Intratester and Intertester Reliability of Toe Pressure Measurements in People with and Without Diabetes Performed by Podiatric Physicians

2015 ◽  
Vol 105 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Jennifer A. Sonter ◽  
Vivienne Chuter ◽  
Sarah Casey
Keyword(s):  
Pressure Measurement ◽  
Intraclass Correlation ◽  
Systolic Pressure ◽  
Correlation Coefficients ◽  
Arterial Disease ◽  
Screening Tools ◽  
Pressure Measurements ◽  
Limits Of Agreement ◽  
Doppler Probe ◽  
Toe Pressure

Background Toe pressures and the toe brachial index (TBI) represent possible screening tools for peripheral arterial disease; however, limited evidence is available regarding their reliability. The aim of this study was to determine intratester and intertester reliability of toe systolic pressure and the TBI in participants with and without diabetes performed by podiatric physicians. Methods Two podiatric physicians performed toe and brachial pressure measurements on 80 participants, 40 with and 40 without diabetes, during two testing sessions using photoplethysmography and Doppler probe. Intraclass correlation coefficients (ICCs) and 95% limits of agreement were determined. Results In people with diabetes, intratester reliability of toe pressure measurement was excellent for both testers (ICCs, 0.84 and 0.82). Reliability of the TBI was good (ICCs, 0.72 and 0.75) and brachial pressure fair (ICCs, 0.43 and 0.55). The intertester reliability of toe pressure (ICC, 0.82) and the TBI (ICC, 0.80) was excellent. Intertester reliability of brachial pressure was reduced in people with diabetes (ICC, 0.49). In age-matched participants, intratester reliability of toe pressure measurement was excellent for both testers (ICCs, 0.83 and 0.87), and reliability of the TBI (ICCs, 0.74 and 0.80) and brachial pressure (ICCs, 0.73 and 0.78) was good to excellent. Intertester reliability of toe pressure (ICC, 0.84), the TBI (ICC, 0.81), and brachial pressure (ICC, 0.77) was excellent. Conclusions Toe pressures and the TBI demonstrated excellent reliability in people with and without diabetes and can be an effective component of lower-extremity vascular screening. However, wide limits of agreement relative to blood pressure values for both cohorts indicate that results should be interpreted with caution.

Evaluating Intratester Reliability of Manual Masking of Plantar Pressure Measurements Associated with Chronic Gout

2011 ◽  
Vol 101 (5) ◽  
pp. 424-429
Author(s):  
Keith Rome ◽  
David George Survepalli ◽  
Maria Lobo ◽  
Nicola Dalbeth ◽  
Fiona McQueen ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Pressure Measurements ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Intraclass Correlation Coefficients ◽  
Chronic Gout ◽  
Pressure Time

Background: Plantar pressure measurements are commonly used to evaluate foot function in chronic musculoskeletal conditions. However, manually identifying anatomical landmarks is a source of measurement error and can produce unreliable data. The aim of this study was to evaluate intratester reliability associated with manual masking of plantar pressure measurements in patients with gout. Methods: Twenty-five patients with chronic gout (mean disease duration, 22 years) were recruited from rheumatology outpatient clinics. Patients were excluded if they were experiencing an acute gout flare at the time of assessment, had lower-limb amputation, or had diabetes mellitus. Manual masking of peak plantar pressures and pressure-time integrals under ten regions of the foot were undertaken on two occasions on the same day using an in-shoe pressure measurement system. Test-retest reliability was assessed by using intraclass correlation coefficients, SEM, 95% limits of agreement, and minimal detectable change. Results: Mean peak pressure intraclass correlation coefficients ranged from 0.92 to 0.97, with SEM of 8% to 14%. The 95% limits of agreement ranged from−150.3 to 133.5 kPa, and the minimal detectable change ranged from 30.8 to 80.6 kPa. For pressure-time integrals, intraclass correlation coefficients were 0.86 to 0.94, and SEM were 5% to 29%, with the greater errors observed under the toes. The 95% limits of agreement ranged from −48.5 to 48.8 kPa/sec, and the minimal detectable change ranged from 6.8 to 21.0 kPa/sec. Conclusions: These findings provide clinicians with information confirming the errors associated with manual masking of plantar pressure measurements in patients with gout. (J Am Podiatr Med Assoc 101(5): 424–429, 2011)

Reproducibility of Toe Pressure Measurements

2009 ◽  
Vol 33 (3) ◽  
pp. 129-132 ◽  
Author(s):  
Neil Cloete ◽  
Clare Kiely ◽  
Mary Paula Colgan ◽  
Naseem Haider ◽  
Sean O'Neill ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Carotid Artery Disease ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Pressure Measurements ◽  
Repeatability Coefficient ◽  
Significant Difference ◽  
Artery Disease ◽  
Toe Pressure

Introduction Ankle/brachial indices are inaccurate in the presence of calcification, and physicians may rely on the measurement of digital pressures. As the population continues to age and with the escalation in type 2 diabetes, the importance of, and reliance on, toe pressure measurements will increase. The aim of this study was to assess the reproducibility of toe pressure measurements in a single vascular laboratory. Methods Repeated ankle/brachial indices and toe pressures were measured in 20 patients (10 with known peripheral vascular disease and 10 with aneurysmal or carotid artery disease but no history of PVD), and 10 control patients. Three measurements were made 48 hours apart. All measurements were made by a single vascular technologist. Reproducibility was assessed by the use of the repeatability coefficient and the intraclass correlation coefficient. Results Ankle/brachial indices ranged from 0.36 to 2.4, toe pressures from 18 mmHg to 173 mmHg, and toe/brachial indices from 0.11 to 1.1. The repeatability coefficient showed no significant difference between measurements ( p > 0.1) and the intraclass correlation coefficient estimates showed high agreement between repeated measurements (0.77–0.99). Bland-Altman plots indicated that the observer variability was equally distributed across the range of pressure measurements. Conclusion These results confirm the intraobserver reproducibility of toe pressure measurements; however, further work is required to demonstrate inter-observer reproducibility.

Assessment of Arterial Disease Using Digital Systolic Pressure Measurement

1988 ◽  
Vol 2 (4) ◽  
pp. 349-351 ◽  
Author(s):  
Peter T. McCollum ◽  
Stephen T. Stanley ◽  
Patrick Kent ◽  
Maria C. Grouden ◽  
Dermot J. Moore ◽  
...  
Keyword(s):  
Pressure Measurement ◽  
Systolic Pressure ◽  
Arterial Disease

scholarly journals Autorefraction, Retinoscopy, Javal’s Rule, and Grosvenor’s Modified Javal’s Rule: The Best Predictor of Refractive Astigmatism

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kofi Asiedu ◽  
Samuel Kyei ◽  
Emmanuel Ekow Ampiah
Keyword(s):  
Clinical Sample ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Spherical Equivalent ◽  
Limits Of Agreement ◽  
Intraclass Correlation Coefficients ◽  
Starting Point ◽  
Cylinder Power ◽  
Level Of Agreement

The aim of the study was to determine the level of agreement between Javal’s rule, autorefraction, retinoscopy, and refractive astigmatism and to determine which technique is the most suitable substitute when subjective refraction is not applicable using a clinical sample. A total of 36 subjects, 14 males and 22 females, were involved in this study. The intraclass correlation coefficients between subjective refraction, autorefraction, and retinoscopy were 0.895 and 0.989, respectively, for the spherical equivalent. The Bland-Altman 95% limits of agreement between subjective refraction and autorefraction; subjective refraction and retinoscopy; and autorefraction and retinoscopy were −2.84 to 3.58, −0.88 to 1.12, and −3.01 to 3.53, respectively, for the spherical equivalent. The intraclass correlation coefficients between spectacle total astigmatism and the following techniques were as follows: retinoscopy (0.85); autorefraction (0.92); Javal’s rule (0.82); and Grosvenor et al. version (0.85). The Bland-Altman 95% limits of agreement between subjective refraction and autorefraction; subjective refraction and retinoscopy; subjective refraction and Javal’s rule; and subjective refraction and Grosvenor et al. version were −0.87 to 1.25, −1.49 to 1.99, −0.73 to 1.93, and −0.89 to 1.7, respectively, for the total astigmatism. The study showed that autorefraction and Javal’s rule may provide a starting point for subjective refraction cylinder power determination but only retinoscopy may satisfactorily replace subjective refraction total astigmatism when subjective refraction is not applicable.

Development and assessment of the inter-rater and intra-rater reproducibility of a self-administration version of the ALSFRS-R

2019 ◽  
Vol 91 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Leonhard A Bakker ◽  
Carin D Schröder ◽  
Harold H G Tan ◽  
Simone M A G Vugts ◽  
Ruben P A van Eijk ◽  
...  
Keyword(s):  
Rating Scale ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
The Self ◽  
Coefficient Alpha ◽  
Rater Agreement ◽  
Self Administration ◽  
Limits Of Agreement ◽  
Rater Reliability

ObjectiveThe Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials.MethodsThe self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach’s coefficient alpha.ResultsThe self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable.DiscussionThe self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.

scholarly journals The Influence of Heating on Toe pressure in Patients with Peripheral Arterial Disease

2017 ◽  
Vol 107 (1) ◽  
pp. 62-67 ◽  
Author(s):  
N. Settembre ◽  
T. Kagayama ◽  
P. Kauhanen ◽  
P. Vikatmaa ◽  
Y. Inoue ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Skin Temperature ◽  
Arterial Disease ◽  
Pressure Measurements ◽  
Baseline Measurement ◽  
The Third ◽  
The Mean ◽  
Peripheral Arterial ◽  
Different Response ◽  
Toe Pressure

Background and Aim: The toe skin temperature in vascular patients can be low, making reliable toe pressure measurements difficult to obtain. The aim of this study was to evaluate the effect of heating on the toe pressure measurements. Materials and Methods: A total of 86 legs were examined. Brachial pressure and toe pressure were measured at rest in a supine position using a laser Doppler device that also measured skin temperature. After heating the toes for 5 min with a heating pad, we re-measured the toe pressure. Furthermore, after heating the skin to 40° with the probe, toe pressures were measured a third time. Results: The mean toe skin temperature at the baseline measurement was 24.0 °C (standard deviation: 2.8). After heating the toes for 5 min with a warm heating pad, the skin temperature rose to a mean 27.8 °C (standard deviation: 2.8; p = 0.000). The mean toe pressure rose from 58.5 (standard deviation: 32) to 62 (standard deviation: 32) mmHg (p = 0.029). Furthermore, after the skin was heated up to 40 °C with the probe, the mean toe pressure in the third measurement was 71 (standard deviation: 34) mmHg (p = 0.000). The response to the heating varied greatly between the patients after the first heating—from −34 mmHg (toe pressure decreased from 74 to 40 mmHg) to +91 mmHg. When the toes were heated to 40 °C, the change in to toe pressure from the baseline varied between −28 and +103 mmHg. Conclusion: Our data indicate that there is a different response to the heating in different clinical situations and in patients with a different comorbidity.

scholarly journals Toe pressure and toe brachial index are predictive of cardiovascular mortality regardless of the most diseased arterial segment in symptomatic lower-extremity artery disease—A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259122
Author(s):  
V. Koivunen ◽  
M. Juonala ◽  
M. Venermo ◽  
M. Laivuori ◽  
J. M. Jalkanen ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Pressure Measurements ◽  
Arterial Segment ◽  
Toe Brachial Index ◽  
Disease Location ◽  
Toe Pressure

Objective Although lower extremity arterial disease (LEAD) is most often multisegmental, the predominant disease location and risk factors differ between patients. Ankle-brachial index (ABI), toe-brachial index (TBI), and toe pressure (TP) are predictive of outcome in LEAD patients. Previously, we reported a classification method defining the most diseased arterial segment (MDAS); crural (CR), femoropopliteal (FP), or aortoiliac (AOI). Current study aimed to analyze the associations between MDAS, peripheral pressure measurements and cardiovascular mortality. Materials and methods We reviewed retrospectively 729 consecutive LEAD patients (Rutherford 2–6) who underwent digital subtraction angiography between January, 2009 to August, 2011 and had standardized peripheral pressure measurements. Results In Cox Regression analyses, cardiovascular mortality was associated with MDAS and non-invasive pressure indices as follows; MDAS AOI, TP <30 mmHg (HR 3.00, 95% CI 1.13–7.99); MDAS FP, TP <30 mmHg (HR 2.31, 95% CI 1.36–3.94), TBI <0.25 (HR 3.20, 95% CI 1.34–7.63), ABI <0.25 (HR 5.45, 95% CI 1.56–19.0) and ≥1.30 (HR 6.71, 95% CI 1.89–23.8), and MDAS CR, TP <30 mmHg (HR 4.26, 95% CI 2.19–8.27), TBI <0.25 (HR 7.71, 95% CI 1.86–32.9), and ABI <0.25 (HR 2.59, 95% CI 1.15–5.85). Conclusions Symptomatic LEAD appears to be multisegmental with severe infrapopliteal involvement. Because of this, TP and TBI are strongly predictive of cardiovascular mortality and they should be routinely measured despite the predominant disease location or clinical presentation.

Test–Retest Reliability of Soccer Dribbling Tests in Children

2021 ◽  
pp. 1-7
Author(s):  
Michael J. Duncan ◽  
Darren Richardson ◽  
Rhys Morris ◽  
Emma Eyre ◽  
Neil D. Clarke
Keyword(s):  
Coefficient Of Variation ◽  
Pediatric Population ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Systematic Bias ◽  
Limits Of Agreement ◽  
Good Reliability ◽  
Retest Reliability ◽  
Intraclass Correlation Coefficients ◽  
Test Retest Reliability

The present study examined the test–retest reliability of the Ghent University dribbling test and short dribble test in a pediatric population. Fifty-four boys aged 9–14 years (mean ± SD = 11 ± 2 years) undertook the Ghent University and dribbling tests on two occasions separated by 2 weeks. Intraclass correlation coefficients, coefficient of variation, and 95% limits of agreement were conducted for each test. Intraclass correlation coefficients and coefficient of variation indicated good to excellent reliability, and relatively small variability for both dribbling tests. The 95% limits of agreement indicated relatively little bias Ghent University dribbling test for both running alone and running with the ball components, and the Bangsbo and Mohr short dribble test. The results of the present study suggest both dribbling tests examined in the present study demonstrate good reliability and low levels of systematic bias.

Reliability of a Computerized Target-Pursuit System for Measuring Coordinated Exertion of Force

2003 ◽  
Vol 96 (3_suppl) ◽  
pp. 1071-1085 ◽  
Author(s):  
Yoshinori Nagasawa ◽  
Shinichi Demura ◽  
Masakatsu Nakada
Keyword(s):  
Grip Strength ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Visual Images ◽  
Visually Guided ◽  
Time Analysis ◽  
Limits Of Agreement ◽  
Intraclass Correlation Coefficients ◽  
Pursuit System ◽  
Target Pursuit

The purpose was to examine trial-to-trial and day-to-day reliability and sensitivity for measurements of the ability to coordinate exertion of force based on target-pursuit, 30 college students were required to match their grip strength to a changing demand value appearing on the display of a personal computer, using two visual images in the form of a bar chart and waveform. The variable was the sum of the differences between demanded and produced grip strength over time. Analysis indicated high intraclass correlation coefficients (ICC) for bar chart and waveform displays (ICC = .87, ICC = .95, respectively). The limits of agreement, designating the interval comprising 95% of the differences between three measurements in a stable individual, were −14.8 to 99.3% for the bar chart and −3.5 to 113.6% for the waveform displays. One-tailed, paired t tests of the day-to-day measurements showed significant ( p < .05) improvement in both the bar chart and waveform displays. ICCs for day-to-day measurements were low-to-moderate for bar chart and waveform displays (ICC = .33 to .71, ICC = .48 to .76, respectively). The limits of agreement between measurements of two trials for day-to-day measurements were −112.2 to 218.6% for the bar chart and −139.2 to 352.8% for the waveform displays. The repeatability coefficients of trial-to-trial and day-to-day measurements for bar chart and waveform displays were 141 and 173%, and 152 and 176%, respectively. The limits of agreement between each test were relatively wide. We believe that these tests, on which the force response is visually guided, can be useful in objectively documenting the ability to coordinate exertion of force.

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