Remote Assessment of Wrist Range of Motion: Inter- and Intra-Observer Agreement of Provider Estimation and Direct Measurement With Photographs and Tracings

2019 ◽  
Vol 44 (11) ◽  
pp. 954-965 ◽  
Author(s):  
Kelly L. Scott ◽  
Cecelia M. Skotak ◽  
Kevin J. Renfree
Keyword(s):  
Range Of Motion ◽  
Direct Measurement ◽  
Observer Agreement ◽  
Remote Assessment

Telemedicine in long-term care of glaucoma patients

2018 ◽  
Vol 26 (1-2) ◽  
pp. 92-99 ◽  
Author(s):  
Jamie L Odden ◽  
Cheryl L Khanna ◽  
Clara M Choo ◽  
Bingying Zhao ◽  
Saumya M Shah ◽  
...  
Keyword(s):  
Real Life ◽  
Observer Agreement ◽  
Kappa Statistics ◽  
Term Care ◽  
Glaucoma Progression ◽  
Remote Assessment ◽  
Clinical Detail ◽  
Clinic Practice

Introduction This manuscript describes data from an original study, simulating a tele-glaucoma programme in an established clinic practice with an interdisciplinary team. This is a ‘real life’ trial of a telemedicine approach to see a follow-up patient. The goal is to evaluate the accuracy of such a programme to detect worsening and/or unstable disease. Such a programme is attractive since in-clinic time could be reduced for both the patient and provider. This study evaluates agreement between in-person and remote assessment of glaucoma progression. Methods A total of 200 adult glaucoma patients were enrolled at a single institution. The in-person assessment by an optometrist or glaucoma specialist at time of enrolment was used as the gold standard for defining progression. Collated clinical data were then reviewed by four masked providers who classified glaucoma as progression or non-progression in each eye by comparing data from enrolment visit to data from the visit immediately prior to enrolment. Agreement of glaucoma progression between the masked observer and the in-person assessment was determined using Kappa statistics. Intra-observer agreement was calculated using Kappa to compare in-person to remote assessment when both assessments were performed by the same provider ( n = 279 eyes). Results A total of 399 eyes in 200 subjects were analysed. Agreement between in-person versus remote assessment for the determination of glaucoma progression was 63%, 62%, 69% and 68% for each reader 1–4 (kappa values = 0.19, 0.20, 0.35 and 0.33, respectively). For intra-observer agreement, reader 1 agreed with their own in-person assessment for 65% of visits (kappa = 0.18). Discussion Intra-observer agreement was similar to the agreement for each provider who did not see the patient in person. This similarity suggests that telemedicine may be equally effective at identifying glaucomatous disease progression, regardless of whether the same provider performed both in-clinic and remote assessments. However, fair agreement levels highlight a limitation of using only telemedicine data to determine progression compared with clinical detail available during in-patient assessment.

A Method of two-Dimensional Measurement for Evaluating Finger Motion Impairment

1995 ◽  
Vol 20 (5) ◽  
pp. 691-695 ◽  
Author(s):  
H-Y. CHIU
Keyword(s):  
Range Of Motion ◽  
Direct Measurement ◽  
Conventional Method ◽  
Muscle Injury ◽  
New Method ◽  
Two Dimensional ◽  
Dimensional Measurement ◽  
Finger Motion ◽  
Contraction And Relaxation ◽  
Dimensional Range

A new method has been designed for direct measurement of the two-dimensional range of motion (ROM) of the finger. The two-dimensional method encompasses the postures imposed by various combinations of contraction and relaxation of the finger motors, so that an individual muscle injury or adhesion might be more easily detected. The figures and values obtained from the two-dimensional method are easier to interpret than those from conventional measurements, making the progress of the rehabilitated finger more apparent. Since the passive ROM cannot be evaluated by this method, it is a supplement rather than a substitution for the conventional range of motion evaluation for each joint. The drawback of the two-dimensional method is that it is more difficult to use than the conventional method.

scholarly journals Design and Construction of a Bilateral Haptic System for the Remote Assessment of the Stiffness and Range of Motion of the Hand

2016 ◽  
Author(s):  
Fabio Oscari ◽  
Roberto Oboe ◽  
Omar Daud ◽  
Stefano Masiero ◽  
Giulio Rosati
Keyword(s):  
Range Of Motion ◽  
Clinical Tests ◽  
Medical Assessment ◽  
Haptic System ◽  
Rehabilitation Centers ◽  
Remote Assessment ◽  
Recorded Data ◽  
Clinical Conditions ◽  
Assessment Scales ◽  
Standard Framework

The use of haptic devices in rehabilitation of impaired limbs has become rather popular, given the proven effectiveness in promoting recovery. In a standard framework, such devices are used in rehabilitation centers, where patients interact with virtual tasks, presented on a screen. To track their sessions, kinematic/dynamic parameters or performance scores are recorded. However, as Internet access is now available at almost every home, and in order to reduce the hospitalization time of the patient, the idea of doing rehabilitation at home is gaining wide consent. Medical care programs can be synchronized with the home rehabilitation device; patient data can be sent to the central server that could redirect to the therapist laptop (tele-healthcare). The controversial issue is that the recorded data do not actually represent the clinical conditions of the patients according to the medical assessment scales, forcing them to frequently undergo clinical tests at the hospital. To respond to this demand, we propose the use of a bilateral master/slave haptic system that could allow the clinician, who interacts with the master, to assess remotely and in real time the clinical conditions of the patient that uses the home rehabilitation device as the slave. In this paper, we describe a proof of concept to highlight the main issues of such an application, limited to one degree of freedom, and to the measure of the stiffness and range of motion of the hand.

scholarly journals Design and Construction of a Bilateral Haptic System for the Remote Assessment of the Stiffness and Range of Motion of the Hand

Sensors ◽  
2016 ◽  
Vol 16 (10) ◽  
pp. 1633 ◽  
Author(s):  
Fabio Oscari ◽  
Roberto Oboe ◽  
Omar Daud Albasini ◽  
Stefano Masiero ◽  
Giulio Rosati
Keyword(s):  
Range Of Motion ◽  
Haptic System ◽  
Remote Assessment ◽  
Design And Construction

Observer Agreement on Disfluency and Stuttering

1981 ◽  
Vol 24 (4) ◽  
pp. 595-600 ◽  
Author(s):  
Richard F. Curlee
Keyword(s):  
Graduate Student ◽  
Adult Male ◽  
Observer Agreement

Groups of undergraduate and graduate stndent listeners identified the stutterings and disfluencies of eight adult male stutterers during videotaped samples of their reading and speaking. Stuttering and disfluency loci were assigned to words or to intervals between words. The data indicated that stuttering and disfluency are not two reliable and unambiguous response classes and are not usually assigned to different, nonoverlapping behaviors. Furthermore, judgments of stuttering and disfluency were distributed similarly across words and intervals. For both undergraduate and graduate student listeners, there was relatively low unit-by-unit agreement among listeners and within the same listeners from one judgment session to another.

Direct Measurement of the Listening of Hearing-Impaired Children

1970 ◽  
Vol 13 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Mary Mira
Keyword(s):  
Direct Measurement ◽  
Continuous Measurement ◽  
Hearing Impaired ◽  
Reinforcement System ◽  
School Aged Children ◽  
Conjugate Reinforcement ◽  
Impaired Children ◽  
Hearing Impaired Children

Listening, a significant dimension of the behavior of hearing-impaired children, may be measured directly by recording childrens' responses to obtain audio narrations programmed via a conjugate reinforcement system. Twelve hearing-impaired, school-aged children responded in varying ways to the opportunity to listen. Direct and continuous measurement of listening has relevance for evaluation of remediation methods and for discovery of variables potentially related to listening.

Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Disk Herniation ◽  
Fourth Edition ◽  
Recurrent Injury ◽  
Injury Model ◽  
Whole Person ◽  
Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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