scholarly journals Evaluation of Prolonged Walking in Persons with Multiple Sclerosis: Reliability of the Spatio-Temporal Walking Variables during the 6-Minute Walk Test

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3075
Author(s):  
Nawale Hadouiri ◽  
Elisabeth Monnet ◽  
Arnaud Gouelle ◽  
Pierre Decavel ◽  
Yoshimasa Sagawa

Background: Walking disorders represent the most disabling condition in persons with Multiple Sclerosis (PwMS). Several studies showed good reliability of the 6-min walk test (6MWT) (i.e., especially distance traveled), but little is known about the reliability of the Spatio-temporal (ST) variables in the 6MWT. Objective: To evaluate the test-retest reliability of ST variables and perceived exertion during the 6MWT in PwMS and comparable healthy persons. Methods: We explored three 1-min intervals (initial: 0′–1′, middle: 2′30″–3′30″, end: 5′–6′) of the 6MWT. Six ST variables and perceived exertion were measured (respectively, using the GAITRite system and the Borg Scale). These measurements were performed twice, 1 week apart. The test-retest effects were assessed using the intraclass correlation coefficient (ICC) or the weighted kappa. Results: Forty-five PwMS and 24 healthy persons were included. The test-retest reliability of ST variables values was good-to-excellent for PwMS (ICC range: 0.858–0.919) and moderate-to-excellent for healthy persons (ICC range: 0.569–0.946). The test-retest reliability values of perceived exertion were fair for PwMS (weighted kappa range: 0.279–0.376) and substantial for healthy persons (weighted kappa range: 0.734–0.788). Conclusion: The measurement of ST variables during these 6MWT intervals is reliable and applicable in clinical practice and research to adapt rehabilitation care in PwMS.

Hand Therapy ◽  
2021 ◽  
pp. 175899832110025
Author(s):  
Alberto Dottor ◽  
Eleonora Camerone ◽  
Mirko Job ◽  
Diletta Barbiani ◽  
Elisa Frisaldi ◽  
...  

Introduction Given that pinch is a precision grip involved in sustained submaximal activities, a Sustained Contraction (SC) task could be associated to Maximal Voluntary Contraction (MVC). To better evaluate the thumb-index system, the test-retest reliability of pinch MVC and SC, measured by a visual feedback-based pinch gauge was assessed. Methods 26 healthy participants performed MVC and SC in two separate sessions. SC required to maintain 40%MVC as long as possible and it was evaluated in terms of time, accuracy (Mean Distance between force trace and target force, MD), precision (Coefficient of Variability of force trace, CV). MD and CV analyses were conducted dividing the SC task into three equivalent time stages (beginning, middle, exhaustion). Relative Reliability (RR) was measured by Intraclass Correlation Coefficient, and Absolute Reliability (AR) was measured by Standard Error of Measurement and by Bland-Altman plot. Results MVC and Time showed high RR and AR in both hands. RR of MD and CV in right hand was excellent in the beginning and middle stages, and fair in the exhaustion one, showing decreasing reliability as fatigue increases. In the left hand RR of MD and CV was generally lower. MD showed excellent reliability in the beginning stage and good reliability in the other stages. CV showed fair relative reliability at both beginning and middle stages, excellent in the last one. Conversely, it was observed high AR of MD and CV in all stages in both hands. Conclusions All indices are reliable to assess motor control of thumb-index pinch in both hands.


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.


2020 ◽  
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Marijn B Martens ◽  
...  

BACKGROUND The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS. OBJECTIVE The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT). METHODS We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the “HC matched” group) and 58 subjects had a less intense assessment schedule to determine reference values (the “HC normative” group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT. RESULTS The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS. CONCLUSIONS The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.


Sports ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 117
Author(s):  
Mike Climstein ◽  
Jessica L. Alder ◽  
Alyce M. Brooker ◽  
Elissa J. Cartwright ◽  
Kevin Kemp-Smith ◽  
...  

Background: Usage of wrist-worn activity monitors has rapidly increased in recent years, and these devices are being used by both fitness enthusiasts and in clinical populations. We, therefore, assessed the test–retest reliability of the Polar Vantage M (PVM) watch when measuring heart rate (HR) during various treadmill exercise intensities. Methods: HR was measured every 30 s (simultaneous electrocardiography (ECG) and PVM). Test–retest reliability was determined using an intraclass correlation coefficient (ICC) with 95% confidence intervals (CIs). Standard error of measurement (SEM) and smallest real difference (SRD) were used to determine measurement variability. Results: A total of 29 participants completed the trials. ICC values for PVM during stages 1, 2 and 5 demonstrated good to excellent test–retest reliability (0.78, 0.78 and 0.92; 95% CI (0.54–0.90, 0.54–0.9, 0.79–0.97)). For PVM during stages 0 (rest), 3 and 4, the ICC values indicated poor to good reliability (0.42, 0.68 and 0.58; 95% CI (−0.27–0.73, 0.32–0.85, 0.14–0.80)). Conclusion: This study identified that the test–retest reliability of the PVM was comparable at low and high exercise intensities; however, it revealed a poor to good test–retest reliability at moderate intensities. The PVM should not be used in a clinical setting where monitoring of an accurate HR is crucial to the patients’ safety.


2013 ◽  
Vol 48 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Rebecca Shultz ◽  
Scott C. Anderson ◽  
Gordon O. Matheson ◽  
Brandon Marcello ◽  
Thor Besier

Context: The Functional Movement Screen (FMS) is a popular test to evaluate the degree of painful, dysfunctional, and asymmetric movement patterns. Despite great interest in the FMS, test-retest reliability data have not been published. Objective: To assess the test-retest and interrater reliability of the FMS and to compare the scoring by 1 rater during a live session and the same session on video. Design: Cross-sectional study. Setting: Human performance laboratory in the sports medicine center. Patients or Other Participants: A total of 21 female (age = 19.6 ± 1.5 years, height = 1.7 ± 0.1 m, mass = 64.4 ± 5.1 kg) and 18 male (age = 19.7 ± 1.0 years, height = 1.9 ± 0.1 m, mass = 80.1 ± 9.9 kg) National Collegiate Athletic Association Division IA varsity athletes volunteered. Intervention(s): Each athlete was tested and retested 1 week later by the same rater who also scored the athlete's first session from a video recording. Five other raters scored the video from the first session. Main Outcome Measure(s): The Krippendorff α (K α) was used to assess the interrater reliability, whereas intraclass correlation coefficients (ICCs) were used to assess the test-retest reliability and reliability of live-versus-video scoring. Results: Good reliability was found for the test-retest (ICC = 0.6), and excellent reliability was found for the live-versus-video sessions (ICC = 0.92). Poor reliability was found for the interrater reliability (K α = .38). Conclusions: The good test-retest and high live-versus-video session reliability show that the FMS is a usable tool within 1 rater. However, the low interrater K α values suggest that the FMS within the limits of generalization should not be used indiscriminately to detect deficiencies that place the athlete at greater risk for injury. The FMS interrater reliability may be improved with better training for the rater.


2021 ◽  
pp. 1-6
Author(s):  
Fei Tian ◽  
Yaqi Zhao ◽  
Jixin Li ◽  
Wenjin Wang ◽  
Danni Wu ◽  
...  

Context: Many methods used to evaluate knee proprioception have shortcomings that limit their use in clinical settings. Based on an inexpensive 3D camera, a new portable device was recently used to evaluate the joint position sense (JPS) of the knee joint. However, the test–retest reliability of the new method remains unclear. This study aimed to evaluate the test–retest reliability of the new device and a long-arm goniometer for assessing knee JPS, and to compare the variability of the 2 methods. Design: Prospective observational study of the test–retest reliability of knee JPS measurements. Methods: Twenty-one healthy adults were tested in 2 sessions with a 1-week interval. Three target knee flexion angles (30°, 45°, and 60°) were reproduced in each session. Target and reproduced angles were measured with both methods. Intraclass correlation coefficients, standard error of the measurement, and Bland–Altman plots were used to quantify test–retest reliability. Paired t tests were used to compare knee JPS (absolute error of the target-reproduced angle) between the methods. Results: The new device (good to excellent intraclass correlation coefficients .74–.80; standard error of the measurement 0.52°–0.61°) demonstrated better test–retest reliability than the goniometer (poor to fair intraclass correlation coefficients .23–.43; standard error of the measurement 0.89°–2.07°) and better test–retest agreement (respective mean differences for the 30°, 45°, and 60° knee angles: 0.11°, 0.13°, and 0.41° for the new system; 0.84°, 1.52°, and 1.18° for the goniometer). The measurements (absolute errors of the target-reproduced angles) with the goniometer were significantly greater than those with the new device (P < .05); the SDs of repeated measurements with the goniometer (1.50°–2.41°) were greater than with the new device (1.08°–1.38°). Conclusions: Given that the new device has good reliability and sufficient precision, it is the better alternative for evaluating knee JPS. Goniometers should be used with caution to assess knee JPS.


2020 ◽  
Vol 4 (3) ◽  
pp. 925-945
Author(s):  
Leonardo Tozzi ◽  
Scott L. Fleming ◽  
Zachary D. Taylor ◽  
Cooper D. Raterink ◽  
Leanne M. Williams

Countless studies have advanced our understanding of the human brain and its organization by using functional magnetic resonance imaging (fMRI) to derive network representations of human brain function. However, we do not know to what extent these “functional connectomes” are reliable over time. In a large public sample of healthy participants ( N = 833) scanned on two consecutive days, we assessed the test-retest reliability of fMRI functional connectivity and the consequences on reliability of three common sources of variation in analysis workflows: atlas choice, global signal regression, and thresholding. By adopting the intraclass correlation coefficient as a metric, we demonstrate that only a small portion of the functional connectome is characterized by good (6–8%) to excellent (0.08–0.14%) reliability. Connectivity between prefrontal, parietal, and temporal areas is especially reliable, but also average connectivity within known networks has good reliability. In general, while unreliable edges are weak, reliable edges are not necessarily strong. Methodologically, reliability of edges varies between atlases, global signal regression decreases reliability for networks and most edges (but increases it for some), and thresholding based on connection strength reduces reliability. Focusing on the reliable portion of the connectome could help quantify brain trait-like features and investigate individual differences using functional neuroimaging.


2018 ◽  
Vol 20 (5) ◽  
pp. 231-237 ◽  
Author(s):  
Kathryn D. Mitchell ◽  
Han Chen ◽  
Sheri P. Silfies

Abstract Background: Individuals with multiple sclerosis (MS) have balance deficits that result in falls. Balance tests developed for older adults do not discriminate between fallers and nonfallers with MS. The Balance Evaluation Systems Test (BESTest) identifies body systems contributing to imbalance/fall risk. This study evaluated the test-retest reliability and construct validity of the BESTest to assess balance in individuals with MS, compared the diagnostic accuracy of the BESTest and Berg Balance Scale (BBS), and investigated the minimal detectable change of the BESTest in this population. Methods: Twenty individuals with MS were recruited. Age, onset of disease, and fall history were obtained. The following measures were used: Expanded Disability Status Scale, University of Illinois at Chicago Fear of Falling Measure, BESTest, and BBS. Twelve participants were retested to determine test-retest reliability of the BESTest. Results: The BESTest demonstrated strong test-retest reliability (intraclass correlation coefficient [3,1] = 0.98 [95% CI, 0.91–0.99], P = .01) and was highly correlated with the BBS (r = 0.94, P = .01). The BBS had poor accuracy to identify fallers. Using a score of 81%, the BESTest had moderate sensitivity (0.89) to identify fallers. The standard error of the measurement for the BESTest was 4.16 points, which translates into a minimal detectable change of 9.7% [90% CI] to 11.5% [95% CI]. Conclusions: The BESTest demonstrates excellent test-retest reliability and diagnostic utility as a measure of functional balance in persons with moderate MS. A change in BESTest score of at least 10% may indicate a true change in balance performance in this population.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Li Alemo Munters ◽  
Ronald F. van Vollenhoven ◽  
Helene Alexanderson

Objectives. Polymyositis (PM) and dermatomyositis (DM) are characterized by impaired muscle function with a majority of patients developing sustained disability. The aim of this study was to evaluate the patient’s individual priorities (patient preference) of disabilities most important to improve in PM/DM using the MacMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR), to correlate the MACTAR to myositis outcomes and to evaluate its test-retest reliability. Methods. Twenty-eight patients with PM/DM performed recommended outcomes as well as the MACTAR, which was performed twice with one week apart. Results. Sexual activity, walking, biking, social activities, and sleep constituted the predominating disabilities. Seventy-two and 33% of the identified disabilities were not covered by items of the Health Assessment Questionnaire and the Myositis Activities Profile. Correlations between the MACTAR and health-related quality of life measures were = −0.67–0.73, correlations with measures of activities of daily living and participation in society were = 0.51–0.60 with lower correlations for other outcomes. Intraclass correlation (ICC) and weighted Kappa () coefficients were 0.83 and 0.68, respectively, for test-retest reliability of the MACTAR. Conclusions. The MACTAR interview had promising measurement properties and identified patient preference disabilities in PM/DM that were not covered by recommended outcomes.


2004 ◽  
Vol 94 (2) ◽  
pp. 725-732 ◽  
Author(s):  
Fredric D. Wolinsky ◽  
Stacie M. Metz ◽  
William M. Tierney ◽  
Kathleen W. Wyrwich ◽  
Ajit N. Babu ◽  
...  

This study investigated the short-term stability of the 1991 Mirowsky-Ross 2 × 2 Index of the Sense of Control. From an ongoing longitudinal study, 304 subjects were randomly selected for test-retest interviews occurring 1 to 4 days after their regularly scheduled first follow-up interview. Test-retest reliability was assessed at the item level using percent agreement and weighted kappa. At the scale score level, reliability was assessed with the intraclass correlation coefficient ( ICC). ICCs were also calculated within categories of demographic, socioeconomic, psychosocial, and functional status characteristics. There was moderate to substantial item-level agreement (mean weighted kappa = .51; weighted kappa range =.38 to .66). At the scale score level there was substantial agreement ( ICC =.71). No appreciable differences in ICC values were found in the demographic, socioeconomic, psychosocial, and functional comparisons of status characteristics. Thus, this sense of control measure has acceptable test-retest reliability and is appropriate for use in longitudinal research.


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