Diagnosing Syndesmosis Instability: Dynamic Ultrasound versus Arthroscopy: A Cadaveric Study

Category: Ankle Introduction/Purpose: To evaluate whether sagittal translation could be detected with ultrasound and arthroscopy and to compare the increasing tibiofibular sagittal translation seen with ultrasound (US) and Arthroscopy. Methods: Eight fresh lower leg cadaveric specimen amputated above the proximal tibiofibular joint were used in this study. The ankle syndesmosis was evaluated using a handheld US device (Butterfly iQ, Butterfly Network Inc, Guilford) and arthroscopy with intact-, and after sequent sectioning of anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior- inferior tibiofibular ligament (PITFL). Sagittal plane translation was simulated with 100N of anterior to posterior (A-to-P) and posterior to anterior (P-to-A) hook force which was applied 5cm above of the ankle joint (Figure 1). Pearson’s correlation, one- way repeated measures ANOVA, and Wilcoxon signed-rank test were used for comparison. Three cadavers were measured by two independent observers to assess reliability and analyzed using intraclass correlation coefficients (ICC). Results: A-to-P translation values obtained with US and Arthroscopy had a correlation of -0.14, and P-to-A translation correlation of 0.44. Using US, intact translation was 0.94+-0.62 with A-to-P hook and 0.87+-0.5 with P-to-A hook. Subsequent A- to-P and P-to-A translation increased with 0.07+-0.96mm and 0.04+-0.76 after AITFL cut, with 0.53+-0.9 and 0.15+-0.5 after IOL cut, and with 0.81+-1.3mm and 0.45+-0.8 after PITFL cut (p-values between 0.122 and 0.270) . Using arthroscopy, intact translation was 0.40 +-0.3 with A-to-P hook and 0.99+-0.5 with P-to-A hook. Subsequent A-to-P and P-to-A translation increased from intact with; 0.001+-0.3 and 0.30+-0.4 after AITFL cut, 0.19+-0.4 and 0.74+-0.7 after IOL cut, and 0.40+-0.5 and 1.1+-0.9 after PITFL cut (p-values between 0.005 and 0.037). No statistical differences between US and Arthroscopy were found. Conclusion: US was unable to differentiate between the different stages of injury, even though a similar increase in translation was seen as compared to arthroscopy. Probably this is due to the high variability seen in the US translation values. As US does have several advantages over arthroscopy; availability, non-invasiveness, low costs, and allowance of using the contralateral side as a direct comparison, this technique should be further explored as a potential diagnostic assessment technique of diagnosing occult syndesmotic instability in the sagittal plane.

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Portable Dynamic Ultrasonography Versus Fluoroscopy for the Evaluation of Syndesmotic Instability: A Cadaveric Study

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00043 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0004

Author(s):

Noortje Hagemeijer ◽

Bart Lubberts ◽

Jirawat Saengsin ◽

Rohan Bhimani ◽

Go Sato ◽

...

Keyword(s):

External Rotation ◽

Intraclass Correlation ◽

Diagnostic Technique ◽

P Value ◽

Proximal Tibiofibular Joint ◽

Diagnostic Modality ◽

Interosseous Ligament ◽

Cadaveric Specimen ◽

Tibiofibular Ligament ◽

The Us

Category: Ankle; Trauma Introduction/Purpose: Syndesmotic instability, when subtle, is challenging to diagnose and often requires visualization of the syndesmosis during applied stress. The purpose of this study was to determine the association between tibiofibular clear space (TFCS) values measured with 1) a portable ultrasound (US) device and 2) fluoroscopy during applied external roation stress for the evaluation of syndesmotic instability. Methods: Eight fresh lower leg cadaveric specimen amputated above the proximal tibiofibular joint were used in this study. Portable US device (Butterfly iQ, Butterfly Network Inc) images and fluoroscopic images taken by a mini C-arm were used to evaluate the ankle syndesmosis in the intact stage, and after sequentially sectioning of the anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior-inferior tibiofibular ligament (PITFL) at 7.5Nm torque. A Pearson’s correlation was performed to investigate the correlation between the TFCS among the two modalities. A paired t-test was used to compare TFCS values measured with US or fluoroscopy. Three cadavers were measured by two independent observers to assess reliability of the measurements for each diagnostic modality and analyzed using intraclass correlation coefficients (ICC). P-values of < 0.05 were considered significant. Results: The mean TFCS (+- SD mm) values measured with the US and fluoroscopy are presented in Table 1. TFCS values obtained with the US and fluoroscopy correlated (rho 0.60). Between the imaging modalities similar TFCS values were found in the intact state (difference 0.81+-1.0, p-value 0.061). Compared with fluoroscopy, the TFCS values measured using US increased significantly after sequential transection of the AITFL (0.039), IOL (p=0.004) and PITFL (p<0.001). The ICC for measuring the TFCS with US was 0.86 and 0.84 with fluoroscopy indicating excellent agreement. Conclusion: During application of an external rotation force to the ankle, US and fluoroscopic TFCS measurements among different stages of syndesmotic ligamentous injury correlate. However, compared with fluoroscopy, a portable US ultrasound device seems to be a more sensitive diagnostic technique to evaluate subtle syndesmotic instability. [Table: see text]

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Portable Dynamic Ultrasonography is a Useful Tool for the Evaluation of Suspect Syndesmotic Instability: A Cadaveric Study

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00242 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0024

Author(s):

Noortje Hagemeijer ◽

Rohan Bhimani ◽

Jirawat Saengsin ◽

Bart Lubberts ◽

Gregory R. Waryasz ◽

...

Keyword(s):

Repeated Measures ◽

External Rotation ◽

P Value ◽

Proximal Tibiofibular Joint ◽

Interosseous Ligament ◽

Portable Ultrasound ◽

Cadaveric Specimen ◽

Ultrasound Device ◽

Tibiofibular Ligament ◽

Significant Difference

Category: Ankle; Sports; Trauma Introduction/Purpose: To evaluate syndesmotic instability by measuring the tibiofibular clear space (TFCS) opening using a portable ultrasound device. In addition, we assessed the optimal amount of external rotation torque required to detect syndesmotic instability. Methods: Eight fresh lower leg cadaveric specimen amputated above the proximal tibiofibular joint were used. Using a portable ultrasound device (Butterfly iQ, Butterfly Network Inc) the ankle syndesmosis was evaluated in the intact stage, and after sequentially sectioning of the anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior-inferior tibiofibular ligament (PITFL)(Figure 1). In each ligamentous sectioning stage TFCS in millimeter (mm) was measured with ultrasound while consecutively 0N, 45N, 60N, 75N, and 90N external rotation directed torque was applied to the ankle. To evaluate which amount of torque would be sufficient to detect syndesmotic instability the delta increase of TFCS opening at different states of torque compared to the unstressed state was calculated. One-way repeated measures ANOVA was used to detect whether an increase in delta-TFCS opening could be detected between the intact state and consecutive syndesmotic ligament transection stages. Correction for multiple comparisons was performed using the Bonferroni-Holm correction. Results: Under all torque-loading conditions TFCS (mean+-SDmm) opening increased as additional syndesmosis ligaments were transected (p-values<0.001). With all ligaments intact an increase of TFCS opening was detected during torque increment, ranging from 4.50+-1.2mm at 0N to 5.7+-1.00mm at 90N. After AITFL transection this amount increased from 5.2+-1.4mm at 0N to 6.5+-1.8mm at 90N. After AITFL+IOL transaction from 6.2+-1.3mm at 0N to 10.6+-6.2mm increase at 90N, and after AITFL+IOL+PITFL transection the TFCS opening increased from 6.8+-1.2mm at 0N to 11.1+-2.8mm at 90N. Significant difference from intact was seen after transection of the IOL, already from the unstressed (0N) state on (difference 3.0+-1.4mm, p-value 0.036). Additionally, the AITF+IOL could also be differentiated from AITFL transection stage at 45N with a difference in TFCS opening of 2.06+-1.2mm (p-value 0.006). Conclusion: Portable dynamic ultrasonography is a useful tool to evaluate suspect syndesmotic instability. TFCS opening increased as additional ligaments of the syndesmosis were transected and application of 45N torque seems to be sufficient to detect syndesmotic instability.

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Comparing Performance Across In-person and Videoconference-Based Administrations of Common Neuropsychological Measures in Community-Based Survivors of Stroke

Journal of the International Neuropsychological Society ◽

10.1017/s1355617720001174 ◽

2020 ◽

pp. 1-14

Author(s):

Jodie E. Chapman ◽

Betina Gardner ◽

Jennie Ponsford ◽

Dominique A. Cadilhac ◽

Renerus J. Stolwyk

Keyword(s):

Neuropsychological Assessment ◽

Language Impairment ◽

Repeated Measures ◽

Verbal Learning ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Preliminary Evidence ◽

Service Access ◽

Community Based ◽

Neuropsychological Measures

Abstract Objective: Neuropsychological assessment via videoconference could assist in bridging service access gaps due to geographical, mobility, or infection control barriers. We aimed to compare performances on neuropsychological measures across in-person and videoconference-based administrations in community-based survivors of stroke. Method: Participants were recruited through a stroke-specific database and community advertising. Stroke survivors were eligible if they had no upcoming neuropsychological assessment, concurrent neurological and/or major psychiatric diagnoses, and/or sensory, motor, or language impairment that would preclude standardised assessment. Thirteen neuropsychological measures were administered in-person and via videoconference in a randomised crossover design (2-week interval). Videoconference calls were established between two laptop computers, facilitated by Zoom. Repeated-measures t tests, intraclass correlation coefficients (ICCs), and Bland–Altman plots were used to compare performance across conditions. Results: Forty-eight participants (26 men; M age = 64.6, SD = 10.1; M time since stroke = 5.2 years, SD = 4.0) completed both sessions on average 15.8 (SD = 9.7) days apart. For most measures, the participants did not perform systematically better in a particular condition, indicating agreement between administration methods. However, on the Hopkins Verbal Learning Test – Revised, participants performed poorer in the videoconference condition (Total Recall Mdifference = −2.11). ICC estimates ranged from .40 to .96 across measures. Conclusions: This study provides preliminary evidence that in-person and videoconference assessment result in comparable scores for most neuropsychological tests evaluated in mildly impaired community-based survivors of stroke. This preliminary evidence supports teleneuropsychological assessment to address service gaps in stroke rehabilitation; however, further research is needed in more diverse stroke samples.

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Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

Scientific Reports ◽

10.1038/s41598-021-88095-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pieter-Jan Verhelst ◽

H. Matthews ◽

L. Verstraete ◽

F. Van der Cruyssen ◽

D. Mulier ◽

...

Keyword(s):

Repeated Measures ◽

Intraclass Correlation ◽

Three Dimensional ◽

Correlation Coefficients ◽

Surface Registration ◽

Anatomical Landmarks ◽

Centroid Size ◽

Intraclass Correlation Coefficients ◽

Total Variability ◽

Automatic Phenotyping

AbstractAutomatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were < 2 mm, accounting for < 1% of the total variability of the centroid size of the mandibles in this sample. ICC’s for the multivariate set of 325 interlandmark distances were all > 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape.

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Navigation-assisted suture anchor insertion for arthroscopic rotator cuff repair

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-3021-2 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Ivan Micic ◽

Erica Kholinne ◽

Hanpyo Hong ◽

Hyunseok Choi ◽

Jae-Man Kwak ◽

...

Keyword(s):

Suture Anchor ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Rank Test ◽

Subscapularis Tendon ◽

Signed Rank ◽

Original Target ◽

Signed Rank Test ◽

Arthroscopic Rotator Cuff ◽

Anchor Fixation

Abstract Background Suture anchor placement for subscapularis repair is challenging. Determining the exact location and optimum angle relative to the subscapularis tendon direction is difficult because of the mismatch between a distorted arthroscopic view and the actual anatomy of the footprint. This study aimed to compare the reliability and reproducibility of the navigation-assisted anchoring technique with conventional arthroscopic anchor fixation. Methods Arthroscopic shoulder models were tested by five surgeons. The conventional and navigation-assisted methods of suture anchoring in the subscapularis footprint on the humeral head were tested by each surgeon seven times. Angular results and anchor locations were measured and compared using the Wilcoxon signed rank test. Interobserver intraclass correlation coefficients (ICCs) were analyzed among the surgeons. Results The mean angular errors of the targeted anchor fixation guide without and with navigation were 17° and 2° (p < 0.05), respectively, and the translational errors were 15 and 3 mm (p < 0.05), respectively. All participants showed a narrow range of anchor fixation angular and translational errors from the original target. Among the surgeons, the interobserver reliabilities of angular errors for ICCs of the navigation-assisted and conventional methods were 0.897 and 0.586, respectively, and the interobserver ICC reliabilities for translational error were 0.938 and 0.619, respectively. Conclusions The navigation system may help surgeons be more aware of the surrounding anatomy and location, providing better guidance for anchor orientation, including footprint location and anchor angle.

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Interobserver Reliability and Change in the Sagittal Tibial Tubercle–Trochlear Groove Distance with Increasing Knee Flexion Angles

The Journal of Knee Surgery ◽

10.1055/s-0041-1729547 ◽

2021 ◽

Author(s):

Ian S. MacLean ◽

Taylor M. Southworth ◽

Ian J. Dempsey ◽

Neal B. Naveen ◽

Hailey P. Huddleston ◽

...

Keyword(s):

Knee Flexion ◽

Sagittal Plane ◽

Interobserver Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Flexion Angle ◽

Tibial Tubercle ◽

Trochlear Groove ◽

Knee Flexion Angle ◽

Intraclass Correlation Coefficients

AbstractThe tibial tubercle–trochlear groove (TT-TG) distance is currently utilized to evaluate knee alignment in patients with patellar instability. Sagittal plane pathology measured by the sagittal tibial tubercle–trochlear groove (sTT-TG) distance has been described in instability but may also be important to consider in patients with cartilage injury. This study aims to (1) describe interobserver reliability of the sTT-TG distance and (2) characterize the change in the sTT-TG distance with respect to changing knee flexion angles. In this cadaveric study, six nonpaired cadaveric knees underwent magnetic resonance imaging (MRI) studies at each of the following degrees of knee flexion: −5, 0, 5, 10, 15, and 20. The sTT-TG distance was measured on the axial T2 sequence. Four reviewers measured this distance for each cadaver at each flexion angle. Intraclass correlation coefficients were calculated to determine interobserver reliability and reproducibility of the sTT-TG measurement. Analysis of variance (ANOVA) tests and Friedman's tests with a Bonferroni's correction were performed for each cadaver to compare sTT-TG distances at each flexion angle. Significance was defined as p < 0.05. There was excellent interobserver reliability of the sTT-TG distance with all intraclass correlation coefficients >0.9. The tibial tubercle progressively becomes more posterior in relation to the trochlear groove (more negative sTT-TG distance) with increasing knee flexion. The sTT-TG distance is a measurement that is reliable between attending surgeons and across training levels. The sTT-TG distance is affected by small changes in knee flexion angle. Awareness of knee flexion angle on MRI is important when this measurement is utilized by surgeons.

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Increased Foot and Tibial Angles at Footstrike Decrease Vertical Loadrate in Runners

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00482 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0048

Author(s):

Adam Tenforde ◽

Haylee Donaghe Borgstrom ◽

Steve Jamison ◽

Irene Davis

Keyword(s):

Injury Risk ◽

Loading Rate ◽

Sagittal Plane ◽

Video Recording ◽

Correlation Coefficients ◽

Group Differences ◽

P Values ◽

Source Program ◽

Running Injuries ◽

The Relationship

Category: Sports Introduction/Purpose: It is well established that elevated vertical loadrates on footstrike are a risk factor for developing running injuries. Overstriding, or increased foot and tibial angles at footstrike, has been theorized to increase loading rate. Thus, it is often suggested that runners shorten their stride to reduce their injury risk. However, the relationship between landing alignment and loadrates has not been well established in current literature. Thus, we aimed to investigate the relationship between sagittal plane foot angle (FA) and tibial angle (TA) with vertical loadrates in both healthy and injured forefoot (FFS) and rearfoot strike (RFS) runners. It was hypothesized that as FA and TA increased, loadrate would increase for all runners. Methods: This is an ongoing study with 52 healthy runners (35 RFS, 17 FFS) and 24 injured runners (14 RFS, 10 FFS) for a total of 76 runners (51 M, 25 F; age34.3±11.4 yrs). Vertical average loadrate (VALR) and vertical instantaneous loadrate (VILR) were obtained while running at 2.68 m/s on an instrumented treadmill. All runners reported 0/10 pain during the assessment. Sagittal plane FA and TA at footstrike were measured from video recording using an open-source program. Positive FA designated RFS. Positive TA was defined as ankle anterior to the knee. Between-group differences were evaluated using paired two-tailed t-tests. Correlation coefficients (r) were computed for FA and TA with VALR and VILR (p=0.05; trend: p =0.10). Results: Healthy RFS - FA and TA were negatively correlated with VALR and VILR. Injured RFS – There was a trend toward negative correlation between TA and both VALR and VILR. Healthy FFS – TA was negatively correlated with both loadrates. Injured FFS – There were no significant correlations. Correlation coefficients, slopes, and p values are presented in Table 1. VALR and VILR were higher in RFS vs FFS runners (56±20 vs 40±10, 69±25 vs 54±12 BW/s, p<0.01), but were not significantly different for healthy vs injured runners (52±19 vs 56±26, 63±21 vs 67±27 BW/s, p=0.4). Conclusion: In contrast to current thought, preliminary results suggest that increasing FA and TA at footstrike are associated with decreasing vertical loadrates. This relationship was strongest for FA in the healthy RFS runners and weakest for FA in both the healthy and injured FFS runners. With increased FA, load attenuation may be due to increased eccentric activity of the tibialis anterior as well as increased knee flexion excursion and eccentric quadriceps activity with increased TA.

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Comparing Counts of Park Users With a Wearable Video Device and an Unmanned Aerial System

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2020-0063 ◽

2021 ◽

pp. 1-8

Author(s):

Richard R. Suminski ◽

Gregory M. Dominick ◽

Matthew Saponaro

Keyword(s):

Repeated Measures ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Future Research ◽

Unmanned Aerial Systems ◽

Park Use ◽

Intraclass Correlation Coefficients ◽

Potential Benefits ◽

Absolute Agreement ◽

Aerial Systems

Evidence suggests that video captured with a wearable video device (WVD) may augment or supplant traditional methods for assessing park use. Unmanned aerial systems (UASs) are used to assess human activity, but research employing them for park assessments is sparse. Therefore, this study compared park user counts between a WVD and UAS. A diverse set of 33 amenities (e.g., playground) in three parks were videoed simultaneously by one researcher wearing a WVD and another operating the UAS. Assessments were done at 12 p.m. and 7 p.m. on weekends, with one park evaluated on two occasions 7 days apart. Two investigators independently reviewed videos and reached consensus on the counts of individuals at each amenity. Intraclass correlation coefficients (ICCs) were used to determine intra- and interrater reliabilities. A total of 404 (M = 4.7; SD = 9.6) and 389 (M = 4.5; SD = 9.0) individuals were counted in the UAS and WVD videos, respectively. Absolute agreement was 86% (74/86) and 100% when no individuals were using the amenity. Whether using all 86 videos or only videos having people (48 videos), ICCs indicated excellent reliability (ICC = .99; p < .001). The totals seen for the repeated measures were UAS = 146 and WVD = 136 for Day 1 and UAS = 169 and WVD = 161 for Day 2. Intrarater reliability was excellent for the UAS (ICC = .92; p < .001) and good for the WVD (ICC = .89; p < .001). Disagreement was mainly due to obstructions—people behind or under structures. This study provides support for the use of UASs for counting park users and future research examining the potential benefits of video analysis for assessing park use.

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Standardising the measurement of physical activity in people receiving haemodialysis: considerations for research and practice

BMC Nephrology ◽

10.1186/s12882-019-1634-1 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Hannah M. L. Young ◽

Mark W. Orme ◽

Yan Song ◽

Maurice Dungey ◽

James O. Burton ◽

...

Keyword(s):

Physical Activity ◽

Sample Size ◽

Repeated Measures ◽

A Priori ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Future Research ◽

Wear Time ◽

Minimum Number ◽

The Uk

Abstract Background Physical activity (PA) is exceptionally low amongst the haemodialysis (HD) population, and physical inactivity is a powerful predictor of mortality, making it a prime focus for intervention. Objective measurement of PA using accelerometers is increasing, but standard reporting guidelines essential to effectively evaluate, compare and synthesise the effects of PA interventions are lacking. This study aims to (i) determine the measurement and processing guidance required to ensure representative PA data amongst a diverse HD population, and; (ii) to assess adherence to PA monitor wear amongst HD patients. Methods Clinically stable HD patients from the UK and China wore a SenseWear Armband accelerometer for 7 days. Step count between days (HD, Weekday, Weekend) were compared using repeated measures ANCOVA. Intraclass correlation coefficients (ICCs) determined reliability (≥0.80 acceptable). Spearman-Brown prophecy formula, in conjunction with a priori ≥ 80% sample size retention, identified the minimum number of days required for representative PA data. Results Seventy-seven patients (64% men, mean ± SD age 56 ± 14 years, median (interquartile range) time on HD 40 (19–72) months, 40% Chinese, 60% British) participated. Participants took fewer steps on HD days compared with non-HD weekdays and weekend days (3402 [95% CI 2665–4140], 4914 [95% CI 3940–5887], 4633 [95% CI 3558–5707] steps/day, respectively, p < 0.001). PA on HD days were less variable than non-HD days, (ICC 0.723–0.839 versus 0.559–0.611) with ≥ 1 HD day and ≥ 3 non-HD days required to provide representative data. Using these criteria, the most stringent wear-time retaining ≥ 80% of the sample was ≥7 h. Conclusions At group level, a wear-time of ≥7 h on ≥1HD day and ≥ 3 non-HD days is required to provide reliable PA data whilst retaining an acceptable sample size. PA is low across both HD and non- HD days and future research should focus on interventions designed to increase physical activity in both the intra and interdialytic period.

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Reliability of Safe Maximum Lifting Determinations of a Functional Capacity Evaluation

Physical Therapy ◽

10.1093/ptj/82.4.364 ◽

2002 ◽

Vol 82 (4) ◽

pp. 364-371 ◽

Cited By ~ 73

Author(s):

Douglas P Gross ◽

Michele C Battié

Keyword(s):

Functional Capacity ◽

Repeated Measures ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Functional Capacity Evaluation ◽

Measurement Variability ◽

Retest Reliability ◽

Repeated Measures Design ◽

Test Retest Reliability

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.

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