scholarly journals Accuracy and Reliability of X-ray Measurements in the Cervical Spine

2020 ◽  
Vol 14 (2) ◽  
pp. 169-176
Author(s):  
Catarina Marques ◽  
Emma Granström ◽  
Anna MacDowall ◽  
Nuno Canto Moreira ◽  
Martin Skeppholm ◽  
...  

Study Design: This study is a post hoc analysis of a multicenter prospective randomized controlled trial which compared artificial disc replacement and anterior cervical discectomy and fusion.Purpose: Useful radiographic parameters for assessing cervical alignment include the Cobb angles, T1 slope (T1S), occipitocervical inclination (OCI), K-line tilt (KLT), and cervical sagittal vertical axis (cSVA). This study aimed to determine measurement accuracy and reliability for these parameters.Overview of Literature: Various authors have assessed repeatability by comparing different methods of measurement, but knowledge of measurement error and minimal detectable change is scarce.Methods: We evaluated 758 lateral cervical radiographs. One medical student and one spine surgeon (i.e., measured ×2 within 4 weeks) independently measured the parameters obtaining 5,850 values. Standard error of measurement (SEm) and minimum detectable change (MDC) were calculated for each parameter. The accuracy and reliability of the Cobb angle measurements were calculated for the different types of angles: cervical lordosis, prosthesis angle, segmental angle with two bone surfaces (SABB), and segmental angle with one bone and one metal surface. Reliability was determined with intraclass correlation coefficient (ICC).Results: SEm was 1.8° and MDC was 5.0° for the Cobb angle, with an intraobserver/interobserver ICC of 0.958/0.886. All the different subtypes of Cobb angles had an ICC higher than 0.950, except SABB (intraobserver/interobserver ICC of 0.922/0.716). The most accurate and reliable measurement was for KLT.Conclusions: This study provides normative data on SEm and MDC for Cobb angles, T1S, KLT, OCI, and cSVA in cervical lateral radiographs. Reliability was excellent for all parameters except SABB (e.g., good).

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Scaramuzzo ◽  
Antonino Zagra ◽  
Giuseppe Barone ◽  
Stefano Muzzi ◽  
Leone Minoia ◽  
...  

AbstractAim of the study was to evaluate sagittal parameters modifications, with particular interest in thoracic kyphosis, in patients affected by adolescent idiopathic scoliosis (AIS) comparing hybrid and all-screws technique. From June 2010 to September 2018, 145 patients were enrolled. Evaluation included: Lenke classification, Risser scale, coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS). Patients were divided in two groups (1 all-screws and 2 hybrid); a further division, in both groups, was done considering preoperative TK values. Descriptive and inferential statistical analysis was conducted. 99 patients were in group 1, 46 in group 2 (mean follow-up 3.7 years). Patients with a normo-kyphotic profile developed a little variation in TK (Δ pre–post = 2.4° versus − 2.0° respectively). Hyper-kyphotic subgroups had a tendency of restoring a good sagittal alignment. Hypo-kyphotic subgroups, patients treated with all-screw implants developed a higher increase in TK mean Cobb angle (Δ pre–post = 10°) than the hybrid subgroup (Δ pre–post = 5.4°) (p = 0.01). All-screws group showed better results in restoring sagittal alignment in all subgroups compared to hybrid groups, especially in hypo-TK subgroup, with the important advantage to give better correction on coronal plane.


Author(s):  
María Carmen Sánchez-González ◽  
Raquel García-Oliver ◽  
José-María Sánchez-González ◽  
María-José Bautista-Llamas ◽  
José-Jesús Jiménez-Rejano ◽  
...  

In our work, we determined the value of visual acuity (VA) with ETDRS charts (Early Treatment Diabetic Retinopathy Study). The purpose of the study was to determine the measurement reliabilities, calculating the correlation coefficient interclass (ICC), the value of the error associated with the measure (SEM), and the minimal detectable change (MDC). Forty healthy subjects took part. The mean age was 23.5 ± 3.1 (19 to 26) years. Visual acuities were measured with ETDRS charts (96% ETDRS chart nº 2140) and (10% SLOAN Contrast Eye Test chart nº 2153). The measurements were made (at 4 m) under four conditions: Firstly, photopic conditions with high contrast (HC) and low contrast (LC) and after 15 min of visual rest, mesopic conditions with high and low contrast. Under photopic conditions and high contrast, the ICC = 0.866 and decreased to 0.580 when the luminosity and contrast decreased. The % MDC in the four conditions was always less than 10%. It was minor under photopic conditions and HC (5.83) and maximum in mesopic conditions and LC (9.70). Our results conclude a high reliability of the ETDRS test, which is higher in photopic and high contrast conditions and lower when the luminosity and contrast decreases.


2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27 ◽  
Author(s):  
Kitima Rongsawad ◽  
Laddawon Worawan ◽  
Karnsiree Jirarojprapa ◽  
Sararat Kaewkham ◽  
Sarawut Khattiwong

Abstract Introduction Static postural stability is the ability to maintain the posture with minimum sway. Increasing postural sway during standing in different sensory conditions is associated with aging due to decline in sensory and motor functions. Sway area measured by using sway meter is usually simple method for assessing postural stability in elderly subjects. Like many biological measurements, sway area has an intrinsic variability that affects their test-retest reliability and responsiveness of postural stability assessment. The minimal detectable change (MDC) is ability to detect smallest change beyond measurement error that reflects a reliable change. Therefore, the MDC value could provide information of clinical relevance on postural stability. The aims of this study were to determine test-retest reliability and MDC of sway area obtained from sway meter in elderly subjects. Methods Twelve healthy elderly subjects aged 60 years and above were participated in this study. The test and retest repeatability of postural sway measurements were performed twice with a 1-hour interval. For each subject was assess postural sway using Lord’s sway meter during standing on 4 sensory conditions for 30 seconds of each condition. The test-retest reliability of sway area was calculated using intraclass correlation coefficient. The MDC for each sway area was calculated to quantify clinical relevance. Results The test-retest reliability of sway area revealed good to excellent reliability ranged from 0.85 to 0.94. Standard error of measurement (SEM) and MDC ranged from 75 to 205 mm2 and 209 to 568 mm2, respectively. Discussion and Conclusion Our findings reveal that sway area in different sensory conditions could be used in assessment of postural stability in elderly subjects. SEM and MDC of sway area increased when subjects were asked to close their eyes and on foam surface. The sway meter is a reliable tool for assessing postural stability in clinical setting.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 285
Author(s):  
José Manuel Tánori-Tapia ◽  
Ena Monserrat Romero-Pérez ◽  
Néstor Antonio Camberos ◽  
Mario A. Horta-Gim ◽  
Gabriel Núñez-Othón ◽  
...  

Among female breast cancer survivors, there is a high prevalence of lymphedema subsequent to axillary lymph node dissection and axillary radiation therapy. There are many methodologies available for the screening, diagnosis and follow-up of breast cancer survivors with or without lymphedema, the most common of which is the measurement of patients’ arm circumference. The purpose of this study was to determine the intra-rater minimal detectable change (MDC) in the volume of the upper limb, both segmentally and globally, using circumference measurements for the evaluation of upper limb volume. In this study, 25 women who had received a unilateral mastectomy for breast cancer stage II or III participated. On two occasions separated by 15 min, the same researcher determined 11 perimeters for each arm at 4 cm intervals from the distal crease of the wrist in the direction of the armpit. The MDC at the segmental level ranged from 3.37% to 7.57% (2.7 to 14.6 mL, respectively) and was 2.39% (42.9 mL) at the global level of the arm; thus, minor changes in this value result in a high level of uncertainty in the interpretation of the results associated with the diagnosis of lymphedema and follow-up for presenting patients.


2020 ◽  
Vol 47 (4) ◽  
pp. 479-486
Author(s):  
Yuki Kondo ◽  
Kyota Bando ◽  
Yosuke Ariake ◽  
Wakana Katsuta ◽  
Kyoko Todoroki ◽  
...  

BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely.


Author(s):  
Chahyun Oh ◽  
Chan Noh ◽  
Jieun Lee ◽  
Sangmin Lee ◽  
Boohwi Hong ◽  
...  

(1) Background: Although radiography performed on the subject in an upright position is considered the standard method for assessing sagittal cervical alignment, it is frequently determined, or reported, based on MRI performed on the subject in a supine position. (2) Methods: Cervical alignment observed in both imaging modalities was assessed using four methods: the C2-7 Cobb angle, the absolute rotation angle (ARA), Borden’s method, and the sagittal vertical axis (SVA). Cervical alignment was determined (lordosis, kyphosis, and straight) based on radiography. Then, the diagnostic cut-off values for the MRI images and their corresponding diagnostic accuracies were assessed. (3) Results: The analysis included 142 outpatients. The determined diagnostic cut-off values for lordosis, using three measurements (Cobb angle, ARA, and Borden’s method), were −8.5°, −12.5°, and 3.5 mm, respectively, and the cut-off values for kyphosis were −4.5°, 0.5°, and −1.5 mm, respectively. The cut-off value for SVA > 40 mm was 19.5 mm. The Cobb angle, ARA, and Borden’s method, on MRI, showed high negative predictive values for determining kyphosis. The SVA on MRI measurements also showed high negative predictive values for determining >40 mm. (4) Conclusions: MRI measurements may be predictive of cervical alignment, especially for the exclusion of kyphosis and SVA > 40 mm. However, caution is needed in the other determinations using MRI, as their accuracies are limited.


2018 ◽  
Vol 4 (1) ◽  
pp. e000365 ◽  
Author(s):  
Ben Ashworth ◽  
Patrick Hogben ◽  
Navraj Singh ◽  
Laura Tulloch ◽  
Daniel D Cohen

ObjectivesLower limb isometric tests are used to assess strength and strength asymmetries and monitor reductions in muscle force that may contribute to loss of performance and increase injury risk. Isometric tests in the upper body may be appropriate to monitor neuromuscular performance of the shoulder joint in sports involving contact and overhead actions. The aim of this study was to determine the reliability of a novel upper body isometric strength test.MethodsEighteen elite rugby players (age 22.4±4.6 years; body mass 95.5±13.4 kg) were tested on consecutive days. Maximal isometric contractions using both limbs against a force platform were assessed at three angles of abduction (180°, ‘I’; 135°, ‘Y’ and 90°, ‘T’), in a prone lying position. To evaluate interday reliability, intraclass coefficients (ICC) were calculated for mean net peak force (NPF) and highest NPF achieved in any trial (peak NPF). Intratrial variability was assessed using coefficient of variation (CV), and the standard error of measurement (SEM) was used to calculate minimal detectable change (MDC).ResultsInterday reliability for NPF was excellent in all test positions (ICC 0.94–0.98). The test demonstrated high absolute reliability values (SEM 4.8–10.8) and interday measurement error was below 10% in all test positions (CV 5.0–9.9%) except for the non-dominant arm I-position (CV 11.3%). Minimum detectable change was between 13.2 and 25.9 N.ConclusionThe Athletic Shoulder test demonstrated excellent reliability for each test position supporting its use as a reliable tool to quantify the ability to produce and transfer force across the shoulder girdle.


2021 ◽  
Author(s):  
Juan Pablo Martinez-Cano ◽  
Daniel Vernaza-Obando ◽  
Julián Chica ◽  
Andrés Mauricio Castro

Abstract Background: Patellofemoral pain is a very common complaint in orthopedic sports medicine clinics. Disease-specific patient-reported outcome measures (PROMs) are useful for research and clinical practice; thus, it is important to have validated translations available for new PROMs. This study aims to translate and validate the Spanish version of the patellofemoral pain and osteoarthritis subscale of the knee injury and osteoarthritis outcome score (KOOS-PF).Methods: The KOOS-PF was translated and culturally adapted to Spanish following current guidelines, which included translation, back-translation, conciliation and pilot studies. Patients with a diagnosis of patellofemoral pain and/or osteoarthritis from one medical center were invited to participate and complete the questionnaire. The evaluation of the score included internal consistency (Cronbach´s alpha), floor and ceiling effects, measurement error, minimal detectable change and minimal important change. For test-retest reliability, the intraclass correlation coefficient (ICC) was used, and for responsiveness, the global rating of change (GROC) scale was measured one month later.Results: Sixty patients with patellofemoral pain and/or osteoarthritis were included in the study. The Spanish version showed very good internal consistency (Cronbach’s alpha: 0.93) and test-retest reliability (intraclass correlation coefficient: 0.82). Responsiveness was confirmed, with the KOOS-PF demonstrating a strong correlation with the GROC score (r 0.64). The minimal detectable change was 11.1 points, the minimal important change was 17.2 points, and there were no floor or ceiling effects for the score.Conclusions: The Spanish version of the KOOS-PF demonstrated very good measurement properties, including internal consistency, reliability and responsiveness. The KOOS-PF can be used in Spanish-speaking patients for clinical and research purposes in patellofemoral pain and osteoarthritis.Trial registration: Fundación Valle del Lili, Biomedical Research Ethical Committee: No. 01438.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030475 ◽  
Author(s):  
Orna A Donoghue ◽  
George M Savva ◽  
Axel Börsch-Supan ◽  
Rose Anne Kenny

ObjectiveTo estimate the effects of repeat assessments, rater and time of day on mobility measures and to estimate their variation between and within participants in a population-based sample of Irish adults aged ≥50 years.DesignTest–retest study in a population representative sample.SettingAcademic health assessment centre of The Irish Longitudinal Study on Ageing (TILDA).Participants128 community-dwelling adults from the Survey for Health, Ageing and Retirement in Europe (SHARE) Ireland study who agreed to take part in the SHARE-Ireland/TILDA collaboration.InterventionsNot applicable.Outcome measuresParticipants performed timed up-and-go (TUG), repeated chair stands (RCS) and walking speed tests administered by one of two raters. Repeat assessments were conducted 1–4 months later. Participants were randomised with respect to a change in time (morning, afternoon) and whether the rater was changed between assessments. Within and between-participant variance for each measure was estimated using mixed-effects models. Intraclass correlation (ICC), SE of measurement and minimum detectable change (MDC) were reported.ResultsAverage performance did not vary between baseline and repeat assessments in any test, except RCS. The rater significantly affected performance on all tests except one, but time of day did not. Reliability varied from ICC=0.66 (RCS) to ICC=0.88 (usual gait speed). MDC was 2.08 s for TUG, 4.52 s for RCS and ranged from 19.49 to 34.73 cm/s for walking speed tests. There was no evidence for lower reliability of gait parameters with increasing time between assessments.ConclusionsReliability varied for each test when measurements are obtained over 1–4 months with most variation due to rater effects. Usual and motor dual task gait speed demonstrated highest reliability.


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