scholarly journals mHealth App for Pressure Ulcer Wound Assessment in Patients With Spinal Cord Injury: Clinical Validation Study

10.2196/26443 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e26443
Author(s):  
Ariane Do Khac ◽  
Claire Jourdan ◽  
Sylvain Fazilleau ◽  
Claire Palayer ◽  
Isabelle Laffont ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pressure Ulcer ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intraclass Correlation Coefficients ◽  
Wound Assessment ◽  
Cord Injury

Background Clinical evaluation of a pressure ulcer is based on quantitative and qualitative evaluation. In clinical practice, acetate tracing is the standard technique used to measure wound surface area; however, it is difficult to use in daily practice (because of material availability, data storage issues, and time needed to calculate the surface area). Planimetry techniques developed with mobile health (mHealth) apps can be used to overcome these difficulties. Objective The goal of this study was to evaluate the metrological properties of a free-access mHealth app, called imitoMeasure, to assess pressure ulcers. Methods This was a noninterventional, validation study. We included patients with spinal cord injury presenting with a pressure ulcer, regardless of its stage or location. We performed wound measurements with a ruler, and we performed acetate tracing using a transparent dressing with a wound measurement grid. Wound evaluation via the mHealth app was conducted twice by the main investigator and also by a coinvestigator to determine validity, intrarater reproducibility, and interrater reproducibility. Bland-Altman plots and intraclass correlation coefficients were used to compute the minimal detectable change percentage. Results Overall, 61 different pressure ulcers were included. The validity, intrarater reproducibility, and interrater reproducibility of the mHealth app vs acetate tracing (considered the method of reference) were good, with intraclass correlation coefficients of 0.97 (95% CI 0.93-0.99), 0.99 (95% CI 0.98-0.99), and 0.98 (95% CI 0.96-0.99), respectively, and minimal detectable change percentages between 17% and 35%. Conclusions The imitoMeasure app had good validity and reproducibility. It could be an alternative to standard wound assessment methods. Further studies on larger and more diverse wounds are needed. Trial Registration ClinicalTrials.gov NCT04402398; http://clinicaltrials.gov/ct2/show/NCT04402398

scholarly journals Reliability of three-dimensional kinematic gait data in adults with spinal cord injury

2017 ◽  
Vol 4 ◽  
pp. 205566831772999 ◽  
Author(s):  
Pia Wedege ◽  
Kathrin Steffen ◽  
Vegard Strøm ◽  
Arve Isak Opheim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Cord Injury ◽  
Hip Rotation ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Objectives Three-dimensional gait analysis has been recommended as part of standardized gait assessment in people with spinal cord injury. The aim was to investigate inter- and intra-session reliabilities of gait kinematics in people with spinal cord injury. Methods Fifteen adults with spinal cord injury performed two test sessions on separate days. Six infrared cameras, 16 reflective markers and the Plug-in gait model were used. For each subject, five gait trials from both sessions were included. The Gait Profile Score and the Gait Variable Score were used as kinematic outcome measures. Reliability was assessed with intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland–Altman plots. Results Inter-session intraclass correlation coefficient for all variables was >0.82 and standard error of measurement <1.8°, except for hip rotation. Intra-session reliability was found to be high (≥0.78) and slightly better than that for inter-session. Minimal detectable change for all variables was <4.7°, except for hip rotation. Conclusions The high inter- and intra-session reliabilities indicate small intrinsic variation of gait. Thus, three-dimensional gait analysis seems to be a reliable tool to evaluate kinematic gait in adults with spinal cord injury, but caution is warranted especially for hip rotation evaluation.

An investigation into the validity and reliability of the Chinese version of Spinal Cord Independence Measure III (SCIM III)

2020 ◽  
pp. 026921552096670
Author(s):  
Huayi Xing ◽  
Nan Liu ◽  
Fin Biering-Sørensen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Barthel Index ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Chinese Version ◽  
Validity And Reliability ◽  
Post Injury ◽  
Cord Injury

Objective: To investigate the validity and reliability of a Chinese version of Spinal Cord Independence Measure III (SCIM III) in individuals with spinal cord injury. Design: Study on psychometric properties. Setting: An inpatient rehabilitation facility in China. Subjects: 102 participants with spinal cord injury. Mean (SD) age was 48.8 (15.6) years; tetraplegia/paraplegia ratio was 50/52; median time post injury was 2 months. Intervention: SCIM III was translated into Chinese. Chinese versions of Barthel Index and SCIM III were filled out for each participant by Rater 1. SCIM III was then administered by Rater 2 after 24 hours ( n = 67) and 7 days ( n = 65). Main Measures: Validity, inter-rater/test-retest reliability, and internal consistency of the Chinese version of SCIM III. Results: The total scores between the two raters were similar (mean ± SD: 33.8 ± 25.8 vs 33.8 ± 25.5, P = 0.95). Total agreement between the raters in each item was >80%, with both Pearson and intraclass correlation coefficients >0.97 ( P < 0.01) for each subscale and total score. The Pearson correlation coefficients of the two independent assessments performed by Rater 2 were also >0.97 ( P < 0.01) for each subscale and the total score. Cronbach α was >0.7 for each subscale and the total score for both raters. High consistency was found between Barthel Index and SCIM III total scores (Pearson correlation coefficient = 0.88, P < 0.01). Conclusion: The Chinese version of SCIM III is valid and reliable for the functional assessment of patients with SCI.

scholarly journals Test-retest reliability and minimal detectable change of the Balance Evaluation Systems Test and its two abbreviated versions in persons with mild to moderate spinocerebellar ataxia: A pilot study

2020 ◽  
Vol 47 (4) ◽  
pp. 479-486
Author(s):  
Yuki Kondo ◽  
Kyota Bando ◽  
Yosuke Ariake ◽  
Wakana Katsuta ◽  
Kyoko Todoroki ◽  
...  
Keyword(s):  
Spinocerebellar Ataxia ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Retest Reliability ◽  
Evaluation Systems ◽  
Intraclass Correlation Coefficients ◽  
Interclass Correlation ◽  
Test Retest Reliability

BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely.

scholarly journals Reliability and validity of transfer assessment instrument version 3.0 in individuals with acute spinal cord injury in early rehabilitation phase

2018 ◽  
Vol 38 (02) ◽  
pp. 115-123
Author(s):  
Preeti Baghel ◽  
Shefali Walia ◽  
Majumi M Noohu
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Early Rehabilitation ◽  
Assessment Instrument ◽  
Minimal Detectable Change ◽  
Cord Injury

Background: Transfers are very important in functional activities of subjects with spinal cord injury (SCI). The transfer assessment instrument (TAI) was the first tool to standardize the assessment of transfer technique. Objective: The purpose of this study was to establish the reliability and validity of TAI 3.0 in people with SCI in early rehabilitation phase. Methods: Thirty subjects with acute traumatic SCI were recruited from a tertiary care center for SCI management. Four raters assessed the quality of transfer using TAI 3.0 and a fifth rater used global assessment of transfer scale (VAS). TAI 3.0’s intraclass correlation coefficient (ICC) for intrarater and interrater reliability, standard error of measurement (SEM), minimal detectable change (MDC), limits of agreement and concurrent validity was determined. Results: The intrarater ICC was 0.93 to 0.98 and interrater ICC was 0.99, indicating high levels of reliability. The SEMs among the raters for TAI 3.0 total was from 0.23 to 0.28. The MDC among the raters TAI 3.0 total was from 0.54 to 0.86. Correlation for different raters between the TAI 3.0 and VAS ranged between 0.88 and 0.90. Conclusion: TAI 3.0 is a reliable and valid tool to assess the transfer skill in individuals with SCI in early rehabilitation phase.

scholarly journals Spinal Cord Injury Functional Ambulation Profile: A Preliminary Look at Responsiveness

2014 ◽  
Vol 94 (2) ◽  
pp. 240-250 ◽  
Author(s):  
Kristin E. Musselman ◽  
Jaynie F. Yang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Endurance Training ◽  
Minimal Detectable Change ◽  
Walk Test ◽  
Detectable Change ◽  
Convenience Sample ◽  
Change Scores ◽  
Cord Injury ◽  
Functional Ambulation Profile

Background The Spinal Cord Injury Functional Ambulation Profile (SCI-FAP) is a valid, reliable measure of walking skill (eg, walking while negotiating obstacles, doors, and stairs). Objective The responsiveness of the SCI-FAP was assessed at least 7 months after spinal cord injury (SCI) and compared with that of the 10-Meter Walk Test (10MWT) and the Six-Minute Walk Test (6MWT). Design A secondary analysis of data collected during a randomized, single-blind, crossover trial was performed. Methods Participants had incomplete SCI and could walk at least 5 m without manual assistance. After 3 or 4 baseline assessments, participants completed 2 months of precision training (stepping over obstacles and onto targets on the ground) and 2 months of endurance training (treadmill training with body weight support, if needed). Walking function was assessed with the SCI-FAP, 10MWT, and 6MWT. Internal responsiveness was evaluated through change scores and standardized response means (SRMs). External responsiveness was gauged by correlating change scores on the SCI-FAP, 10MWT, and 6MWT. The minimal detectable change was calculated from the standard error of measurement from the baseline assessments. Results The SCI-FAP scores improved with both interventions. The magnitude of change was greater for participants whose pretraining self-selected speed was less than 0.5 m/s. The SCI-FAP had moderate SRMs. The 10MWT (fastest speed) and 6MWT had the largest SRMs after precision training and endurance training, respectively. The minimal detectable change in the SCI-FAP was 96 points. Limitations The convenience sample was small and all participants could ambulate independently (with devices); therefore, the generalizability of the findings is limited. Conclusions The SCI-FAP was responsive to changes in walking ability in participants who had incomplete SCI and walked at slow speeds, but overall the 10MWT and 6MWT were more responsive.

Evaluating Intratester Reliability of Manual Masking of Plantar Pressure Measurements Associated with Chronic Gout

2011 ◽  
Vol 101 (5) ◽  
pp. 424-429
Author(s):  
Keith Rome ◽  
David George Survepalli ◽  
Maria Lobo ◽  
Nicola Dalbeth ◽  
Fiona McQueen ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Pressure Measurements ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Intraclass Correlation Coefficients ◽  
Chronic Gout ◽  
Pressure Time

Background: Plantar pressure measurements are commonly used to evaluate foot function in chronic musculoskeletal conditions. However, manually identifying anatomical landmarks is a source of measurement error and can produce unreliable data. The aim of this study was to evaluate intratester reliability associated with manual masking of plantar pressure measurements in patients with gout. Methods: Twenty-five patients with chronic gout (mean disease duration, 22 years) were recruited from rheumatology outpatient clinics. Patients were excluded if they were experiencing an acute gout flare at the time of assessment, had lower-limb amputation, or had diabetes mellitus. Manual masking of peak plantar pressures and pressure-time integrals under ten regions of the foot were undertaken on two occasions on the same day using an in-shoe pressure measurement system. Test-retest reliability was assessed by using intraclass correlation coefficients, SEM, 95% limits of agreement, and minimal detectable change. Results: Mean peak pressure intraclass correlation coefficients ranged from 0.92 to 0.97, with SEM of 8% to 14%. The 95% limits of agreement ranged from−150.3 to 133.5 kPa, and the minimal detectable change ranged from 30.8 to 80.6 kPa. For pressure-time integrals, intraclass correlation coefficients were 0.86 to 0.94, and SEM were 5% to 29%, with the greater errors observed under the toes. The 95% limits of agreement ranged from −48.5 to 48.8 kPa/sec, and the minimal detectable change ranged from 6.8 to 21.0 kPa/sec. Conclusions: These findings provide clinicians with information confirming the errors associated with manual masking of plantar pressure measurements in patients with gout. (J Am Podiatr Med Assoc 101(5): 424–429, 2011)

scholarly journals Intrasession and Intersession Reliability of Isometric Trunk and Hip Strength Measurements Using the Portable Tension Dynamometer

2021 ◽  
pp. 1-4
Author(s):  
Sakiko Oyama ◽  
Edgar Garza ◽  
Kylie Dugan
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Leg Length ◽  
Trunk Flexion ◽  
Hip Strength ◽  
Intraclass Correlation Coefficients ◽  
Hip Abduction ◽  
Abduction Strength

Context: The trunk/pelvis is an important link between the upper- and lower-extremities. Therefore, assessing strength of the trunk and hip muscles that control the segments is clinically meaningful. While an isokinetic dynamometer can be used to measure trunk strength, the equipment is expensive and not portable. Objective: To test the reliability of simple trunk and hip strength measures that utilize a bar, straps, and a portable tension dynamometer. Design: Test–retest reliability study. Setting: Biomechanics research laboratory. Patients (or Other Participants): Twenty college-age individuals (10 males/10 females, age = 20.9 [3.7] y) participated. Intervention(s): The participants attended 2 testing sessions, 1 week apart. The participants’ trunk-flexion, rotation, and hip abduction strength were measured at each session. Main Outcome Measures: Peak trunk flexion, rotation, and hip abduction forces were normalized to the participant’s body weight (BW). In addition, hip-abduction torque was calculated by multiplying the force times the leg length and normalized to BW. The trial data from both sessions were used to calculate the intrasession reliability, and the averages from the 2 sessions were used to calculate the intersession reliability. Intraclass correlation coefficients, SEM, and minimal detectable change were calculated to evaluate reliability of measures. Results: The intrasession intraclass correlation coefficients (SEM) for trunk flexion, rotation, hip abduction, and hip abduction torque were .837 (5.2% BW), .978 (1.3% BW), .955 (1.0% BW), and .969 (5.8 N·m/BW), respectively. The intersession reliability for trunk flexion, rotation, hip abduction, and hip abduction torque were .871 (4.3% BW), .801 (3.8% BW), .894 (1.5% BW), and .968 (5.9 N·m/BW), respectively. Conclusions: The measures of trunk and hip abduction strength are highly repeatable within a session. The reliability of the measures between sessions was also good/excellent with relatively small SEM and minimal detectable change. The tests described in this study can be used to assess changes in trunk/hip strength over time.

Clinical validation of a mHealth App for wound assessment: correlation and reliability study (Preprint)

2020 ◽  
Author(s):  
Ariane DO KHAC ◽  
Claire JOURDAN ◽  
Sylvain FAZILLEAU ◽  
Claire PALAYER ◽  
Isabelle LAFFONT ◽  
...  
Keyword(s):  
Data Storage ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Intraclass Correlation ◽  
Qualitative Evaluation ◽  
Daily Practice ◽  
Minimal Detectable Change ◽  
Free Access ◽  
Wound Assessment ◽  
Cord Injury

BACKGROUND The clinical evaluation of a pressure ulcer is based on a quantitative and qualitative evaluation. In clinical practice, the technique of reference to measure wound surface is the use of acetate tracing, however it is difficult to use in daily practice (availability of the material, data storage issues, time needed to calculate the surface are). Planimetry techniques developed with mobile health (mHealth) apps can overcome these difficulties. OBJECTIVE To evaluate the metrological properties of a free access mHealth app to assess pressure ulcers. METHODS This was a non-interventional validation study (2019_IRB-MTP_06-02). We included patients with spinal cord injury presenting with a pressure ulcer, regardless of its stage or location. We performed wound measurements with a ruler and acetate tracing using a transparent dressing with a wound measurement grid. Wound evaluation via the mHealth app was conducted twice by the main investigator and also with a co-investigator (validity study, intra and inter-rater reproducibility). The Bland-Altman plot and intraclass correlation coefficient (ICC) were used to compute the minimal detectable change expressed as percentage (MDC%). RESULTS Overall, 61 different pressure ulcers were included. Analyses showed that the validity and intra- and inter-rater reliability of the mHealth app vs. acetate tracing (considered the method of reference) were good, with ICC respectively at 0.97 (0.93-0.99), 0.99 (0.98-0.99) and 0.98 (0.96-0.99), and a MDC% between 17 and 35%. CONCLUSIONS This study unveils the good validity and reproducibility of the imitoMeasure app. It could be a proper alternative to standard wound assessment methods. Further studies are needed, especially on larger and more diverse wounds. CLINICALTRIAL ClinicalTrials.gov NCT04402398

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