scholarly journals Reliability and Validity of Three Clinical Methods to Measure Lower Extremity Muscle Power

2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Mattie E. Pontiff ◽  
Li Li ◽  
Noelle G. Moreau
Keyword(s):  
Lower Extremity ◽  
Repeated Measures ◽  
Muscle Power ◽  
Intraclass Correlation ◽  
Force Plate ◽  
Reliability And Validity ◽  
Cross Sectional ◽  
Position Transducer ◽  
Lower Extremity Muscle ◽  
Highly Correlated

Background: Lower extremity muscle power is critical for daily activities and athletic performance in clinical populations. Objective: The purpose of this study was to determine the reliability and validity of 3 clinically feasible methods to measure lower extremity muscle power during a leg press. Methods: Ten of 26 subjects performed 2 sessions of 5 submaximal leg presses separated by 3-7 days in this repeated-measures cross-sectional design; the remaining performed 1 test session. Power was calculated independently for each method [simple video, linear position transducer, and accelerometer] and compared to the reference force plate. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC). Pearson’s correlation coefficient (r), Bland-Altman plots with 95% limits of agreement (LOA), and mean bias percentages (%) were used to determine relative and absolute validity. Results: Power measures were reliable for all methods (ICC=.97-.99). All were highly correlated with the force plate (r=.96-.98). Mean bias was -0.8% (LOA: -16.57% to 14.98%) (video), -13.21% (LOA: -23.81% to -2.61%) (position transducer) compared to the force plate. Proportional bias was observed for accelerometry. Conclusion: All methods were reliable and highly correlated with the force plate. Only the video and position transducer demonstrated absolute validity. The position transducer was the most feasible method because of its simplicity and accuracy in measuring power.

Reliability and Concurrent Validity of Shoulder Tissue Irritability Classification

2021 ◽  
Author(s):  
Stephen M Kareha ◽  
Philip W McClure ◽  
Alicia Fernandez-Fernandez
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Repeated Measures ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Strong Relationship ◽  
Rating System ◽  
Roc Curve Analysis ◽  
Cross Sectional

Abstract Objective Rating tissue irritability has been recommended to aid decision making in several recent clinical practice guidelines. An explicit method for rating tissue irritability was proposed as part of the Staged Algorithm for Rehabilitation Classification: Shoulder Disorders (STAR-Shoulder), but the reliability and validity of this classification are unknown. The purpose of this study was to examine the reliability and concurrent validity of shoulder tissue irritability ratings as part of a system designed to guide appropriate treatment strategy and intensity. Methods A clinical measurement, prospective repeated-measures cross-sectional design was used. The 101 consecutive participants with primary complaints of shoulder pain were assessed by pairs of blinded raters (24 raters in total) and rated for tissue irritability. Patients completed 3 patient-rated outcome (PRO) measures reflecting both pain and disability, and these scores were compared with ratings of tissue irritability. Paired ratings of irritability were analyzed for reliability with prevalence-adjusted, bias-adjusted Kappa for ordinal scales (PABAK-OS). Analysis of variance (ANOVA) was used to compare PRO measures across different levels of irritability. Receiver operating characteristic (ROC) curve analysis was utilized to derive cut-off scores for 3 PRO instruments. Results Interrater reliability was 0.69 (95% CI = 0.59–0.78), with 67% agreement. All PRO measures were significantly different among 3 levels of tissue irritability. Conclusion There appear to be acceptable reliability and a strong relationship between PRO measures and therapist-rated tissue irritability, supporting the use of the STAR-Shoulder irritability rating system. Impact Several clinical practice guidelines have recommended that clinicians rate tissue irritability as part of their examination. This study provides important new information supporting the reliability and validity of the STAR-Shoulder tissue irritability rating system.

scholarly journals Lower extremity muscle power – A critical determinant of physical function in aging and multiple sclerosis

2021 ◽  
pp. 111347
Author(s):  
Rasmus A.W. Stagsted ◽  
Cintia Ramari ◽  
Anders G. Skjerbaek ◽  
Cecilie Thrue ◽  
Ulrik Dalgas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Extremity ◽  
Physical Function ◽  
Muscle Power ◽  
Critical Determinant ◽  
Lower Extremity Muscle

scholarly journals Role of Occupational Footwear and Prolonged Walking on Lower Extremity Muscle Activation during Maximal Exertions and Postural Stability Tasks

Biomechanics ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 202-213
Author(s):  
Harish Chander ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Alana J. Turner ◽  
Reuben F. Burch V ◽  
Adam C. Knight ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Postural Stability ◽  
Muscle Activation ◽  
Medial Gastrocnemius ◽  
Lower Extremity Muscle ◽  
Prolonged Duration ◽  
The Mean ◽  
The Impact

Background: Occupational footwear and a prolonged duration of walking have been previously reported to play a role in maintaining postural stability. The purpose of this paper was to analyze the impact of three types of occupational footwear: the steel-toed work boot (ST), the tactical work boot (TB), and the low-top work shoe (LT) on previously unreported lower extremity muscle activity during postural stability tasks. Methods: Electromyography (EMG) muscle activity was measured from four lower extremity muscles (vastus medialis (VM), medial hamstrings (MH), tibialis anterior (TA), and medial gastrocnemius (MG) during maximal voluntary isometric contractions (MVIC) and during a sensory organization test (SOT) every 30 min over a 4 h simulated workload while wearing ST, TB, and LT footwear. The mean MVIC and the mean and percentage MVIC during each SOT condition from each muscle was analyzed individually using a repeated measures ANOVA at an alpha level of 0.05. Results: Significant differences (p < 0.05) were found for maximal exertions, but this was limited to only the time main effect. No significant differences existed for EMG measures during the SOT. Conclusion: The findings suggest that occupational footwear type does not influence lower extremity muscle activity during both MVIC and SOT. Significantly lower muscle activity during maximal exertions over the course of the 4 h workload was evident, which can be attributed to localized muscular fatigue, but this was not sufficient to impact muscle activity during postural stability tasks.

scholarly journals Tai Chi training’s effect on lower extremity muscle co-contraction during single- and dual-task gait: Cross-sectional and randomized trial studies

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0242963
Author(s):  
Peter M. Wayne ◽  
Brian J. Gow ◽  
Fengzhen Hou ◽  
Yan Ma ◽  
Jeffrey M. Hausdorff ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Postural Control ◽  
Usual Care ◽  
Randomized Trial ◽  
Dual Task ◽  
Muscle Activation ◽  
Tai Chi ◽  
Mean Difference ◽  
Cross Sectional ◽  
Lower Extremity Muscle

Background Tai Chi (TC) mind-body exercise has been shown to reduce falls and improve balance and gait, however, few studies have evaluated the role of lower extremity muscle activation patterns in the observed benefits of TC on mobility. Purpose To perform an exploratory analysis of the association between TC training and levels of lower extremity muscle co-contraction in healthy adults during walking under single-task (ST) and cognitive dual-task (DT) conditions. Methods Surface electromyography of the anterior tibialis and lateral gastrocnemius muscles was recorded during 90 sec trials of overground ST (walking normally) and DT (walking with verbalized serial subtractions) walking. A mean co-contraction index (CCI), across all strides, was calculated based on the percentage of total muscle activity when antagonist muscles were simultaneously activated. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts and 60 age-matched TC-naïve older adults. A longitudinal comparison assessed the shorter-term effects of TC; TC-naïve participants were randomly allocated to either 6 months of TC training or to usual care. Results Across all participants at baseline, greater CCI was correlated with slower gait speed under DT (β(95% CI) = -26.1(-48.6, -3.7)) but not ST (β(95% CI) = -15.4(-38.2, 7.4)) walking. Linear models adjusting for age, gender, BMI and other factors that differed at baseline indicated that TC experts exhibited lower CCI compared to TC naives under DT, but not ST conditions (ST: mean difference (95% CI) = -7.1(-15.2, 0.97); DT: mean difference (95% CI) = -10.1(-18.1, -2.4)). No differences were observed in CCI for TC-naive adults randomly assigned to 6 months of TC vs. usual care. Conclusion Lower extremity muscle co-contraction may play a role in the observed benefit of longer-term TC training on gait and postural control. Longer-duration and adequately powered randomized trials are needed to evaluate the effect of TC on neuromuscular coordination and its impact on postural control. Trial registration The randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).

scholarly journals Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability

2020 ◽  
Vol 100 (4) ◽  
pp. 708-717
Author(s):  
Kavita Venkataraman ◽  
Kristopher Amis ◽  
Lawrence R Landerman ◽  
Kevin Caves ◽  
Gerald C Koh ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Interrater Reliability ◽  
Video Quality ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Slow Motion ◽  
Frame Rate ◽  
Normal Speed ◽  
Lower Frame ◽  
Rehabilitation Needs

Abstract Background Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation. Objective The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment. Design This repeated-measures study compared the test performances of in-person, slow motion (SM) review, and normal-speed (NS) video ratings at various fixed frame rates (8, 15, and 30 frames per second) and bandwidth (128, 384, and 768 kB/s) configurations. Methods Overall bias, validity, and interrater reliability were assessed for in-person, SM video, and NS video ratings, with SM video rating as the gold standard, as well as for different frame rate and bandwidth configurations within NS videos. Results There was moderate to good interrater reliability for the POMA-G (intraclass correlation coefficient [ICC] = 0.66–0.77 across all configurations) and moderate validity for in-person (β = 0.62; 95% confidence interval [CI] = 0.37–0.87) and NS video (β = 0.74; 95% CI = 0.67–0.80) ratings compared with the SM video rating. For cane height, interrater reliability was good (ICC = 0.66–0.77), although it was significantly lower at the lowest frame rate (8 frames per second) (ICC = 0.66; 95% CI = 0.54–0.76) and bandwidth (128 kB/s) (ICC = 0.69; 95% CI = 0.57–0.78) configurations. Validity for cane height was good for both in-person (β = 0.80; 95% CI = 0.62–0.98) and NS video (β = 0.86; 95% CI = 0.81–0.90) ratings compared with SM video rating. Limitations Some lower frame rate and bandwidth configurations may limit the reliability of remote cane height assessments. Conclusions Teleassessment for POMA-G and cane height using typically available internet and video quality is feasible, valid, and reliable.

Bioimpedance Spectroscopy Is a Valid and Reliable Measure of Edema Following Hand Burn Injury (Part 1—Method Validation)

2020 ◽  
Vol 41 (4) ◽  
pp. 780-787 ◽  
Author(s):  
Dale O Edwick ◽  
Dana A Hince ◽  
Jeremy M Rawlins ◽  
Fiona M Wood ◽  
Dale W Edgar
Keyword(s):  
Repeated Measures ◽  
Burn Injury ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Whole Body ◽  
Bioimpedance Spectroscopy ◽  
Water Displacement ◽  
Reliable Measure ◽  
Minimum Detectable Difference

Abstract The assessment of swelling following burn injury is complicated by the presence of wounds and dressings and due to patients experiencing significant pain and impaired movement. There remains a lack of sensitive objective measures for edema in patients presenting with hand burn injury. Bioimpedance spectroscopy (BIS) is a measure of body composition that has been demonstrated by our group to be reliable for measuring whole body and limb edema during resuscitation and to be sensitive to edema changes within healing wounds. The aim of this study was to determine the reliability and validity of BIS as a measure of edema following hand burn injury specifically. One hundred patients presenting with burn injury including a portion of a hand were recruited to this trial. Repeated measures of the hand were recorded using a novel application of BIS and in parallel with water displacement volumetry (WDV). The results were analyzed using mixed-effects regressions. Paired repeated measures were obtained for 195 hands, using four electrode configurations. BIS demonstrated high reliability in measuring hand BIS—Intraclass Correlation Coefficient 0.995 to 0.999 (95% CI 0.992–1.000) and sensitivity—Minimum Detectable Difference 0.74 to 3.86 Ω (0.09–0.48 Ω/cm). A strong correlation was shown with WDV, Pearson’s r = −0.831 to −0.798 (P &lt; .001). BIS is a sensitive and reliable measure of edema following acute hand burn injury.

Reliability and Validity of the Posture and Fine Motor Assessment of Infants

1989 ◽  
Vol 9 (5) ◽  
pp. 259-272 ◽  
Author(s):  
Jane Case-Smith
Keyword(s):  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Fine Motor ◽  
Motor Assessment ◽  
Intraclass Correlation Coefficients ◽  
Highly Correlated ◽  
Peabody Developmental Motor Scales ◽  
The Individual ◽  
Test Retest Reliability

The Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1987) is a newly developed instrument for assessing the quality of motor function in infants. The test measures components of posture and fine motor control as they first develop. The purpose of this study was to support the test's reliability and validity. Interrater reliability, analyzed with intraclass correlation coefficients (ICCs), was high (.989 for total scores). Test-retest reliability, measured by ICCs, was .853 and .913 for the two test sections. The PFMAI demonstrated concurrent validity with the Peabody Developmental Motor Scales, Revised (Folio & Fewell, 1983) (correlations were .673 and .829 for the individual sections). Scores on the PFMAI were highly correlated with the infant's ages (.892 to .941); this finding provided one indication of construct validity.

scholarly journals Comparative Kinematic and Electromyographic Assessment of Clinician- and Device-Assisted Sit-to-Stand Transfers in Patients With Stroke

2013 ◽  
Vol 93 (10) ◽  
pp. 1331-1341 ◽  
Author(s):  
Judith M. Burnfield ◽  
Bernadette McCrory ◽  
Yu Shu ◽  
Thad W. Buster ◽  
Adam P. Taylor ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Muscle Activation ◽  
Joint Movement ◽  
Trunk Flexion ◽  
Cross Sectional ◽  
Ankle Motion ◽  
Repeated Measures Design ◽  
Sit To Stand ◽  
Lower Extremity Muscle ◽  
Combat Injuries

Background Workplace injuries from patient handling are prevalent. With the adoption of no-lift policies, sit-to-stand transfer devices have emerged as one tool to combat injuries. However, the therapeutic value associated with sit-to-stand transfers with the use of an assistive apparatus cannot be determined due to a lack of evidence-based data. Objective The aim of this study was to compare clinician-assisted, device-assisted, and the combination of clinician- and device-assisted sit-to-stand transfers in individuals who recently had a stroke. Design This cross-sectional, controlled laboratory study used a repeated-measures design. Methods The duration, joint kinematics, and muscle activity of 4 sit-to-stand transfer conditions were compared for 10 patients with stroke. Each patient performed 4 randomized sit-to-stand transfer conditions: clinician-assisted, device-assisted with no patient effort, device-assisted with the patient’s best effort, and device- and clinician-assisted. Results Device-assisted transfers took nearly twice as long as clinician-assisted transfers. Hip and knee joint movement patterns were similar across all conditions. Forward trunk flexion was lacking and ankle motion was restrained during device-assisted transfers. Encouragement and guidance from the clinician during device-assisted transfers led to increased lower extremity muscle activation levels. Limitations One lifting device and one clinician were evaluated. Clinician effort could not be controlled. Conclusions Lack of forward trunk flexion and restrained ankle movement during device-assisted transfers may dissuade clinicians from selecting this device for use as a dedicated rehabilitation tool. However, with clinician encouragement, muscle activation increased, which suggests that it is possible to safely practice transfers while challenging key leg muscles essential for standing. Future sit-to-stand devices should promote safety for the patient and clinician and encourage a movement pattern that more closely mimics normal sit-to-stand biomechanics.

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