Interadministrator Reliability of a Modified Instrumented Push and Release Test of Reactive Balance

2021 ◽  
pp. 1-7
Author(s):  
Amanda Morris ◽  
Nora F. Fino ◽  
Ryan Pelo ◽  
Nicholas Kreter ◽  
Benjamin Cassidy ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Intraclass Correlation ◽  
Step Length ◽  
Clinical Test ◽  
Release Test ◽  
Lean Angle ◽  
Measurement Units ◽  
Objective Outcomes ◽  
Traditional Assessments ◽  
Reactive Balance

Context: Traditional assessments of reactive balance require sophisticated instrumentation to ensure objective, highly repeatable paradigms. This instrumentation is clinically impractical. The Push and Release test (P&R) is a well-validated clinical test that examines reactive balance, and the application of wearable inertial measurement units (IMU) enables sensitive and objective assessment of this clinically feasible test. The P&R relies on administrator experience and may be susceptible to interadministration reliability concerns. The purpose of this study was to evaluate the interadministrator reliability of objective outcomes from an instrumented, modified version of the P&R test. Design: Crossover interadministrator design. Methods: Twenty healthy adults (20–35 y) completed the P&R in 4 directions with 2 different administrators. Measures quantified using IMUs included step latency, step length, and time to stability. Lean angle (LA) at release was used as a measure of administration consistency. The intraclass correlation coefficient (ICC) estimate was used to assess interadministrator reliability in each direction. To determine consistency of LA within and across administrators, we calculated the SDs for each rater by direction and the interadministrator reliability of LA using ICC. Results: Across individual directions, the ICC for agreement between raters ranged from .16 to .39 for step latency, from .52 to .62 for time to stability, and from .48 to .84 for step length. Summary metrics across all 4 directions produced higher ICC values. There was poor to moderate consistency in administration based on LA, but LA did not significantly affect any of the outcomes. Conclusion: The modified P&R yields moderate interadministrator reliability and high validity. Summary metrics over all 4 directions (the maximum step latency, the median time to stability, and the median step length) are likely more reliable than direction-specific scores. Variations in body size should also be considered when comparing populations.

scholarly journals Retest reliability of balance and mobility measurements in people with mild to moderate Alzheimer's disease

2011 ◽  
Vol 23 (7) ◽  
pp. 1152-1159 ◽  
Author(s):  
Plaiwan Suttanon ◽  
Keith D. Hill ◽  
Karen J. Dodd ◽  
Catherine M. Said
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mixed Model ◽  
Intraclass Correlation ◽  
Step Length ◽  
Clinical Test ◽  
Retest Reliability ◽  
Relative Reliability ◽  
Manual Task ◽  
Minimum Detectable Change

ABSTRACTBackground: To interpret changes of balance and mobility in people with Alzheimer's disease (AD), we require measures of balance and mobility that have demonstrated reliability in this population. The aim of the study was to determine the safety, feasibility and retest reliability of clinical and forceplate balance and mobility measurements in people with AD.Methods: Relative and absolute reliabilities were examined in 14 older people with mild to moderate AD. Relative reliability was calculated using the intraclass correlation coefficient, two-way mixed model (ICC3,1). Absolute reliability was calculated using the standard error of measurement (SEM), the minimum detectable change (MDC) and the coefficient of variation (CV).Results: All measurements were clinically feasible and could be safely administered. ICC values were excellent and CVs were less than 11% in all clinical balance and mobility measures except the Timed Up & Go test with cognitive or manual task (ICC3,1= 0.5 and 0.7, and CV = 14% and 10%, respectively). Most balance and mobility measures tested on the Neurocom™ forceplate (modified Clinical Test of Sensory Interaction on Balance, Walk Across (step width, step length parameters), and Sit to Stand (rising index parameter)) had excellent relative reliability (ICC3,1ranging from 0.75 to 0.91). ICC values were fair to good for the other measures.Conclusions: Retest reliability of the balance and mobility measures used in this study ranged between fair to good, and good to excellent. Clinicians should consider retest reliability when deciding which balance and mobility measures are used to assess people with AD.

scholarly journals Validity of Inertial Sensors for Assessing Balance Kinematics and Mobility during Treadmill-Based Perturbation and Dance Training

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3065
Author(s):  
Ernest Kwesi Ofori ◽  
Shuaijie Wang ◽  
Tanvi Bhatt
Keyword(s):  
Concurrent Validity ◽  
Inertial Sensors ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Human Motion ◽  
Intraclass Correlation Coefficients ◽  
Dance Training ◽  
Silver Standard ◽  
Mean Square Errors ◽  
Reactive Balance

Inertial sensors (IS) enable the kinematic analysis of human motion with fewer logistical limitations than the silver standard optoelectronic motion capture (MOCAP) system. However, there are no data on the validity of IS for perturbation training and during the performance of dance. The aim of this present study was to determine the concurrent validity of IS in the analysis of kinematic data during slip and trip-like perturbations and during the performance of dance. Seven IS and the MOCAP system were simultaneously used to capture the reactive response and dance movements of fifteen healthy young participants (Age: 18–35 years). Bland Altman (BA) plots, root mean square errors (RMSE), Pearson’s correlation coefficients (R), and intraclass correlation coefficients (ICC) were used to compare kinematic variables of interest between the two systems for absolute equivalency and accuracy. Limits of agreements (LOA) of the BA plots ranged from −0.23 to 0.56 and −0.21 to 0.43 for slip and trip stability variables, respectively. The RMSE for slip and trip stabilities were from 0.11 to 0.20 and 0.11 to 0.16, respectively. For the joint mobility in dance, LOA varied from −6.98–18.54, while RMSE ranged from 1.90 to 13.06. Comparison of IS and optoelectronic MOCAP system for reactive balance and body segmental kinematics revealed that R varied from 0.59 to 0.81 and from 0.47 to 0.85 while ICC was from 0.50 to 0.72 and 0.45 to 0.84 respectively for slip–trip perturbations and dance. Results of moderate to high concurrent validity of IS and MOCAP systems. These results were consistent with results from similar studies. This suggests that IS are valid tools to quantitatively analyze reactive balance and mobility kinematics during slip–trip perturbation and the performance of dance at any location outside, including the laboratory, clinical and home settings.

scholarly journals Smartphone Monitoring of Gait and Balance During Irregular Surface Walking and Obstacle Crossing

2020 ◽  
Vol 2 ◽  
Author(s):  
Janeesata Kuntapun ◽  
Patima Silsupadol ◽  
Teerawat Kamnardsiri ◽  
Vipul Lugade
Keyword(s):  
Older Adults ◽  
Intraclass Correlation ◽  
Step Length ◽  
Living Environment ◽  
The Body ◽  
Irregular Surface ◽  
Time Step ◽  
Free Living ◽  
Obstacle Crossing ◽  
Gait Adaptation

As gait adaptation is vital for successful locomotion, the development of field-based tools to quantify gait in challenging real-world environments are crucial. The aims of this study were to assess the reliability and validity of a smartphone-based gait and balance assessment while walking on unobstructed and obstructed terrains using two phone placements. Furthermore, age-related differences in smartphone-derived gait strategies when navigating different walking conditions and environments were evaluated. By providing a method for evaluating gait in the simulated free-living environment, results of this study can elucidate the strategies young and older adults utilize to navigate obstructed and unobstructed walking paths. A total of 24 young and older adults ambulated indoors and outdoors under three conditions: level walking, irregular surface walking, and obstacle crossing. Android smartphones placed on the body and in a bag computed spatiotemporal gait (i.e., velocity, step time, step length, and cadence) and balance (i.e., center of mass (COM) displacement), with motion capture and video used to validate parameters in the laboratory and free-living environments, respectively. Reliability was evaluated using the intraclass correlation coefficient and validity was evaluated using Pearson's correlation and Bland-Altman analysis. A three-way ANOVA was used to assess outcome measures across group, condition, and environment. Results showed that smartphones were reliable and valid for measuring gait across all conditions, phone placements, and environments (ICC2,1: 0.606–0.965; Pearson's r: 0.72–1.00). Although body and bag placement demonstrated similar results for spatiotemporal parameters, accurate vertical COM displacement could only be obtained from the body placement. Older adults demonstrated a longer step time and lower cadence only during obstacle crossing, when compared to young adults. Furthermore, environmental differences in walking strategy were observed only during irregular surface walking. In particular, participants utilized a faster gait speed and a longer step length in the free-living environment, compared to the laboratory environment. In conclusion, smartphones demonstrate the potential for remote patient monitoring and home health care. Along with being easy-to-use, inexpensive, and portable, smartphones can accurately evaluate gait during both unobstructed and obstructed walking, indoors and outdoors.

scholarly journals The Coefficient of Variation of Step Time Can Overestimate Gait Abnormality: Test-Retest Reliability of Gait-Related Parameters Obtained with a Tri-Axial Accelerometer in Healthy Subjects

Sensors ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 577 ◽  
Author(s):  
Shunrou Fujiwara ◽  
Shinpei Sato ◽  
Atsushi Sugawara ◽  
Yasumasa Nishikawa ◽  
Takahiro Koji ◽  
...  
Keyword(s):  
Coefficient Of Variation ◽  
Intraclass Correlation ◽  
Step Length ◽  
Gait Parameter ◽  
Data Set ◽  
Gait Abnormality ◽  
Significant Difference ◽  
Assessment Time ◽  
The Difference ◽  
Gait Abnormalities

The aim of this study was to investigate whether variation in gait-related parameters among healthy participants could help detect gait abnormalities. In total, 36 participants (21 men, 15 women; mean age, 35.7 ± 9.9 years) performed a 10-m walk six times while wearing a tri-axial accelerometer fixed at the L3 level. A second walk was performed ≥1 month after the first (mean interval, 49.6 ± 7.6 days). From each 10-m data set, the following nine gait-related parameters were automatically calculated: assessment time, number of steps, stride time, cadence, ground force reaction, step time, coefficient of variation (CV) of step time, velocity, and step length. Six repeated measurement values were averaged for each gait parameter. In addition, for each gait parameter, the difference between the first and second assessments was statistically examined, and the intraclass correlation coefficient (ICC) was calculated with the level of significance set at p < 0.05. Only the CV of step time showed a significant difference between the first and second assessments (p = 0.0188). The CV of step time also showed the lowest ICC, at <0.50 (0.425), among all parameters. Test–retest results of gait assessment using a tri-axial accelerometer showed sufficient reproducibility in terms of the clinical evaluation of all parameters except the CV of step time.

Safety, Feasibility, and Reliability of the Maximal Step Length, Gait Speed, and Chair Test Measured by Seniors Themselves: The Senior Step Study

2015 ◽  
Vol 23 (3) ◽  
pp. 438-443 ◽  
Author(s):  
Kim T.J. Bongers ◽  
Yvonne Schoon ◽  
Maartje J. Graauwmans ◽  
Marlies E. Hoogsteen-Ossewaarde ◽  
Marcel G.M. Olde Rikkert
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Fall Risk ◽  
Intraclass Correlation ◽  
Step Length ◽  
Community Dwelling ◽  
Self Management ◽  
Training Effect ◽  
Community Dwelling Older Adults ◽  
At Home

Self-management of mobility and fall risk might be possible if older adults could use a simple and safe self-test to measure their own mobility, balance, and fall risk at home. The aim of this study was to determine the safety, feasibility, and intraindividual reliability of the maximal step length (MSL), gait speed (GS), and chair test (CT) as potential self-tests for assessing mobility and fall risk. Fifty-six community-dwelling older adults performed MSL, GS, and CT at home once a week during a four-week period, wherein the feasibility, test-retest reliability, coefficients of variation, and linear mixed models with random effects of these three self-tests were determined. Forty-nine subjects (mean age 76.1 years [SD: 4.0], 19 females [42%]) completed the study without adverse effects. Compared with the other self-tests, MSL gave the most often (77.6%) valid measurement results and had the best intraclass correlation coefficients (0.95 [95% confidence interval: 0.91−0.97]). MSL and GS gave no significant training effect, whereas CT did show a significant training effect (p < .01). Community-dwelling older adults can perform MSL safely, correctly, and reliably, and GS safely and reliably. Further research is needed to study the responsiveness and beneficial effects of these self-tests on self-management of mobility and fall risk.

scholarly journals KINEMATICAL STRATEGY TO REGAIN BALANCE DURING A FORWARD FALL ON A SLIPPERY FLOOR

2001 ◽  
Vol 13 (01) ◽  
pp. 27-32 ◽  
Author(s):  
PEI-HSI CHOU ◽  
YOU-LI CHOU ◽  
SHANG-LIN LEE ◽  
JIA-YUAN YOU ◽  
FONG-CHIN SU ◽  
...  
Keyword(s):  
Response Time ◽  
Horizontal Plane ◽  
Step Length ◽  
Human Walking ◽  
Motion Analysis System ◽  
Related Factors ◽  
Lean Angle ◽  
Foot Strike ◽  
Analysis System ◽  
Biomechanical Factors

Slips and falls often occur in the industrial environments. They are not only caused by environmental hazards but also by some biomechanical factors related to deficient ability of postural control to arrest impending falls. The purpose of this study is to simulate the slip condition in human walking and to find out the possible related factors of biomechanics. Eleven male and 9 female recruited were healthful without any musculoskeletal and neurological impairments. In order to provide different disturbance level, three lean angles of tilting boards were designed as 10, 20, 30 degrees with respect to horizontal plane. Subjects wore a safety harness, stood on the tilting board and were released without awareness. A forceplate applied a soap patch was in front of the tilting board to serve the slippery perturbation and to measure the fool/floor reactions. Movements of body segments were measured using the motion analysis system. The results were shown that lean angle had a significant effect to all parameters except step length, response time, maximum ankle forward velocity, hip forward velocity, and ankle flex angle. The gender significantly affected on the step length, response time, maximum ankle forward velocity, and knee forward velocity. Larger lean angle made subjects to take a more rapid step. In order to absorb the shock in foot strike, subjects flexed more their knee and increased the foot landing angle in larger lean angle. Male tended to adopt the long step-length strategy to respond to the slippery perturbation and female tended to use the short step-length strategy instead. The results of maximum ankle forward velocity suggested that short step-length strategy could be belter to reduce the foot slip than long step-length strategy.

Reproducibility of Acoustic Rhinometry in the Investigation of Occupational Rhinitis

2007 ◽  
Vol 21 (4) ◽  
pp. 474-477 ◽  
Author(s):  
Roberto Castano ◽  
Gilles Thériault ◽  
Denyse Gautrin ◽  
Heberto Ghezzo ◽  
Carole Trudeau ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Acoustic Rhinometry ◽  
Nasal Patency ◽  
Cross Sectional ◽  
Occupational Rhinitis ◽  
Intraclass Correlation Coefficients ◽  
Objective Monitoring ◽  
Coefficients Of Variation

Background To diagnose occupational rhinitis, it is mandatory to conduct an objective assessment of changes in nasal patency during specific inhalation challenge (SIC). The reproducibility of acoustic rhinometry measurements in the setting of occupational challenges has never been examined. This study assessed the reproducibility of acoustic rhinometry during SIC investigation of occupational rhinitis. Methods Twenty-four subjects underwent acoustic rhinometry measurements during SIC investigation of occupational rhinitis. Subjects attended 3–6 days of SIC within a week by means of a realistic or closed-circuit apparatus methodology Results All of the within-day intraclass correlation coefficients (ICCs) for nasal volume (2–5 cm) and minimum cross-sectional area (MCA) based on a different number of measurements (2–7) were above 0.85; all of the coefficients of variation (CVs) for the same parameters were low (below 10%). The between-day CVs based on different numbers of SIC sessions ranged from 8.0 to 8.8% and from 6.8 to 8.8% for nasal volume and MCA, respectively. The between-day ICCs ranged from 0.80 to 0.88 and from 0.83 to 0.94 for nasal volume and MCA, respectively. Conclusion Acoustic rhinometry showed good within- and between-day reproducibility and can be recommended for the objective monitoring of nasal patency during SIC investigating occupational rhinitis.

Video Head Impulse Testing (vHIT) and the Assessment of Horizontal Semicircular Canal Function

2015 ◽  
Vol 26 (05) ◽  
pp. 518-523 ◽  
Author(s):  
Kristal M. Riska ◽  
Owen Murnane ◽  
Faith W. Akin ◽  
Courtney Hall
Keyword(s):  
Semicircular Canal ◽  
Objective Assessment ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Horizontal Semicircular Canal ◽  
Head Impulse ◽  
New Instrument ◽  
Qualitative Test

Background: Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been developed to provide an objective assessment to the clinical test. Questions persist regarding how this test may be used in the overall vestibular test battery. Purpose: The purpose of this case report is to describe vestibular test results (vHIT, rotational testing, vestibular evoked myogenic potentials, and balance and gait performance) in an individual with a 100% unilateral caloric weakness who was asymptomatic for dizziness, vertigo or imbalance. Data Collection and/or Analysis: Comprehensive assessment was completed to evaluate vestibular function. Caloric irrigations, rotary chair testing, vHIT, and vestibular evoked myogenic potentials were completed. Results: A 100% left-sided unilateral caloric weakness was observed in an asymptomatic individual. vHIT produced normal gain with covert saccades. Conclusions: This case demonstrates the clinical usefulness of vHIT as a diagnostic tool and indicator of vestibular compensation and functional status.

Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer

2021 ◽  
pp. 1-5
Author(s):  
Gabriel dos Santos Oliveira ◽  
João Breno de Araujo Ribeiro-Alvares ◽  
Felipe Xavier de Lima-e-Silva ◽  
Rodrigo Rodrigues ◽  
Marco Aurélio Vaz ◽  
...  
Keyword(s):  
Coefficient Of Variation ◽  
Intraclass Correlation ◽  
Load Cell ◽  
Effect Sizes ◽  
Clinical Test ◽  
Strength Assessment ◽  
Knee Flexor ◽  
Hamstring Strain ◽  
Typical Error ◽  
Flexor Strength

Context: Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries. Objective: To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer. Design: Reliability study. Setting: Physical Therapy Laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). Participants: Fifty male amateur athletes (soccer or rugby players; 24 [3] y). Main Outcome Measures: Eccentric knee flexor strength. Results: When compared with a load cell–based device, the clinical test using a handheld dynamometer provided smaller force values (P < .05) with large effect sizes (.92–1.21), moderate intraclass correlation (.60–.62), typical error of 30 to 31 N, and coefficient of variation of 10% to 11%. Regarding the test–retest reproducibility (2 sessions separated by 1 week), the clinical test provided similar force values (P > .05) with only small effect sizes (.20–.27), moderate to good correlation (.67–.76), typical error of 23 to 24 N, and coefficient of variation of 9% to 10%. Conclusion: The clinical test with handheld dynamometer proposed by this study can be considered an affordable and relatively reliable tool for eccentric knee flexor strength assessment in the clinical setting, but results should not be directly compared with those provided by load cell–based devices.

scholarly journals Reproducibility of the Evolution of Stride Biomechanics During Exhaustive Runs

2018 ◽  
Vol 64 (1) ◽  
pp. 57-69
Author(s):  
Géraldine Martens ◽  
Dorian Deflandre ◽  
Cédric Schwartz ◽  
Nadia Dardenne ◽  
Thierry Bury
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Step Length ◽  
Stride Frequency ◽  
Time To Exhaustion ◽  
Centre Of Gravity ◽  
Maximal Aerobic Speed ◽  
S Period ◽  
The Individual

Abstract Running biomechanics and its evolution that occurs over intensive trials are widely studied, but few studies have focused on the reproducibility of stride evolution in these runs. The purpose of this investigation was to assess the reproducibility of changes in eight biomechanical variables during exhaustive runs, using three-dimensional analysis. Ten male athletes (age: 23 ± 4 years; maximal oxygen uptake: 57.5 ± 4.4 ml02·min-1·kg-1; maximal aerobic speed: 19.3 ± 0.8 km·h-1) performed a maximal treadmill test. Between 3 to 10 days later, they started a series of three time-to-exhaustion trials at 90% of the individual maximal aerobic speed, seven days apart. During these trials eight biomechanical variables were recorded over a 20-s period every 4 min until exhaustion. The evolution of a variable over a trial was represented as the slope of the linear regression of these variables over time. Reproducibility was assessed with intraclass correlation coefficients and variability was quantified as standard error of measurement. Changes in five variables (swing duration, stride frequency, step length, centre of gravity vertical and lateral amplitude) showed moderate to good reproducibility (0.48 ≤ ICC ≤ 0.72), while changes in stance duration, reactivity and foot orientation showed poor reproducibility (-0.71 ≤ ICC ≤ 0.04). Fatigue-induced changes in stride biomechanics do not follow a reproducible course across the board; however, several variables do show satisfactory stability: swing duration, stride frequency, step length and centre of gravity shift.

Sign in / Sign up

Export Citation Format

Share Document