Reliability of Measurement of Maximal Isometric Lateral Trunk-Flexion Strength in Athletes Using Handheld Dynamometry

2012 ◽  
Vol 21 (4) ◽  
Author(s):  
Bram L. Newman ◽  
Courtney L. Pollock ◽  
Michael A. Hunt
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Trunk Flexion ◽  
Intrarater Reliability ◽  
Force Output ◽  
Test Occasion ◽  
Maximum Effort ◽  
And Function ◽  
Flexion Strength

Context: Lateral trunk-flexion strength is an important determinant of overall trunk stability and function, but the reliability in measuring this outcome clinically in athletic individuals is not known. Objective: To determine the interrater and intrarater reliability of lateral trunk-flexion strength measurement in athletic individuals using handheld dynamometry. Design: Reliability study. Setting: Research laboratory. Participants: 12 healthy, athletic individuals. Intervention: Lateral trunk-flexion strength was measured using handheld dynamometry across 2 different trunk placements (lateral aspect of the axilla and laterally at the level of the midtrunk) and 2 testing occasions by 2 therapists. Three maximum-effort trials during a "make test" at each placement were completed for each therapist on both occasions. Main Outcome Measures: Maximum force output was identified and converted to a torque. Intraclass correlation coefficients (ICC2,1) were calculated for each dynamometer placement, therapist, and test occasion to determine intrarater and interrater reliability. Results: Intrarater reliability was moderate to good (ICC2,1 = .53-.77), while interrater reliability was good to very good (ICC2,1 = .79-81) at the axilla position. For the midtrunk position, intrarater reliability was good to very good (ICC2,1 = .80-.86), while interrater reliability was good on both days (ICC2,1 = .87-.88). Finally, the standard errors of measurement were low for the axilla position (0.20 Nm/kg; 95% CI .15, .28) and midtrunk position (0.09 Nm/kg; 95% CI .07, .12). Conclusions: Maximum lateral trunk-flexion strength can be reliably measured in athletic individuals with greater overall strength. Based on the 2 positions used in this study, measurement with a dynamometer placement at the midtrunk may be more reliable than that obtained at the axilla.

Assessment of the Intrarater and Interrater Reliability of an Established Clinical Task Analysis Methodology

2002 ◽  
Vol 96 (5) ◽  
pp. 1129-1139 ◽  
Author(s):  
Jason Slagle ◽  
Matthew B. Weinger ◽  
My-Than T. Dinh ◽  
Vanessa V. Brumer ◽  
Kevin Williams
Keyword(s):  
Real Time ◽  
Task Analysis ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Intrarater Reliability ◽  
Intraclass Correlation Coefficients ◽  
Percent Time ◽  
Analysis Methodology ◽  
And Task

Background Task analysis may be useful for assessing how anesthesiologists alter their behavior in response to different clinical situations. In this study, the authors examined the intraobserver and interobserver reliability of an established task analysis methodology. Methods During 20 routine anesthetic procedures, a trained observer sat in the operating room and categorized in real-time the anesthetist's activities into 38 task categories. Two weeks later, the same observer performed task analysis from videotapes obtained intraoperatively. A different observer performed task analysis from the videotapes on two separate occasions. Data were analyzed for percent of time spent on each task category, average task duration, and number of task occurrences. Rater reliability and agreement were assessed using intraclass correlation coefficients. Results Intrarater reliability was generally good for categorization of percent time on task and task occurrence (mean intraclass correlation coefficients of 0.84-0.97). There was a comparably high concordance between real-time and video analyses. Interrater reliability was generally good for percent time and task occurrence measurements. However, the interrater reliability of the task duration metric was unsatisfactory, primarily because of the technique used to capture multitasking. Conclusions A task analysis technique used in anesthesia research for several decades showed good intrarater reliability. Off-line analysis of videotapes is a viable alternative to real-time data collection. Acceptable interrater reliability requires the use of strict task definitions, sophisticated software, and rigorous observer training. New techniques must be developed to more accurately capture multitasking. Substantial effort is required to conduct task analyses that will have sufficient reliability for purposes of research or clinical evaluation.

scholarly journals Navicular Drop Measurement in People With Rheumatoid Arthritis: Interrater and Intrarater Reliability

2005 ◽  
Vol 85 (7) ◽  
pp. 656-664 ◽  
Author(s):  
Joseph A Shrader ◽  
John M Popovich ◽  
G Chris Gracey ◽  
Jerome V Danoff
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Afternoon Session ◽  
Intrarater Reliability ◽  
Navicular Drop ◽  
Physical Therapist Student ◽  
And Function

Abstract Background and Purpose. Navicular drop (ND) measurement may be a valuable examination technique for patients with rheumatoid arthritis (RA). However, no data exist on reliability for this technique in patients with RA. The purposes of this study were: (1) to determine interrater and intrarater reliability of ND measurements in people with RA, (2) to compare ND values of people with RA with published normative data, and (3) to investigate ND measurement error associated with the use of skin markings. Subjects. Ten women (20 feet) with RA consented to participate. Methods. Patients completed demographic and function questionnaires. Navicular height (NH) measurements were taken by 2 physical therapists and 1 physical therapist student, following four 1-hour training sessions, using standardized methods and a digital height gauge. Four different NH measurements were taken 3 times on each foot by each of the 3 examiners during a morning session and then repeated during an afternoon session on the same day. Navicular drop values were calculated, including ND1 (as reported in the literature), ND2 (compensating for skin error), and ND3 (single-limb stance). Intraclass correlation coefficients (ICCs) and standard errors of measurement (SEMs) were used to establish reliability. Results. Means (±SD) for each ND measure for sessions 1 and 2, respectively, were as follows: ND1=8.36±5.29 mm and 8.29±5.24 mm, ND2=9.95±5.44 mm and 9.57±5.37 mm. The ICCs (2,1 and 2,k, respectively) for all interrater measurements ranged from .67 to .92 (SEM=2.0–3.3 mm) and from .85 to .97 (SEM=1.1–2.0 mm). The ICCs (2,1 and 2,k, respectively) for intrarater measurements ranged from .73 to .95 (SEM=1.3–2.8 mm) and from .90 to .98 (SEM=0.7–1.6 mm). Paired t tests showed the means of ND1 and ND2 for each examiner and for both sessions were significantly different. Discussion and Conclusion. The results suggest that ND measurements for people with RA can be taken reliably by clinicians with varied experience. The ND values for our subjects were slightly greater than reported normal values of 6 to 8 mm. Error associated with skin markings was statistically significant for all sessions and examiners.

Objective and Subjective Clinical Swallowing Outcomes via Telehealth: Reliability in Outpatient Clinical Practice

2021 ◽  
pp. 1-11
Author(s):  
James C. Borders ◽  
Jordanna S. Sevitz ◽  
Jaime Bauer Malandraki ◽  
Georgia A. Malandraki ◽  
Michelle S. Troche
Keyword(s):  
Clinical Practice ◽  
Interrater Reliability ◽  
Video Quality ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Oral Intake ◽  
Caregiver Training ◽  
Intrarater Reliability ◽  
Intraclass Correlation Coefficients ◽  
Remote Patient

Purpose The COVID-19 pandemic has drastically increased the use of telehealth. Prior studies of telehealth clinical swallowing evaluations provide positive evidence for telemanagement of swallowing. However, the reliability of these measures in clinical practice, as opposed to well-controlled research conditions, remains unknown. This study aimed to investigate the reliability of outcome measures derived from clinical swallowing tele-evaluations in real-world clinical practice (e.g., variability in devices and Internet connectivity, lack of in-person clinician assistance, or remote patient/caregiver training). Method Seven raters asynchronously judged clinical swallowing tele-evaluations of 12 movement disorders patients. Outcomes included the Timed Water Swallow Test (TWST), Test of Masticating and Swallowing Solids (TOMASS), and common observations of oral intake. Statistical analyses were performed to examine inter- and intrarater reliability, as well as qualitative analyses exploring patient and clinician-specific factors impacting reliability. Results Forty-four trials were included for reliability analyses. All rater dyads demonstrated “good” to “excellent” interrater reliability for measures of the TWST (intraclass correlation coefficients [ICCs] ≥ .93) and observations of oral intake (≥ 77% agreement). The majority of TOMASS outcomes demonstrated “good” to “excellent” interrater reliability (ICCs ≥ .84), with the exception of the number of bites (ICCs = .43–.99) and swallows (ICCs = .21–.85). Immediate and delayed intrarater reliability were “excellent” for most raters across all tasks, ranging between ICCs of .63 and 1.00. Exploratory factors potentially impacting reliability included infrequent instances of suboptimal video quality, reduced camera stability, camera distance, and obstruction of the patient's mouth during tasks. Conclusions Subjective observations of oral intake and objective measures taken from the TWST and the TOMASS can be reliably measured via telehealth in clinical practice. Our results provide support for the feasibility and reliability of telehealth for outpatient clinical swallowing evaluations during COVID-19 and beyond. Supplemental Material https://doi.org/10.23641/asha.13661378

scholarly journals Functional Index-3: A Valid and Reliable Functional Outcome Assessment Measure in Patients With Dermatomyositis and Polymyositis

2020 ◽  
Vol 48 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Floranne C. Ernste ◽  
Christopher Chong ◽  
Cynthia S. Crowson ◽  
Tanaz A. Kermani ◽  
Orla Ni Mhuircheartaigh ◽  
...  
Keyword(s):  
Construct Validity ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Health Assessment ◽  
Correlation Coefficients ◽  
Measurement Properties ◽  
Muscle Endurance ◽  
Spearman Correlation ◽  
Intrarater Reliability ◽  
Functional Index

Objective.Patients with dermatomyositis (DM) and polymyositis (PM) have reduced muscle endurance.The aim of this study was to streamline the Functional Index-2 (FI-2) by developing the Functional Index-3 (FI-3) and to evaluate its measurement properties, content and construct validity, and intra- and interrater reliability.Methods.A dataset of the previously performed and validated FI-2 (n = 63) was analyzed for internal redundancy, floor, and ceiling effects. The content of the FI-2 was revised into the FI-3. Construct validity and intrarater reliability of FI-3 were tested on 43 DM and PM patients at 2 rheumatology centers. Interrater reliability was tested in 25 patients. The construct validity was compared with the Myositis Activities Profile (MAP), Health Assessment Questionnaire (HAQ), and Borg CR-10 using Spearman correlation coefficient.Results.Spearman correlation coefficients of 63 patients performing FI-3 revealed moderate to high correlations between shoulder flexion and hip flexion tasks and similar correlations with MAP and HAQ scores; there were lower correlations for neck flexion task. All FI-3 tasks had very low to moderate correlations with the Borg scale. Intraclass correlation coefficients (ICC) of FI-3 tasks for intrarater reliability (n = 25) were moderate to good (0.88–0.98). ICC of FI-3 tasks for interrater reliability (n = 17) were fair to good (range 0.83–0.96).Conclusion.The FI-3 is an efficient and valid method for clinically assessing muscle endurance in DM and PM patients. FI-3 construct validity is supported by the significant correlations between functional tasks and the MAP, HAQ, and Borg CR-10 scores.

The Reliability of a Smartphone Goniometer Application Compared With a Traditional Goniometer for Measuring Ankle Joint Range of Motion

2019 ◽  
Vol 109 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Motaz Abdalla Alawna ◽  
Bayram H. Unver ◽  
Ertugrul O. Yuksel
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Ankle Dorsiflexion ◽  
Data Sets ◽  
Intrarater Reliability ◽  
New Device ◽  
Advantages And Disadvantages

Background: Evaluation of range of motion (ROM) is integral to assessment of the musculoskeletal system, is required in health fitness and pathologic conditions, and is used as an objective outcome measure. Several methods are described to check ROM, each with advantages and disadvantages. Hence, this study introduces a new device using a smartphone goniometer to measure ankle joint ROM. Objective: To test the reliability of smartphone goniometry in the ankle joint by comparing it with the universal goniometer (UG) and to assess interrater and intrarater reliability for the smartphone goniometer record (SGR) application. Methods: Fifty-eight healthy volunteers (29 men and 29 women aged 18–30 years) underwent SGR and UG measurement of ankle joint dorsiflexion and plantarflexion. Two examiners measured ankle joint ROM. Descriptive statistics were calculated for descriptive and anthropometric variables, as were intraclass correlation coefficients (ICCs). Results: There were 58 usable data sets. For measuring ankle dorsiflexion ROM, both instruments showed excellent interrater reliability: UG (ICC = 0.87) and SGR (ICC = 0.89). Intrarater reliability was excellent in both instruments in ankle dorsiflexion: UG and SGR (mean ICC = 0.91). For measuring ankle plantarflexion, both instruments showed excellent interrater reliability: UG (ICC = 0.76) and SGR (ICC = 0.82). Intrarater reliability was excellent in both instruments in ankle plantarflexion: UG (mean ICC = 0.85) and SGR (mean ICC = 0.82). Conclusions: Smartphone-based goniometers can be used to assess active ROM of the ankle joint because they can achieve a high degree of intrarater and interrater reliability.

scholarly journals Interrater and Intrarater Reliability of the Tuck Jump Assessment by Health Professionals of Varied Educational Backgrounds

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Lisa A. Dudley ◽  
Craig A. Smith ◽  
Brandon K. Olson ◽  
Nicole J. Chimera ◽  
Brian Schmitz ◽  
...  
Keyword(s):  
Health Professionals ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Clinical Implementation ◽  
Intrarater Reliability ◽  
Study Objective ◽  
Intraclass Correlation Coefficients ◽  
Educational Backgrounds ◽  
And Training

Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds.Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability.Results. Interrater reliability with 5 raters was poor (ICC = 0.47; 95% confidence intervals (CI) 0.33–0.62). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 (95% CI 0.35–0.68) for session one to 0.69 (95% CI 0.55–0.81) for session two. Intrarater reliability was poor to moderate, ranging from 0.44 (95% CI 0.22–0.68) to 0.72 (95% CI 0.55–0.84).Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation.

scholarly journals Validity and Reliability of Hand-Held Dynamometry for Abdominal Flexion Muscular Assessment

2020 ◽  
pp. 1-4
Author(s):  
Brett D. Tarca ◽  
Thomas P. Wycherley ◽  
Anthony Meade ◽  
Paul Bennett ◽  
Katia E. Ferrar
Keyword(s):  
Comparative Analysis ◽  
Reliability Analysis ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Core Stability ◽  
Abdominal Muscles ◽  
Validity And Reliability ◽  
Trunk Flexion ◽  
Intraclass Correlation Coefficients ◽  
Flexion Strength

Context: Abdominal musculature underpins core stability, which can allow for optimal performance in many activities of daily living (eg, walking and rising from a chair). Therefore, assessment of the abdominal muscles poses as an important consideration for clinicians in order to identify people at risk of injury or functional decline. Objective: This study aimed to build on the limited amount of knowledge surrounding abdominal muscle strength assessments by investigating the validity and reliability of hand-held dynamometry (HHD) for the assessment of isometric abdominal flexion strength. Study Design and Participants: Comparative analysis for validity and test–retest reliability was employed on a cohort of apparently healthy individuals. HHD was compared with the criterion, isokinetic dynamometry, through an isometric contraction of trunk flexion on both instruments. Hand-held dynamometry assessments only were performed on a subsequent day for reliability analysis. The peak values for all assessments were recorded. Results: A total of 35 participants were recruited from the University of South Australia and the general public. Comparative analysis between the HHD and isokinetic dynamometer showed good agreement (intraclass correlation coefficients = .82), with the Bland–Altman plots confirming no proportional bias. Reliability analysis for the HHD reported good consistency (intraclass correlation coefficients = .87). Conclusion: HHD together with the participant setup (supine, trunk flexed, and supported at 25° with the legs horizontal and remaining unfixed) is a valid and reliable tool to assess isometric abdominal flexion strength.

Interobserver Reliability Using the Phonetic Level Evaluation With Severely and Profoundly Hearing-Impaired Children

1991 ◽  
Vol 34 (5) ◽  
pp. 989-999 ◽  
Author(s):  
Stephanie Shaw ◽  
Truman E. Coggins
Keyword(s):  
Interrater Reliability ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Hearing Impaired ◽  
Intraclass Correlation Coefficients ◽  
Assessment Measure ◽  
Impaired Children ◽  
Speech Assessment ◽  
Hearing Impaired Children

This study examines whether observers reliably categorize selected speech production behaviors in hearing-impaired children. A group of experienced speech-language pathologists was trained to score the elicited imitations of 5 profoundly and 5 severely hearing-impaired subjects using the Phonetic Level Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass correlation coefficients. Overall, the magnitude of the coefficients was found to be considerably below what would be accepted in published behavioral research. Failure to obtain acceptably high levels of reliability suggests that the Phonetic Level Evaluation may not yet be an accurate and objective speech assessment measure for hearing-impaired children.

Development and Initial Validation of a Project-Based Rubric to Assess the Systems-Based Practice Competency of Residents in the Clinical Chemistry Rotation of a Pathology Residency

2014 ◽  
Vol 138 (6) ◽  
pp. 809-813
Author(s):  
Carolyn R. Vitek ◽  
Jane C. Dale ◽  
Henry A. Homburger ◽  
Sandra C. Bryant ◽  
Amy K. Saenger ◽  
...  
Keyword(s):  
Critical Thinking ◽  
Interrater Reliability ◽  
Clinical Chemistry ◽  
Core Competencies ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Thinking Skills ◽  
Project Evaluation ◽  
Critical Thinking Skills

Context.— Systems-based practice (SBP) is 1 of 6 core competencies required in all resident training programs accredited by the Accreditation Council for Graduate Medical Education. Reliable methods of assessing resident competency in SBP have not been described in the medical literature. Objective.— To develop and validate an analytic grading rubric to assess pathology residents' analyses of SBP problems in clinical chemistry. Design.— Residents were assigned an SBP project based upon unmet clinical needs in the clinical chemistry laboratories. Using an iterative method, we created an analytic grading rubric based on critical thinking principles. Four faculty raters used the SBP project evaluation rubric to independently grade 11 residents' projects during their clinical chemistry rotations. Interrater reliability and Cronbach α were calculated to determine the reliability and validity of the rubric. Project mean scores and range were also assessed to determine whether the rubric differentiated resident critical thinking skills related to the SBP projects. Results.— Overall project scores ranged from 6.56 to 16.50 out of a possible 20 points. Cronbach α ranged from 0.91 to 0.96, indicating that the 4 rubric categories were internally consistent without significant overlap. Intraclass correlation coefficients ranged from 0.63 to 0.81, indicating moderate to strong interrater reliability. Conclusions.— We report development and statistical analysis of a novel SBP project evaluation rubric. The results indicate the rubric can be used to reliably assess pathology residents' critical thinking skills in SBP.

Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device

2018 ◽  
Vol 25 (3) ◽  
pp. 286-290 ◽  
Author(s):  
Elif Bilgic ◽  
Madoka Takao ◽  
Pepa Kaneva ◽  
Satoshi Endo ◽  
Toshitatsu Takao ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Instructional Video ◽  
Validity Evidence ◽  
Laparoscopic Suturing ◽  
Intraclass Correlation Coefficients ◽  
Operative Assessment ◽  
Suturing Skills

Background. Needs assessment identified a gap regarding laparoscopic suturing skills targeted in simulation. This study collected validity evidence for an advanced laparoscopic suturing task using an Endo StitchTM device. Methods. Experienced (ES) and novice surgeons (NS) performed continuous suturing after watching an instructional video. Scores were based on time and accuracy, and Global Operative Assessment of Laparoscopic Surgery. Data are shown as medians [25th-75th percentiles] (ES vs NS). Interrater reliability was calculated using intraclass correlation coefficients (confidence interval). Results. Seventeen participants were enrolled. Experienced surgeons had significantly greater task (980 [964-999] vs 666 [391-711], P = .0035) and Global Operative Assessment of Laparoscopic Surgery scores (25 [24-25] vs 14 [12-17], P = .0029). Interrater reliability for time and accuracy were 1.0 and 0.9 (0.74-0.96), respectively. All experienced surgeons agreed that the task was relevant to practice. Conclusion. This study provides validity evidence for the task as a measure of laparoscopic suturing skill using an automated suturing device. It could help trainees acquire the skills they need to better prepare for clinical learning.

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