PROTOCOL FOR ASSESSING THE PRECISION OF PARALYMPIC BOCCIA PLAYERS

ABSTRACT Introduction: Although Paralympic boccia is an up-and-coming sport, demanding more and requiring higher levels of performance from athletes, protocols are not available for evaluating its indicators. Objective: To develop and verify the applicability of a new protocol for assessing the precision of athletes of the sport. Methods: Two targets with two different resolutions (0.5 [RES-0.5] and 1.0 [RES-1.0] points) were developed, graduated from 1 to 7. The protocol consists of placing the targets at 6 locations on the court, and each athlete makes two shots for each target. The best results are considered, from which total precision (TotalP), short precision (SP), medium precision (MP) and long precision (LP) are extracted. Nine players participated in the application of the protocol. The indicators of both targets were compared and verified using the intraclass correlation coefficient (ICC), standard error of measurement (SEm), bias (Bland-Altman) and minimum detectable difference (MDD). Results: Only for LP were there differences between targets (RES-0.5: 9.111 versus RES-1.0: 7.167; p <0.05), while TotalP, SP and MP did not show any significant differences (RES-0.5: 23.11 versus RES-1.0: 25.39; RES-0.5: 18.22 versus RES-1.0: 17.78; RES-0.5: 9.11 versus RES-1.0: 12.44, respectively). In addition, the RES-0.5 target obtained better concordance results (ICC = 0.73; SEm = 3.45; bias = -0.5938; MDD = 8.00), while the RES-1.0 target obtained lower values (CCI = 0.53; SEm = 6.28; bias = 0.3750; MDD = 14.56). Conclusions: The proposed protocol presents excellent applicability results. However, a larger sample of athletes including more details on specific precision indicators should be performed. Level of evidence II; Prospective comparative study.

French translation and validation of the Keele STarT MSK Tool

Background The Keele STarT MSK Tool is a 10-item questionnaire developed to classify patients suffering from one of the five most common types of musculoskeletal pain into 3 sub-groups of risk of chronic pain (i.e. low risk, medium risk and high risk). Objective The objective of the present study was to translate the Keele STarT MSK Tool into French and to evaluate its main psychometric properties. Methods The translation and intercultural adaptation of the questionnaire were carried out using a 6-step process. The following psychometric properties were investigated: floor and ceiling effects, construct validity, internal consistency and test-retest reliability including Standard Error of Measurement and Smallest Detectable Change. Results 101 patients suffering from musculoskeletal pain participated in the study. No floor nor ceiling effects were observed. A Cronbach’s alpha of 0.65 was found, revealing a moderate internal consistency. Nevertheless, all items were demonstrated to be significantly correlated with the total score (range of correlations: r=0.2 for item 7 to r=0.78 for item 1). A good construct validity was also found with a significant correlation of r=0.78 between the French Keele STarT MSK Tool and the ÖMPSQ-short. Test-retest reliability was excellent (Intraclass Correlation Coefficient 0.97). A Standard Error of Measurement of 0.42 and a Smallest Detectable Change of ±1.17 were measured. Conclusion A validated French version of the Keele STarT MSK Tool is now available and can be used by health practitioners to stratify patients as being at low, medium or high risk of persistent musculoskeletal pain.

A modified digital functional reach test device using an ultrasonic sensor for balance assessment: A test of validity and reliability

Study aim: Evaluation of dynamic balance is inferred to be compulsory for fall prevention in the elderly. Therefore, this study aimed to develop a modified digital functional reach test device using an ultrasonic sensor for balance assessment and to test validity and reliability of the newly developed tool to qualify psychometric properties. Material and methods: This study was a cross-sectional study of a convenient sample including 50 participants both males and females. Mean age of the participants was 51.20 ± 19.30 years. Reliability of the newly developed device was analysed using the intraclass correlation coefficient (ICC) and standard error of measurement (SEM). The criterion validity was also investigated using a yardstick mounted on the wall at a level of shoulder together with the MaxTraq® 2D motion analysis software. The modified digital functional reach test device using an ultrasonic sensor was correlated with the conventional FRT and the MaxTraq® 2D motion analysis. Results: The results presented that test-retest reliability of the modified digital functional reach test device was good reliability (ICC = 0.76) and low standard error of measurement (1.41) was found for test-retest reliability. The degree of agreement between the modified device, the conventional FRT, and the MaxTraq® 2D motion analysis was high (r = 0.71 and 0.77 respectively). Conclusions: The findings suggested that the modified digital functional reach test device using an ultrasonic sensor was a valid and reliable instrument for fall risk screening towards functional reach distance.

Reproducibility and responsiveness of the Frailty Index and Frailty Phenotype in older hospitalized patients

Background There is growing interest for interventions aiming at preventing frailty progression or even to reverse frailty in older people, yet it is still unclear which frailty instrument is most appropriate for measuring change scores over time to determine the effectiveness of interventions. The aim of this prospective cohort study was to determine reproducibility and responsiveness properties of the Frailty Index (FI) and Frailty Phenotype (FP) in acutely hospitalized medical patients aged 70 years and older. Methods Reproducibility was assessed by Intra-Class Correlation Coefficients (ICC), standard error of measurement (SEM) and smallest detectable change (SDC); Responsiveness was assessed by the standardized response mean (SRM), and area under the receiver operating characteristic curve (AUC). Results At baseline, 243 patients were included with a median age of 76 years (range 70–98). The analytic samples included 192 and 187 patients in the three and twelve months follow-up analyses, respectively. ICC of the FI were 0.85 (95 % confidence interval [CI]: 0.76; 0.91) and 0.84 (95% CI: 0.77; 0.90), and 0.65 (95% CI: 0.49; 0.77) and 0.77 (95% CI: 0.65; 0.84) for the FP. SEM ranged from 5 to 13 %; SDC from 13 to 37 %. SRMs were good in patients with unchanged frailty status (< 0.50), and doubtful to good for deteriorated and improved patients (0.43–1.00). AUC’s over three months were 0.77 (95% CI: 0.69; 0.86) and 0.71 (95% CI: 0.62; 0.79) for the FI, and 0.68 (95% CI: 0.58; 0.77) and 0.65 (95% CI: 0.55; 0.74) for the FP. Over twelve months, AUCs were 0.78 (95% CI: 0.69; 0.87) and 0.82 (95% CI: 0.73; 0.90) for the FI, and 0.78 (95% CI: 0.69; 0.87) and 0.75 (95% CI: 0.67; 0.84) for the FP. Conclusions The Frailty Index showed better reproducibility and responsiveness properties compared to the Frailty Phenotype among acutely hospitalized older patients.

Rehabilitative ultrasound imaging for the assessment of selected morphometric parameters of the flexor hallucis longus muscle in healthy individuals: An inter- and intra- rater reliability study

IntroductionUltrasound imaging (USI) is useful to evaluate structures of the foot to guide treatment, but the reliability of USI technique needs to be clarified. The goal of the study was to evaluate the intra- and inter-examiner reliability of USI image capture, and measurement of the cross-sectional area (CSA) and thickness of the flexor hallucis longus (FHL) for experienced and novice examinersMaterial and methodsFHL images were captured for 20 healthy adults. Reliability of image capture was evaluated between images repeated at 10-min interval for an experienced and a novice examiner. Reliability of image-based measurements was evaluated for one experienced and one novice rater, using all images. The intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) were calculatedResultsIntra-examiner reliability of image capture for the FHL muscle examined by USI was excellent for both thickness (ICC3,1, 0.944–0.976; SEM, 6.8%–10.0%) and CSA (ICC3,1, 0.954–0.979; SEM, 10.8%–16.5%), with no effect of examiner experience. Reliability was also excellent for measurement of thickness (ICC3,1, 0.954–0.972; SEM, 1.2%–9.6%) and CSA (ICC3,1, 0.961–0.986; SEM, 9.2%–14.1%), with no effects of experience.ConclusionsReliability of image capture and image-based measurements developed by USI of CSA and thickness for the FHL muscle in healthy individuals was excellent, independent of the examiner experience.

WITHIN-DAY AND BETWEEN-DAY RELIABILITY OF A FBG-BASED SMART SOCK SYSTEM FOR MEASURING ACTIVE TOE FLEXION DISPLACEMENT OF THE HALLUX

This study examined the test-retest reliability of hallux flexion displacement measured using a smart sock system with embedded fiber Bragg grating (FBG) sensors. Thirty female participants consisting of 15 hallux valgus (HV) patients and 15 control participants were recruited. Maximum active hallux flexion displacement was measured twice on each participant in the first visit; the same procedures were repeated 7 days later. Intraclass correlation coefficients (ICC2,1) and standard error of measurement (SEM) were applied to test within-day and between-day reliability. Paired-samples T-test was performed to compare the displacements between trials. Results showed almost perfect within-day reliability for both HV and control groups ([Formula: see text] and 0.977, respectively) with small SEM (both 0.5[Formula: see text]cm). However, fair to moderate between-day reliability was found (0.323 and 0.438, respectively). Significant differences were found between repeated measurements taken on the same day (mean [Formula: see text][Formula: see text]cm, [Formula: see text]) and on different days (mean [Formula: see text][Formula: see text]cm, [Formula: see text]), though the effect size was small. The poorer between-day reliability is likely due to the inconsistency in fitting the sock onto the foot. Future optimization of the prototype design is called for to improve the fitting consistency of wearable sensors onto patients.

Reliability of a Cycle Sprint Test to Measure Lower Limb Muscle Power

This study examined the reliability of a cycle sprint test for measuring lower limb muscle power. Twenty asymptomatic volunteers completed the test on two occasions, with one week between test sessions. Participants sat on a stationary road bicycle with commercial power meters in the pedal cranks. Maximum and average muscle power was measured during three, 10-second sprint efforts. The test demonstrated excellent within- and between-day reliability for both maximum and average power measurement (ICC=0.93 to 0.97). The within-day Standard Error of Measurement (SEM) was between 25.9W (6.1%) and 35.1W (8.5%), and 24.8 (6.5%) and 28.6W (7.7%) for maximum and average power respectively. The between-day SEM was 34.3W (7.8%) for maximum power and 26.4W (7.1%) for average power. Reliability of the cycle sprint test has been established, along with thresholds for significant change. The cycle sprint test may have relevance in clinical populations to evaluate lower limb muscle power following injury, or to measure rehabilitation outcomes.

Absolute Reliability and Concurrent Validity of Hand-Held Dynamometry in Shoulder Rotator Strength Assessment: Systematic Review and Meta-Analysis

The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test–retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) −5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI −2.69 to 9.27. ICC between devices was 0.94, CI (0.91 to 0.96) for shoulder internal rotators and 0.92, IC (0.88 to 0.97) for shoulder external rotators. Very high correlation was found for shoulder rotator torque assessment between HHDs and IDs. The COSMIN checklist classified the selected studies as adequate and inadequate.

Pelvic incidence and pelvic tilt can be calculated using either the femoral heads or acetabular domes in patients with hip osteoarthritis

Aims The aim of the study was to compare two methods of calculating pelvic incidence (PI) and pelvic tilt (PT), either by using the femoral heads or acetabular domes to determine the bicoxofemoral axis, in patients with unilateral or bilateral primary hip osteoarthritis (OA). Methods PI and PT were measured on standing lateral radiographs of the spine in two groups: 50 patients with unilateral (Group I) and 50 patients with bilateral hip OA (Group II), using the femoral heads or acetabular domes to define the bicoxofemoral axis. Agreement between the methods was determined by intraclass correlation coefficient (ICC) and the standard error of measurement (SEm). The intraobserver reproducibility and interobserver reliability of the two methods were analyzed on 31 radiographs in both groups to calculate ICC and SEm. Results In both groups, excellent agreement between the two methods was obtained, with ICC of 0.99 and SEm 0.3° for Group I, and ICC 0.99 and SEm 0.4° for Group II. The intraobserver reproducibility was excellent for both methods in both groups, with an ICC of at least 0.97 and SEm not exceeding 0.8°. The study also revealed excellent interobserver reliability for both methods in both groups, with ICC 0.99 and SEm 0.5° or less. Conclusion Either the femoral heads or acetabular domes can be used to define the bicoxofemoral axis on the lateral standing radiographs of the spine for measuring PI and PT in patients with idiopathic unilateral or bilateral hip OA. Cite this article: Bone Joint J 2021;103-B(8):1345–1350.