scholarly journals Relative and Absolute Interrater Reliabilities of a Hand-Held Myotonometer to Quantify Mechanical Muscle Properties in Patients with Acute Stroke in an Inpatient Ward

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Wai Leung Ambrose Lo ◽  
Jiang Li Zhao ◽  
Le Li ◽  
Yu Rong Mao ◽  
Dong Feng Huang
Keyword(s):  
Mechanical Properties ◽  
Acute Stroke ◽  
Biceps Brachii ◽  
Intraclass Correlation ◽  
Rectus Femoris ◽  
Muscle Properties ◽  
Inpatient Ward ◽  
Stroke Population ◽  
First Occurrence ◽  
Absolute Reliability

Introduction. The reliability of using MyotonPRO to quantify muscles mechanical properties in a ward setting for the acute stroke population remains unknown. Aims. To investigate the within-session relative and absolute interrater reliability of MyotonPRO. Methods. Mechanical properties of biceps brachii, brachioradialis, rectus femoris, and tibialis anterior were recorded at bedside. Participants were within 1 month of the first occurrence of stroke. Relative reliability was assessed by intraclass correlation coefficient (ICC). Absolute reliability was assessed by standard error of measurement (SEM), SEM%, smallest real difference (SRD), SRD%, and the Bland-Altman 95% limits of agreement. Results. ICCs of all studied muscles ranged between 0.63 and 0.97. The SEM of all muscles ranged within 0.30–0.88 Hz for tone, 0.07–0.19 for decrement, 6.42–20.20 N/m for stiffness, and 0.04–0.07 for creep. The SRD of all muscles ranged within 0.70–2.05 Hz for tone, 0.16–0.45 for decrement, 14.98–47.15 N/m for stiffness, and 0.09–0.17 for creep. Conclusions. MyotonPRO demonstrated acceptable relative and absolute reliability in a ward setting for patients with acute stroke. However, results must be interpreted with caution, due to the varying level of consistency between different muscles, as well as between different parameters within a muscle.

scholarly journals PRACTICAL CONSIDERATIONS FOR STANDARDIZED RECORDING OF MUSCLE MECHANICAL PROPERTIES USING A MYOMETRIC DEVICE: RECORDING SITE, MUSCLE LENGTH, STATE OF CONTRACTION AND PRIOR ACTIVITY

2018 ◽  
Vol 21 (02) ◽  
pp. 1850010 ◽  
Author(s):  
Sandra Agyapong-Badu ◽  
Martin Warner ◽  
Dinesh Samuel ◽  
Maria Stokes
Keyword(s):  
Mechanical Properties ◽  
Biceps Brachii ◽  
Muscle Length ◽  
Rectus Femoris ◽  
Healthy Adults ◽  
Muscle Stiffness ◽  
Minimal Detectable Change ◽  
Experimental Conditions ◽  
Cross Sectional ◽  
Resting Muscle

Purpose: This study aimed to systematically examine the influence of various muscle and experimental conditions on Myoton recordings. Methods: A cross-sectional, observational design was used to examine muscle conditions and experimental factors (different recording sites, muscle length, level of contraction and prior physical activity) that may influence reproducibility of Myoton recordings for biceps brachii (BB) and rectus femoris (RF). Fifty-three healthy adults (26 young, 27 older) aged 18–90 years were studied. Muscle stiffness, tone and elasticity were measured using the MyotonPRO device. Results: Statistically significant differences in Myoton parameters were found for aspects of all four muscle and experimental conditions compared with the control condition ([Formula: see text]). However, clinically relevant differences in tone, stiffness and elasticity were only found for contracted compared to resting muscle, with changes being greater than the minimal detectable change. Elasticity was not affected by prior activity. Conclusions: The conditions studied significantly altered Myoton parameters of BB and RF in healthy adults, but only changes in parameters during muscle contraction were clinically relevant. These findings provide evidence to support the need to consider muscle condition and experimental factors for improving the robustness of test protocols for assessing muscle mechanical properties using the MyotonPRO device.

scholarly journals Validity and Reliability of the Newly Developed Surface Electromyography Device for Measuring Muscle Activity during Voluntary Isometric Contraction

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Myung Hun Jang ◽  
Se Jin Ahn ◽  
Jun Woo Lee ◽  
Min-Hyung Rhee ◽  
Dasom Chae ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Isometric Contraction ◽  
Surface Electromyography ◽  
Biceps Brachii ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Rectus Femoris ◽  
Validity And Reliability ◽  
Maximal Voluntary Isometric Contraction ◽  
Developed Surface

Objective. The purpose of this study was to establish the validity and reliability of the newly developed surface electromyography (sEMG) device (PSL-EMG-Tr1) compared with a conventional sEMG device (BTS-FREEEMG1000). Methods. In total, 20 healthy participants (10 males, age 30.3 ± 2.9 years; 10 females, age 22.3 ± 2.7 years) were recruited. EMG signals were recorded simultaneously on two devices during three different isometric contractions (maximal voluntary isometric contraction (MVIC, 40% MVIC, 80% MVIC)). Two trials were performed, and the same session was repeated after 1 week. EMG amplitude recorded from the dominant biceps brachii (BB) and rectus femoris (RF) muscles was analyzed for reliability using intrasession intraclass correlation coefficient (ICC). Concurrent validity of the two devices was determined using Pearson’s correlation coefficient. Results. Nonnormalized sEMG data showed moderate to very high reliability for all three contraction levels (ICC = 0.832–0.937 (BB); ICC = 0.814–0.957 (RF)). Normalized sEMG values showed no to high reliability (ICC = 0.030–0.831 (BB); ICC = 0.547–0.828 (RF)). sEMG signals recorded by the PSL-EMG-Tr1 showed good to excellent validity compared with the BTS-FREEEMG1000, at 40% MVIC (r = 0.943 (BB), r = 0.940 (RF)) and 80% MVIC (r = 0.983 (BB); r = 0.763 (RF)). Conclusions. The PSL-EMG-Tr1 was performed with acceptable validity. Furthermore, the high accessibility and portability of the device are useful in adjusting the type and intensity of exercise.

Reliability of scapular upward rotation and anterior-posterior tilt measurements using a modified digital inclinometer in patients with subacromial impingement syndrome

2021 ◽  
pp. 1-7
Author(s):  
Da-In An ◽  
Jung-Eun Park ◽  
Chang-Hyung Lee ◽  
Soo-Yong Kim
Keyword(s):  
Intraclass Correlation ◽  
Absolute Measurement ◽  
Impingement Syndrome ◽  
Subacromial Impingement Syndrome ◽  
Subacromial Impingement ◽  
Digital Inclinometer ◽  
Posterior Tilt ◽  
Standard Error Of Measurement ◽  
Absolute Reliability ◽  
Anterior Posterior

BACKGROUD: Reliable scapular upward rotation and anterior-posterior tilt data are required for patients with subacromial impingement syndrome (SIS). Only a few studies have explored the reliability of such measurements derived using a modified inclinometer. OBJECTIVES: To determine the relative and absolute reliability of scapular upward rotation and anterior-posterior tilt measurements derived using a modified digital inclinometer in patients with SIS. METHOD: Seventeen SIS patients were assessed twice within 1 week. We determined the relative and absolute measurement reliability by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Both intra- and interrater reliability were determined. RESULTS: The intra-rater reliability (both measurements) was high (0.72–0.88), and the interrater ICC was high to excellent (0.72–0.98). Clinically acceptable SEM and MCID values were obtained for scapular upward rotation (SEM: 4.28–9.33∘, MCID: 5.1–11.3∘) and anterior-posterior tilt (SEM: 3.72–7.55∘, MCID: 2.5–10.8∘). CONCLUSIONS: Measurements of scapular upward rotation and anterior-posterior tilt using a modified digital inclinometer reliably reveal scapular position and kinematics in patients with SIS.

scholarly journals Psychometric Properties of the MyotonPRO in Dementia Patients with Paratonia

Gerontology ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 401-412 ◽  
Author(s):  
Hans Drenth ◽  
Sytse U. Zuidema ◽  
Wim P. Krijnen ◽  
Ivan Bautmans ◽  
Cees van der Schans ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Functional Mobility ◽  
Future Research ◽  
Minimal Detectable Change ◽  
Muscle Properties ◽  
Dementia Patients ◽  
Longitudinal Outcome

Background: Paratonia is a distinctive form of hypertonia, causing loss of functional mobility in early stages of dementia to severe high muscle tone and pain in the late stages. For assessing and evaluating therapeutic interventions, objective instruments are required. Objective: Determine the psychometric properties of the MyotonPRO, a portable device that objectively measures muscle properties, in dementia patients with paratonia. Methods: Muscle properties were assessed with the MyotonPRO by 2 assessors within one session and repeated by the main researcher after 30 min and again after 6 months. Receiver operating characteristic curves were constructed for all MyotonPRO outcomes to discriminate between participants with (n = 70) and without paratonia (n = 82). In the participants with paratonia, correlation coefficients were established between the MyotonPRO outcomes and the Modified Ashworth Scale for paratonia (MAS-P) and muscle palpation. In participants with paratonia, reliability (intraclass correlation coefficient) and agreement values (standard error of measurement and minimal detectable change) were established. Longitudinal outcome from participants with paratonia throughout the study (n = 48) was used to establish the sensitivity for change (correlation coefficient) and responsiveness (minimal clinical important difference). Results: Included were 152 participants with dementia (mean [standard deviation] age of 83.5 [98.2]). The area under the curve ranged from 0.60 to 0.67 indicating the MyotonPRO is able to differentiate between participants with and without paratonia. The MyotonPRO explained 10-18% of the MAS-P score and 8-14% of the palpation score. Interclass correlation coefficients for interrater reliability ranged from 0.57 to 0.75 and from 0.54 to 0.71 for intrarater. The best agreement values were found for tone, elasticity, and stiffness. The change between baseline and 6 months in the MyotonPRO outcomes explained 8-13% of the change in the MAS-P scores. The minimal clinically important difference values were all smaller than the measurement error. Conclusion: The MyotonPRO is potentially applicable for cross-sectional studies between groups of paratonia patients and appears less suitable to measure intraindividual changes in paratonia. Because of the inherent variability in movement resistance in paratonia, the outcomes from the MyotonPRO should be interpreted with care; therefore, future research should focus on additional guidelines to increase the clinical interpretation and improving reproducibility.

scholarly journals Changes in Muscle Hardness from Resting to Mid-Range Lengthened Positions Detected by Shear Wave Elastography (SWE) with a Novel Protocol of Ultrasound Probe Placement

2021 ◽  
Vol 11 (1) ◽  
pp. 452
Author(s):  
Long-Jun Ren ◽  
Connie Lok-Kan Cheng ◽  
Christina Zong-Hao Ma ◽  
Yong-Ping Zheng
Keyword(s):  
Shear Wave ◽  
Intraclass Correlation ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Healthy Adults ◽  
Physiological Status ◽  
Ultrasound Probe ◽  
Muscle Hardness ◽  
Age Related ◽  
Probe Placement

Muscle hardness and its relationship with different muscle lengths/positions are important for understanding its underlying physiological status, and yet remained unclear. This study aimed to detect the local muscle hardness at different muscle lengths and identify the influence of muscle position on muscle hardness in healthy adults. A total of 26 healthy adults participated in this study. Shear wave elastography (SWE) was used to measure the muscle hardness of the Rectus Femoris (RF), Tibialis Anterior (TA) and Gastrocnemius Medialis (GM). Each muscle was tested at both resting (RST) and mid-range lengthened (MRL) positions. A novel ultrasound probe placing method was introduced, applied, and evaluated in this study. Moderate to excellent intra-/inter-rater reliability (Intraclass Correlation Coefficient, ICC ≥ 0.70) was found for muscle hardness measurements. The muscle hardness significantly increased from the RST to MRL position for all three muscles (p < 0.001). This study found that the muscle hardness increased at its mid-range lengthened position from the resting position. The mid-range lengthened muscle position of TA and GM could also be sensitive enough to reflect the age-related changes in local muscle hardness. This study also highlights the importance of placing the assessed extremities in an appropriate and consistent position when assessing muscle qualities by ultrasonics in clinical practice.

scholarly journals Reliability Limits Of The Modified Thomas Test For Assessing Rectus Femoris Muscle Flexibility About The Knee Joint

2008 ◽  
Vol 43 (5) ◽  
pp. 470-476 ◽  
Author(s):  
Jason D. Peeler ◽  
Judy E. Anderson
Keyword(s):  
Knee Joint ◽  
Intraclass Correlation ◽  
Rectus Femoris ◽  
Scoring Systems ◽  
Nonparametric Tests ◽  
Method Error ◽  
Statistical Reliability ◽  
Active Population ◽  
Rectus Femoris Muscle ◽  
Femoris Muscle

Abstract Context: The modified Thomas test is commonly used in the clinical setting to assess flexibility about the thigh region. Objective: To evaluate the clinical reliability of the modified Thomas test for evaluating the flexibility of the rectus femoris muscle about the knee joint. Design: Descriptive laboratory study using a test-retest design. Setting: Institution-based clinical orthopaedic setting. Patients Or Other Participants: Fifty-seven individuals between the ages of 18 and 45 years with no history of trauma participated. Of those, 54 completed the study. Intervention(s): Three Board-certified athletic therapists with an average of 12.67 years of sport medicine expertise assessed rectus femoris flexibility using pass/fail and goniometer scoring systems. A retest session was completed 7 to 10 days later. Main Outcome Measure(s): Parametric and nonparametric tests were used to compare participants' test-retest results. Results: Chance-corrected κ values (intrarater x¯  =  0.40, 95% confidence interval [CI]  =  0.30, 0.54; interrater x¯  =  0.33, 95% CI  =  0.23, 0.41) indicated generally poor levels of reliability for pass/fail scoring. Intraclass correlation coefficient (ICC) values (intrarater x¯  =  0.67, 95% CI  =  0.55, 0.76; interrater x¯  =  0.50, 95% CI  =  0.40, 0.60) indicated fair to moderate levels of reliability for goniometer data. Measurement error values (standard error of measurement  =  7°, method error  =  6°, and coefficient of variation  =  13%) and Bland-Altman plots (with 95% limits of agreement) further demonstrated the degree of intrarater variance for each examiner when conducting the test. Conclusions: These results call into question the statistical reliability of the modified Thomas test and provide clinicians with important information regarding its reliability limits when used to clinically assess flexibility of the rectus femoris muscle about the knee joint in a physically active population. More research is needed to ascertain the variables that may confound the statistical reliability of this orthopaedic technique.

scholarly journals Changes in muscle ultrasound for the diagnosis of intensive care unit acquired weakness in critically ill patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Weiqing Zhang ◽  
Jun Wu ◽  
Qiuying Gu ◽  
Yanting Gu ◽  
Yujin Zhao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Diagnostic Accuracy ◽  
Biceps Brachii ◽  
Rectus Femoris ◽  
Apache Ii ◽  
Cross Sectional ◽  
Icu Admission ◽  
The Right ◽  
Muscle Ultrasound

AbstractTo test diagnostic accuracy of changes in thickness (TH) and cross-sectional area (CSA) of muscle ultrasound for diagnosis of intensive care unit acquired weakness (ICU-AW). Fully conscious patients were subjected to muscle ultrasonography including measuring the changes in TH and CSA of biceps brachii (BB) muscle, vastus intermedius (VI) muscle, and rectus femoris (RF) muscles over time. 37 patients underwent muscle ultrasonography on admission day, day 4, day 7, and day 10 after ICU admission, Among them, 24 were found to have ICW-AW. Changes in muscle TH and CSA of RF muscle on the right side showed remarkably higher ROC-AUC and the range was from 0.734 to 0.888. Changes in the TH of VI muscle had fair ROC-AUC values which were 0.785 on the left side and 0.779 on the right side on the 10th day after ICU admission. Additionally, Sequential Organ Failure Assessment (SOFA), Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores also showed good discriminative power on the day of admission (ROC-AUC 0.886 and 0.767, respectively). Ultrasonography of changes in muscles, especially in the TH of VI muscle on both sides and CSA of RF muscle on the right side, presented good diagnostic accuracy. However, SOFA and APACHE II scores are better options for early ICU-AW prediction due to their simplicity and time efficiency.

Abstract 70: Importance of Both Self-consent and Proxy- consent Enrollments to Avoid Bias in Acute Stroke Randomized Trials

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kristina Shkirkova ◽  
Nelson Wu ◽  
Sidney Starkman ◽  
Nerses Sanossain ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Informed Consent ◽  
Acute Stroke ◽  
Randomized Trials ◽  
Proxy Consent ◽  
Long Term Outcomes ◽  
Stroke Population ◽  
Acute Cerebral Ischemia ◽  
Hemorrhage Volume ◽  
Artery Disease

Background: Informed consent options for acute stroke randomized trials include self-consent from patients with retained competency, proxy consent from a legally authorized representative (LAR), and exception from informed consent in emergency circumstances (EFIC). Mechanisms other than self-consent trespass upon the ethical principle of autonomy (respect for persons), and should be used only if self-consent alone would bias the patient population. Methods: We analyzed acute stroke patients enrolled within 2h of symptom onset in the NIH Phase 3 Field Administration of Stroke Therapy - Magnesium (FAST-MAG) trial, comparing entry characteristics and outcomes with different consent mechanisms. Results: Among 1700 patients, median time from onset to study entry was 45 min (IQR 35-62). Overall, 60% of patients were competent and provided self-consent, 39% noncompetent and enrolled by proxy consent from an on-scene LAR, and 1% noncompetent enrolled using EFIC/delayed consent. Compared to self-consented patients, proxy-consented patients were: older, 73.8 vs 66.5, p<0.001; more often female, 47% vs 40%, p<0.02; and a higher frequency of several vascular risk factors, including hypertension, 81% vs 76%, p<0.05, diabetes, 26% vs20%, p<0.01, atrial fibrillation, 29% vs 17%, p<0.001, and coronary artery disease, 24% vs 19%, p<0.01. Proxy consent patients had more severe initial stroke deficits, prehospital LAMS, 4.1 vs 3.5, p<0.001. Proxy consent patients with acute cerebral ischemia had more advanced initial ischemic stroke lesions, ASPECTS 8.3 vs 9.3, p<0.001, and received tPA more often, 35% vs 20%, p<0.001. Proxy consent patients with intracerebral hemorrhage patient had larger initial hemorrhage volume (cc), 42.2 vs 22.6, p<0.001. Proxy consent patients had worse final outcomes, with freedom from disability (mRS 0-1) at 90d, 23.6% vs 44.3%, p<0.001. Conclusions: Proxy-informed consent patients differ systematically from self-consent patients, with older age, more comorbidities, more severe deficits, and worse long term outcomes. To ensure that acute stroke trial cohorts are representative of the general stroke population, it is important that enrollment mechanisms include proxy and/or deferred consent.

scholarly journals Inter-day test–retest reliability and feasibility of isokinetic, isometric, and isotonic measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease: A multicenter study

2018 ◽  
Vol 16 ◽  
pp. 147997311881649 ◽  
Author(s):  
Erik Frykholm ◽  
Sarah Géphine ◽  
Didier Saey ◽  
Hieronymus van Hees ◽  
Arthur Lemson ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Intraclass Correlation ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Total Work ◽  
Obstructive Pulmonary Disease ◽  
Relative Reliability ◽  
Very High ◽  
Absolute Reliability

The aims were to determine reliability and feasibility of measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease. Sixty participants (forced expiratory volume in one second (mean ± standard deviation) 55 ± 18% of predicted, age 67 ± 8 years) were tested in an inter-day, test–retest design. Isokinetic, isometric, and isotonic protocols were performed using a computerized dynamometer. Test–retest relative and absolute reliability was determined via intraclass correlation coefficient (ICC), coefficient of variation (CV%), and limits of agreement (LoA%). Isokinetic total work demonstrated very high relative reliability (ICC: [95% confidence interval] = 0.98 [0.94–0.99]) and the best absolute reliability (CV% (LoA%) = 6.5% (18.0%)). Isokinetic fatigue index, isometric, and isotonic measures demonstrated low-to-high relative reliability (ICC = 0.64 [0.46–0.77], 0.88 [0.76–0.94], 0.91 [0.85–0.94]), and measures of absolute reliability (CV% (LoA%)) were 20.3% (56.4%), 14.9% (40.8%), and 15.8% (43.1%). For isokinetic total work and isometric measurements, participants performed better on retest (4.8% and 10.0%, respectively). The feasibility was similar across protocols with an average time consumption of less than 7.5 minutes. In conclusion, isokinetic, isometric, and isotonic measurements of quadriceps endurance were feasible to a similar extent and presented low-to-very high relative reliability. Absolute reliability seems to favor isokinetic total work measurements.

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