Psychometric Properties of a Clinical Strength Assessment Protocol in People with Multiple Sclerosis

Background: Strength training in people with multiple sclerosis (MS) is an important component of rehabilitation, but it can be challenging for clinicians to quantify strength accurately and reliably. This study investigated the psychometric properties of a clinical strength assessment protocol using handheld dynamometry and other objective, quantifiable tests for the lower extremities and trunk in people with MS. Methods: This study determined discriminant validity between 25 participants with MS and 25 controls and between participants with MS who had higher versus lower disability; test-retest reliability across 7 to 10 days; and response stability. The protocol included handheld dynamometry measurements of ankle dorsiflexion, knee flexion and extension; hip flexion, extension, abduction, and adduction; and trunk lateral flexion. Muscular endurance tests were used to measure trunk extension, trunk flexion, and ankle plantarflexion. Results: The protocol discriminated between participants with MS and controls for all muscles tested (P < .001–.003). The protocol also discriminated between low- and moderate-disability groups (P = .001–.046) for 80% of the muscles tested. Test-retest reliability intraclass correlation coefficients were high (0.81–0.97). Minimal detectable change as a percentage of the mean was 13% to 36% for 85% of muscles tested. Conclusions: This study provides evidence for the discriminant validity, test-retest reliability, and response stability of a strength assessment protocol in people with MS. This protocol may be useful for tracking outcomes in people with MS for clinical investigations and practice.

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Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

Physical Therapy ◽

10.1093/ptj/pzab045 ◽

2021 ◽

Author(s):

A Wallin ◽

M Kierkegaard ◽

E Franzén ◽

S Johansson

Keyword(s):

Multiple Sclerosis ◽

Measurement Errors ◽

Balance Control ◽

Intraclass Correlation ◽

Repeated Measurements ◽

Minimal Detectable Change ◽

Detectable Change ◽

Limits Of Agreement ◽

Retest Reliability ◽

Test Retest Reliability

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.

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Test-Retest Reliability, Validity, and Minimal Detectable Change of the Balance Evaluation Systems Test to Assess Balance in Persons with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2016-118 ◽

2018 ◽

Vol 20 (5) ◽

pp. 231-237 ◽

Cited By ~ 5

Author(s):

Kathryn D. Mitchell ◽

Han Chen ◽

Sheri P. Silfies

Keyword(s):

Multiple Sclerosis ◽

Fear Of Falling ◽

Intraclass Correlation ◽

Berg Balance Scale ◽

Minimal Detectable Change ◽

Detectable Change ◽

Balance Performance ◽

Retest Reliability ◽

Evaluation Systems ◽

Test Retest Reliability

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.

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Instrumented Four Square Step Test in Adults with Transfemoral Amputation: Test-Retest Reliability and Discriminant Validity between Two Types of Microprocessor Knees

Sensors ◽

10.3390/s20174782 ◽

2020 ◽

Vol 20 (17) ◽

pp. 4782

Author(s):

Arnaud Gouelle ◽

Michael Jason Highsmith

Keyword(s):

Discriminant Validity ◽

Intraclass Correlation ◽

Step Test ◽

Functional Improvement ◽

Minimal Detectable Change ◽

Transfemoral Amputation ◽

Detailed Measurement ◽

Retest Reliability ◽

Four Square ◽

Test Retest Reliability

Technology-based outcomes have recently been proposed to complement the standard Four Square Step Test (FSST) by providing a decomposition of the sequences and information about the stepping pattern. A test-retest study and a randomized crossover design have been used to determine immediate test-retest reliability and to assess discriminant validity, in persons with a unilateral transfemoral amputation, for the parameters computed by an instrumented version of the Four Square Step Test. Twenty adults, independent and unlimited community ambulators, with a unilateral transfemoral amputation, performed two Four Square Step Tests on a pressure mat first with a microprocessor knee, then, a few weeks later with another one. One of these prosthetic knees was acknowledged to be superior and to provide functional improvement. Test-retest, intraclass correlation coefficients and minimal detectable change at 95% confidence level were calculated for each variable. Paired samples t-tests were then used to identify differences between the two microprocessor knee systems. The test-retest reliability of most outcome measures was good to excellent. Few variables showed a systematic difference and a trend to improve between test 1 and test 2. When comparing both microprocessor knees, significant differences in the expected direction were observed, with interpretation in accordance with a functional improvement. Importantly, we highlighted that various strategies to improve the performance in the test might complexify the interpretation of the most detailed measurement. The instrumented Four Square Step test provides reliable measures with satisfactory test-retest reliability and discriminant validity in persons with unilateral transfemoral amputation.

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Cross-cultural translation and validation of the Spanish version of the patellofemoral pain and osteoarthritis subscale of the KOOS (KOOS-PF)

BMC Research Notes ◽

10.1186/s13104-021-05619-3 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Juan Pablo Martinez-Cano ◽

Daniel Vernaza-Obando ◽

Julián Chica ◽

Andrés Mauricio Castro

Keyword(s):

Intraclass Correlation ◽

Patellofemoral Pain ◽

Spanish Version ◽

Minimal Detectable Change ◽

Global Rating ◽

Minimal Important Change ◽

Specific Patient ◽

Retest Reliability ◽

Patient Reported ◽

Test Retest Reliability

Abstract Objective The aim of this study was to translate to Spanish the patellofemoral pain and osteoarthritis subscale of the knee injury and osteoarthritis outcome score (KOOS-PF) and validate this Spanish version of a disease-specific patient-reported outcome measure (PROM) for patellofemoral pain. Results The KOOS-PF was translated to Spanish and sixty patients with patellofemoral pain and/or osteoarthritis accepted to complete the questionnaire. 1-week later 58 patients answered the questions again for the test–retest reliability validation and finally 55 patients completed 1-month later for the responsiveness assessment. 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, showing a strong correlation with the global rating of change (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.

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Psychometric properties of the critical thinking disposition assessment test amongst medical students in China: a cross-sectional study

BMC Medical Education ◽

10.1186/s12909-020-02437-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liyuan Cui ◽

Yaxin Zhu ◽

Jinglou Qu ◽

Liming Tie ◽

Ziqi Wang ◽

...

Keyword(s):

Factor Analysis ◽

Critical Thinking ◽

Medical Students ◽

Psychometric Properties ◽

Internal Consistency ◽

Discriminant Validity ◽

Retest Reliability ◽

Critical Thinking Disposition ◽

Thinking Disposition ◽

Test Retest Reliability

Abstract Background Critical thinking disposition helps medical students and professionals overcome the effects of personal values and beliefs when exercising clinical judgment. The lack of effective instruments to measure critical thinking disposition in medical students has become an obstacle for training and evaluating students in undergraduate programs in China. The aim of this study was to evaluate the psychometric properties of the CTDA test. Methods A total of 278 students participated in this study and responded to the CTDA test. Cronbach’s α coefficient, internal consistency, test-retest reliability, floor effects and ceiling effects were measured to assess the reliability of the questionnaire. Construct validity of the pre-specified three-domain structure of the CTDA was evaluated by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). The convergent validity and discriminant validity were also analyzed. Results Cronbach’s alpha coefficient for the entire questionnaire was calculated to be 0.92, all of the domains showed acceptable internal consistency (0.81–0.86), and the test-retest reliability indicated acceptable intra-class correlation coefficients (ICCs) (0.93, p < 0.01). The EFA and the CFA demonstrated that the three-domain model fitted the data adequately. The test showed satisfactory convergent and discriminant validity. Conclusions The CTDA is a reliable and valid questionnaire to evaluate the disposition of medical students towards critical thinking in China and can reasonably be applied in critical thinking programs and medical education research.

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The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000102 ◽

2021 ◽

pp. 1-10

Author(s):

Hala Darwish ◽

Pia Zeinoun ◽

Natali Farran ◽

Husam Ghusn ◽

Bassem Yamout ◽

...

Keyword(s):

Multiple Sclerosis ◽

Psychometric Properties ◽

Cognitive Assessment ◽

Healthy Subjects ◽

Good Evidence ◽

Normative Values ◽

Arabic Version ◽

Retest Reliability ◽

Test Retest Reliability ◽

Healthy Participants

Abstract Objective: Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients’ cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. Method: The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived. Results: The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. Conclusions: This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT’s reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.

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Psychometric Analysis of an Ecological Vocal Effort Scale in Individuals With and Without Vocal Hyperfunction During Activities of Daily Living

American Journal of Speech-Language Pathology ◽

10.1044/2021_ajslp-21-00111 ◽

2021 ◽

pp. 1-16

Author(s):

Katherine L. Marks ◽

Alessandra Verdi ◽

Laura E. Toles ◽

Kaila L. Stipancic ◽

Andrew J. Ortiz ◽

...

Keyword(s):

Construct Validity ◽

Intraclass Correlation ◽

Muscle Tension ◽

Voice Rehabilitation ◽

Minimal Detectable Change ◽

Retest Reliability ◽

Vocal Hyperfunction ◽

Before And After ◽

Vocal Effort ◽

Test Retest Reliability

Objective The purpose of this study was to examine the psychometric properties of an ecological vocal effort scale linked to a voicing task. Method Thirty-eight patients with nodules, 18 patients with muscle tension dysphonia, and 45 vocally healthy control individuals participated in a week of ambulatory voice monitoring. A global vocal status question was asked hourly throughout the day. Participants produced a vowel–consonant–vowel syllable string and rated the vocal effort needed to produce the task on a visual analog scale. Test–retest reliability was calculated for a subset using the intraclass correlation coefficient, ICC(A, 1). Construct validity was assessed by (a) comparing the weeklong vocal effort ratings between the patient and control groups and (b) comparing weeklong vocal effort ratings before and after voice rehabilitation in a subset of 25 patients. Cohen's d, the standard error of measurement ( SEM ), and the minimal detectable change (MDC) assessed sensitivity. The minimal clinically important difference (MCID) assessed responsiveness. Results Test–retest reliability was excellent, ICC(A, 1) = .96. Weeklong mean effort was statistically higher in the patients than in controls ( d = 1.62) and lower after voice rehabilitation ( d = 1.75), supporting construct validity and sensitivity. SEM was 4.14, MDC was 11.47, and MCID was 9.74. Since the MCID was within the error of the measure, we must rely upon the MDC to detect real changes in ecological vocal effort. Conclusion The ecological vocal effort scale offers a reliable, valid, and sensitive method of monitoring vocal effort changes during the daily life of individuals with and without vocal hyperfunction.

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Psychometric properties of a self-report version of the Sexual Interest and Desire Inventory for Women (SIDI-F-SR)

10.31219/osf.io/8ghda ◽

2020 ◽

Cited By ~ 1

Author(s):

Julia Velten ◽

Gerrit Hirschfeld ◽

Milena Meyers ◽

Jürgen Margraf

Keyword(s):

Psychometric Properties ◽

Internal Consistency ◽

Sexual Interest ◽

Intraclass Correlation ◽

Self Report ◽

Clinical Psychologist ◽

Retest Reliability ◽

Absolute Agreement ◽

Test Retest Reliability ◽

Restriction Of Range

Background: The Sexual Interest and Desire Inventory Female (SIDI-F) is a clinician-administered scale that allows for a comprehensive assessment of symptoms related to Hypoactive Sexual Desire Dysfunction (HSDD). As self-report questionnaires may facilitate less socially desirable responding and as time and resources are scarce in many clinical and research settings, a self-report version was developed (SIDI-F-SR). Aim: To investigate the agreement between the SIDI-F and a self-report version (SIDI-F-SR) and assess psychometric properties of the SIDI-F-SR. Methods: A total of 170 women (Mage=36.61, SD=10.61, range=20-69) with HSDD provided data on the SIDI-F, administered by a clinical psychologist via telephone, and the SIDI-F-SR, delivered as an Internet-based questionnaire. A subset of 19 women answered the SIDI-F-SR twice over a period of 14 weeks. Outcomes: Intraclass correlation as well as predictors of absolute agreement between SIDI-F and SIDI-F-SR, as well as internal consistency, test-retest reliability, and criterion-related validity of the SIDI-F-SR were examined. Results: There was high agreement between SIDI-F and SIDI-F-SR (ICC=.86). On average, women scored about one point higher in the self-report vs. the clinician-administered scale. Agreement was higher in young women and those with severe symptoms. Internal consistency of the SIDI-F-SR was acceptable (α=.76) and comparable to the SIDI-F (α=.74). When corrections for the restriction of range were applied, internal consistency of the SIDI-F-SR increased to .91. Test-retest-reliability was good (r=.74). Criterion-related validity was low but comparable between SIDI-F and SIDI-F-SR.

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Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study (Preprint)

10.2196/preprints.18160 ◽

2020 ◽

Author(s):

Pim van Oirschot ◽

Marco Heerings ◽

Karine Wendrich ◽

Bram den Teuling ◽

Marijn B Martens ◽

...

Keyword(s):

Multiple Sclerosis ◽

Construct Validity ◽

Validation Study ◽

Intraclass Correlation ◽

Study Participant ◽

Smartphone App ◽

Retest Reliability ◽

Matched Group ◽

Test Retest Reliability ◽

Study Participants

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.

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72 Test-Retest Reliability and Minimal Detectable Change for Postural Sway by using Sway Meter in Elderly Subjects

Age and Ageing ◽

10.1093/ageing/afz164.72 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27 ◽

Cited By ~ 1

Author(s):

Kitima Rongsawad ◽

Laddawon Worawan ◽

Karnsiree Jirarojprapa ◽

Sararat Kaewkham ◽

Sarawut Khattiwong

Keyword(s):

Clinical Relevance ◽

Postural Stability ◽

Postural Sway ◽

Intraclass Correlation ◽

Elderly Subjects ◽

Minimal Detectable Change ◽

Detectable Change ◽

Simple Method ◽

Retest Reliability ◽

Test Retest Reliability

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.

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