The reliability and validity of the weight-bearing lunge test in a Congenital Talipes Equinovarus population (CTEV)

The reliability and validity of joint range of motion measurement using zoom and a smartphone application

[Purpose] This study aimed to evaluate the reliability and validity of measuring the range of motion of joints using a remote videoconferencing system (Zoom) and a smartphone application. [Participants and Methods] This study included 16 young and healthy adults. The participants were instructed to perform shoulder joint flexion exercises in a seated position, with automatic motions, and maintain that posture throughout the measurement. Two measurements were performed: 1) angle measurement using a three-dimensional (3D) motion analyzer, and 2) angle measurement using the videoconference software, Zoom, and a smartphone application. Intra- and inter-rater reliabilities were calculated using the intraclass correlation coefficients (ICC). The degree of agreement between the representative values of each measurer and the 3D motion analyzer was examined. [Results] ICC (1, 1) for intra-examiner reliability were 0.912 and 0.996. For the inter-rater reliability, the ICC (2, 1) was 0.945. The correlation coefficient between each examiner's value and the value of the 3D motion analyzer was 0.955 and 0.980, respectively. The Bland-Altman analysis results indicated no systematic error. [Conclusion] The method of remotely measuring joint range of motion using Zoom and a smartphone application demonstrated high reliability and validity.

Development of the Idiopathic Toe Walking Outcome (iTWO) proforma: A modified delphi study and online parent survey for measurement consensus

BACKGROUND

Idiopathic toe walking (ITW) is an exclusionary diagnosis given when children toe walk without a medical reason. Treatment effectiveness studies rarely collect data other than ankle range of motion or presence of toe walking.

RESEARCH QUESTION

To develop a set of outcome measures identified by health professionals for use when providing treatment with children who have ITW, to understand if parents agreed with this set, and if parents believed they could perform these measures in clinician absence.

METHODS

Study 1 developed consensus and agreement on outcome measures for children receiving treatment for ITW through the modified Delphi technique with 10 expert health professionals. Parents of children who toe walked were invited to participate in an online survey for the second study, in which they were asked to rate the importance of these measures and if they believed they may be able to collect the data about their child without the health professional being present.

RESULTS

Ten health professionals developed nine questions and assessments through consensus and agreement over the three rounds. There were 34 parents providing information about satisfaction with toe walking assessments and treatments. Of these, 27 provide detailed responses about the outcome questions and assessments. The majority (91 % of 24 parents) in support of the outcome measures identified by experts. Parents expressed a willingness to self-complete questions or be taught assessments to monitor their child's progress.

SIGNIFICANCE

Use of these clinically based measures may enable consistent data collection regardless of the setting and provide the foundation for large data pooling in future treatment research.

Reliability of the weight-bearing ankle dorsiflexion range of motion measurement using a smartphone goniometer application

Background

Weight-bearing ankle dorsiflexion range of motion measurement (weight-bearing lunge test) is gaining in popularity because it mimics lower extremity function in daily physical activities. The purpose of the study is to assess the intra-rater and the inter-rater reliability of the weight-bearing ankle dorsiflexion range of motion measurement with a flexed knee using a smartphone application Spirit Level Plus installed on an Android smartphone.

Methods

Thirty-two young, healthy subjects participated in the study and were measured in four sessions by two examiners. One measurement was taken on each ankle in every session. Eight measurements were taken from each participant. A total of 256 were taken from all the participants. The measurements for the individual subject were repeated no sooner than 24 hours after the first session. In order to assess the reliability, intraclass correlation coefficients (ICC), standard error measurements (SEM) and minimal detectable change (MDC) at the 95% confidence interval were calculated.

Results

Statistical data analysis revealed moderate intra-rater reliability for the right ankle (ICC = 0.72, 95% CI [0.49–0.85]) and good intra-rater reliability for the left ankle (ICC = 0.82, 95% CI [0.66–0.91]). Inter-rater reliability is moderate for the right (ICC = 0.73, 95% CI [0.52–0.86]) and the left ankle (ICC = 0.65, 95% CI [0.39–0.81]).

Conclusion

The observed method is moderately reliable and appropriate when the main objective is to assess ankle dorsiflexion mobility in weight-bearing when weight-bearing is not contraindicated. The concurrent validity of the Spirit Level Plus application is excellent.

Reliability of joint position sense measured in the knee using the level function of the iPhone "Measure" application

An impaired joint position sense (JPS) causes activity limitations, postural imbalance, and falls. This study compares the reliability of knee JPS measurements between the iPhone's "Measure" application and VICON motion capture system. Eleven healthy participants were recruited for the study. To conduct the study measures, the blindfolded participant, with an iPhone fixed to the lower non-dominant leg, was seated with their lower limbs in a relaxed position. The examiner held the participant's leg at the target angle (30°/60° from initial position) for 5 s before releasing it. The participant was then instructed to move the leg to the same target angle and hold it for 5 s (replicated angle). Absolute angular error (AAE), i.e., the difference between the target and replicated angles, was measured. Intraclass and Pearson correlation coefficients established statistically significant relationships. The study comprised 6 males and 5 females of mean age 27.6±5.6 years, mean height 1.67±0.10 m, and mean body weight 60.7±10.3 kg. Strong correlations existed between iPhone and VICON 30° (ICC = 0.969, r = 0.960, P < 0.001) and 60° AAEs (ICC 0.969, r = 0.960, P < 0.001). Bland-Altman plots showed a mean difference of 0.43° and 0.20° between the AAE measurements at 30° and 60°, respectively. The iPhone's "Measure" application is a simple and reliable method for measuring JPS in clinical practice and sports/fitness settings.