Psychometrics of the Wrist Stability and Hand Mobility Subscales of the Fugl-Meyer Assessment in Moderately Impaired Stroke

Background There remains a need for a quickly administered, stroke-specific, bedside measure of active wrist and finger movement for the expanding stroke population. The wrist stability and hand mobility scales of the upper extremity Fugl-Meyer Assessment (w/h UE FM) constitute a valid, reliable measure of paretic UE impairment in patients with active wrist and finger movement. Objective The aim of this study was to determine performance on the w/h UE FM in a stable cohort of survivors of stroke with only palpable movement in their paretic wrist flexors. Design A single-center cohort study was conducted. Method Thirty-two individuals exhibiting stable, moderate upper extremity hemiparesis (15 male, 17 female; mean age=56.6 years, SD=10.1; mean time since stroke=4.6 years, SD=5.8) participated in the study, which was conducted at an outpatient rehabilitation clinic in the midwestern United States. The w/h UE FM and Action Research Arm Test (ARAT) were administered twice. Intraclass correlation coefficients (ICCs), Cronbach alpha, and ordinal alpha were computed to determine reliability, and Spearman rank correlation coefficients and Bland-Altman plots were computed to establish validity. Results Intraclass correlation coefficients for the w/h UE FM and ARAT were .95 and .99, respectively. The w/h UE FM intrarater reliability and internal consistency were greater than .80, and concurrent validity was greater than .70. This also was the first stroke rehabilitative study to apply ordinal alpha to examine internal consistency values, revealing w/h UE FM levels greater than .85. Concurrent validity findings were corroborated by Bland-Altman plots. Conclusions It appears that the w/h UE FM is a promising tool to measure distal upper extremity movement in patients with little active paretic wrist and finger movement. This finding widens the segment of patients on whom the w/h UE FM can be effectively used and addresses a gap, as commonly used measures necessitate active distal upper extremity movement.

Download Full-text

Reliability, Internal Consistency, and Validity of Data Obtained With the Functional Gait Assessment

Physical Therapy ◽

10.1093/ptj/84.10.906 ◽

2004 ◽

Vol 84 (10) ◽

pp. 906-918 ◽

Cited By ~ 267

Author(s):

Diane M Wrisley ◽

Gregory F Marchetti ◽

Diane K Kuharsky ◽

Susan L Whitney

Keyword(s):

Internal Consistency ◽

Concurrent Validity ◽

Physical Therapist ◽

Rank Order ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Vestibular Disorders ◽

Intraclass Correlation Coefficients ◽

Gait Assessment ◽

Functional Gait

Background and Purpose. The Functional Gait Assessment (FGA) is a 10-item gait assessment based on the Dynamic Gait Index. The purpose of this study was to evaluate the reliability, internal consistency, and validity of data obtained with the FGA when used with people with vestibular disorders. Subjects. Seven physical therapists from various practice settings, 3 physical therapist students, and 6 patients with vestibular disorders volunteered to participate. Methods. All raters were given 10 minutes to review the instructions, the test items, and the grading criteria for the FGA. The 10 raters concurrently rated the performance of the 6 patients on the FGA. Patients completed the FGA twice, with an hour's rest between sessions. Reliability of total FGA scores was assessed using intraclass correlation coefficients (2,1). Internal consistency of the FGA was assessed using the Cronbach alpha and confirmatory factor analysis. Concurrent validity was assessed using the correlation of the FGA scores with balance and gait measurements. Results. Intraclass correlation coefficients of .86 and .74 were found for interrater and intrarater reliability of the total FGA scores. Internal consistency of the FGA scores was .79. Spearman rank order correlation coefficients of the FGA scores with balance measurements ranged from .11 to .67. Discussion and Conclusion. The FGA demonstrates what we believe is acceptable reliability, internal consistency, and concurrent validity with other balance measures used for patients with vestibular disorders.

Download Full-text

Translation and Initial Validation of the Chinese Version of the Action Research Arm Test in People with Stroke

BioMed Research International ◽

10.1155/2019/5416560 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Jiang-Li Zhao ◽

Pei-Ming Chen ◽

Wen-Feng Li ◽

Rui-Hao Bian ◽

Ming-Hui Ding ◽

...

Keyword(s):

Action Research ◽

Upper Extremity ◽

Internal Consistency ◽

Concurrent Validity ◽

Rank Correlation ◽

Correlation Coefficients ◽

Chinese Version ◽

Floor Effect ◽

Initial Validation ◽

Excellent Internal Consistency

Purpose. This study aimed to translate the English version of the Action Research Arm Test (ARAT) into Chinese and to evaluate the initial validation of the Chinese version (C-ARAT) in patients with a first stroke. Methods. An expert group translated the original ARAT from English into Chinese using a forward-backward procedure. Forty-four patients (36 men and 8 women) aged 22–80 years with a first stroke were enrolled in this study. The participants were evaluated using 3 stroke-specific outcome measures: C-ARAT, the upper extremity section of the Fugl–Meyer assessment (UE-FMA), and the Wolf Motor Function Test (WMFT). Internal consistency was analysed using Cronbach’s α coefficients and item-scale correlations. Concurrent validity was determined using Spearman’s rank correlation coefficients. Floor and ceiling effects were considered to be present when more than 20% of patients fell outside the preliminarily set lower or upper boundary, respectively. Results. The C-ARAT items yielded excellent internal consistency, with a Cronbach’s α of 0.98 (p < 0.001) and item-total correlations ranging from 0.727 to 0.948 (p < 0.001). The C-ARAT exhibited good-to-excellent correlations with the UE-FMA and WMFT functional ability (WMFT-FA) scores, with respective ρ values of 0.824 and 0.852 (p < 0.001), and an excellent negative correlation with the WMFT performance time (WMFT-time), with a ρ value of -0.940 (p < 0.001). The C-ARAT subscales generally exhibited good-to-excellent correlations with stroke-specific assessments, with ρ values ranging from 0.773 to 0.927 (p < 0.001). However, the gross subscale exhibited moderate-to-good correlations with the UE-FMA and WMFT-FA scores, with respective ρ values of 0.665 and 0.720 (p < 0.001). No significant floor effect was observed, and a significant ceiling effect was observed only on the WMFT-time. Conclusions. The C-ARAT demonstrated excellent internal consistency and good-to-excellent concurrent validity. This test could be used to evaluate upper extremity function in stroke patients without cognitive impairment.

Download Full-text

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

Sensors ◽

10.3390/s21093065 ◽

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.

Download Full-text

Validation of an Evidence-Based Medicine Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET)

Journal of Graduate Medical Education ◽

10.4300/jgme-d-12-00049.1 ◽

2013 ◽

Vol 5 (2) ◽

pp. 252-256 ◽

Cited By ~ 2

Author(s):

Hans B. Kersten ◽

John G. Frohna ◽

Erin L. Giudice

Keyword(s):

Internal Consistency ◽

Evidence Based Medicine ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Evidence Based ◽

Evaluation Tool ◽

Intraclass Correlation Coefficients ◽

Excellent Internal Consistency ◽

Based Medicine

Abstract Background Competence in evidence-based medicine (EBM) is an important clinical skill. Pediatrics residents are expected to acquire competence in EBM during their education, yet few validated tools exist to assess residents' EBM skills. Objective We sought to develop a reliable tool to evaluate residents' EBM skills in the critical appraisal of a research article, the development of a written EBM critically appraised topic (CAT) synopsis, and a presentation of the findings to colleagues. Methods Instrument development used a modified Delphi technique. We defined the skills to be assessed while reviewing (1) a written CAT synopsis and (2) a resident's EBM presentation. We defined skill levels for each item using the Dreyfus and Dreyfus model of skill development and created behavioral anchors using a frame-of-reference training technique to describe performance for each skill level. We evaluated the assessment instrument's psychometric properties, including internal consistency and interrater reliability. Results The EBM Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET) is composed of 14 items that assess residents' EBM and global presentation skills. Resident presentations (N = 27) and the corresponding written CAT synopses were evaluated using the EBM C-PET. The EBM C-PET had excellent internal consistency (Cronbach α = 0.94). Intraclass correlation coefficients were used to assess interrater reliability. Intraclass correlation coefficients for individual items ranged from 0.31 to 0.74; the average intraclass correlation coefficients for the 14 items was 0.67. Conclusions We identified essential components of an assessment tool for an EBM CAT synopsis and presentation with excellent internal consistency and a good level of interrater reliability across 3 different institutions. The EBM C-PET is a reliable tool to document resident competence in higher-level EBM skills.

Download Full-text

Dietary flavonoids and flavonoid-rich foods: validity and reproducibility of FFQ-derived intake estimates

Public Health Nutrition ◽

10.1017/s1368980020001627 ◽

2020 ◽

Vol 23 (18) ◽

pp. 3295-3303

Author(s):

Yiyang Yue ◽

Joshua Petimar ◽

Walter C Willett ◽

Stephanie A Smith-Warner ◽

Changzheng Yuan ◽

...

Keyword(s):

Intraclass Correlation ◽

Rank Correlation ◽

Correlation Coefficients ◽

Food Composition ◽

Total Flavonoid ◽

Random Measurement Error ◽

Men And Women ◽

Intraclass Correlation Coefficients ◽

Spearman’S Rank Correlation ◽

Flavonoid Intake

AbstractObjective:To evaluate the validity and reproducibility of a 152-item semi-quantitative FFQ (SFFQ) for estimating flavonoid intakes.Design:Over a 1-year period, participants completed two SFFQ and two weighed 7-d dietary records (7DDR). Flavonoid intakes from the SFFQ were estimated separately using Harvard (SFFQHarvard) and Phenol-Explorer (SFFQPE) food composition databases. 7DDR flavonoid intakes were derived using the Phenol-Explorer database (7DDRPE). Validity was assessed using Spearman’s rank correlation coefficients deattenuated for random measurement error (rs), and reproducibility was assessed using rank intraclass correlation coefficients.Setting:This validation study included primarily participants from two large observational cohort studies.Participants:Six hundred forty-one men and 724 women.Results:When compared with two 7DDRPE, the validity of total flavonoid intake assessed by SFFQPE was high for both men and women (rs = 0·77 and rs = 0·74, respectively). The rs for flavonoid subclasses ranged from 0·47 for flavones to 0·78 for anthocyanins in men and from 0·46 for flavonols to 0·77 for anthocyanins in women. We observed similarly moderate (0·4–0·7) to high (≥0·7) validity when using SFFQHarvard estimates, except for flavonesHarvard (rs = 0·25 for men and rs = 0·19 for women). The SFFQ demonstrated high reproducibility for total flavonoid and flavonoid subclass intake estimates when using either food composition database. The intraclass correlation coefficients ranged from 0·69 (flavonolsPE) to 0·80 (proanthocyanidinsPE) in men and from 0·67 (flavonolsPE) to 0·77 (flavan-3-ol monomersHarvard) in women.Conclusions:SFFQ-derived intakes of total flavonoids and flavonoid subclasses (except for flavones) are valid and reproducible for both men and women.

Download Full-text

Using Pedometers to Estimate Ambulatory Physical Activity in Vietnam

Journal of Physical Activity and Health ◽

10.1123/jpah.8.1.52 ◽

2011 ◽

Vol 8 (1) ◽

pp. 52-61 ◽

Cited By ~ 2

Author(s):

Au Bich Thuy ◽

Leigh Blizzard ◽

Michael Schmidt ◽

Costan Magnussen ◽

Emily Hansen ◽

...

Keyword(s):

Physical Activity ◽

Concurrent Validity ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Population Based ◽

Work Activities ◽

Intraclass Correlation Coefficients ◽

Significant Difference ◽

Day Of The Week ◽

Population Based Survey

Background:Pedometer measurement of physical activity (PA) has been shown to be reliable and valid in industrialized populations, but its applicability in economically developing Vietnam remains untested. This study assessed the feasibility, stability and validity of pedometer estimates of PA in Vietnam.Methods:250 adults from a population-based survey were randomly selected to wear Yamax pedometers and record activities for 7 consecutive days. Stability and concurrent validity were assessed using intraclass correlation coefficients (ICC) and Spearman correlation coefficients.Results:Overall, 97.6% of participants provided at least 1 day of usable recordings, and 76.2% wore pedometers for all 7 days. Only 5.2% of the sample participants were involved in work activities not measurable by pedometer. The number of steps increased with hours of wear. There was no significant difference between weekday and weekend in number of steps, and at least 3 days of recordings were required (ICC of the 3 days of recordings: men 0.96, women 0.97). Steps per hour were moderately correlated (men r = .42, women r = .26) with record estimates of total PA.Conclusions:It is feasible to use pedometers to estimate PA in Vietnam. The measure should involve at least 3 days of recording irrespective of day of the week.

Download Full-text

The Validity of Gait Variability and Fractal Dynamics Obtained From a Single, Body-Fixed Triaxial Accelerometer

Journal of Applied Biomechanics ◽

10.1123/jab.2013-0107 ◽

2014 ◽

Vol 30 (2) ◽

pp. 343-347 ◽

Cited By ~ 9

Author(s):

Dylan Kobsar ◽

Chad Olson ◽

Raman Paranjape ◽

John M. Barden

Keyword(s):

Older Adults ◽

Concurrent Validity ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Gait Variability ◽

Limited Information ◽

Triaxial Accelerometer ◽

Healthy Older Adults ◽

Intraclass Correlation Coefficients ◽

Dynamic Measures

A single triaxial accelerometer has the ability to collect a large amount of continuous gait data to quantitatively assess the control of gait. Unfortunately, there is limited information on the validity of gait variability and fractal dynamics obtained from this device. The purpose of this study was to test the concurrent validity of the variability and fractal dynamic measures of gait provided by a triaxial accelerometer during a continuous 10 minute walk in older adults. Forty-one healthy older adults were fitted with a single triaxial accelerometer at the waist, as well as a criterion footswitch device before completing a ten minute overground walk. The concurrent validity of six outcome measures was examined using intraclass correlation coefficients (ICC) and 95% limits of agreement. All six dependent variables measured by the accelerometer displayed excellent agreement with the footswitch device. Mean parameters displayed the highest validity, followed by measures of variability and fractal dynamics in stride times and measures of variability and fractal dynamics in step times. These findings suggest that an accelerometer is a valid and unique device that has the potential to provide clinicians with valid quantitative data for assessing their clients’ gait.

Download Full-text

A Digital Photographic Measurement Method for Quantifying Foot Posture: Validity, Reliability, and Descriptive Data

Journal of Athletic Training ◽

10.4085/1062-6050-46.1.20 ◽

2011 ◽

Vol 46 (1) ◽

pp. 20-30 ◽

Cited By ~ 17

Author(s):

Stephen C. Cobb ◽

C. Roger James ◽

Matthew Hjertstedt ◽

James Kruk

Keyword(s):

Concurrent Validity ◽

Measurement Method ◽

Injury Risk ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Validity And Reliability ◽

Descriptive Data ◽

Data Set ◽

Intraclass Correlation Coefficients ◽

Foot Posture

Abstract Context: Although abnormal foot posture long has been associated with lower extremity injury risk, the evidence is equivocal. Poor intertester reliability of traditional foot measures might contribute to the inconsistency. Objectives: To investigate the validity and reliability of a digital photographic measurement method (DPMM) technology, the reliability of DPMM-quantified foot measures, and the concurrent validity of the DPMM with clinical-measurement methods (CMMs) and to report descriptive data for DPMM measures with moderate to high intratester and intertester reliability. Design: Descriptive laboratory study. Setting: Biomechanics research laboratory. Patients or Other Participants: A total of 159 people participated in 3 groups. Twenty-eight people (11 men, 17 women; age = 25 ± 5 years, height = 1.71 ± 0.10 m, mass = 77.6 ± 17.3 kg) were recruited for investigation of intratester and intertester reliability of the DPMM technology; 20 (10 men, 10 women; age = 24 ± 2 years, height = 1.71 ± 0.09 m, mass = 76 ± 16 kg) for investigation of DPMM and CMM reliability and concurrent validity; and 111 (42 men, 69 women; age = 22.8 ± 4.7 years, height = 168.5 ± 10.4 cm, mass = 69.8 ± 13.3 kg) for development of a descriptive data set of the DPMM foot measurements with moderate to high intratester and intertester reliabilities. Intervention(s): The dimensions of 10 model rectangles and the 28 participants' feet were measured, and DPMM foot posture was measured in the 111 participants. Two clinicians assessed the DPMM and CMM foot measures of the 20 participants. Main Outcome Measure(s): Validity and reliability were evaluated using mean absolute and percentage errors and intraclass correlation coefficients. Descriptive data were computed from the DPMM foot posture measures. Results: The DPMM technology intratester and intertester reliability intraclass correlation coefficients were 1.0 for each tester and variable. Mean absolute errors were equal to or less than 0.2 mm for the bottom and right-side variables and 0.1° for the calculated angle variable. Mean percentage errors between the DPMM and criterion reference values were equal to or less than 0.4%. Intratester and intertester reliabilities of DPMM-computed structural measures of arch and navicular indices were moderate to high (>0.78), and concurrent validity was moderate to strong. Conclusions: The DPMM is a valid and reliable clinical and research tool for quantifying foot structure. The DPMM and the descriptive data might be used to define groups in future studies in which the relationship between foot posture and function or injury risk is investigated.

Download Full-text

The development of a scale to measure concepts of schizophrenia: experience among Brazilian psychiatrists

Revista de Saúde Pública ◽

10.1590/s0034-89101998000300001 ◽

1998 ◽

Vol 32 (3) ◽

pp. 201-208 ◽

Cited By ~ 2

Author(s):

Darci N. Santos ◽

Robert Blizard ◽

Anthony H. Mann

Keyword(s):

Internal Consistency ◽

Factor Model ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Intra Class Correlation ◽

Intraclass Correlation Coefficients ◽

Scale Scores ◽

The Stability ◽

Test Retest Reliability ◽

The University

INTRODUCTION: Among psychiatric disorders schizophrenia is often said to be the condition with the most disputed definition.The Bleulerian and Schneiderian approaches have given rise to diagnostic formulations that have varied with time and place. Controversies over the concept of schizophrenia were examined within European/North American settings in the early 1970s but little has since been reported on the views of psychiatrists in developing countries. In Brazil both concepts are referred to in the literature. A scale was developed to measure adherence to Bleulerian and Schneiderian concepts among psychiatrists working in S. Paulo. METHODOLOGY: A self-reported questionnaire comprising seventeen visual analogue-scale statements related to Bleulerian and Schneiderian definitions of Shizophrenia, plus sociodemographic and training characteristics, was distributed to a non-randomised sample of 150 psychiatrists. The two sub-scales were assessed by psychometric methods for internal consistency, sub-scale structure and test-retest reliability. Items selected according to internal consistency were examined by a two-factor model exploratory factor analysis. Intraclass correlation coefficients described the stability of the scale. RESULTS: Replies were received from 117 psychiatrists (mean age 36 (SD 7.9)), 74% of whom were made and 26% female. The Schneiderian scale showed better overall internal consistency than the Bleulerian scale. Intra-class correlation coefficients for test-retest comparisons were between 0.5 and 0.7 for Schneiderian items and 0.2 and 0.7 for Bleulerian items. There was no negative association between Bleulerian and Schneiderian scale scores, suggesting that respondents may hold both concepts. Place of training was significantly associated with the respondent's opinion; disagreement with a Bleulerian standpoint predominated for those trained at the University of S. Paulo. CONCLUSIONS: The less satisfactory reliability for the Bleulerian sub-scale limits confidence in the whole scale but on the other hand this questionnaire contributes to the understanding of the controversy over Bleulerian and Schneiderian models for conceptualisation of schizophrenia, the former requiring more inference and therefore being prone to unreliability.

Download Full-text

Translation, linguistic and cultural adaptation, reliability and validity of the Radboud Oral Motor Inventory for Parkinson's Disease – ROMP questionnaire

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20180033 ◽

2018 ◽

Vol 76 (5) ◽

pp. 316-323 ◽

Cited By ~ 2

Author(s):

Monia Presotto ◽

Maira Rozenfeld Olchik ◽

Johanna G. Kalf ◽

Carlos R.M. Rieder

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Internal Consistency ◽

Rating Scale ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Brazilian Portuguese ◽

Intraclass Correlation Coefficients ◽

Oral Motor

ABSTRACT Objective: To translate and linguistically and culturally adapt to Brazilian Portuguese, and verify the reliability and validity of the Radboud Oral Motor Inventory for Parkinson's Disease (ROMP). Methods: The ROMP was translated and retranslated, and the instrument reliability was verified by analyzing the internal consistency and the reproducibility of the intra-examiner retest. The final version was applied to 27 participants with Parkinson's disease. Results: Internal consistency was 0.99 for the total ROMP and 0.96 to 0.99 for the three domains. Intraclass correlation coefficients for reproducibility were 0.99 for the total ROMP and 0.93 to 0.99 for the subscales. The ROMP and its subscales correlated substantially with the Likert-type scale, as well as with the unified Parkinson's disease rating scale II and III items. Conclusion: The linguistic and cultural equivalence of the ROMP in Brazilian Portuguese is now available, with excellent reliability and validity.

Download Full-text