scholarly journals Flatfoot or not: subjective perception of the height of the feet arch among orthopedists

2020 ◽  
Vol 8 (2) ◽  
pp. 179-184
Author(s):  
Alyona Ju. Dimitrieva ◽  
Vladimir M. Kenis ◽  
Andrei V. Sapogovskiy

Background. The visual assessment of flatfoot is the most commonly used method by pediatric orthopedists. It is necessary to confirm good consistency among specialists to justify its use as a standard. Aim. The aim of this study was to determine the consistency of visual assessment of flatfoot among orthopedists. Materials and methods. The first stage of this study included 187 primary school-aged children. The main methods used were clinical examination and computer plantography. Then, 130 images of the right foot were randomly selected in standard projections medial and posterior, which were provided to 32 orthopedists (ten of whom were experts). Specialists needed to note whether the foot presented for analysis was flat. We used the w-Kendall concordance coefficient and -Kendall correlation coefficient to determine the inter-rater reliability. After five months, the intra-rater reliability was determined, and the Cohen coefficient was calculated. Results. Our study demonstrated that the inter-rater reliability varied significantly depending on whether the orthopedist specialized in foot pathology. When calculating the concordance coefficient, an increase in the consistency among experts was noted after five months (0.58 and 0.76, respectively), compared with orthopedists who do not specialize in foot pathology. Although some heterogeneity was noted according to experts on the same foot, the overall correlation coefficient corresponded to a good and excellent level of consistency (0.650.84). Cohens coefficient among specialists corresponded to a good level of confidence (0.72), whereas among orthopedists who do not specialize in foot pathology, there was a low level of confidence (0.31). According to experts, the frequency of flatfoot was 24.6%, whereas according to orthopedists who do not specialize in foot pathology, it was 40.9% when they evaluated images of the same feet. Conclusion. Experts answers regarding which foot should be considered flat demonstrated a good and excellent level of consistency. Therefore, they can be used to determine reference values of anthropometric parameters of the medial foot arch.

2018 ◽  
Vol 44 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Aline Pedrini ◽  
Márcia Aparecida Gonçalves ◽  
Bruna Estima Leal ◽  
Michelle Gonçalves de Souza Tavares ◽  
Wellington Pereira Yamaguti ◽  
...  

ABSTRACT Objective: To investigate the concurrent validity, as well as the intra- and inter-rater reliability, of assessing diaphragmatic mobility by area (DMarea) on chest X-rays of healthy adults. Methods: We evaluated anthropometric parameters, pulmonary function, and diaphragmatic mobility in 43 participants. Two observers (rater A and rater B) determined diaphragmatic mobility at two time points. We used Pearson’s correlation coefficient to evaluate the correlation between DMarea and the assessment of diaphragmatic mobility by distance (DMdist). To evaluate intra- and inter-rater reliability, we used the intraclass correlation coefficient (ICC [2,1]), 95% CI, and Bland-Altman analysis. Results: A significant correlation was found between the DMarea and DMdist methods (r = 0.743; p < 0.0001). For DMarea, the intra-rater reliability was found to be quite high for the right hemidiaphragm (RHD)-ICC (2,1) = 0.92 (95% CI: 0.86-0.95) for rater A and ICC (2,1) = 0.90 (95% CI: 0.84-0.94) for rater B-and the left hemidiaphragm (LHD)-ICC (2,1) = 0.96 (95% CI: 0.93-0.97) for rater A and ICC (2,1) = 0.91 (95% CI: 0.81-0.95) for rater B-(p < 0.0001 for all). Also for DMarea, the inter-rater reliability was found to be quite high for the first and second evaluations of the RHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.95 (95% CI: 0.86-0.97), respectively-and the LHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.94 (95% CI: 0.87-0.97)-(p < 0.0001 for both). The Bland-Altman analysis showed good agreement between the mobility of the RHD and that of the LHD. Conclusions: The DMarea method proved to be a valid, reliable measure of diaphragmatic mobility.


Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 71 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Mei-Chu Chen ◽  
Yi-Chi Chiu ◽  
Der-Sheng Han ◽  
...  

Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.


2021 ◽  
pp. 003151252110365
Author(s):  
Alessandra V. Prieto ◽  
Kênnea Martins Almeida Ayupe ◽  
Ana C. A. Abreu ◽  
Paulo J. B. Gutierres Filho

Improvement in rider mobility represents an important functional gain for people with disabilities undergoing hippotherapy. However, there is no validated measuring instrument to track and document the rider's progress in riding activities. In this study, we aimed to develop and establish validity evidence for an instrument to assess hippotherapy participants’ mobility on horseback. We report on this development through the stages of: (a) content validation, (b) construct validation, (c) inter- and intra-rater reliability and (d) internal consistency analysis. We evaluated its factor structure with exploratory factor analyses, calculated values for inter- and intra-rater reliability using the intra-class correlation coefficient, and calculated its internal consistency using Cronbach's alpha. We followed recommendations by the Guidelines for Reporting Reliability and Agreement Studies. We found good inter-rater reliability (intra-class correlation coefficient – ICC = 0.991–0.999) and good intra-rater reliability (ICC = 0.997–1.0), and there was excellent internal consistency (Cronbach's α = 0.937–0.999). The instrument’s factor structure grouped its three domains into one factor. As this instrument is theoretically consistent and has been found to be appropriate and reliable for its intended use, it is now available for the measurement of horseback mobility among hippotherapy riders.


Author(s):  
L. V. Ulyanova ◽  
V. S. Ledneva ◽  
N. S. Burdina ◽  
M. I. Talykova ◽  
A. S. Ivannikova ◽  
...  

The successful provision of optimal nutrition in children with serious diseases depends on the right diet, as well as the addition of specialized mixtures for its correction. The aim of the study was to study the effectiveness of supplemental nutrition in hereditary fermentopathy (cystic fibrosis) in children. The work included a three-year follow-up of 69 children aged 3 to 15 years suffering from cystic fibrosis. Patients were divided into two groups: 37 patients with cystic fibrosis group 1, receiving a modified version of treatment with additional enteral nutrition and 32 patients with cystic fibrosis group 2, receiving traditional treatment. The study conducted a comparative analysis of changes in trophic status in patients using nutritional support mixture produced in the Russian Federation – "Nutrien-standard"in diet therapy. Laboratory, functional and anthropometric parameters were monitored once a month. A significant increase in the physical development of patients was obtained only in the second year of use in the diet of supplementary nutrition, p<0.05. At the 3rd year of treatment, the results of positive dynamics of nutritional status in both groups were confirmed, while the increase in body mass index in the main group was 6.7%, and in the control group-only 1% (p<0.05). It is noted that the use of this mixture allows to achieve positive dynamics of nutritional status in 27% of patients and in 73% of cases to completely eliminate it. The obtained results prove the expediency of additional use of "Nutrient-standard" mixture in the complex therapy of patients with hereditary pancreatic enzyme deficiency, cystic fibrosis


2015 ◽  
Vol 7 (3) ◽  
pp. 51-59
Author(s):  
MONIKA OPANOWSKA ◽  
ELZBIETA PRETKIEWICZ-ABACJEW

Background: The aim of the research was to assess the longitudinal and the transverse shape of the foot arch in male and female pole vaulters. Material/Methods: The research involved 14 women and 16 men training pole vault professionally and possessing the highest level of sport’s proficiency. The assessment of the foot arch was made in static conditions, using a podoscope. The longitudinal foot arch was assessed by Clarke’s method and the transverse foot arch was based on the calcaneal angle. Results: The obtained results showed that the correct and excessive foot arch occur most frequently. Conclusions: Numerous technical exercises performed by pole vaulters on the forefoot and toes strengthen the foot (shortening muscles responsible for a proper level of the longitudinal and the transverse foot arch) and result in the correct or excessive arch in the right and the left foot.


EDUSAINS ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 20-29
Author(s):  
M Ubaidilah Hasan ◽  
Ira Nurmawati

THE RELATIONSHIP OF STUDENTS' UNDERSTANDING LEVEL OF ANIMAL MORPHOLOGY CHARACTERISTICS WITH THE ABILITY TO MEMORIZE ANIMAL LATIN NAMES IN GRADE 10 IPAAbstractAnimal taxonomy subjects often use animal's Latin names. Many students think that this subject is annoying because it is dominated by memorizing animal's Latin names, even though memorizing becomes a prerequisite for understanding. Meanwhile, most of the language materials memorized need an understanding before the memorizing process. This study aimed to find a relationship between the level of students' understanding of an animal's morphological characteristics and the ability to memorize animal's Latin names at the Xth grade of IPA students in SMAN 3 Jember. This study used a quantitative approach with a type of ex post facto. The test obtained the data. Then it was descriptively and inferentially analyzed by Kendall correlation. This research indicated that 56 students who answered test of the level of understanding animal's morphological characteristics and the ability to memorize animal's Latin names resulted in a correlation coefficient of score 0.673, and significance 0,000 < 0.05. Therefore, if the level of students’ understanding of an animal's morphological characteristics increased, the ability to memorize animal's Latin names at the Xth grade of IPA students in SMAN 3 Jember also increased, conversely. AbstrakNama latin hewan sering digunakan dalam materi taksonomi hewan. Banyak siswa beranggapan bahwa materi tersebut membosankan karena didominasi oleh menghafal nama latin hewan, padahal menghafal menjadi prasyarat pemahaman. Sementara itu, sebagian besar materi bahasa yang dihafal membutuhkan pemahaman sebelum proses menghafal berlangsung. Tujuan penelitian ini ialah mengetahui hubungan tingkat pemahaman karakteristik morfologi hewan dengan kemampuan menghafal nama latin hewan pada siswa kelas X IPA SMA Negeri 3 Jember. Penelitian ini menggunakan pendekatan kuantitatif dengan jenis eks post facto. Data didapatkan menggunakan instrumen tes. Kemudian dianalisis secara deskriptif dan inferensial menggunakan korelasi Kendall. Penelitian ini menunjukkan bahwa dari 56 siswa yang menjawab tes tingkat pemahaman karakteristik morfologi hewan dan kemampuan menghafal nama latin hewan menghasilkan koefisien korelasi 0,673 dan signifikansi 0,000 < 0,05. Dengan demikian, jika tingkat pemahaman karakteristik morfologi hewan meningkat, kemampuan menghafal nama latin hewan pada siswa kelas X IPA SMA Negeri 3 Jember juga meningkat, begitupula sebaliknya. 


2015 ◽  
Vol 114 (1) ◽  
pp. 108-117 ◽  
Author(s):  
E. Combet ◽  
M. Bouga ◽  
B. Pan ◽  
M. E. J. Lean ◽  
C. O. Christopher

Iodine is a key component of the thyroid hormones, which are critical for healthy growth, development and metabolism. The UK population is now classified as mildly iodine-insufficient. Adequate levels of iodine during pregnancy are essential for fetal neurodevelopment, and mild iodine deficiency is linked to developmental impairments. In the absence of prophylaxis in the UK, awareness of nutritional recommendations during pregnancy would empower mothers to make the right dietary choices leading to adequate iodine intake. The present study aimed to: estimate mothers' dietary iodine intake in pregnancy (using a FFQ); assess awareness of the importance of iodine in pregnancy with an understanding of existing pregnancy dietary and lifestyle recommendations with relevance for iodine; examine the level of confidence in meeting adequate iodine intake. A cross-sectional survey was conducted and questionnaires were distributed between August 2011 and February 2012 on local (Glasgow) and national levels (online electronic questionnaire); 1026 women, UK-resident and pregnant or mother to a child aged up to 36 months participated in the study. While self-reported awareness about general nutritional recommendations during pregnancy was high (96 %), awareness of iodine-specific recommendations was very low (12 %), as well as the level of confidence of how to achieve adequate iodine intake (28 %). Median pregnancy iodine intake, without supplements, calculated from the FFQ, was 190 μg/d (interquartile range 144–256μg/d), which was lower than that of the WHO's recommended intake for pregnant women (250 μg/d). Current dietary recommendations in pregnancy, and their dissemination, are found not to equip women to meet the requirements for iodine intake.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Silvia Bel-Serrat ◽  
Mairéad Madigan ◽  
Rachel Sheane ◽  
Celine M. Murrin ◽  
Cecily C. Kelleher ◽  
...  

AbstractIntroductionValidation studies are indispensable to test the appropriateness of dietary assessment methods used within epidemiological surveys to accurately assess food intake in young populations. The aim of this study was to examine the relative validity of the food group frequency questionnaire (FGFQ) used to assess dietary intake in the Childhood Obesity Surveillance Initiative.Materials and MethodsThis study was undertaken in a convenience sample of 33 Irish children aged 7–9 years old from urban Dublin-based primary schools. Food group intake estimates were collected with the FGFQand compared with those obtained with a 7-day semi-weighed food diary. Agreement between frequencies of intake between the two instruments were examined using Spearman's correlation coefficient, cross-classification analyses and weighted kappa.ResultsThe FGFQ over-estimated the number of portions for most of the food groups as compared with the reference method. Spearman correlation coefficients ranged from 0.75 (cheese) to 0.03 (flavoured milk). Level of agreement was moderate with an average correlation coefficient of 0.45. The proportion of children classified in the same category ranged from 96.9% (sweet treats) to 60.6% (vegetables). Misclassification was less than 15% for fruit, soft drinks, low fat milk, fish, savoury snacks and sweet treats and above 30% for vegetables, dairy products and pastries & biscuits. Weighted kappa statistic values ranged from 0.84 (sweet treats) to 0.10 (vegetables). Mean level of agreement was moderate (0.39). No agreement (< 0.0) was found for soft drinks.DiscussionAlthough the strength of association estimates varied by food group, strong to moderate levels of relative validity were observed. Our results show that the FGFQ gives acceptable estimates of food group intakes among Irish school-aged children and that the tool can be used for ranking subjects according to food group intakes.


Ultrasound ◽  
2019 ◽  
Vol 27 (3) ◽  
pp. 156-166 ◽  
Author(s):  
Vanessa L Kennedy ◽  
Carol A Flavell ◽  
Kenji Doma

A “free hand” real-time-ultrasound method is commonly applied to measure transversus abdominis. Potentially, this increases transversus abdominis measurement error due to uncontrolled variability in probe to skin force, inclination, and roll, particularly for novice examiners. This single-group repeated-measures reliability study compared the intra-rater reliability of transversus abdominis thickness and activation measurement by a novice examiner between free hand and a standardized probe force device method. The examiner captured ultrasound videos of transversus abdominis in a single session in healthy participants ( n =  33). Free hand ultrasound featured uncontrolled probe force, inclination, and roll, while probe force device method ultrasound standardized these parameters. Images of transversus abdominis at rest and contracted were measured and transversus abdominis activation calculated. Intraclass correlation coefficient, coefficient of variation, standard error of measurement, and worthwhile differences were calculated. The probe force device method resulted in greater reliability (intraclass correlation coefficient = 0.75–0.96) and lower measurement error (coefficient of variation = 8.89–28.7%) compared to free hand (intraclass correlation coefficient = 0.63–0.93; coefficient of variation = 6.52–29.4%). Reliability was good for all measurements except free hand TrA-C, which was moderate. TrA-C had the lowest reliability, followed by contracted thickness of the transverse abdominis, with resting thickness of the transverse abdominis being highest. Worthwhile differences were lower using a probe force device method versus free hand for resting thickness of the transverse abdominis and contracted thickness of the transverse abdominis and similar for TrA-C. Standardization using probe force device method ultrasound to measure transversus abdominis improved intra-rater reliability in a novice examiner. Use of a probe force device method is recommended to improve reliability through reduced sources of measurement error. Probe force device method intra- and inter-rater reliability in examiners of varying experience, in clinical populations, and to visualize other structures merits exploration.


Vascular ◽  
2016 ◽  
Vol 25 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Kenneth Ouriel ◽  
Richard L Ouriel ◽  
Yeun J Lim ◽  
Gregory Piazza ◽  
Samuel Z Goldhaber

Purpose Computed tomography angiography is used for quantifying the significance of pulmonary embolism, but its reliability has not been well defined. Methods The study cohort comprised 10 patients randomly selected from a 150-patient prospective trial of ultrasound-facilitated fibrinolysis for acute pulmonary embolism. Four reviewers independently evaluated the right-to-left ventricular diameter ratios using the standard multiplanar reformatted technique and a simplified (axial) method, and thrombus burden with the standard modified Miller score and a new, refined Miller scoring system. Results The intraclass correlation coefficient for intra-observer variability was .949 and .970 for the multiplanar reformatted and axial methods for estimating right-to-left ventricular ratios, respectively. Inter-observer agreement was high and similar for the two methods, with intraclass correlation coefficient of .969 and .976. The modified Miller score had good intra-observer agreement (intraclass correlation coefficient .820) and was similar to the refined Miller method (intraclass correlation coefficient .883) for estimating thrombus burden. Inter-observer agreement was also comparable between the techniques, with intraclass correlation coefficient of .829 and .914 for the modified Miller and refined Miller methods. Conclusions The reliability of computed tomography angiography for pulmonary embolism was excellent for the axial and multiplanar reformatted methods for quantifying the right-to-left ventricular ratio and for the modified Miller and refined Miller scores for quantifying of pulmonary artery thrombus burden.


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