Reliability and Validity of a Novel Approach to Measure Hip Rotation

2016 ◽  
Vol 25 (4) ◽  
pp. 330-337 ◽  
Author(s):  
Brett Aefsky ◽  
Niles Fleet ◽  
Heather Myers ◽  
Robert J. Butler

Context:Currently, hip-rotation range of motion (ROM) is clinically measured in an open kinetic chain in either seated or prone position using passive or active ROM. However, during activities of daily living and during sports participation the hip must be able to rotate in a loaded position, and there is no standard measurement for this.Objective:To determine if a novel method for measuring hip rotation in weight bearing will result in good to very good reliability as demonstrated by an intraclass correlation coefficient (ICC) of >.80 and to investigate if weight-bearing hip measurements will result in significantly reduced hip ROM compared with non-weight-bearing methods.Design:Repeated measures.Setting:Outpatient sports physical therapy clinic.Participants:20 healthy participants (10 men, 10 women) recruited for hip-rotation measurements.Methods:Three trials of both internal and external rotation were measured in sitting, prone, and weight bearing. Two therapists independently measured each participant on the same day. The participants returned the following day to repeat the same measurements with the same 2 therapists.Main Outcome Measures:Degrees of hip internal and external rotation measured in prone, sitting, and loaded positions.Results:In general, the measurement of hip ROM across the different conditions was reliable. The intrarater reliability was .67–.95, while interrater reliability was .59–.96. Interrater reliability was improved when values were averaged across the measures (.75–.97). ICCs for active loaded ROM were .67–.81, while interrater ICCs were .53–.87. In general, prone hip ROM was greater than supine and supine was greater than loaded.Conclusions:Loaded hip rotation can be measured in a clinical setting with moderate to good reliability. The rotation ROM of a loaded hip can be significantly decreased compared with unloaded motion.

2018 ◽  
Vol 27 (4) ◽  
Author(s):  
Marissa C. Gradoz ◽  
Lauren E. Bauer ◽  
Terry L. Grindstaff ◽  
Jennifer J. Bagwell

Context: Hip rotation range of motion (ROM) is commonly assessed in individuals with lower extremity or spine pathology. It remains unknown which hip rotation ROM testing position is most reliable. Objective: To compare interrater and intrarater reliabilities between hip internal rotation (IR) and external rotation (ER) ROM in supine and seated positions. Study Design: Controlled laboratory study. Setting: University research laboratory. Participants: A total of 19 participants (11 females and 8 males; age = 23.5 [1.2] y; height = 173.2 [8.6] cm; and mass = 69.2 [13.4] kg) without hip, knee, low back, or sacroiliac pain within the preceding 3 months or history of hip or low back surgery were recruited. Interventions: Three testers obtained measures during 2 testing sessions. Passive supine and seated hip IR and ER ROM were performed with the hip and knee flexed to 90°. Main Outcome Measures: The primary outcome measures were hip IR and ER ROM in supine and seated positions (in degrees). Interrater and intrarater reliabilities were calculated using intraclass correlation coefficients (ICCs). Minimal detectable change was calculated. Differences between supine and seated hip IR and ER ROM values were assessed using paired t tests (significance level was .05). Results: Supine hip IR and ER ROM interrater and intrarater reliabilities were excellent (ICC = .75–.91). Seated hip IR ROM interrater and intrarater reliabilities were good (ICC = .64–.71). Seated hip ER ROM interrater reliability was good (ICC = .65), and intrarater reliabilities were good to excellent (ICC = .65–.82). Minimal detectable change values for supine and seated hip IR and ER ROM ranged from 6.1° to 8.6°. There were significant differences between supine and seated positions for hip IR and ER ROM (41.6° vs 44.5°; P < .01 and 53.0° vs 44.2°; P < .01, respectively). Conclusion: Supine hip rotation had higher interrater and intrarater reliabilities. Hip IR and ER ROM values differed significantly between supine and seated positions and should not be used interchangeably.


2016 ◽  
Vol 25 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Gidon Herman ◽  
Oren Nakdimon ◽  
Pazit Levinger ◽  
Shmuel Springer

Context:The forward-step-down (FSD) test may be used to identify underlying pathologies related to lower-extremity injuries. However, research on its interrater reliability is limited.Objective:To assess the interrater reliability of the FSD test with a broad cohort of clinicians and to compare the level of agreement with an expert panel.Design:Single-measure, interrater reliability.Setting:Annual conference of the Israeli Physical Therapy Society.Participants:15 healthy subjects who performed the FSD test and 142 physical therapists (PTs) who evaluated performance.Methods:Each subject performed the FSD while being videoed. Six videos were selected by an expert panel for analysis. After viewing the videos, FSD performance was rated by 142 PTs, as well as by the expert panel, using a 3-level scale.Main Outcome Measures:Interrater reliability determined by intraclass correlation coefficient (ICC) and percentage of agreement with the expert panel.Results:Fair to good reliability and acceptable agreement were found for the entire sample of raters (ICC –.61, agreement 74%). The percentage of agreement was greater in the subgroup of raters who were familiar with the FSD than in those who were not (78.08% vs 69.32%, respectively, P = .004). Years of work experience did not affect the percentage of agreement (P = .141).Conclusions:Fair to good interrater reliably of the FSD test was demonstrated by a broad cohort of PTs. The findings support the clinical utility of the FSD test as an assessment tool for quality of movement.


2005 ◽  
Vol 14 (2) ◽  
pp. 124-136 ◽  
Author(s):  
W. Steven Tucker ◽  
Charles W. Armstrong ◽  
Erik E. Swartz ◽  
Brian M. Campbell ◽  
James M. Rankin

Context:Closed kinetic chain exercises are reported to provide a more functional rehabilitation outcome.Objective:To determine the amount of muscle activity in 4 shoulder muscles during exercise on the Cuff Link.Design:Repeated measures.Setting:Laboratory.Subjects:10 men and 10 women, age 18–50.Intervention:Subjects performed 3 sets of 5 revolutions on the Cuff Link in non-weight-bearing, partial-weight-bearing, and full-weight-bearing positions.Main Outcome Measures:Electromyography data were collected from the upper trapezius, anterior deltoid, serratus anterior, and pectoralis major and were expressed as percentage of maximal isometric contractions.Results:Significant differences were found across the weight-bearing conditions for all 4 muscles. Exercise on the Cuff Link required minimal to significant amounts of muscle recruitment.Conclusions:Muscle recruitment increases as weight bearing increases during use of the Cuff Link, suggesting an increase in dynamic stabilization of the glenohumeral joint.


2012 ◽  
Vol 21 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Derya Ozer Kaya ◽  
Irem Duzgun ◽  
Gul Baltaci ◽  
Selma Karacan ◽  
Filiz Colakoglu

Objective:To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training.Design:Randomized, controlled, assessor-blinded, repeated-measures.Setting:University research laboratory.Participants and Intervention:Healthy, sedentary, female participants age 25–50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training.Main Outcome Measures:Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training.Results:For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05).Conclusions:It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.


2020 ◽  
Vol 100 (4) ◽  
pp. 708-717
Author(s):  
Kavita Venkataraman ◽  
Kristopher Amis ◽  
Lawrence R Landerman ◽  
Kevin Caves ◽  
Gerald C Koh ◽  
...  

Abstract Background Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation. Objective The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment. Design This repeated-measures study compared the test performances of in-person, slow motion (SM) review, and normal-speed (NS) video ratings at various fixed frame rates (8, 15, and 30 frames per second) and bandwidth (128, 384, and 768 kB/s) configurations. Methods Overall bias, validity, and interrater reliability were assessed for in-person, SM video, and NS video ratings, with SM video rating as the gold standard, as well as for different frame rate and bandwidth configurations within NS videos. Results There was moderate to good interrater reliability for the POMA-G (intraclass correlation coefficient [ICC] = 0.66–0.77 across all configurations) and moderate validity for in-person (β = 0.62; 95% confidence interval [CI] = 0.37–0.87) and NS video (β = 0.74; 95% CI = 0.67–0.80) ratings compared with the SM video rating. For cane height, interrater reliability was good (ICC = 0.66–0.77), although it was significantly lower at the lowest frame rate (8 frames per second) (ICC = 0.66; 95% CI = 0.54–0.76) and bandwidth (128 kB/s) (ICC = 0.69; 95% CI = 0.57–0.78) configurations. Validity for cane height was good for both in-person (β = 0.80; 95% CI = 0.62–0.98) and NS video (β = 0.86; 95% CI = 0.81–0.90) ratings compared with SM video rating. Limitations Some lower frame rate and bandwidth configurations may limit the reliability of remote cane height assessments. Conclusions Teleassessment for POMA-G and cane height using typically available internet and video quality is feasible, valid, and reliable.


2002 ◽  
Vol 82 (4) ◽  
pp. 364-371 ◽  
Author(s):  
Douglas P Gross ◽  
Michele C Battié

Abstract Background and Purpose. Functional capacity evaluations (FCEs) are measurement tools used in predicting readiness to return to work following injury. The interrater and test-retest reliability of determinations of maximal safe lifting during kinesiophysical FCEs were examined in a sample of people who were off work and receiving workers' compensation. Subjects. Twenty-eight subjects with low back pain who had plateaued with treatment were enrolled. Five occupational therapists, trained and experienced in kinesiophysical methods, conducted testing. Methods. A repeated-measures design was used, with raters testing subjects simultaneously, yet independently. Subjects were rated on 2 occasions, separated by 2 to 4 days. Analyses included intraclass correlation coefficients (ICCs) and 95% confidence intervals. Results. The ICC values for interrater reliability ranged from .95 to .98. Test-retest values ranged from .78 to .94. Discussion and Conclusion. Inconsistencies in subjects' performance across sessions were the greatest source of FCE measurement variability. Overall, however, test-retest reliability was good and interrater reliability was excellent.


2005 ◽  
Vol 85 (12) ◽  
pp. 1349-1355 ◽  
Author(s):  
Kevin D Harris ◽  
Darren M Heer ◽  
Tanja C Roy ◽  
Diane M Santos ◽  
Julie M Whitman ◽  
...  

Abstract Background and Purpose. Neck flexor muscle endurance has been negatively correlated with cervical pain and dysfunction. The purposes of this study were to determine rater reliability in subjects both withand without neck pain and to determine whether there was a difference in neck flexor muscle endurance between the 2 groups. Subjects. Forty-one subjects with and without neck pain were enrolled in this repeated-measures reliability study. Methods. Two raters used an isometric neck retraction test to assess neck flexor muscle endurancefor all subjects during an initial session, and subjects without neck pain returned for testing 1 week later. Results. For the group without neck pain, intrarater reliability was good to excellent (intraclass correlation coefficient [ICC(3,1)]=.82–.91), and interrater reliability was moderate to good (ICC[2,1]=.67–.78). The associated standard error of measurement (SEM) ranged from 8.0 to 11.0 seconds and from 12.6 to 15.3 seconds, respectively. For the group with neck pain, interrater reliability was moderate(ICC[2,1]=.67, SEM=11.5). Neck flexor muscle endurance test results for the group without neck pain (X̄=38.95 seconds, SD=26.4) and the group with neck pain (X̄=24.1 seconds, SD=12.8) were significantly different. Discussion and Conclusion. Reliability coefficients differed between the 2 groups and ranged from moderate to excellent and improved after the first test session. The interrater reliability of data obtained with the neck flexor muscle endurance test in people with neck pain must be improved in order for clinicians to distinguish a clinically meaningful change from measurement error. Neck flexor muscle endurance was both statistically and clinically greater for subjects without neck pain than for those with neck pain.


2012 ◽  
Vol 21 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Scott K. Lynn ◽  
Ricardo A. Padilla ◽  
Kavin K.W. Tsang

Context:Proper functioning of the intrinsic foot musculature (IFM) is essential in maintaining the integrity of the medial longitudinal arch (MLA). Improper functioning of the IFM leads to excessive pronation of the foot, which has been linked to various pathologies. Therefore, training the IFM to avoid excessive pronation may help prevent some of these pathologies; however, it is not clear how to train these muscles optimally.Objective:To investigate the effects of 2 different types of IFM training on the height of the MLA and static- and dynamic-balance task performance.Design:Randomized controlled trial, repeated-measures mixed-model design.Setting:University biomechanics laboratory for testing and a home-based training program.Participants:24 healthy, university-age volunteers (3 groups of 8) with no history of major lower limb pathology or balance impairment.Interventions:One experimental group performed 4 wk of the short-foot exercise (SFE) and the other performed 4 wk of the towel-curl exercise (TCE). Participants were asked to perform 100 repetitions of their exercise per day.Main Outcome Measures:Navicular height during weight bearing, the total range of movement of the center of pressure (COP) in the mediolateral (ML) direction for a static-balance test and a dynamic-balance test.Results:There were no differences in the navicular height or static-balance tests. For the dynamic-balance test, all groups decreased the ML COP movement on the dominant limb by a small amount (~5 mm); however, the SFE group was able to decrease COP movement much more than the TCE group in the nondominant limb.Conclusions:The SFE appeared to train the IFM more effectively than the TCE; however, there were differing results between the dominant and nondominant legs. These imbalances need to be taken into consideration by clinicians.


2013 ◽  
Vol 48 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Rebecca Shultz ◽  
Scott C. Anderson ◽  
Gordon O. Matheson ◽  
Brandon Marcello ◽  
Thor Besier

Context: The Functional Movement Screen (FMS) is a popular test to evaluate the degree of painful, dysfunctional, and asymmetric movement patterns. Despite great interest in the FMS, test-retest reliability data have not been published. Objective: To assess the test-retest and interrater reliability of the FMS and to compare the scoring by 1 rater during a live session and the same session on video. Design: Cross-sectional study. Setting: Human performance laboratory in the sports medicine center. Patients or Other Participants: A total of 21 female (age = 19.6 ± 1.5 years, height = 1.7 ± 0.1 m, mass = 64.4 ± 5.1 kg) and 18 male (age = 19.7 ± 1.0 years, height = 1.9 ± 0.1 m, mass = 80.1 ± 9.9 kg) National Collegiate Athletic Association Division IA varsity athletes volunteered. Intervention(s): Each athlete was tested and retested 1 week later by the same rater who also scored the athlete's first session from a video recording. Five other raters scored the video from the first session. Main Outcome Measure(s): The Krippendorff α (K α) was used to assess the interrater reliability, whereas intraclass correlation coefficients (ICCs) were used to assess the test-retest reliability and reliability of live-versus-video scoring. Results: Good reliability was found for the test-retest (ICC = 0.6), and excellent reliability was found for the live-versus-video sessions (ICC = 0.92). Poor reliability was found for the interrater reliability (K α = .38). Conclusions: The good test-retest and high live-versus-video session reliability show that the FMS is a usable tool within 1 rater. However, the low interrater K α values suggest that the FMS within the limits of generalization should not be used indiscriminately to detect deficiencies that place the athlete at greater risk for injury. The FMS interrater reliability may be improved with better training for the rater.


2021 ◽  
Author(s):  
Peter Sutton ◽  
Marie Ohlsson ◽  
Ulrik Röijezon

Abstract Background: Assessment of shoulder proprioception outside the laboratory in the absence of specialized equipment remains a challenge with field-based tests often lacking good reliability, validity and feasibility. This study aimed to enhance the knowledge base surrounding the assessment of shoulder proprioception and investigated the effect of fatigue on shoulder joint position sense (JPS) amongst amateur male handball players.Method: 27 healthy recreationally active participants and 13 amateur male handball players undertook two sessions of active JPS tests using laser pen technology and a calibrated 2-dimensional target to assess test-retest reliability. The active JPS test was then utilized on the subgroup of handball players who were subjected to five bouts of a repeated throwing task in order to investigate the effect of local fatigue on shoulder JPS. Results: The intraclass correlation coefficient for the active JPS test was 0.78 (95% CI = [0.57; 0.89]). Standard error of measurement between trials was 0.70° (range 0.57°-0.90°). For the throwing task, repeated measures analysis of variance revealed a significant interaction for arm x bout (F5=2.74, p=0.028) and a significant effect for arm (F1=5.85, p=0.034). Post hoc analysis showed a significant difference between throwing arm and non-throwing arm after throwing bout one (p=0.036), three (p=0.026) and four (p=0.041). Conclusion: Assessment of the active JPS test showed acceptable reliability and measurement error. Repeated throwing to fatigue decreased shoulder JPS in amateur male handball players which indicate validity of the test to identify reduced proprioception.


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