scholarly journals Tonic Stretch Reflex Threshold as a Measure of Ankle Plantar-Flexor Spasticity After Stroke

2016 ◽  
Vol 96 (5) ◽  
pp. 687-695 ◽  
Author(s):  
Andreanne K. Blanchette ◽  
Aditi A. Mullick ◽  
Karina Moïn-Darbari ◽  
Mindy F. Levin
Keyword(s):  
Stretch Reflex ◽  
Regression Line ◽  
Intraclass Correlation ◽  
Motor Deficits ◽  
Plantar Flexor ◽  
Study Objective ◽  
Promising Alternative ◽  
Significant Difference ◽  
Dynamic Velocity ◽  
Reflex Threshold

Background Commonly used spasticity scales assess the resistance felt by the evaluator during passive stretching. These scales, however, have questionable validity and reliability. The tonic stretch reflex threshold (TSRT), or the angle at which motoneuronal recruitment begins in the resting state, is a promising alternative for spasticity measurement. Previous studies showed that spasticity and voluntary motor deficits after stroke may be characterized by a limitation in the ability of the central nervous system to regulate the range of the TSRT. Objective The study objective was to assess interevaluator reliability for TSRT plantar-flexor spasticity measurement. Design This was an interevaluator reliability study. Methods In 28 people after stroke, plantar-flexor spasticity was evaluated twice on the same day. Plantar-flexor muscles were stretched 20 times at different velocities assigned by a portable device. Plantar-flexor electromyographic signals and ankle angles were used to determine dynamic velocity-dependent thresholds. The TSRT was computed by extrapolating a regression line through dynamic velocity-dependent thresholds to the angular axis. Results Mean TSRTs in evaluations 1 and 2 were 66.0 degrees (SD=13.1°) and 65.8 degrees (SD=14.1°), respectively, with no significant difference between them. The intraclass correlation coefficient (2,1) was .851 (95% confidence interval=.703, .928). Limitations The notion of dynamic stretch reflex threshold does not exclude the possibility that spasticity is dependent on acceleration, as well as on velocity; future work will study both possibilities. Conclusions Tonic stretch reflex threshold interevaluator reliability for evaluating stroke-related plantar-flexor spasticity was very good. The TSRT is a reliable measure of spasticity. More information may be gained by combining the TSRT measurement with a measure of velocity-dependent resistance.

scholarly journals Rapid and Sensitive Determination of Lipid Oxidation Using the Reagent Kit Based on Spectrophotometry (FOODLABfatSystem)

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Chang Woo Kwon ◽  
Kyung-Min Park ◽  
Jeong Woong Park ◽  
JaeHwan Lee ◽  
Seung Jun Choi ◽  
...  
Keyword(s):  
Lipid Oxidation ◽  
Human Error ◽  
Time Course ◽  
Edible Oils ◽  
Regression Line ◽  
Acid Value ◽  
Standard Mixture ◽  
Promising Alternative ◽  
Significant Difference ◽  
Time Course Study

The reliability and availability of FOODLABfatsystem for determining acid value (AV) and peroxide value (POV) were assessed during the hydrolytic rancidification and lipid oxidation of edible oils. This reagent kit based on spectrophotometry was compared to the official methods (ISO 660 and 3960 protocols) based on manual titration employing the standard mixture for the simulated oxidation models and edible oils during the thermally induced oxidation at 180°C. The linear regression line of standard mixture and the significant difference of thermally oxidized time course study determined between them showed high correlations (R2=0.998andp<0.05) in both AVs and POVs. Considering ISO protocols with a probability of human error in manual titration, the rapidness and simplicity of the reagent kit based on spectrophotometry make it a promising alternative to monitor the lipid oxidation of edible oils and lipid-containing foods.

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

scholarly journals Shear bond strength of novel calcium aluminate-based cement (EndoBinder) to root dentine

2014 ◽  
Vol 08 (04) ◽  
pp. 498-503 ◽  
Author(s):  
Lucas da Fonseca Roberti Garcia ◽  
Hebert Luis Rossetto ◽  
Fernanda de Carvalho Panzeri Pires-de-Souza
Keyword(s):  
Bond Strength ◽  
Calcium Aluminate ◽  
Shear Bond Strength ◽  
Testing Machine ◽  
Mineral Trioxide Aggregate ◽  
Acrylic Resin ◽  
Promising Alternative ◽  
Mean Values ◽  
Significant Difference ◽  
Molar Teeth

ABSTRACT Objective: To evaluate the shear bond strength of a novel calcium aluminate-based cement, EndoBinder (EB), to dentine in comparison with Grey and White Mineral Trioxide Aggregate (MTA). Materials and Methods: Root canal hemi-sections obtained from 30 extracted molar teeth were embedded in self-polymerized acrylic resin and were grounded wet in order to obtain a flat dentine surface. Next, the roots were randomly assigned into three groups (n = 10), according to the cement used, as follows: EB: EndoBinder; WMTA: White MTA and GMTA: Grey MTA. The shear bond strength test was performed using a Universal Testing Machine (0.5 mm/min) and the data were submitted to statistical analysis (1-way ANOVA and Tukey tests, P < 0.05). Results: EB presented the highest shear bond strength values; however, there was no statistically significant difference in comparison with GMTA (P > 0.05). WMTA presented the lowest mean values, which were significant in comparison with EB (P < 0.05). Conclusions: The novel calcium aluminate-based cement presented higher shear bond strength than WMTA, and should be considered as a promising alternative in endodontic therapy.

Validity and reliability of the Turkish version of the Patient Dignity Inventory

2021 ◽  
pp. 1-8
Author(s):  
Yasemin Eskigülek ◽  
Sultan Kav
Keyword(s):  
Palliative Care ◽  
Factor Analysis ◽  
Intraclass Correlation ◽  
Validity And Reliability ◽  
Turkish Version ◽  
Retest Reliability ◽  
Significant Difference ◽  
Test Retest Reliability ◽  
Fit Index ◽  
Turkish Society

Abstract Objective The aim of this study was to investigate the validity and reliability of the Patient Dignity Inventory (PDI) in the Turkish society, which was developed to evaluate dignity-related distress in palliative care patients. Methods One hundred and twenty-seven adults with advanced cancer hospitalized in several clinics of two university hospitals were included in the study. The patients whose Palliative Performance Scale score was at least 40% were recruited to study. The data were collected with a patient demographic form, the Turkish version of Hospital Anxiety and Depression Scale (HADS-TR), and the Turkish version of the PDI (PDI-TR). The PDI-TR was finalized and back-translated after translating into Turkish and obtaining 10 expert opinions. Exploratory and confirmatory factor analysis, internal consistency, concurrent validity, and test–retest reliability analysis were performed. Results The Cronbach's α coefficient of PDI-TR was 0.94. Factor analysis resulted in a five-factor solution, and all items were loaded on factors. Factors were labeled as symptom distress, existential distress, self-confidence, dependency, and supportive care needs and accounted for 68.70% of the overall variance. The model's normed fit index, comparative fit index, and X2/SD were found between acceptable range (0.90, 0.93, and 2.64, respectively). A positive and strong correlation was found between subdimension scores of HADS-TR and the total score of PDI-TR (r = 0.70 for anxiety subdimension; r = 0.73 for depression subdimension). The test–retest reliability was conducted with 32 patients within the sample two weeks after the first application, and no significant difference was found between the two application scores as the result of paired-sample t-test (p > 0.05). An intraclass correlation coefficient of test–retest reliability was r = 0.855. Significance of results PDI-TR was found to be a valid and reliable tool in palliative care patients in Turkish society.

scholarly journals Using Differential Item Functioning to Test for Interrater Reliability in Constructed Response Items

2020 ◽  
Vol 80 (4) ◽  
pp. 808-820
Author(s):  
Cindy M. Walker ◽  
Sakine Göçer Şahin
Keyword(s):  
Differential Item Functioning ◽  
Interrater Reliability ◽  
Rating Scales ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Kappa Statistic ◽  
Promising Alternative ◽  
Constructed Response ◽  
Polytomous Item ◽  
Item Functioning

The purpose of this study was to investigate a new way of evaluating interrater reliability that can allow one to determine if two raters differ with respect to their rating on a polytomous rating scale or constructed response item. Specifically, differential item functioning (DIF) analyses were used to assess interrater reliability and compared with traditional interrater reliability measures. Three different procedures that can be used as measures of interrater reliability were compared: (1) intraclass correlation coefficient (ICC), (2) Cohen’s kappa statistic, and (3) DIF statistic obtained from Poly-SIBTEST. The results of this investigation indicated that DIF procedures appear to be a promising alternative to assess the interrater reliability of constructed response items, or other polytomous types of items, such as rating scales. Furthermore, using DIF to assess interrater reliability does not require a fully crossed design and allows one to determine if a rater is either more severe, or more lenient, in their scoring of each individual polytomous item on a test or rating scale.

Baclofen increases the soleus stretch reflex threshold in the early swing phase during walking in spastic multiple sclerosis patients

2000 ◽  
Vol 6 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Jørgen F Nielsen ◽  
Jacob B Anderson ◽  
Thomas Sinkjær
Keyword(s):  
Multiple Sclerosis ◽  
Stretch Reflex ◽  
Swing Phase ◽  
Modulation Index ◽  
Emg Activity ◽  
Walking Performance ◽  
Linear Fit ◽  
Reflex Threshold ◽  
Multiple Sclerosis Patients ◽  
Velocity Input

The effect of baclofen on walking performance was examined in nine spastic multiple sclerosis patient. In addition, nine healthy subjects were tested as controls. The modulation of the short latency soleus stretch reflex was closer to normal with baclofen compared to the recordings without baclofen, the modulation index being 74% (range: 60-100) with baclofen and 62% (range: 20 -100) without baclofen, P=0.03. In healthy subject the modulation index was 100% (range: 52 -100). In the early swing phase the threshold of the soleus stretch reflex was significantly higher during baclofen medication being 139 degls (range: 63 -302) compared with 93 degls (range: 37-187) with out baclofen, P=0.004. The relation between the stretch velocity (input) and the amplitude of the stretch reflex (output) in early swing phase was unchanged being 0.27 μVs/deg (range: 0.1-1.51) in patient with baclofen and 0.24 μVs/deg (range: 0.08-0.79) without baclofen, P=0.25. Baclofen induced no change in input-output properties of the stretch reflex during walking compared with findings in a sitting position at matched EMG activity. There was a significant correlation between clinical spasticity score and stretch reflex threshold in the early swing phase (p=-0.61, P=0.04) and between clinical spasticity score and the slope of the best linear fit in the early swing phase (p=0.72, P=0.009).

scholarly journals The Patient’s Denture Assessment (Thai version) is a valid and reliable tool for evaluating the outcome of treatment with complete denture

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sahaprom Namano ◽  
Orapin Komin
Keyword(s):  
Treatment Outcome ◽  
Pearson Correlation ◽  
Treatment Success ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Complete Denture ◽  
Care Clinic ◽  
Geriatric Dentistry ◽  
Significant Difference ◽  
Denture Treatment

Abstract Background Complete tooth losses are still being major problems which resulted in lesser quality of life especially for elderly patients. However, there are still lack of questionnaire to evaluate the treatment outcome from the patient’s aspect. The objective of this study is to evaluate the reliability and validity of the Patient’s Denture Assessment-Thai version (PDA-T), then use this questionnaire to assess patient satisfaction with complete denture treatment outcome also investigates the factors involving their satisfaction. Methods The subjects comprised 120 edentulous adult patients (49 men/71 women; average age 70 years-old) from the Prosthodontic and the Geriatric Dentistry and Special Patients Care Clinic at the Faculty of Dentistry, Chulalongkorn University during 2019 March‒2020 March. The patients were divided into two groups: the group experienced (Exper) (n = 54) with wearing complete dentures, and the non-experienced (NonExper) group (n = 66). The patients used the validated PDA-T to self-assess their treatment at different times. The Exper group completed the questionnaire at t0 (during treatment), t0.5 (2‒8-weeks after t0), and t1 (final follow-up). The NonExper group completed the questionnaire only at t1. Results In the Exper group, Cronbach’s α and average inter-item correlation was 0.95 (range 0.76‒0.95) and 0.47 (range 0.57‒0.83), respectively. The intraclass correlation coefficients (n = 18, 95% confidence interval) were 0.98 overall. The paired t-test (p < 0.05) between t0 and t1 indicated a significant difference between t0 and t1 in every PDA-T topic, and the effect size was 1.71. In the NonExper group, the Pearson correlation analysis indicated no significant correlation between the patients' demographics and masticatory function. Conclusion The reliability and validity of the PDA-T indicate it is a valuable tool for evaluating complete denture treatment. Treatment success affected the patients' satisfaction but was not associated with the type of doctors, genders, ages, or educational level.

An Evaluation of the Effects of Elevated Body Mass Index on Skeletal Age

2021 ◽  
Author(s):  
Michael H. French ◽  
Michael S. Kung ◽  
W. Nathan Holmes ◽  
Hossein Aziz ◽  
Evelyn S. Thomas ◽  
...  
Keyword(s):  
Chart Review ◽  
Pediatric Patients ◽  
Intraclass Correlation ◽  
Retrospective Chart Review ◽  
Skeletal Age ◽  
Chronological Age ◽  
Age Group ◽  
Obese Children ◽  
Significant Difference ◽  
Hand Radiographs

Abstract BackgroundMany treatment decisions in children’s Orthopaedics are based on age. This study determined whether a discrepancy between chronological age (CA) and skeletal age (SA) is dependent on BMI and if overweight or obese children would have an advanced SA.Materials and Methods120 children between ages 8-17 with an adequate hand radiograph and a correlating BMI were enrolled by retrospective chart review. Stratification based on age, sex, ethnicity, and BMI percentile was performed. For each age group, 6 males and 6 females were selected with 50% of each group having an elevated BMI. Two blinded physicians independently evaluated hand radiographs and recorded the SA. Statistical analyses evaluated inter-rater reliability and any discrepancy between groups.ResultsThe final statistical analysis included 96 children. The Intraclass Correlation Coefficient for SA determined by the two reviewers was excellent at 0.95. A difference of 13 months was found between CA and SA in the elevated BMI cohort versus the non-elevated BMI cohort, (p<0.001). No significant difference was seen between CA and SA for the non-elevated cohort (p=0.72), while matching for age and sex. ConclusionChronological age and skeletal age are not always equivalent especially in pediatric patients who are overweight or obese.

Effects of a physical self-care support program for patients with fibromyalgia: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Suélem B. de Lorena ◽  
Angela L.B.P. Duarte ◽  
Markus Bredemeier ◽  
Vanessa M. Fernandes ◽  
Eduardo A.S. Pimentel ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Fibromyalgia Impact Questionnaire ◽  
Self Care ◽  
Support Program ◽  
Control Group ◽  
Study Objective ◽  
Study Results ◽  
Significant Difference ◽  
Stretching Exercises ◽  
Care Support

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the CONTROL group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.

Interruption of cardiac output does not affect short-term growth and metabolic rate in day 3 and 4 chick embryos

2000 ◽  
Vol 203 (24) ◽  
pp. 3831-3838 ◽  
Author(s):  
W.W. Burggren ◽  
S.J. Warburton ◽  
M.D. Slivkoff
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Body Mass ◽  
Regression Line ◽  
Heart Beat ◽  
Chick Embryos ◽  
Simple Diffusion ◽  
Significant Difference ◽  
Vertebrate Embryos ◽  
Cervical Flexure

The heart beat of vertebrate embryos has been assumed to begin when convective bulk transport by blood takes over from transport by simple diffusion. To test this hypothesis, we measured eye growth, cervical flexure and rates of oxygen consumption (V(O2)) in day 3–4 chick embryos denied cardiac output by ligation of the outflow tract and compared them with those of embryos with an intact cardiovascular system.Eye diameter, used as the index for embryonic growth, increased at a rate of approximately 4.5-5 % h(−)(1) during the observation period. There was no significant difference (P&gt;0.1) in the rate of increase in eye diameter between control (egg opened), sham-ligated (ligature present but not tied) and ligated embryos. Similarly, the normal progression of cervical flexure was not significantly altered by ligation (P&gt;0.1). V(O2) (ml O(2)g(−)(1)h(−)(1)) at 38 degrees C, measured by closed respirometry, was not significantly different (P&gt;0.1) on day 3 in sham-ligated (14.5+/−1.9 ml O(2)g(−)(1)h(−)(1)) and ligated 17.6+/−1.8 ml O(2)g(−)(1)h(−)(1)) embryos. Similarly, on day 4, V(O2) in sham-ligated and ligated embryos was statistically the same (sham-ligated 10. 5+/−2.9 ml O(2)g(−)(1)h(−)(1); ligated 9.7+/−2.9 ml O(2)g(−)(1)h(−)(1)). Expressed as a linear function of body mass (M), V(O2) in sham-ligated embryos was described by the equation V(O2)=−0.48M+24.06 (r(2)=0.36, N=18, P&lt;0.01), while V(O2) in ligated embryos was described by the equation V(O2)=−0.53M+23.32 (r(2)=0.38, N=16, P&lt;0.01). The regression line describing the relationship between body mass and V(O2) for pooled sham-ligated and ligated embryos (the two populations being statistically identical) was V(O2)=−0.47M+23.24. The slope of this regression line, which was significantly different from zero (r(2)=0.30, N=34, P&lt;0.01), was similar to slopes calculated from previous studies over the same range of body mass.Collectively, these data indicate that growth and V(O2) are not dependent upon cardiac output and the convective blood flow it generates. Thus, early chick embryos join those of the zebrafish, clawed frog and axolotl in developing a heart beat and blood flow hours or days before required for convective oxygen and nutrient transport. We speculate that angiogenesis is the most likely role for the early development of a heart beat in vertebrate embryos.

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