Validity and Reliability of a New Assessment of Lower-Extremity Dysfunction

We identified biomechanical variables indicative of lower extremity dysfunction, distinct from age-related gait adaptations, and examined interrelationships among these variables to better understand the neuromuscular adaptations in gait. Sagittal plane ankle, knee, and hip peak angles, moments, and powers and spatiotemporal parameters were acquired during preferred-speed gait in 120 subjects: 45 healthy young, 37 healthy elders, and 38 elders with functional limitations due to lower extremity musculoskeletal pathology, primarily arthritis. Multiple analysis of covariance with discriminate analysis, adjusted for gait speed, was used to identify the variables discriminating groups. Correlation analysis was used to explore interrelationships among these variables within each group. Healthy elders were discriminated (sensitivity 76%, specificity 82%) from young adults via decreased late-stance ankle plantar flexion angle, increased late-stance knee power absorption, and early-stance hip extensor power generation. Disabled elders were discriminated (sensitivity 74%, specificity 73%) from healthy elders via decreased late-stance ankle plantar flexor moment and power generation, increased early-stance ankle dorsiflexor moment, and late-stance hip flexor moment and power absorption. Relationships among variables showed a higher degree of coupling for the disabled elders compared with the healthy groups, suggesting a reduced ability to alter motor strategies. Our data suggest that, beyond age-related changes, elders with lower extremity dysfunction rely excessively on passive action of hip flexors to provide propulsion in late stance and contralateral ankle dorsiflexors to enhance stability. These findings support a growing body of evidence that gait changes with age and disablement have a neuromuscular basis, which may be informative in a motor control framework for physical therapy interventions.

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Validity and Reliability of a Smartphone and Digital Inclinometer in Measuring the Lower Extremity Joints Range of Motion

Montenegrin Journal of Sports Science and Medicine ◽

10.26773/mjssm.210907 ◽

2021 ◽

Vol 10 (2) ◽

pp. 47-52

Author(s):

Walaa S. Mohammad ◽

◽

Faten F. Elattar ◽

Walaa M. Elsais ◽

Salameh O. AlDajah ◽

...

Keyword(s):

Lower Extremity ◽

Range Of Motion ◽

Sagittal Plane ◽

Low Cost ◽

Smart Phone ◽

Correlation Coefficients ◽

Plane Motion ◽

Clinical Settings ◽

Validity And Reliability ◽

Digital Inclinometer

In clinical settings, available valid and reliable tools are important components in evaluating the lower extremity range of motion. Although the digital inclinometer is highly reliable compared to the universal goniometer, its availability and high cost impede its extensive use. Nowadays, smartphone applications have become widely available to clinicians for assessing the joint range of motion. The present study aims to assess the validity and intra-rater reliability of the smart- phone application “Clinometer” for measuring hip, knee, and ankle sagittal ranges of motion, using the digital inclinom- eter as the reference standard. Active hip, knee flexion and ankle dorsiflexion and plantarflexion range-of-motion mea- surements were recorded in 102 young, healthy female participants on two separate occasions using Clinometer and a digital inclinometer. Pearson’s correlation coefficients (r) were used to evaluate the smartphone application’s validity against the digital inclinometer. To assess the reliability of the Clinometer app, the intra-class correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD) were used. Clinometer displayed excellent validity when compared to the digital inclinometer for hip and knee movements (r>0.90), while ankle ROM displayed moderate validity (r = 0.52-0.57). Additionally, Clinometer demonstrated excellent reliability (ICC > 0.90) for hip and knee sagittal plane motion and moderate reliability for the ankle sagittal plane motion (ICC = 0.53–0.67). Cli- nometer is a portable, low-cost, valid, and reliable tool for assessing active hip and knee range of motions and can be easily incorporated into clinical settings; however, it cannot be used interchangeably for ankle measures.

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Reliability and validity varies among smartphone apps for range of motion measurements of the lower extremity: a systematic review

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2021-0015 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Sarah Hahn ◽

Inga Kröger ◽

Steffen Willwacher ◽

Peter Augat

Keyword(s):

Lower Extremity ◽

Range Of Motion ◽

Reliability And Validity ◽

Knee Extension ◽

Cochrane Library ◽

Study Quality ◽

Smartphone Applications ◽

Validity And Reliability ◽

Library Studies ◽

Baseline Information

Abstract The aim of this review was to determine whether smartphone applications are reliable and valid to measure range of motion (RoM) in lower extremity joints. A literature search was performed up to October 2020 in the databases PubMed and Cochrane Library. Studies that reported reliability or validity of smartphone applications for RoM measurements were included. The study quality was assessed with the QUADAS-2 tool and baseline information, validity and reliability were extracted. Twenty-five studies were included in the review. Eighteen studies examined knee RoM, whereof two apps were analysed as having good to excellent reliability and validity for knee flexion (“DrGoniometer”, “Angle”) and one app showed good results for knee extension (“DrGoniometer”). Eight studies analysed ankle RoM. One of these apps showed good intra-rater reliability and excellent validity for dorsiflexion RoM (“iHandy level”), another app showed excellent reliability and moderate validity for plantarflexion RoM (“Coach’s Eye”). All other apps concerning lower extremity RoM had either insufficient results, lacked study quality or were no longer available. Some apps are reliable and valid to measure RoM in the knee and ankle joint. No app can be recommended for hip RoM measurement without restrictions.

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2P1-T10 Development of the Stance-control system for Lower extremity dysfunction : Natural walking of Polio patients(Welfare Robotics and Mechatronics(4))

The Proceedings of JSME annual Conference on Robotics and Mechatronics (Robomec) ◽

10.1299/jsmermd.2012._2p1-t10_1 ◽

2012 ◽

Vol 2012 (0) ◽

pp. _2P1-T10_1-_2P1-T10_3

Author(s):

Yasuhiro WATANABE ◽

Katsuhiro OKUMURA ◽

Yoshie NAKANISHI ◽

Futoshi WADA ◽

Noriaki KATO ◽

...

Keyword(s):

Control System ◽

Lower Extremity ◽

Stance Control ◽

Lower Extremity Dysfunction

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Interrater and Intrarater Reliability and Discriminant Validity of a Pediatric Lower Extremity Physical Therapy Clearance Test

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120983827 ◽

2021 ◽

Vol 9 (2) ◽

pp. 232596712098382

Author(s):

Matthew D. Ellington ◽

Kelly Randich ◽

Jessica Garfin ◽

Nicole Archambault ◽

Joanna Roocroft ◽

...

Keyword(s):

Physical Therapy ◽

Lower Extremity ◽

Discriminant Validity ◽

Physical Therapist ◽

Cruciate Ligament ◽

Video Recording ◽

Return To Sports ◽

Validity And Reliability ◽

Intrarater Reliability ◽

Level Of Evidence

Background: Few studies have validated when an athlete can safely return to sports, and even fewer have identified when he or she no longer requires physical therapy after surgery. Discontinuing physical therapy is often dictated by insurance restrictions, but most studies have suggested that the decision should be multifactorial, stemming from patient-derived subjective outcome questionnaires, clinical examination, and isokinetic and functional testing. Purpose/Hypothesis: The purpose of this study was to establish discriminant validity and reliability of an objective physical therapy clearance (PTC) test in a clinical setting. The hypotheses were that the PTC test (1) will demonstrate different scores between normal and postoperative cohorts and (2) will have acceptable inter- and intraobserver reliability. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Four cohorts (27 total participants; age range, 12-18 years) underwent the PTC test: 9 adolescents 6 months after anterior cruciate ligament reconstruction, 4 adolescents 6 weeks after partial meniscectomy, 5 adolescents with nonstructural knee pain, and 9 control/healthy participants without any lower extremity complaint. The PTC test included a dynamic warm-up, objective measures (knee range of motion, thigh girth, and muscle motor tone), functional strength tests (heel raises, single-leg dips, hop tests, tuck jumps), and agility tests (shuffle and sprint T-test). Each testing session was videotaped and scored live by the physical therapist administering the test, and then scored via the video recording by an independent physical therapist and 2 orthopaedic surgeons. Results: The PTC test was found to have discriminant validity between the control cohort and both cohorts with previous surgery. The single-leg dip, single-leg hop, and vertical tuck jump were the most discriminatory components. The PTC test had moderate to almost perfect intrarater reliability (κ = 0.57-1), but only fair to moderate interrater reliability among video graders (κ = 0.29-0.58) and slight to substantial reliability between video graders and the live PT rater (κ = 0.19-0.63). Conclusion: The PTC test was found to have moderate inter- and intraobserver agreement, with the ability to discriminate between postoperative and control patients.

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