Reliability of the Assisting Hand Assessment (AHA) for Children and Youth With Acquired Brain Injury

2010 ◽  
Vol 11 (2) ◽  
pp. 113-124 ◽  
Author(s):  
Elizabeth Davis ◽  
Jane Galvin ◽  
Cheryl Soo
Keyword(s):  
Clinical Practice ◽  
Brain Injury ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Motor Impairment ◽  
Acquired Brain Injury ◽  
Weighted Kappa ◽  
Children And Youth ◽  
Measurement Properties ◽  
Intrarater Reliability

AbstractIntroduction:The ability to use both hands to interact with objects is required in daily activities and is therefore important to measure in clinical practice. The Assisting Hand Assessment (AHA) is unique in evaluating the function of a child or youth's assisting hand, through observing the spontaneous manipulation of objects during bimanual activity. The AHA was developed for children with unilateral motor impairment, and shows strong psychometric properties when used with children who have cerebral palsy (CP) or obstetric brachial plexus palsy (OBPP). The AHA is currently used in clinical practice with children who have an acquired brain injury (ABI), however there is limited research on the measurement properties of its use with this population.Objectives:The study aimed to determine the interrater and intrarater reliability of the AHA for children and youth with unilateral motor impairment following ABI. Methods: For interrater reliability, two occupational therapists (OT1 and OT2) independently rated the same 26 children and youth. For intrarater reliability, OT2 conducted a second assessment on the 26 participants 1 week later. Association between item scores on the AHA were analysed using weighted kappa (Kw), while intraclass correlation coefficients (ICCs) were used for domain and total scores.Results:The AHA items demonstrated good to excellent intrarater reliability (Kw= 0.67–1.00). Interrater reliability was good to excellent (Kw=0.60–0.84) for 20 of the 22 items of the AHA. Interrater and intrarater reliability coefficients for all domain and total scores were in the excellent range (ICC = 0.85–0.99).Conclusion:The current study indicates that the AHA shows good interrater and intrarater reliability when used with the paediatric ABI population. Findings provide preliminary support for the continued use of the AHA for children and youth with acquired hemiplegia.

scholarly journals HoNOS–ABI: a reliable outcome measure of neuropsychiatric sequelae to brain injury?

2005 ◽  
Vol 29 (2) ◽  
pp. 53-55 ◽  
Author(s):  
S. Fleminger ◽  
E. Leigh ◽  
P. Eames ◽  
L. Langrell ◽  
R. Nagraj ◽  
...  
Keyword(s):  
Brain Injury ◽  
Interrater Reliability ◽  
Outcome Measure ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Acquired Brain Injury ◽  
Weighted Kappa ◽  
Routine Clinical Practice ◽  
Clinical Implications ◽  
Intraclass Correlation Coefficients

Aims and MethodThe Health of the Nation Outcome Scale for Acquired Brain Injury (HoNOS–ABI) is a relatively new outcome measure designed to assess the neuropsychiatric sequelae of brain damage. This study investigated the interrater reliability of this scale. Fifty patients with traumatic brain injury receiving rehabilitation were each rated twice on the HoNOS–ABI, by two different raters. There were 24 raters in total.ResultsWeighted kappa values ranged from 0.43 to 0.84 and intraclass correlation coefficients from 0.58 to 0.97 for the ten items assessed. This indicated that agreement was moderate to substantial for all items.Clinical ImplicationsThe scales consistently measured the items of interest across different raters. This indicates that HoNOS–ABI is a reliable outcome measure when applied by different raters in routine clinical practice.

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.

scholarly journals Assesing motor impairment of the trunk in patients with traumatic brain injury: reliability and validity of the trunk impairment scale

2006 ◽  
Vol 62 (2) ◽  
Author(s):  
G. Verheyden ◽  
J. Hughes ◽  
J. Jelsma ◽  
A. Nieuwboer ◽  
W De Weerdt
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intraclass Correlation ◽  
Motor Impairment ◽  
Rank Correlation ◽  
Reliability And Validity ◽  
Weighted Kappa ◽  
Sitting Balance ◽  
Scale Scores ◽  
Dynamic Sitting

Introduction: Literature regarding trunk assessment after Traumatic Brain Injury (TBI) is limited. The Trunk Impairment Scale (TIS) is a newly developed tool which is intended to assess static and dynamic sitting balance and trunk co-ordination.Aim: It was the aim of this study to examine the reliability andvalidity of the TIS in TBI patients.Methods: Thirty TBI subjects were recruited from within arehabilitation setting. Two researchers observed each subjectsimultaneously, but scored independently. Each subject wasre-examined by one of the raters.Results: Kappa and weighted kappa values for all items ranged from 0.34 to 1. All percentages of agreement were 70% or higher. Intraclass correlation (ICC) coefficients for the sub-scale scores were between 0.72 and 0.88. Test-retest and inter-rater reliability for the total TIS score (ICC) was 0.88 and 0.95, respectively. The 95% limits of agreement for the test-retest and interexaminer measurement error interval were -4,4 and -3,3, respectively. The construct validity was evaluated by means of the Spearman rank correlation coefficient between the TIS and the Barthel Index (r=0.59, p=.0007).Discussion and conclusion: Fair to perfect item agreement was found but the reliability of certain items requiresfurther attention. Acceptable sub-scale and total TIS reliability and validity justify the use of the TIS in TBI treatmentand research.

scholarly journals Evaluative Frailty Index for Physical Activity (EFIP): A Reliable and Valid Instrument to Measure Changes in Level of Frailty

2013 ◽  
Vol 93 (4) ◽  
pp. 551-561 ◽  
Author(s):  
Nienke M. de Vries ◽  
J. Bart Staal ◽  
Marcel G.M. Olde Rikkert ◽  
Maria W.G. Nijhuis-van der Sanden
Keyword(s):  
Physical Activity ◽  
Clinical Practice ◽  
Construct Validity ◽  
Interrater Reliability ◽  
Rating Scale ◽  
Frailty Index ◽  
Intraclass Correlation ◽  
Small Sample ◽  
Intrarater Reliability ◽  
Valid Instrument

BackgroundPhysical activity is assumed to be important in the prevention and treatment of frailty. It is unclear, however, to what extent frailty can be influenced because instruments designed to assess frailty have not been validated as evaluative outcome instruments in clinical practice.ObjectivesThe aims of this study were: (1) to develop a frailty index (ie, the Evaluative Frailty Index for Physical Activity [EFIP]) based on the method of deficit accumulation and (2) to test the clinimetric properties of the EFIP.DesignThe content of the EFIP was determined using a written Delphi procedure. Intrarater reliability, interrater reliability, and construct validity were determined in an observational study (n=24).MethodIntrarater reliability and interrater reliability were calculated using Cohen kappa and intraclass correlation coefficients (ICCs). Construct validity was determined by correlating the score on the EFIP with those on the Timed “Up & Go” Test (TUG), the Performance-Oriented Mobility Assessment (POMA), and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G).ResultsFifty items were included in the EFIP. Interrater reliability (Cohen kappa=0.72, ICC=.96) and intrarater reliability (Cohen kappa=0.77 and 0.80, ICC=.93 and .98) were good. As expected, a fair to moderate correlation with the TUG, POMA, and CIRS-G was found (.61, −.70, and .66, respectively).LimitationsReliability and validity of the EFIP have been tested in a small sample. These and other clinimetric properties, such as responsiveness, will be assessed or reassessed in a larger study population.ConclusionThe EFIP is a reliable and valid instrument to evaluate the effect of physical activity on frailty in research and in clinical practice.

scholarly journals Comparison of motor outcomes between preschool children with univentricular and biventricular critical heart disease not diagnosed with cerebral palsy or acquired brain injury

2021 ◽  
pp. 1-8
Author(s):  
M. Florencia Ricci ◽  
Alastair Fung ◽  
Diane Moddemann ◽  
Victoria Micek ◽  
Gwen Y. Bond ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Heart Disease ◽  
Preschool Children ◽  
Brain Injury ◽  
Standard Deviation ◽  
Motor Skills ◽  
Odds Ratio ◽  
Motor Impairment ◽  
Acquired Brain Injury ◽  
Manual Dexterity

Abstract This comparison study of two groups within an inception cohort aimed to compare the frequency of motor impairment between preschool children with univentricular and biventricular critical congenital heart disease (CHD) not diagnosed with cerebral palsy/acquired brain injury, describe and compare their motor profiles and explore predictors of motor impairment in each group. Children with an intellectual quotient <70 or cerebral palsy/acquired brain injury were excluded. Motor skills were assessed with the Movement Assessment Battery for Children-2. Total scores <5th percentile indicated motor impairment. Statistical analysis included χ2 test and multiple logistic regression analysis. At a mean age of 55.4 (standard deviation 3.77) months, motor impairment was present in 11.8% of those with biventricular critical CHD, and 32.4% (p < 0.001) of those with univentricular critical CHD. The greatest difference between children with biventricular and univentricular CHD was seen in total test scores 8.73(2.9) versus 6.44(2.8) (p < 0.01) and in balance skills, 8.84 (2.8) versus 6.97 (2.5) (p = 0.001). Manual dexterity mean scores of children with univentricular CHD were significantly below the general population mean (>than one standard deviation). Independent odds ratio for motor impairment in children with biventricular critical CHD was presence of chromosomal abnormality, odds ratio 10.9 (CI 2.13–55.8) (p = 0.004); and in children with univentricular critical CHD odds ratio were: postoperative day 1–5 highest lactate (mmol/L), OR: 1.65 (C1.04–2.62) (p = 0.034), and dialysis requirement any time before the 4.5-year-old assessment, OR: 7.8 (CI 1.08–56.5) (p = 0.042). Early assessment of motor skills, particularly balance and manual dexterity, allows for intervention and supports that can address challenges during the school years.

scholarly journals Reliability Assessment of Scores From Video-Recorded TGMD-3 Performances

2017 ◽  
Vol 5 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Pauli Olavi Rintala ◽  
Arja Kaarina Sääkslahti ◽  
Susanna Iivonen
Keyword(s):  
Motor Development ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Kappa Statistic ◽  
Intrarater Reliability ◽  
Gross Motor ◽  
Gross Motor Development ◽  
Percent Agreement ◽  
Two Samples ◽  
Ball Skills

This study examined the intrarater and interrater reliability of the Test of Gross Motor Development—3rd Edition (TGMD-3). Participants were 60 Finnish children aged between 3 and 9 years, divided into three separate samples of 20. Two samples of 20 were used to examine the intrarater reliability of two different assessors, and the third sample of 20 was used to establish interrater reliability. Children’s TGMD-3 performances were video-recorded and later assessed using an intraclass correlation coefficient, a kappa statistic, and a percent agreement calculation. The intrarater reliability of the locomotor subtest, ball skills subtest, and gross motor total score ranged from 0.69 to 0.77, and percent agreement ranged from 87 to 91%. The interrater reliability of the locomotor subtest, ball skills subtest, and gross motor total score ranged from 0.56 to 0.64. Percent agreement of 83% was observed for locomotor skills, ball skills, and total skills, respectively. Hop, horizontal jump, and two-hand strike assessments showed the most difference between the assessors. These results show acceptable reliability for the TGMD-3 to analyze children’s gross motor skills.

Neurological outcome in children and youth with acquired brain injury 2-year post-injury

2018 ◽  
Vol 21 (7) ◽  
pp. 465-474 ◽  
Author(s):  
Suzanne A.M. Lambregts ◽  
Frederike Van Markus-Doornbosch ◽  
Coriene E. Catsman-Berrevoets ◽  
Monique A.M. Berger ◽  
Arend J. De Kloet ◽  
...  
Keyword(s):  
Brain Injury ◽  
Neurological Outcome ◽  
Acquired Brain Injury ◽  
Children And Youth ◽  
Post Injury

scholarly journals Influence of Rater Training on Inter- and Intrarater Reliability When Using the Rat Grimace Scale

2019 ◽  
Vol 58 (2) ◽  
pp. 178-183 ◽  
Author(s):  
Emily Q Zhang ◽  
Vivian SY Leung ◽  
Daniel SJ Pang
Keyword(s):  
Acute Pain ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Training Group ◽  
Intrarater Reliability ◽  
Rater Training ◽  
Trainee Group ◽  
Pain Models ◽  
Ongoing Pain ◽  
And Performance

Rodent grimace scales facilitate assessment of ongoing pain. Reported rater training using these scales varies considerably and may contribute to the observed variability in interrater reliability. This study evaluated the effect of training on interrater reliability with the Rat Grimace Scale (RGS). Two training sets (42 and 150 images) were prepared from acute pain models. Four trainee raters progressed through 2 rounds of training, scoring 42 images (set 1) followed by 150 images (set 2a). After each round, trainees reviewed the RGS and any problematic images with an experienced rater. The 150 images were then rescored (set 2b). Four years later, trainees rescored the 150 images (set 2c). A second group of raters (no-training group) scored the same image sets without review with the experienced rater. Inter- and intrarater reliability were evaluated by using the intraclass correlation coefficient (ICC), and ICC values were compared by using the Feldt test. In the trainee group, interrater reliability increased from moderate to very good between sets 1 and 2b and increased between sets 2a and 2b. Action units with the highest and lowest ICC at set 2b were orbital tightening and whiskers, respectively. In comparison to an experienced rater, the ICC for all trainees improved, ranging from 0.88 to 0.91 at set 2b. Four years later, very good interrater reliability was retained, and intrarater reliability was good or very good). The interrater reliability of the no-training group was moderate and did not improve from set 1 to set 2b. Training improved interrater reliability, with an associated reduction in 95%CI. In addition, training improved interrater reliability with an experienced rater, and performance was retained.

Sign in / Sign up

Export Citation Format

Share Document