORCE Sens® was "very good" for all wrist movements. There was a very strong correlation between flexion-extension movements on the dominant side (r = 0.955), and a strong correlation between ulnar-radial deviation movements (r = 0.745). There was also a very strong (r = 0.863) correlation between flexion-extension movements on the non-dominant side and a strong correlation (r = 0.690) between ulnar-radial deviation movements (p < 0.05). Our results showed that the KFORCE Sens® device was a valid and reliable evaluation means of assessing wrist position sense.
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Affiliation(s)
- F Tekin
- Pamukkale University, School of Physical Therapy and Rehabilitation, Çamlaraltı District, University Street, Kınıklı Campus, No: 11, 20160, Denizli, Turkey.
| | - T Can-Akman
- Pamukkale University, School of Physical Therapy and Rehabilitation, Çamlaraltı District, University Street, Kınıklı Campus, No: 11, 20160, Denizli, Turkey.
| | - A Kitiş
- Pamukkale University, School of Physical Therapy and Rehabilitation, Çamlaraltı District, University Street, Kınıklı Campus, No: 11, 20160, Denizli, Turkey.
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Sabbah A, El Mously S, Elgendy HHM, Farag MAAE, Elwishy AAB. Functional outcome of joint mobilization added to task-oriented training on hand function in chronic stroke patients. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00170-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Approximately half of stroke patients show impaired upper limb and hand function. Task-oriented training focuses on functional tasks, while joint mobilization technique aims to restore the accessory movements of the joints.
Objective
To investigate the effect of adding joint mobilization to task-oriented training to help the patients in reaching a satisfactory level of recovery for their hand function.
Patients and methods
Thirty chronic stroke patients with paretic hand participated in the study; they were divided equally into study and control groups. The study group received joint mobilization followed by task-oriented training for the affected hand. Meanwhile, the control group received task-oriented training only. Both groups received their treatment in the form of 3 sessions per week for 6 successive weeks. The primary outcome measures were hand function that was assessed by Jebsen-Taylor hand function test (JTT) and active and passive wrist extension range of motion (ROM) that was measured by a standard goniometer. The secondary outcome measure was the grip strength of the hand that was assessed by a JAMAR adjustable hand dynamometer.
Results
There was a significant improvement in all the outcome measurements in both groups that were more evident in the study group.
Conclusion
Combining joint mobilization with task-oriented training had a highly significant effect in improving the hand function in chronic stroke patients compared to task-oriented training alone.
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Larouche MC, Camiré Bernier S, Racine R, Collin O, Desmons M, Mailloux C, Massé-Alarie H. Stretch-induced hypoalgesia: a pilot study. Scand J Pain 2020; 20:837-845. [PMID: 32881712 DOI: 10.1515/sjpain-2020-0018] [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] [Received: 01/23/2020] [Accepted: 07/10/2020] [Indexed: 01/07/2023]
Abstract
Objectives Stretching is an intervention often used in various kinds of rehabilitation protocols and the effects on pain sensitivity has sparsely been investigated, especially when addressing potential effects on pain. The objective is to investigate the immediate effects of an axial and peripheral prolonged stretch on pressure pain sensitivity (PPT) and temporal summation (TS) on local and distal sites in healthy subjects. Methods Twenty-two healthy volunteers were recruited to participate in this pilot study. Two prolonged stretching protocols were performed: low back and wrist extensors stretches. PPT and pinprick TS were measured pre- and post-intervention at local and remote sites. Repeated measures analysis of variance (ANOVA) was used to examine the effects and significance of the interventions. Results The low back stretch induced an increase in PPT for both local and remote sites, and the wrist stretch produced a PPT increase only at the local site. TS did not change. Conclusions Low back stretching induced an increase in PPT at both local and remote sites whereas the wrist stretch only increased PPT locally, suggesting hypoalgesia at these sites. Further studies are needed to confirm the effect and mechanisms using randomised, controlled and parallel study design. Considering that pain sensitivity is different than clinical pain, results are difficult to extrapolate to clinical practice. Future studies testing clinical pain are needed to better understand the clinical implication of these results.
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Affiliation(s)
| | | | - Rosalie Racine
- McGill University, School of Occupational and Physical Therapy, Montreal, Canada
| | - Olivier Collin
- McGill University, School of Occupational and Physical Therapy, Montreal, Canada
| | - Mikaël Desmons
- Cirris research centre, Université Laval, Quebec City, Canada
| | | | - Hugo Massé-Alarie
- Cirris research centre, Université Laval, Quebec City, Canada.,Rehabilitation Unit, Université Laval, Quebec City, Canada
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Smedes F, Giacometti da Silva L. Motor learning with the PNF-concept, an alternative to constrained induced movement therapy in a patient after a stroke; a case report. J Bodyw Mov Ther 2019; 23:622-627. [DOI: 10.1016/j.jbmt.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/12/2018] [Accepted: 05/26/2018] [Indexed: 11/28/2022]
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El-Nashar H, ElWishy A, Helmy H, El-Rwainy R. Do core stability exercises improve upper limb function in chronic stroke patients? THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0087-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Marcuzzi A, Wainwright AC, Costa DSJ, Wrigley PJ. Vibration testing: Optimizing methods to improve reliability. Muscle Nerve 2018; 59:229-235. [PMID: 30390398 DOI: 10.1002/mus.26373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/07/2022]
Abstract
INTRODUCTION In this study we assessed the test-retest reliability of a Rydel-Seiffer tuning fork and an electronic vibrameter with hand-held and fixed probes. METHODS Fifty healthy volunteers were assessed twice in the upper and lower limb 15 minutes apart. Reliability was assessed by intraclass correlation coefficient (ICC) and standard error of measurement (SEM). The effect of stimulus parameters on vibration disappearance threshold (VDT) was assessed by analysis of variance. RESULTS All 3 tools showed good reliability (ICCs = 0.65-0.95). Vibrameter recordings with the fixed probe showed high variability. The vibrameter was more sensitive in detecting body-site and age differences in vibration thresholds than the tuning fork. Significantly higher VDT was observed when higher starting amplitudes and slower rates of change were used. DISCUSSION The hand-held vibrameter is a superior tool to monitor vibration sense. The stimulus amplitude and rate of change are important to control as they alter VDT. Muscle Nerve 59:229-235, 2019.
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Affiliation(s)
- Anna Marcuzzi
- Pain Management Research Institute, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alan C Wainwright
- Pain Management Research Institute, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Daniel S J Costa
- Pain Management Research Institute, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Paul J Wrigley
- Pain Management Research Institute, Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Pilbeam C, Hood-Moore V. Test–retest reliability of wrist joint position sense in healthy adults in a clinical setting. HAND THERAPY 2018. [DOI: 10.1177/1758998318770227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Introduction Proprioceptive assessments of the wrist inform clinical decision making. In wrist rehabilitation, joint position sense has emerged as one way of assessing conscious proprioception with varying methods and minimal psychometric analysis reported. The purpose of this study was to standardise the wrist joint position sense test method for clinical use and to determine its test–retest reliability in a healthy population. Methods Four wrist positions (20° and 45° flexion, 20° and 45° extension) were measured twice in a random order, by a single rater, using a universal goniometer on the same day. The absolute error in degrees between each position and reposition was calculated. For relative reliability analysis, the intraclass correlation coefficient (3,1) was calculated. For absolute reliability the standard error of the measurement was calculated and Bland–Altman plots visually inspected. Results Fifty-five healthy volunteers (mean age 31.1 SD±10.25 years) were assessed. The mean absolute error, summarised for all positions for test and retest, was 3.98°. The intraclass correlation coefficients were poor to fair (0.07–0.47), and standard error of the measurement was 2° (rounded) for all positions. The limits of agreement were fairly narrow, and the Bland–Altman plots showed random distribution of errors for each position, therefore the measurement error was clinically acceptable. Conclusions The active wrist joint position sense test using goniometry demonstrated poor to fair test–retest reliability and acceptable measurement error in healthy volunteers. The wrist joint position sense angle of 20° flexion was the most reliable.
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Affiliation(s)
- Chloë Pilbeam
- Pulvertaft Hand Centre, Royal Derby Hospital, Derby, UK
- Rheumatology Department, Royal Derby Hospital, Derby, UK
| | - Victoria Hood-Moore
- Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK
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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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Khamwong P, Paungmali A, Pirunsan U, Joseph L. Prophylactic Effects of Sauna on Delayed-Onset Muscle Soreness of the Wrist Extensors. Asian J Sports Med 2015; 6:e25549. [PMID: 26446307 PMCID: PMC4592767 DOI: 10.5812/asjsm.6(2)2015.25549] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 02/07/2015] [Accepted: 02/17/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND High-intensity of exercise or unaccustomed eccentric exercise can cause the phenomenon of Exercise-Induced Muscle Damage (EIMD) which usually results in cramps, muscle strain, impaired muscle function and delayed-onset muscle soreness. OBJECTIVES This study investigated the prophylactic effects of sauna towards the symptoms associated with muscle damage from eccentric exercises of wrist extensor muscle group. PATIENTS AND METHODS A total of twenty-eight subjects (mean age 20.9 years old, SD = 1.6) were randomly divided into the sauna group (n = 14) and the control group (n = 14). In the sauna group, subjects received sauna before eccentric exercise of the wrist extensor. The eccentric exercises were conducted on the non-dominant arm by using an isokinetic dynamometer. Pain Intensity (PI), Pressure Pain Threshold (PPT) and passive range of motion of wrist flexion (PF-ROM) and extension (PE-ROM) were measured as pain variables. Grip Strength (GS) and Wrist Extension Strength (WES) were measured as variables of wrist extensor muscle function. All the measurements were performed at baseline, immediately after and from 1st to 8th days after the exercise-induced muscle damage. RESULTS The sauna group significantly demonstrated a lower deficit in ROM (passive flexion and passive extension), GS and WES following exercise than that of the control group (P < 0.05). CONCLUSIONS Sauna application prior to the exercise-induced muscle damage demonstrated effectiveness in reduction of sensory impairment (PF-ROM and PE-ROM) and improvement of muscle functions (GS, and WES) in wrist extensor muscle group.
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Affiliation(s)
- Peanchai Khamwong
- Department of Physical Therapy, Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Aatit Paungmali
- Department of Physical Therapy, Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
- Corresponding author: Aatit Paungmali, Department of Physical Therapy, Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand. Tel: +66-53949246, E-mail:
| | - Ubon Pirunsan
- Department of Physical Therapy, Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
| | - Leonard Joseph
- Department of Physical Therapy, Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand
- Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Donaghy A, DeMott T, Allet L, Kim H, Ashton-Miller J, Richardson JK. Accuracy of Clinical Techniques for Evaluating Lower Limb Sensorimotor Functions Associated With Increased Fall Risk. PM R 2015; 8:331-339. [PMID: 26409195 DOI: 10.1016/j.pmrj.2015.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 08/03/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND In prior work, laboratory-based measures of hip motor function and ankle proprioceptive precision were critical to maintaining unipedal stance and fall/fall-related injury risk. However, the optimal clinical evaluation techniques for predicting these measures are unknown. OBJECTIVE To evaluate the diagnostic accuracy of common clinical maneuvers in predicting laboratory-based measures of frontal plane hip rate of torque development (Hip(RTD)) and ankle proprioceptive thresholds (AnkPRO) associated with increased fall risk. DESIGN Prospective, observational study. SETTING Biomechanical research laboratory. PARTICIPANTS A total of 41 older subjects (aged 69.1 ± 8.3 years), 25 with varying degrees of diabetic distal symmetric polyneuropathy and 16 without. ASSESSMENTS Clinical hip strength was evaluated by manual muscle testing (MMT) and lateral plank time, defined as the number of seconds that the laterally lying subject could lift the hips from the support surface. Foot/ankle evaluation included Achilles reflex and vibratory, proprioceptive, monofilament, and pinprick sensations at the great toe. MAIN OUTCOME MEASURES Hip(RTD), abduction and adduction, using a custom whole-body dynamometer. AnkPRO determined with subjects standing using a foot cradle system and a staircase series of 100 frontal plane rotational stimuli. RESULTS Pearson correlation coefficients (r) and receiver operator characteristic (ROC) curves revealed that LPT correlated more strongly with Hip(RTD) (r/P = 0.61/<.001 and 0.67/<.001, for abductor/adductor, respectively) than did hip abductor MMT (r/P = 0.31/.044). Subjects with greater vibratory and proprioceptive sensation, and intact Achilles reflexes, monofilament, and pin sensation had more precise AnkPRO. LPT of <12 seconds yielded a sensitivity/specificity of 91%/80% for identifying Hip(RTD) < 0.25 (body size in Newton-meters), and vibratory perception of <8 seconds yielded a sensitivity/specificity of 94%/80% for the identification of AnkPRO >1.0°. CONCLUSIONS LPT is a more effective measure of Hip(RTD) than MMT. Similarly, clinical vibratory sense and monofilament testing are effective measures of AnkPRO, whereas clinical proprioceptive sense is not.
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Affiliation(s)
- Alex Donaghy
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI(∗)
| | - Trina DeMott
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI(†)
| | - Lara Allet
- University of Applied Sciences, Geneva, Switzerland(‡)
| | - Hogene Kim
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI(§)
| | - James Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI(‖)
| | - James K Richardson
- Department of Physical Medicine and Rehabilitation, University of Michigan Health System, 325 East Eisenhower Pkwy, Ann Arbor, MI 48108(¶).
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Day-to-day reliability of pressure pain threshold and pain ratings in college-aged men. Int J Rehabil Res 2015; 38:213-8. [DOI: 10.1097/mrr.0000000000000111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Smedes F, van der Salm A, Koel G, Oosterveld F. Manual mobilization of the wrist: a pilot study in rehabilitation of patients with a chronic hemiplegic hand post-stroke. J Hand Ther 2015; 27:209-15; quiz 216. [PMID: 24508316 DOI: 10.1016/j.jht.2013.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 12/11/2013] [Accepted: 12/30/2013] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Prospective pilot cohort study, quasi-experimental design. INTRODUCTION Restricted hand mobility, limitation in activities and participation, due to relative immobilization of the hemiplegic hand are frequently reported after stroke. PURPOSE OF THE STUDY To establish whether manual mobilization of the wrist has an additional value in the treatment of the hemiplegic hand. METHODS Eighteen patients received treatment twice a week for a period of 6 weeks. Both treatment groups received therapy based upon the Dutch guidelines for stroke. In the intervention group, a 10-min manual mobilization of the wrist was integrated. The primary outcomes were active and passive wrist mobility and activity limitation. The secondary outcomes were spasticity, grip strength, and pain. Data were collected at 0, 6 and 10 weeks. Statistical analysis was performed using the Friedman's test, related t-test, Wilcoxon test, independent t-test, and Mann-Whitney U-test. RESULTS Statistically significant differences were found in the intervention group; between T0 and T2 measurements in active wrist extension (+18°; p < 0.001), in passive wrist extension (+15°; p < 0.001), and in the Frenchay Arm Test (+2 points, 18%; p = 0.038). This significant improvement was not found in the control group. Statistically significant differences were found between the two groups in active and passive wrist extension (p < 0.001; p = 0.002), as well as a change in Frenchay Arm Test (p = 0.01). CONCLUSION This study suggests that manual mobilization of the wrist has a positive influence on the recovery of the hemiplegic hand. Replication of the results is needed in a large scale randomized controlled trial. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Fred Smedes
- Saxion University of Applied Sciences, Department of Physical Therapy, Enschede, the Netherlands; Practice for Physical Therapy, Losser, the Netherlands.
| | - Arjan van der Salm
- Saxion University of Applied Sciences, Expertise Centre for Health, Social Care & Technology, Enschede, the Netherlands
| | - Gerard Koel
- Saxion University of Applied Sciences, Expertise Centre for Health, Social Care & Technology, Enschede, the Netherlands; Practice for Physical Therapy-Wooldersteen, Hengelo, the Netherlands
| | - Frits Oosterveld
- Saxion University of Applied Sciences, Expertise Centre for Health, Social Care & Technology, Enschede, the Netherlands
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Gerhardsson L, Gillström L, Hagberg M. Test-retest reliability of neurophysiological tests of hand-arm vibration syndrome in vibration exposed workers and unexposed referents. J Occup Med Toxicol 2014; 9:38. [PMID: 25400687 PMCID: PMC4232643 DOI: 10.1186/s12995-014-0038-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/22/2014] [Indexed: 11/12/2022] Open
Abstract
Background Exposure to hand-held vibrating tools may cause the hand-arm vibration syndrome (HAVS). The aim was to study the test-retest reliability of hand and muscle strength tests, and tests for the determination of thermal and vibration perception thresholds, which are used when investigating signs of neuropathy in vibration exposed workers. Methods In this study, 47 vibration exposed workers who had been investigated at the department of Occupational and Environmental Medicine in Gothenburg were compared with a randomized sample of 18 unexposed subjects from the general population of the city of Gothenburg. All participants passed a structured interview, answered several questionnaires and had a physical examination including hand and finger muscle strength tests, determination of vibrotactile (VPT) and thermal perception thresholds (TPT). Two weeks later, 23 workers and referents, selected in a randomized manner, were called back for the same test-procedures for the evaluation of test-retest reliability. Results The test-retest reliability after a two week interval expressed as limits of agreement (LOA; Bland-Altman), intra-class correlation coefficients (ICC) and Pearson correlation coefficients was excellent for tests with the Baseline hand grip, Pinch-grip and 3-Chuck grip among the exposed workers and referents (N = 23: percentage of differences within LOA 91 – 100%; ICC-values ≥0.93; Pearson r ≥0.93). The test-retest reliability was also excellent (percentage of differences within LOA 96–100 %) for the determination of vibration perception thresholds in digits 2 and 5 bilaterally as well as for temperature perception thresholds in digits 2 and 5, bilaterally (percentage of differences within LOA 91 – 96%). For ICC and Pearson r the results for vibration perception thresholds were good for digit 2, left hand and for digit 5, bilaterally (ICC ≥ 0.84; r ≥0.85), and lower (ICC = 0.59; r = 0.59) for digit 2, right hand. For the latter two indices the test-retest reliability for the determination of temperature thresholds was lower and showed more varying results. Conclusion The strong test-retest reliability for hand and muscle strength tests as well as for the determination of VPTs makes these procedures useful for diagnostic purposes and follow-up studies in vibration exposed workers.
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Affiliation(s)
- Lars Gerhardsson
- Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, University of Gothenburg, Medicinaregatan 16, Box 414, SE-405 30 Gothenburg, Sweden
| | - Lennart Gillström
- Company Health Service, Volvo Powertrain Corporation, SE-541 36 Skovde, Sweden
| | - Mats Hagberg
- Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, University of Gothenburg, Medicinaregatan 16, Box 414, SE-405 30 Gothenburg, Sweden
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Khamwong P, Nosaka K, Pirunsan U, Paungmali A. Prophylactic effect of hot pack on symptoms of eccentric exercise-induced muscle damage of the wrist extensors. Eur J Sport Sci 2012. [DOI: 10.1080/17461391.2011.566359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Paungmali A, Sitilertpisan P, Taneyhill K, Pirunsan U, Uthaikhup S. Intrarater reliability of pain intensity, tissue blood flow, thermal pain threshold, pressure pain threshold and lumbo-pelvic stability tests in subjects with low back pain. Asian J Sports Med 2012; 3:8-14. [PMID: 22461960 PMCID: PMC3307961 DOI: 10.5812/asjsm.34718] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 06/12/2011] [Indexed: 12/12/2022] Open
Abstract
Purpose This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain. Methods Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen's Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P>0.05). Results ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level. Conclusions It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error.
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Affiliation(s)
- Aatit Paungmali
- Neuro-Musculoskeletal and Pain Research Unit, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- Corresponding Author: Address: Neuro-Musculoskeletal and Pain Research Unit, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand 50200. E-mail:
| | - Patraporn Sitilertpisan
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Khanittha Taneyhill
- Neuro-Musculoskeletal and Pain Research Unit, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ubon Pirunsan
- Neuro-Musculoskeletal and Pain Research Unit, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sureeporn Uthaikhup
- Neuro-Musculoskeletal and Pain Research Unit, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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