Reliability and validity of the trunk position sense and modified functional reach tests in individuals after stroke

The psychometric qualities of the proprioception and dynamic trunk control tests have rarely been studied in individuals after stroke.

OBJECTIVE

To investigate the reliability and validity of the Trunk Position Sense Test (TPS) and Modified Functional Reach Test (MFRT) in persons after stroke.

METHODS

Thirty-two participants were included. The TPS and MFRT were assessed by two physiotherapists during a first session. After resting, a second session was conducted. The intraclass correlation coefficient (ICC) was calculated to assess the test-retest (ICC3,k) and inter-rater reliability (ICC2,k). Pearson correlations coefficients were calculated between TPS/MFRT performances and clinical tests (trunk strength, Timed Up and Go and Balance Assessment in Sitting and Standing Positions - BASSP).

RESULTS

The TPS inter-rater reliability was good for vertical error (ICC = 0.75 [0.50-0.88]) while it was moderate for horizontal error (ICC = 0.48 [0.10-0.75]) as well as for test-retest reliability (0.39 ≤ ICC ≤ 0.59). As for the MFRT, inter-rater (0.76 ≤ ICC ≤ 0.90) and test-retest reliability (0.71 ≤ ICC ≤ 0.91) were good to excellent for anterior, paretic et non-paretic displacements. Horizontal errors for the TPS (-0.26 ≤ r ≤ -0.36) and anterior MFRT (0.38 ≤ r ≤ 0.64) values correlated moderately with trunk strength.

CONCLUSION

The MFRT is a reliable test for persons after stroke with trunk control impairments. The TPS does not appear to be relevant for post-stroke individuals. This can be explained by the fact that its procedure is not easily applied for individuals after stroke - who may have significant motor and cognitive impairments.

Validity and reliability of center of pressure measures to quantify trunk control ability in individuals after stroke in subacute phase during unstable sitting test

Objective

The objective of this study was to assess, for individuals with hemiparesis after a stroke in subacute phase, the validity and reliability of center of pressure (CoP) parameters measured during sitting balance on an unstable support.

Materials and methods

Thirty-two individuals after stroke were included in this observational study for validity and reliability (mean age: 64.34 ± 9.30y, 23 men, mean post-stroke duration: 55.64 ± 27days). Intra-Class Correlation (ICC) and Bland Altman plot assessed intra-rater reliability and inter-rater reliability of CoP parameters during unstable sitting balance test (anteroposterior or mediolateral imbalance). Validity was established by correlating CoP parameters with the Modified Functional Reach Test, trunk strength, Balance Assessment in Sitting and Standing and Timed Up and Go tests.

Results

The findings highlighted significant correlations between CoP parameters and trunk strength for anteroposterior seated destabilization. Good to excellent intra and inter-rater reliability (0.87 ≤ ICC ≤ 0.95) was observed for all CoP length parameters and CoP mean velocity in both mediolateral and anteroposterior imbalance conditions. CoP parameters for mediolateral unstable sitting condition were more reliable than for anteroposterior instability.

Conclusion

Trunk control assessment during unstable sitting position on a seesaw is a reliable test for assessing trunk control ability in individuals after a stroke. CoP length and mean velocity are found to be the best parameters.

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Center of pressure values during anteroposterior perturbation is related to trunk strength.

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Center of pressure length parameters have excellent intra-rater and inter-rater reliability in individuals after a stroke in subacute phase.

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The reliability is better when the sitting instability is in mediolateral direction.

Metabolism of arsenic by sheep chronically exposed to arsenosugars as a normal part of their diet. 1. Quantitative intake, uptake, and excretion

Information on the effects of long-term organoarsenical consumption by mammals is limited despite the fact that foodstuffs, especially seafood, often contain organoarsenicals at very high concentrations. Here we evaluate the intake, uptake, and excretion (urine and feces) of arsenic by sheep that live on North Ronaldsay in the Orkney Islands and naturally consume large amounts of arsenosugars through their major food source-seaweed. The sheep eat a broad variety of seaweed species, and arsenic concentrations were determined in all the species observed eaten by the sheep (5.7-74.0 mg kg(-1) dry mass). Because of preference and availability, they feed mostly on the seaweed species found to contain the highest arsenic concentrations: Laminaria digitata and Laminaria hyperborea (74 +/- 4 mg kg(-1) dry mass). To quantify the arsenic intake by the sheep, a feeding experiment reflecting natural conditions as close as possible was set up. In the feeding trial, the average daily intake of arsenic by 12 ewes was 35 +/- 6 mg (97% of water-extractable arsenic was present as arsenosugars) gained from feeding on the two brown algae. To test the possible influence of microflora on the metabolism of arsenosugars, six of the sheep were adapted to feeding on grass for 5 months before the start of the trial (control sheep), and the remaining six sheep were kept on their normal seaweed diet (wild sheep). No significant difference in seaweed/arsenic intake and arsenic excretion was found between the two groups of sheep. The arsenic excreted in the feces represents 13 +/- 10% (n = 12) of the total consumed, and on the assumption of that, the average urinary excretion is estimated to 86%.The main arsenic metabolite excreted in urine was dimethylarsinic acid (DMA(V)) (60 +/- 22%) and minor amounts of dimethylarsinoylethanol (DMAE), methylarsonic acid (MA(V)),tetramethylarsonium ion (TMA+), and arsenate (As(V)) together with seven unknown arsenic compounds were also excreted. The urinary arsenic excretion pattern showed a lag period (>4 h) before significant quantities appeared in the urine, an excretion rate that peaked between 4 and 28 h after seaweed intake and a relatively slow half-life (17 h) after end of intake.

Quantitative determination of DNA adducts using liquid chromatography/electrospray ionization mass spectrometry and liquid chromatography/high-resolution inductively coupled plasma mass spectrometry

The quantitative determination of nucleotides from DNA modified by styrene oxide is described using a combination of inductively coupled plasma high-resolution mass spectrometry (ICP-HRMS) and electrospray ionization mass spectrometry (ESI-MS), both interfaced to reversed-phase high-performance liquid chromatography (HPLC). LC/ICP-MS (resolution > 1500 to discriminate against 15N16O+ and 14N16OH+) was employed to determine quantitatively the content of modified nucleotides in standard solutions based on the signal of phosphorus; phosphoric acid served as an internal standard. By means of the standard addition technique the sensitivity of the LC/ESI-MS approach was subsequently determined. Since a comparison of UV, ICP and ESI-MS data suggested that in ESI-MS the ionization efficiency of the adducts is identical within the error limits, quantitative determination of all adducts is possible. For LC/ESI-MS with single ion monitoring, the detection limit for styrene oxide adducts of nucleotides was determined to be 20 pg absolute or 14 modified in 10(8) unmodified nucleotides in a 5 micrograms DNA sample, which comes close to the best methods available for the detection of chemical modifications in DNA.

Occlusal changes from adolescence to adulthood in untreated patients with Class II Division 1 deepbite malocclusion

A sample of 47 untreated children (M 32:F 15) with Class II Division 1 (II/1) deep-overbite malocclusion was collected from a group of patients who declined orthodontic therapy. Longitudinal records consisted of plaster dental casts and lateral cephalograms at original diagnosis and plaster dental casts at a follow-up observation in adulthood, an average of 11.5 years later. To study retrospectively natural changes in dental occlusion during this interval, plaster-cast millimetric measurements were recorded of sagittal dental relationships (first molar and canine), overjet, overbite, and crowding/spacing at the two registrations. Results showed statistically significant improvements in untreated II/1 deepbite malocclusion from adolescence to adulthood for all measured occlusal variables except development of mild crowding. Therefore, assumptions that untreated II/1 distoclusion will worsen with age appear to be unfounded. The evidence indicates that the absence of orthodontic correction for adolescent patients with Class II Division 1 deepbite malocclusion will not usually lead to measurable occlusal deterioration in young adulthood.