Functional Gait Assessment and Balance Evaluation System Test: Reliability, Validity, Sensitivity, and Specificity for Identifying Individuals With Parkinson Disease Who Fall

Background Gait impairments, balance impairments, and falls are prevalent in individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS) can be considered the reference standard for the determination of fall risk, it has a noted ceiling effect. Development of ceiling-free measures that can assess balance and are good at discriminating “fallers” from “nonfallers” is needed. Objective The purpose of this study was to compare the Functional Gait Assessment (FGA) and the Balance Evaluation Systems Test (BESTest) with the BBS among individuals with PD and evaluate the tests' reliability, validity, and discriminatory sensitivity and specificity for fallers versus nonfallers. Design This was an observational study of community-dwelling individuals with idiopathic PD. Methods The BBS, FGA, and BESTest were administered to 80 individuals with PD. Interrater reliability (n=15) was assessed by 3 raters. Test-retest reliability was based on 2 tests of participants (n=24), 2 weeks apart. Intraclass correlation coefficients (2,1) were used to calculate reliability, and Spearman correlation coefficients were used to assess validity. Cutoff points, sensitivity, and specificity were based on receiver operating characteristic plots. Results Test-retest reliability was .80 for the BBS, .91 for the FGA, and .88 for the BESTest. Interrater reliability was greater than .93 for all 3 tests. The FGA and BESTest were correlated with the BBS (r=.78 and r=.87, respectively). Cutoff scores to identify fallers were 47/56 for the BBS, 15/30 for the FGA, and 69% for the BESTest. The overall accuracy (area under the curve) for the BBS, FGA, and BESTest was .79, .80, and .85, respectively. Limitations Fall reports were retrospective. Conclusion Both the FGA and the BESTest have reliability and validity for assessing balance in individuals with PD. The BESTest is most sensitive for identifying fallers.

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The Minnesota Manual Dexterity Test: Reliability, Validity and Reference Values Studies with Healthy Elderly People

Canadian Journal of Occupational Therapy ◽

10.1177/000841749706400504 ◽

1997 ◽

Vol 64 (5) ◽

pp. 270-276 ◽

Cited By ~ 40

Author(s):

Johanne Desrosiers ◽

Annie Rochette ◽

Réjean Hébert ◽

Gina Bravo

Keyword(s):

Elderly People ◽

Reference Values ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Manual Dexterity ◽

Test Reliability ◽

Retest Reliability ◽

Healthy Elderly ◽

Block Test ◽

Test Retest Reliability

Several dexterity tests have been developed, including the Minnesota Rate of Manipulation Test (MRMT) and a new version, the Minnesota Manual Dexterity Test (MMDT). The objectives of the study were: a) to verify the test-retest reliability of the MMDT; b) to compare the MRMT and the MMDT; c) to study the concurrent validity of the MMDT; and d) to establish reference values for elderly people with the MMDT. Two hundred and forty-seven community-living healthy elderly were evaluated with the MMDT, and two other dexterity tests, the Box and Block Test (BBT) and the Purdue Pegboard (PP). Thirty-five of them were evaluated twice with the MMDT and 44 were evaluated with both the MMDT and MRMT. The results show that the test-retest reliability of the MMDT is acceptable to high (intraclass correlation coefficients of 0.79 to 0.87, depending on the subtest) and the validity of the test is demonstrated by significant correlations between the MMDT, the BBT and the PP (0.63 to 0.67). There is a high correlation (0.85 to 0.95) between the MMDT and the MMRT in spite of different results. The reference values will help occupational therapists to differentiate better between real dexterity difficulties and those that may be attributed to normal aging.

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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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Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease

Physical Therapy ◽

10.2522/ptj.20160099 ◽

2016 ◽

Vol 96 (12) ◽

pp. 1955-1964 ◽

Cited By ~ 10

Author(s):

Cathy C. Harro ◽

Alicia Marquis ◽

Natasha Piper ◽

Chris Burdis

Keyword(s):

Parkinson Disease ◽

Disease Severity ◽

Fall Risk ◽

Intraclass Correlation ◽

Community Dwelling ◽

Force Platform ◽

Minimal Detectable Change ◽

Retest Reliability ◽

Balance Impairment ◽

Test Retest Reliability

Abstract Background Complex movement and balance impairments in people with Parkinson disease (PD) contribute to high fall risk. Comprehensive balance assessment is warranted to identify intrinsic fall risk factors and direct interventions. Objective The purpose of this study was to examine the psychometric properties of 3 balance measures of a force platform (FP) system in people with PD. Methods Forty-two community-dwelling individuals with idiopathic PD completed the testing protocol. Test-retest reliability was assessed for the Limits of Stability Test (LOS), Motor Control Test (MCT), and Sensory Organization Test (SOT). Intraclass correlation coefficients (ICC [2,1]) were calculated to determine test-retest reliability and minimal detectable change. Validity was assessed by comparing the FP measures with criterion gait and balance measures using Pearson product moment correlations. Multiple regression analyses examined the contribution of PD characteristics to FP measures. Results All primary FP variables demonstrated excellent test-retest reliability (ICC=.78–.92). The SOT and LOS demonstrated fair to good correlations with criterion measures, whereas the MCT had fair correlations to balance measures only. Both SOT composite equilibrium and MCT average latency were moderately associated with disease severity. Limitations This study's sample had a relatively small number of participants with a positive fall history, which may limit the generalizability of the findings. Conclusions This study's findings provide support that FP measures are reliable and valid tests of balance impairment in people with PD. Disease severity was significantly associated with SOT and MCT measures, perhaps reflecting that these tests are meaningful indicators of decline in postural control with disease progression. Force platform measures may provide valuable quantitative information about underlying balance impairments in people with PD to guide therapeutic interventions for fall risk reduction.

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Reliability of the Function in Sitting Test (FIST)

Rehabilitation Research and Practice ◽

10.1155/2014/593280 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Sharon L. Gorman ◽

Monica Rivera ◽

Lise McCarthy

Keyword(s):

Interrater Reliability ◽

Physical Therapists ◽

Physical Therapist ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Inpatient Rehabilitation ◽

Neurological Dysfunction ◽

Retest Reliability ◽

Reliability Characteristics ◽

Test Retest Reliability

The function in sitting test (FIST) is a newly developed, performance-based measure examining deficits in seated postural control. The FIST has been shown to be internally consistent and valid in persons with neurological dysfunction but intra- and interrater reliability and test-retest reliability have not been previously described. Seven patients with chronic neurologic dysfunction were tested and videotaped performing the FIST on two consecutive days. Seventeen acute care and inpatient rehabilitation physical therapist raters scored six of the videotaped performance of the FIST on two occasions at least 2 weeks apart. Intraclass correlation coefficients were used to calculate the test-retest and intra- and interrater reliability of the FIST. ICC of 0.97 (95% CI 0.847–0.995) indicated excellent test-retest reliability of the FIST. Intra- and interrater reliability was also excellent with ICCs of 0.99 (95% CI 0.994–0.997) and 0.99 (95% CI 0.988–0.994), respectively. Physical therapists and other rehabilitation professionals can confidently use the FIST in a variety of clinical practice and research settings due to its favorable reliability characteristics. More studies are needed to describe the responsiveness and minimal clinically important level of change in FIST scores to further enhance clinical usefulness of this measure.

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Validity of the Functional Gait Assessment in Patients With Parkinson Disease: Construct, Concurrent, and Predictive Validity

Physical Therapy ◽

10.2522/ptj.20130019 ◽

2014 ◽

Vol 94 (3) ◽

pp. 392-400 ◽

Cited By ~ 18

Author(s):

Yaqin Yang ◽

Yongjun Wang ◽

Yanan Zhou ◽

Chen Chen ◽

Deli Xing ◽

...

Keyword(s):

Construct Validity ◽

Parkinson Disease ◽

Likelihood Ratio ◽

Predictive Validity ◽

Positive Likelihood Ratio ◽

Correlation Coefficients ◽

Cutoff Point ◽

Cutoff Score ◽

Gait Assessment ◽

Functional Gait

BackgroundThe Functional Gait Assessment (FGA) is a validated measurement of gait-related activities in certain populations and may be potentially useful to assess balance and gait disorders in patients with Parkinson disease (PD).ObjectiveThe purpose of this study was to determine the construct, concurrent, and predictive validity of the FGA in inpatients with PD.DesignThis was a prospective cohort study.MethodsOne hundred twenty-one inpatients with PD were prospectively enrolled. The FGA and other relevant appraisals of gait, balance, disease severity, and activities of daily living were performed. Six months later, the patients were interviewed by telephone to have their fall information collected. Principal component analysis was used to determine construct validity. Spearman correlation coefficients were used to determine concurrent validity between the FGA and other measures. Cutoff point, sensitivity, specificity, and positive likelihood ratio were calculated for predictive validity based on the receiver operating characteristic curve.ResultsOne common factor was extracted for construct validity, which cumulatively explained 64.0% of the total variance. Correlation coefficients for the FGA compared with other measures ranged from .57 to .85. The cutoff point for predicting falls was 18, with sensitivity of 80.6%, specificity of 80.0%, and positive likelihood ratio of 4.03.LimitationsThis study was limited by the length of time of follow-up and self-reports of falls without the requirement of a fall diary. Medication adjustment after the FGA evaluation may have led to a different cutoff score for identifying those patients who were at risk of falling.ConclusionsThe FGA demonstrated good construct validity in patients with PD. It had moderate to strong correlations with other balance and gait appraisals. The FGA can be used to predict falls within the subsequent 6 months.

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Reliability of Lower Extremity Strength Measurements Using the Belt-Resisted Method

Journal of Aging and Physical Activity ◽

10.1123/japa.6.4.317 ◽

1998 ◽

Vol 6 (4) ◽

pp. 317-326 ◽

Cited By ~ 14

Author(s):

Johanne Desrosiers ◽

François Prince ◽

Annie Rochette ◽

Michel Raîche

Keyword(s):

Lower Extremity ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Muscle Group ◽

Reliability Test ◽

Retest Reliability ◽

Intraclass Correlation Coefficients ◽

Muscle Groups ◽

Test Retest Reliability

The objectives of this study were to standardize measurement procedures and study the test-retest and interrater reliability of the belt-resisted method for measuring the lower extremity isometric strength of three muscle groups. The strength of 33 healthy, elderly, community-dwelling subjects was evaluated with a hand-held dynamometer using the belt-resisted method. Isometric strength testing of three muscle groups (hip flexors, knee extensors, and ankle dorsiflexors) was performed on two separate occasions, I week apart, by the same tester to determine test-retest reliability. The test results of two different examiners testing on different days were used to determine interrater reliability. Test-retest reliability was higher than interrater reliability. Test-retest reliability coefficients of the three muscle groups were high (J9-.95). For interrater reliability, intraclass correlation coefficients varied from .64 to .92. depending on the muscle group and side. For the two kinds of reliability, intraclass correlation coefficients increased from proximal to distal. The method for the hip muscle group should be modified to increase reliability of the measure.

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Clinimetric Evaluation of the Experienced Communication in Dementia Questionnaire (ECD)

The Gerontologist ◽

10.1093/geront/gnab187 ◽

2021 ◽

Author(s):

Maria W L J Olthof-Nefkens ◽

Els W C Derksen ◽

Britt Lambregts ◽

Bert J M de Swart ◽

Maria W G Nijhuis-van der Sanden ◽

...

Keyword(s):

Internal Consistency ◽

Completion Time ◽

Missing Values ◽

Early Stage ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Functional Independence ◽

Community Dwelling ◽

Retest Reliability ◽

Test Retest Reliability

Abstract Background and Objectives Tools to measure self-perceived communication between persons with early-stage dementia and their caregivers are lacking. Therefore, we developed a questionnaire for Experienced Communication in Dementia (ECD) with a patient version (ECD-P) and a caregiver version (ECD-C), that contains items on (1) caregiver competence, (2) social communication, (3) communication difficulties, and (4) experienced emotions. This article describes the feasibility and clinimetric evaluation of this instrument. Research Design and Methods A prospective observational cohort study was conducted with 57 dyads (community-dwelling person with dementia and primary caregiver). ECD-P, ECD-C, and measures on quality of life, caregiver burden, cognitive functioning, physical functioning, and functional independence were administered. After two weeks, the dyads filled out the ECD again. Feasibility (completion time and missing values per item), internal consistency (Cronbach’s α), test-retest reliability (intraclass correlation coefficients (ICCs)) and construct validity (hypotheses testing with Spearman’s r) were evaluated. Results Mean completion time was ten minutes per questionnaire. ICCs for test-retest reliability ranged from 0.67 to 0.78, except for ECD-P2 (ICC = 0.31). Internal consistency ranged from α = 0.75 to 0.82 for ECD-P1 and all parts of ECD-C, except for ECD-P2 (α = 0.66). Correlation coefficients for convergent validity ranged from r = 0.31 to 0.69 and correlation coefficients for divergent validity were r < 0.20 and statistically insignificant. Discussion and Implications Pending future research, the ECD, except part ECD-P2, seems to be a promising tool to measure experienced communication between persons with early-stage dementia and their caregivers.

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The design fluency test: a reliable and valid instrument for the assessment of game intelligence?

German Journal of Exercise and Sport Research ◽

10.1007/s12662-020-00697-0 ◽

2021 ◽

Author(s):

Thomas Finkenzeller ◽

Björn Krenn ◽

Sabine Würth ◽

Günter Amesberger

Keyword(s):

Psychometric Properties ◽

Team Sports ◽

Correlation Coefficients ◽

Soccer Players ◽

Scientific Instrument ◽

Retest Reliability ◽

Adolescent Students ◽

Design Fluency ◽

Test Retest Reliability ◽

Fluency Test

AbstractThe design fluency test (DFT) has been reported to predict successful sports performance of soccer players and has therefore been in the spotlight of sport psychology research. There is, however, a lack of research regarding the psychometric properties of the DFT in elite sports. Thus, the aim of this research was to provide findings of test–retest reliability, practice effects and the diagnostic power of the DFT. Multiple studies of youth and adult elite athletes, as well as nonathlete students, were conducted in applied settings. Test–retest relationship demonstrated poor to acceptable short-term and long-term correlations. Furthermore, significant changes between test and retest were obtained in some variables that differed among samples. The differential value of the DFT was corroborated by significant differences between adolescent students and adolescent elite soccer players. Regarding the prospective value, significant partial correlation coefficients were found between DFT scores and volleyball performance in adult elite players. Although our research partially confirmed previous findings on the differential and prospective power of the DFT, the findings on test–retest reliability indicate that the DFT cannot be recommended for application in sports. The psychometric properties—in particular the findings on test–retest reliability—of the DFT have to be improved before research can be carried out on the application for the selection of team sport athletes and for the prediction of future success in team sports. Further research is needed to develop a scientific instrument for the assessment of game intelligence.

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Psychometric Comparisons of 2 Versions of the Fugl-Meyer Motor Scale and 2 Versions of the Stroke Rehabilitation Assessment of Movement

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308315999 ◽

2008 ◽

Vol 22 (6) ◽

pp. 737-744 ◽

Cited By ~ 64

Author(s):

I-Ping Hsueh ◽

Miao-Ju Hsu ◽

Ching-Fan Sheu ◽

Su Lee ◽

Ching-Lin Hsieh ◽

...

Keyword(s):

Stroke Rehabilitation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Stroke Patients ◽

Chronic Patients ◽

Retest Reliability ◽

Intraclass Correlation Coefficients ◽

Mild Stroke ◽

Test Retest Reliability ◽

Rehabilitation Assessment

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

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Test–Retest Reliability and Internal Consistency of the Activity Card Sort–Australia (18-64)

OTJR Occupation Participation and Health ◽

10.1177/1539449216681277 ◽

2016 ◽

Vol 37 (1) ◽

pp. 50-56 ◽

Cited By ~ 2

Author(s):

Louise Gustafsson ◽

Inez Hui Min Hung ◽

Jacki Liddle

Keyword(s):

Internal Consistency ◽

Descriptive Study ◽

Community Dwelling ◽

Lower Percentage ◽

Card Sort ◽

Retest Reliability ◽

Activity Engagement ◽

Maintenance Activities ◽

Test Retest Reliability ◽

Acceptable Internal Consistency

The Activity Card Sort (ACS) measures activity engagement levels. The Activity Card Sort–Australian version for adults aged 18 to 64 (ACS-Aus (18-64)) was recently developed, and psychometric properties have not yet been determined. This study was established to determine the test–retest reliability and internal consistency of the ACS-Aus (18-64) and describe activity engagement trends for healthy adults. Fifty-four adults aged 18 to 64 participated in this descriptive study. The ACS-Aus (18-64) demonstrated excellent test–retest reliability ( r = .92, p < .001) and acceptable internal consistency (α = .83). Adults aged 18 to 40 retained a lower percentage of activities than adults aged 41 to 64 for personal care, daily life, home maintenance activities ( t = −2.22, p = .03), and recreation and relaxation activities ( t = −2.38, p = .02). The ACS-Aus (18-64) may be used to explore the activity engagement patterns of community-dwelling Australian adults aged 18 to 64. Further research will determine validity for clinical populations.

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