Showing papers on "Intra-rater reliability published in 2015"

Interobserver Reliability of Quantitative Muscle Sonographic Analysis in the Critically Ill Population

Abstract: Objectives There is growing interest in the use of quantitative high-resolution neuromuscular sonography to evaluate skeletal muscles in patients with critical illness. There is currently considerable methodological variability in the measurement technique of quantitative muscle analysis. The reliability of muscle parameters using different measurement techniques and assessor expertise levels has not been examined in patients with critical illness. The primary objective of this study was to determine the interobserver reliability of quantitative sonographic measurement analyses (thickness and echogenicity) between assessors of different expertise levels and using different techniques for selecting the region of interest. Methods We conducted a cross-sectional observational study in neurocritical care and mixed surgical-medical intensive care units from 2 tertiary referral hospitals. Results Twenty diaphragm and 20 quadriceps images were evaluated. Images were obtained by using standardized imaging acquisition techniques. Quantitative sonographic measurements included muscle thickness and echogenicity analysis (either by the trace or square technique). All images were analyzed twice independently by 4 assessors of differing expertise levels. Excellent interobserver reliability was obtained for all measurement techniques regardless of expertise level (intraclass correlation coefficient, >0.75 for all comparisons). There was less variability between assessors for echogenicity values when the square technique was used for the quadriceps muscle and the trace technique for the diaphragm. Conclusions Excellent interobserver reliability exists regardless of expertise level for quantitative analysis of muscle parameters on sonography in the critically ill population. On the basis of these findings, it is recommended that echogenicity analysis be performed using the square technique for the quadriceps and the trace technique for the diaphragm.

Reliability and responsiveness of algometry for measuring pressure pain threshold in patients with knee osteoarthritis.

Abstract: [Purpose] This study aimed to establish the intrarater reliability and responsiveness of a clinically available algometer in patients with knee osteoarthritis as well as to determine the minimum-detectable-change and standard error of measurement of testing to facilitate clinical interpretation of temporal changes. [Subjects] Seventy-three patients with knee osteoarthritis were included. [Methods] Pressure pain threshold measured by algometry was evaluated 3 times at 2-min intervals over 2 clinically relevant sites-mediolateral to the medial femoral tubercle (distal) and lateral to the medial malleolus (local)-on the same day. Intrarater reliability was estimated by intraclass correlation coefficients. The minimum-detectable-change and standard error of measurement were calculated. As a measure of responsiveness, the effect size was calculated for the results at baseline and after treatment. [Results] The intrarater reliability was almost perfect (intraclass correlation coefficient = 0.93-0.97). The standard error of measurement and minimum-detectable-change were 0.70-0.66 and 1.62-1.53, respectively. The pressure pain threshold over the distal site was inadequately responsive in knee osteoarthritis, but the local site was responsive. The effect size was 0.70. [Conclusion] Algometry is reliable and responsive to assess measures of pressure pain threshold for evaluating pain patients with knee osteoarthritis.

Reliability of the penetration aspiration scale with flexible endoscopic evaluation of swallowing.

Abstract: Objectives:The Penetration Aspiration Scale (PAS), although designed for videofluoroscopy, has been utilized with flexible endoscopic evaluation of swallowing (FEES) in both research and clinical practice. The purpose of this investigation was to determine inter- and intrarater reliability of the PAS with FEES as a function of clinician FEES experience and retest interval.Methods:Three groups of 3 clinicians (N = 9) with varying FEES experience (beginning, intermediate, and advanced) assigned PAS scores to 35 swallows. Initial ratings were repeated following short-term (ie, 1 day) and long-term (ie, 1 week) retest intervals.Results:Intraclass correlation coefficients were calculated to assess interrater reliability on the first rating for each group. The coefficients were .91, .82, and .89 for the beginning, intermediate, and advanced clinicians, respectively. Overall interrater reliability across all 9 clinicians, irrespective of experience, was .85. Intraclass correlation coefficients were also calculat...

Pressure algometry is a useful tool to quantify pain in the medial part of the knee: An intra- and inter-reliability study in healthy subjects

Abstract: Purpose Pain quantification is essential for diagnostic and pain monitoring purposes in disorders around the knee. Pressure algometry is a method described to determine pressure pain threshold (PPT) by applying controlled pressure to a given body point. The purpose of this study was to determine the reliability of this method when it was applied to the medial part of the proximal tibia metaphysis and to evaluate the PPT levels between genders. Methods Fifty healthy (mean age; 46.9) volunteers were recruited, 25 men and 25 women. Pressure algometry was applied to a 1 cm2-probe area on the medial part of the knee by 2 raters. Intra- and interclass correlation (ICC) was obtained and differences between genders were evaluated. Bland-Altman plots were performed to evaluate the variability of the measures. Results The mean values of PPT obtained by rater 1 and 2 were 497.5 Kpa and 489 Kpa respectively. The intrarater reliability values (95% IC) for rater 1 and 2 were 0.97 (0.95–0.98) and 0.84 (0.73–0.90) respectively. With regard to interrater reliability, the ICC (95% IC) for the first measurement was 0.92 (0.87–0.95) and 0.86 (0.78–0.92) for the second one. Women showed significant lower values of PPT than men. The Bland-Altmand plots showed excellent agreement. Conclusions Pressure algometry has excellent reliability when it is applied to the medial part of the proximal metaphysis of the tibia. Women have lower values of PTT than men. The high reliability of the PA in an individual volunteer makes it a more valuable tool for longitudinal assessment of a given patient than for comparison between them. Level of evidence Level III. Prospective study.

Intrarater reliability of goniometry and hand-held dynamometry for shoulder and elbow examinations in female team handball athletes and asymptomatic volunteers

Abstract: To evaluate the intrarater reliability for examining active range of motion (ROM) and isometric strength of the shoulder and elbow among asymptomatic female team handball athletes and a control group using a manual goniometer and hand-held dynamometry (HHD). 22 female team handball athletes (age: 21.0 ± 3.7 years) and 25 volunteers (13 female, 12 male, age: 21.9 ± 1.24 years) participated to determine bilateral ROM for shoulder rotation and elbow flexion/extension, as well as isometric shoulder rotation and elbow flexion/extension strength. Subjects were assessed on two separate test sessions with 7 days between sessions. Relative (intraclass correlation coefficients (ICC) and standard error of measurement (SEM) reliability were calculated. Reliability for ROM and strength were good to excellent for both shoulders and groups (athletes: ICC = 0.94–0.97, SEM 1.07°–4.76 N, controls: ICC = 0.96–1.00, SEM = 0.00 N–4.48 N). Elbow measurements for both groups also showed good-to-excellent reliability (athletes: ICC = 0.79–0.97, SEM = 0.98°–5.94 N, controls: ICC = 0.87–1.00, SEM = 0.00 N–5.43 N). It is important to be able to reliably reproduce active ROM and isometric strength evaluations. Using a standardized testing position, goniometry and HHD are reliable instruments in the assessment of shoulder and elbow joint performance testing. We showed good-to-excellent reproducible results for male and female control subjects and female handball athletes, although the single parameters in ROM and strength were different for each group and between the shoulders and elbows.

Validation of a novel radiographic scoring system for calcinosis affecting the hands of patients with systemic sclerosis.

Abstract: OBJECTIVE: There are currently no validated outcome measures to assess calcinosis severity in systemic sclerosis (SSc; scleroderma). We sought to develop and validate a novel radiographic scoring system for calcinosis affecting the hands of SSc patients for potential use in future clinical trials. METHODS: Following a 1-hour teleconference training session, 12 investigators (8 rheumatologists, 1 dermatologist, and 3 radiologists) scored 12 hand radiographs in random order using 2 scoring systems (termed “simple” and “complex”) and re-scored 2 randomly assigned radiographs after a minimum of 24 hours. Interrater and intrarater reliability were assessed using a weighted kappa coefficient for the simple system (κ), and an intraclass correlation coefficient (ICC) for the complex system (ICC 0.7 for excellent). RESULTS: Mean time to complete the complex scoring system was significantly longer than the simple scoring system (4.0 versus 0.4 minutes; P < 0.0001). Overall interrater reliability for the simple scoring system was poor (κ = 0.39, 95% confidence interval [95% CI] 0.1–0.52) but improved if dichotomized as mild/moderate versus severe (κ = 0.51, 95% CI 0.26–0.7). Interrater reliability was excellent for the complex scoring system (ICC 0.89, 95% CI 0.86–0.92). Intrarater reliability was moderate for the simple scoring system (κ = 0.67, 95% CI 0.37–0.96) but almost perfect for the complex scoring system (ICC 0.93, 95% CI 0.89–0.97). CONCLUSION: We developed a novel radiographic scoring system that accounts for the area coverage, density, and anatomic location of calcinosis affecting the hands in patients with SSc. This scoring system is feasible with excellent reliability and should undergo further validation testing for use in clinical trials.

Reliability of Kinovea Computer Program in Measuring Cervical Range of Motion in Sagittal Plane

Abstract: Purpose: This study was conducted to investigate the intrarater and interrater reliability of Kinovea computer program in measuring cervical range of motion in sagittal plane in healthy subjects. Subjects: Sixty-five normal physical therapy intern students participated in this study. Their age ranged from 20 - 24 years with mean (22.42 ± 0.84) and BMI mean (28.60 ± 1.40). Materials and Methods: Digital camera and labtop with installed Kinovea software were used. The cervical ROM of flexion and extension for each participant were measured by Kinovea computer program three times by examiner (B) to detect the intrarater reliability and by three examiners (A, B and C) to detect the interrater reliability. Results: For the intrarater reliability, the ICC between the first and second trials by Rater B for flexion and extension were 0.985 and 0.995. The ICC between the second and third trials were 0.932 and 0.993. The ICC between the first and third trials were 0.920 and 0.986 respectively. For the interrater reliability, the ICC between Rater A & B for flexion and extension were 0.991 and 0.992. The ICC between Rater A & C were 0.988 and 0. 9938. The ICC between Rater B & C were 0.993 and 0.997 respectively. Kinovea computer program had an excellent intrarater and interrater reliability in measuring cervical flexion and extension range of motion at P < 0.05. Conclusion: The Kinovea software program was reliable in both intrarater and interrater reliability in measuring cervical range of motion in sagittal plane.

Reliability of magnetic resonance imaging assessment of rotator cuff: the ROW study.

Abstract: Background Physiatrists encounter patients with rotator cuff disorders, and imaging is frequently an important component of their diagnostic assessment. However, there is a paucity of literature on the reliability of magnetic resonance imaging (MRI) assessment between shoulder specialists and musculoskeletal radiologists. Objective We assessed inter- and intrarater reliability of MRI characteristics of the rotator cuff. Design Cross-sectional secondary analyses in a prospective cohort study. Setting Academic tertiary care centers. Patients Subjects with shoulder pain were recruited from orthopedic and physiatry clinics. Methods Two shoulder-fellowship–trained physicians (a physiatrist and a shoulder surgeon) jointly performed a blinded composite MRI review by consensus of 31 subjects with shoulder pain. Subsequently, MRI was reviewed by one fellowship-trained musculoskeletal radiologist. Main Outcome Measurements We calculated the Cohen kappa coefficients and percentage agreement among the 2 reviews (composite review of 2 shoulder specialists versus that of the musculoskeletal radiologist). Intrarater reliability was assessed among the shoulder specialists by performing a repeated blinded composite MRI review. In addition to this repeated composite review, only one of the physiatry shoulder specialists performed an additional review. Results Interrater reliability (shoulder specialists versus musculoskeletal radiologist) was substantial for the presence or absence of tear (kappa 0.90 [95% confidence interval {CI}, 0.72-1.00]), tear thickness (kappa 0.84 [95% CI, 0.70-0.99]), longitudinal size of tear (kappa 0.75 [95% CI, 0.44-1.00]), fatty infiltration (kappa 0.62 [95% CI, 0.45-0.79]), and muscle atrophy (kappa 0.68 [95% CI, 0.50-0.86]). There was only fair interrater reliability of the transverse size of tear (kappa 0.20 [95% CI, 0.00-0.51]). The kappa for intrarater reliability was high for tear thickness (0.88 [95% CI, 0.72-1.00]), longitudinal tear size (0.61 [95% CI, 0.22-0.99]), fatty infiltration (0.89 [95% CI, 0.80,-0.98]), and muscle atrophy (0.87 [95% CI, 0.76-0.98]). Intrarater reliability for the individual shoulder specialist was similar to that of the composite reviews. Conclusions There was high interrater and intrarater reliability for most findings on shoulder MRI. Analysis of our data supports the reliability of MRI assessment by shoulder specialists for rotator cuff disorders.

A pilot comparison study of four clinician-rated atopic dermatitis severity scales.

Abstract: SummaryBackground There are multiple severity outcome measures for atopic dermatitis (AD). There is a need to compare the reliability of these measures. Objectives To compare the inter-rater and intrarater reliability of the objective Scoring Atopic Dermatitis (oSCORAD), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD) and Three Item Severity index (TIS); and to analyse the correlation between these outcome measures and the quality-of-life instruments Patient-Orientated Eczema Measurement, Dermatology Life Quality Index and Skindex-29. Methods Twelve patients with AD attended a 1-day scoring exercise by five trained dermatology clinicians. Inter-rater and intrarater reliability were assessed using the intraclass correlation coefficient (ICC). Correlation between clinician-rated and patient-reported measures was analysed using Spearman's rho. Results Regarding inter-rater reliability, EASI and SASSAD showed good reliabilities, with ICCs of 0·730 [95% confidence interval (CI) 0·500–0·900] and 0·680 (95% CI 0·440–0·880), respectively. However, the ICCs were poor for TIS and oSCORAD, with 0·497 (95% CI 0·233–0·785) and 0·498 (95% CI 0·234–0·785), respectively. Separate body surface area (BSA) component analyses showed that the oSCORAD BSA component contributed to its inter-rater variations. Regarding intrarater reliability, EASI and TIS showed excellent ICCs of 0·886 (95% CI 0·744–0·952) and 0·820 (0·614–0·923), respectively, while SASSAD showed a good reliability with an ICC of 0·720 (95% CI 0·424–0·878). However, the intrarater ICC was poor for oSCORAD, with 0·446 (95% CI 0·037–0·730). Regarding correlation with patient-reported measures, only SASSAD demonstrated moderate correlation with Skindex-29 (ρ = 0·611, P = 0·035). Conclusions EASI demonstrated the highest inter-rater and intrarater reliability, supporting it as the optimal AD severity outcome measure.

Inter- and intrarater reliability of four single-legged hop tests and isokinetic muscle torque measurements in children

Abstract: Single-legged hop tests and isokinetic muscle torque are common outcome measures in the evaluation of knee function. The reliability of the single-legged hop tests in children has not been documented. The aim was to examine inter- and intrarater reliability of four single-legged hop tests and isokinetic muscle torque measurements in children. Twenty-eight sports-active children (12.4 ± 0.3 years old) were tested three times in two test sessions separated by 1 week. They performed four single-legged hop tests and concentric isokinetic torque measurements during knee extension and flexion. Inter- and intrarater reliability were calculated using the intraclass correlation coefficient (ICC 2,1). Relative terms of the standard error of measurement (SEM %) and smallest real difference (SRD %) were emphasized to allow comparison between the different variables. Twenty-six children were included for statistical analysis. ICCs for inter- and intrarater reliability were moderate to high for the hop tests (0.62–0.91) and isokinetic measurements (0.76–0.87). SEMs % were low for the hop tests (3.9–7.4 %) and the isokinetic measurements (5.2–8.9 %). SRDs % were 20.5 % or less for the hop tests, 15.7 % or less for knee extension, and 24.6 % or less for knee flexion. The single-legged hop tests and isokinetic muscle torque measurements demonstrated moderate-to-high reliability with low measurement error in sports-active children. A change above 20.5 % for the single-legged hop tests, 15.7 % for knee extension, and 24.6 % for knee flexion is necessary to represent a real change in knee function. III.

Intra-rater Reliability of B-Mode Ultrasound Imaging of the Abdominal Muscles in Healthy Adolescents During the Active Straight Leg Raise Test

Abstract: Background To date, the reliability of ultrasound imaging (USI) measures of the abdominal muscles in children and adolescents during the active straight leg raise (ASLR) test has not been confirmed. Objective To assess the intra-rater reliability of USI measures of the thickness and percentage thickness change of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) on both sides of the body during the ASLR test in healthy adolescents. Design Single-group repeated-measures intra-rater reliability study. Setting School. Participants Thirty-nine adolescents between the ages of 13 and 16 years. Methods Three repeated USI measurements were recorded in the supine resting position and during the ASLR test at 2 sessions, 6 to 8 days apart. In the supine position, measurements were collected at the end of normal expiration. In the case of ASLR, measurements were collected when the person undergoing examination touched the transverse delimiter with the distal part of their lower leg, that is, to a 30° flexion of the hip. Main Outcome Measurements USI of abdominal muscle thickness. Results By using the mean of 3 measures in the supine, resting position, intra-examiner reliability point estimates (intraclass correlation coefficient [ICC] 3.3 ) ranged from 0.95 to 0.97 for EO, IO, and TrA. During the ASLR test, the ICC result of thickness measurements of all muscles was also above 0.90. In terms of percentage change of muscle thickness, the highest ICC 3.3 result obtained for the TrA was 0.81-0.85; for EO the result ranged from 0.72-0.89, and the result for the IO was between 0.65 and 0.79. Conclusion USI measurements of the thickness of the EO, IO, and TrA muscles at rest and during the ASLR test in healthy adolescents between 13 and 16 years of age are reliable. Because of an increase in the precision of measurements, we recommend using the mean of 3 consecutive measurements of the EO, IO, and TrA muscles in adolescents to ensure a good reliability level. Based on 3 consecutive measurements, good reliability for the percentage change in the TrA thickness was achieved.

Examination of muscle strength and pressure pain thresholds in knee osteoarthritis: test-retest reliability and agreement.

Abstract: Background and purpose Knee osteoarthritis (OA) is associated with reduced muscle strength and pain sensitization. The purpose of this study was to determine intrarater reliability and agreement (measurement error) of isometric knee extensor and flexor muscle strength assessed using handheld dynamometry and of pressure pain thresholds (PPT; a measure of pain sensitization) from the knee, the leg, and the forearm assessed using handheld algometry in knee OA. Methods A total of 20 subjects with knee OA participated in 2 sessions separated by 1 week. The highest of 4 examinations and the mean of the 3 highest examinations of muscle strength and the first and the mean of 2 PPT examinations were applied in the statistical analyses. Intrarater reliability was assessed using a 2-way random-effects model, consistency-type intraclass correlation coefficient, whereas agreement was assessed using 95% limits of agreement (LOA) as a percentage of the mean (LOA%). Results Intraclass correlation coefficients for muscle strength were between 0.78 and 0.91 when using the highest examination and were between 0.86 and 0.94 when using the mean of the 3 highest examinations. Intraclass correlation coefficients for PPT were between 0.53 and 0.87 when using the first examination and were between 0.84 and 0.91 when using the mean of 2 examinations. Agreement (LOA%) for muscle strength ranged from 38.3% to 47.3% when using the highest examination and from 40.4% to 53.3% when using the mean of the 3 highest examinations. Agreement for PPT ranged from 54.2% to 80.6% when using the first examination and from 50.6% to 58.9% when using the mean of 2 PPT examinations. Discussion A tendency toward improved intraclass correlation coefficients and LOA% (only for PPTs) was found when using the mean of more than 1 examination for both muscle strength and PPTs. Intrarater reliability was high to very high, whereas the LOA/LOA% indicated relatively high measurement errors. Conclusions Examination of muscle strength and PPTs in knee OA is reliable, but affected by the measurement error, which is important to consider when reporting the results of clinical trials and in clinical practice.

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density.

Abstract: Purpose: High breast density, as measured by mammography, is associated with increased breast cancer risk, but standard methods of assessment have limitations including 2D representation of breast tissue, distortion due to breast compression, and use of ionizing radiation. Ultrasound tomography (UST) is a novel imaging method that averts these limitations and uses sound speed measures rather than x-ray imaging to estimate breast density. The authors evaluated the reproducibility of measures of speed of sound and changes in this parameter using UST. Methods: One experienced and five newly trained raters measured sound speed in serial UST scans for 22 women (two scans per person) to assess inter-rater reliability. Intrarater reliability was assessed for four raters. A random effects model was used to calculate the percent variation in sound speed and change in sound speed attributable to subject, scan, rater, and repeat reads. The authors estimated the intraclass correlation coefficients (ICCs) for these measures based on data from the authors’ experienced rater. Results: Median (range) time between baseline and follow-up UST scans was five (1–13) months. Contributions of factors to sound speed variance were differences between subjects (86.0%), baseline versus follow-up scans (7.5%), inter-rater evaluations (1.1%), and intrarater reproducibility (∼0%). When evaluatingmore » change in sound speed between scans, 2.7% and ∼0% of variation were attributed to inter- and intrarater variation, respectively. For the experienced rater’s repeat reads, agreement for sound speed was excellent (ICC = 93.4%) and for change in sound speed substantial (ICC = 70.4%), indicating very good reproducibility of these measures. Conclusions: UST provided highly reproducible sound speed measurements, which reflect breast density, suggesting that UST has utility in sensitively assessing change in density.« less

Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings.

Abstract: Background The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Methods Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss’ kappa (κ) and intraclass correlation coefficient (ICC). Key Results Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45–0.82). Conclusions & Inferences Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia.

Interrater and intrarater reliability and minimal detectable change of the Wisconsin Gait Scale when used to examine videotaped gait in individuals post-stroke.

Abstract: Often, interventions targeting the kinematic and temporal and spatial changes in gait commonly seen after a stroke are based on observations of walking. Having the capacity to objectively identify such changes and track improvements over time using reliable and valid measures is important. The Wisconsin Gait Scale (WGS), which is comprised of 14 items, was developed specifically to examine and document gait changes occurring after a stroke. The purpose of the study was to explore the interrater and intrarater reliability and minimal detectable change (MDC) of the WGS when used by physical therapists to examine gait in adults post-stroke. Fourteen physical therapists from 3 different acute inpatient rehabilitation centers rated videotapes of the gait of 6 adults post-stroke using the WGS. To minimize subject variability from fatigue, videotapes created by using 4 cameras provided right and left lateral, anterior, and posterior views of walking on a level surface. One complete ambulation trial from each subject post-stroke, which included 4 views of the same ambulation trial, was examined by the licensed physical therapists using the WGS. An opportunity was provided to review the tool and a practice trial was performed using an additional videotape not included in the analysis. Gait was examined on 2 different occasions separated by a period of approximately 21 days to minimize the effects of recall bias. Intraclass Correlation Coefficients (ICC) were used to examine the interrater and intrarater reliability of the WGS. Interrater (ICC = 0.83) and intrarater (ICC = 0.91) reliability were both good. The standard error of the measurement (SEM) was 1.47 and the MDC95 was 4.24. There was no statistically significant difference between the scores on the WGS when comparing the 2 different sessions. The WGS shows promise as an instrument that can make observational gait analysis more reliable. High intrarater reliability and low SEM suggests that the WGS is stable when administered across multiple sessions by the same rater. The ICC for interrater reliability was also good, which suggests that multiple examiners can effectively use the instrument. With minimal training, the physical therapists in the study were able to produce highly reliable results using the WGS to objectively document gait dysfunction.

A Bidimensional System of Facial Movement Analysis Conception and Reliability in Adults

Abstract: Objective. To design a bidimensional facial movement measuring tool and study its reliability. Methods. We utilized the free video-analysis software Kinovea that can track preselected points during movements and measure two-point distances off-line. Three raters positioned facial markers on 10 healthy individuals and video-taped them during maximal bilateral contractions of frontalis, corrugator, orbicularis oculi, zygomaticus, orbicularis oris, and buccinator, on two occasions. Each rater also analyzed the first video twice, one week apart. For each muscle, intrarater reliability was measured by percent agreements (PA) and intraclass correlation coefficients (ICC) between two assessments of the same video one week apart and between assessments of two videos collected one week apart. Interrater reliability was measured by PA, ICC, and coefficients of variation (CV) between assessments of the first video-recording by the three raters. Results. Intrarater and interrater reliabilities were good to excellent for frontalis (PA and ICC > 70%; CV < 15%), moderate for orbicularis oculi, zygomaticus, and orbicularis oris, and poor for corrugator and buccinators. Discussion. Without formal prior training, the proposed method was reliable for frontalis in healthy subjects. Improved marker selection, training sessions, and testing reliability in patients with facial paresis may enhance reliability for orbicularis oculi, zygomaticus, and orbicularis oris.

Evaluating the reliability of the human factors analysis and classification system

Abstract: INTRODUCTION: This paper examines the reliability of the Human Factors Analysis and Classification System (HFACS) as tool for coding human error and contributing factors associated with accidents and incidents. METHODS: A systematic review of articles published across a 13-yr period between 2001 and 2014 revealed a total of 14 peer-reviewed manuscripts that reported data concerning the reliability of HFACS. RESULTS: Results revealed that the majority of these papers reported acceptable levels of interrater and intrarater reliability. CONCLUSION: Reliability levels were higher with increased training and sample sizes. Likewise, when deviations from the original framework were minimized, reliability levels increased. Future applications of the framework should consider these factors to ensure the reliability and utility of HFACS as an accident analysis and classification tool. Cohen TN, Wiegmann DA, Shappell SA. Evaluating the reliability of the Human Factors Analysis and Classification System. Aerosp Med Hum Perform. 2015; 86(8):728-735. Language: en

Reliability of measurements of hip abduction strength obtained with a hand-held dynamometer.

Abstract: This study aimed to evaluate intrarater and interrater reliability when measuring hip abductor strength in the supine position using a hand-held dynamometer (HHD) (Study 1), and to elucidate the relationships between measured values and examiners’ physical characteristics (Study 2). Three healthy examiners (1 female, 24 y.o. and 2 males 23 and 27 y.o) and 12 subjects (6 females, 24.5 ± 2.8 years and 6 males, 27.7 ± 3.5 years) participated in Study 1, and 20 healthy examiners (7 females, 22.3 ± 1.3 years and 13 males, 29.4 ± 8.2 years) and 2 subjects (1 female, 24 y.o. and 1 male 27 y.o) participated in Study 2. All healthy examiners were hospital employees. Hip abductor strength was measured by HHD with hand fixation and with belt fixation, and examiner age, sex, height, weight, BMI, and dominant hand grip strength were evaluated. The intraclass correlation coefficient (ICC) (1,1), a measure of intrarater reliability, was 0.89–0.95 with hand fixation and 0.96–0.97 with belt fixation. ICC (2,1), a ...

Italian Validation of Montreal Cognitive Assessment

Abstract: Neuropsychological testing is a milestone of good practice to document cognitive deficits in a rapidly aging population. The aim of this paper is to validate the Italian version of Montreal Cognitive Assessment (MoCA). We compared subjects performance at the Italian version of MoCA with performance at standard Mini Mental State Examination (MMSE). The whole sample is composed of 287 subjects. All participants were administered three MoCA and a standard MMSE within 4 weeks. Through ROC analysis the optimal MoCA cut-off point was identified, showing high levels of sensitivity and specificity and an accuracy of .96, with 95% confidence interval. Intra rater reliability and intra rater reliability are highly significant with respect to the MMSE. Results highlight that MoCA is a valid instrument in clinical and research screening and monitoring of subjects affected by cognitive disorders. Further studies may be directed to the deepening of the reliability and validity of the test.

Validity and Intra-rater Reliability of 2-Dimensional Motion Analysis Using a Hand-held Tablet Compared to Traditional 3-Dimensional Motion Analysis.

Abstract: Context: Lower-extremity landing mechanics have been implicated as a contributing factor in knee pain and injury, yet cost-effective and clinically accessible methods for evaluating movement mechanics are limited. The identification of valid, reliable, and readily accessible technology to assess lower-extremity alignment could be an important tool for clinicians, coaches, and strength and conditioning specialists. Objective: To examine the validity and reliability of using a handheld tablet and movement-analysis application (app) for assessing lower-extremity alignment during a drop vertical-jump task. Design: Concurrent validation. Setting: Laboratory. Participants: 22 healthy college-age subjects (11 women and 11 men, mean age 21 ± 1.4 y, mean height 1.73 ± 0.12 m, mean mass 71 ± 13 kg) with no lower-extremity pathology that prevented safe landing from a drop jump. Intervention: Subjects performed 6 drop vertical jumps that were recorded simultaneously using a 3-dimensional (3D) motion-capture system an...