scholarly journals Repeated Measurements of Arm Joint Passive Range of Motion After Stroke: Interobserver Reliability and Sources of Variation

2012 ◽  
Vol 92 (8) ◽  
pp. 1027-1035 ◽  
Author(s):  
Lex D. de Jong ◽  
Pieter U. Dijkstra ◽  
Roy E. Stewart ◽  
Klaas Postema
Keyword(s):  
Range Of Motion ◽  
Physical Therapists ◽  
Longitudinal Design ◽  
Interobserver Reliability ◽  
Arm Movements ◽  
Error Variance ◽  
Large Contribution ◽  
Standardized Protocol ◽  
Measurement Results ◽  
Sources Of Variation

Background Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking. Objective The aims of this study were to determine the interobserver reliability of measurements of passive range of motion (PROM) over time, explore sources of variation associated with these measurement results, and generate smallest detectable differences for clinical decision making. Design This investigation was a measurement-focused study with a longitudinal design, nested within a 2-arm randomized controlled trial. Methods Two trained physical therapists assessed 7 arm movements at baseline and after 4, 8, and 20 weeks in 48 people with subacute stroke using a standardized protocol. One physical therapist performed the passive movement, and the other read the hydrogoniometer. The therapists then switched roles. The relative contributions of several sources of variation to error variance were explored with analysis of variance. Results Interobserver reliability coefficients ranged from .89 to .97. The PROM measurements were influenced by error variance ranging from 31% to 50%. The participant × time interaction made the largest contribution to error variance, ranging from 59% to 81%. Smallest detectable differences were 6 to 22 degrees and were largest for shoulder movements. Limitations Verification of shoulder pain and hypertonia as sources of error variance led to a substantial number of unstable variance components, necessitating a simpler analysis. Conclusions The assessment of PROM with a standardized protocol, a hydrogoniometer, and 2 trained physical therapists yielded high interobserver reliability indexes for all arm movements. Error variance made a large contribution to the variation in measurement results. The resulting smallest detectable differences can be used to interpret future hemiplegic arm PROM measurements with more confidence.

Intraobserver and Interobserver Reliability of a Method to Measure Ankle Plantar-Flexion Range of Motion in the Hook-Lying Position

2012 ◽  
Vol 21 (4) ◽  
Author(s):  
Guilherme S. Nunes ◽  
Gabriela S. Bayer ◽  
Leticia M.R. da Costa ◽  
Marcos de Noronha
Keyword(s):  
Range Of Motion ◽  
Physical Therapists ◽  
Interobserver Reliability ◽  
Plantar Flexion ◽  
Method Of Measurement ◽  
Experienced Therapist ◽  
Healthy Participants ◽  
Ankle Plantar Flexion ◽  
Very High ◽  
Treatment Table

Context: Physical therapists often have to measure ankle range of motion (ROM) to decide on intervention and investigate improvements. The most common method of measurement is goniometry, but it has been questioned due to its unsatisfactory levels of reliability. Objective: To investigate the intraobserver and interobserver reliability of a new method of measuring plantar-flexion ROM. Design: Prospective and descriptive. Setting: Laboratory. Participants: 20 healthy participants (12 women and 8 men). Main Outcome Measurements: Ankle plantar flexion was measured by 3 observers (A, B, and C) with 3 methods (goniometry, measurement in hook-lying position [MHP], and static-image analysis [SIA]). Observer A was the most experienced therapist, and C, the least. MHP was performed with the participant in the supine position, knees flexed, and first and fifth metatarsals in contact with the treatment table. SIA was recorded and analyzed in the same position. Goniometry was performed with participant seated, lower legs unsupported, and axis positioned on the lateral malleolus. Results: For the interobserver analysis, the ICC2,1 was high for the MHP (.88), high for SIA (.87), and moderate for goniometry (.57). For the intraobserver analysis, the ICC2,1 was high or very high for MHP (.91-.92), high for SIA (.79-.83), and low to moderate for goniometry (.18-.60). Conclusion: MHP is inexpensive, fast, and more reliable than goniometry for measuring plantar-flexion ROM.

scholarly journals Restriction of Passive Glenohumeral Abduction Combined With Normal Passive External Rotation Is a Diagnostic Feature of Calcific Tendinitis

2018 ◽  
Vol 6 (2) ◽  
pp. 232596711775290 ◽  
Author(s):  
Anna Jungwirth-Weinberger ◽  
Christian Gerber ◽  
Glenn Boyce ◽  
Thorsten Jentzsch ◽  
Simon Roner ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Salient Feature ◽  
Supraspinatus Tendon ◽  
Calcific Tendinitis ◽  
Diagnostic Feature ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Standardized Protocol

Background: Passive glenohumeral range of motion may be characteristically limited to specific shoulder pathologies. While pain associated with loss of range of passive external glenohumeral rotation is recognized as a salient feature in adhesive capsulitis, restriction of glenohumeral range of motion in calcific tendinitis of the supraspinatus tendon has never been studied. Hypothesis: On the basis of clinical observation, we hypothesized that calcific tendinitis of the supraspinatus tendon is associated with loss of passive glenohumeral abduction without loss of external rotation. Study Design: Cohort study; Level of evidence, 3. Methods: Ranges of passive glenohumeral rotation and abduction, which are measured with a standardized protocol in our institution, were retrospectively reviewed and compared for patients diagnosed with either adhesive capsulitis or calcific tendinitis of the supraspinatus tendon. A total of 57 patients met the inclusion criteria for the calcific tendinitis, and 77 met the inclusion criteria for the adhesive capsulitis group. Results: When compared with the contralateral, unaffected shoulder, glenohumeral abduction in the calcific tendinitis group was restricted by a median of 10° (interquartile range [IQR], –20° to –5°) as opposed to glenohumeral external rotation, which was not restricted at all (median, 0°; IQR, 0° to 0°). The adhesive capsulitis group showed a median restriction of glenohumeral abduction of 40° (IQR, –50° to –30°) and a median restriction of passive glenohumeral external rotation of 40° (IQR, –60° to –30°). Conclusion: Calcific tendinitis of the supraspinatus does not typically cause loss of external rotation but is frequently associated with mild isolated restriction of abduction. This finding can be used to clinically differentiate adhesive capsulitis from calcific tendinitis.

scholarly journals Changes in Abduction and Rotation Range of Motion in Response to Simulated Dorsal and Ventral Translational Mobilization of the Glenohumeral Joint

2002 ◽  
Vol 82 (6) ◽  
pp. 544-556 ◽  
Author(s):  
Ar-Tyan Hsu ◽  
Tom Hedman ◽  
Jia Hao Chang ◽  
Chuong Vo ◽  
Larry Ho ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Glenohumeral Joint ◽  
Physical Therapists ◽  
Frozen Shoulder ◽  
Testing System ◽  
Before And After ◽  
Medial Rotation ◽  
Fresh Frozen ◽  
Lateral Rotation ◽  
Improved Function

AbstractBackground and Purpose. Translational mobilization techniques are frequently used by physical therapists as an intervention for patients with limited ranges of motion (ROMs). However, concrete experimental support for such practice is lacking. The purpose of the study was to evaluate the effect of simulated dorsal and ventral translational mobilization (DTM and VTM) of the glenohumeral joint on abduction and rotational ROMs. Methods. Fourteen fresh frozen shoulder specimens from 5 men and 3 women (mean age=77.3 years, SD=10.1, range=62–91) were used for this study. Each specimen underwent 5 repetitions of DTM and VTM in the plane of scapula simulated by a material testing system (MTS) in the resting position (40° of abduction in neutral rotation) and at the end range of abduction with 100 N of force. Abduction and rotation were assessed as the main outcome measures before and after each mobilization procedure performed and monitored by the MTS (abduction, 4 N·m) and by a servomotor attached to the piston of the actuator of the MTS (medial and lateral rotation, 2 N·m). Results. There were increases in abduction ROM for both DTM (X̄=2.10°, SD=1.76°) and VTM (X̄=2.06°, SD=1.96°) at the end-range position. No changes were found in the resting position following the same procedure. Small increases were also found in lateral rotation ROM after VTM in the resting position (X̄=0.90°, SD=0.92°, t=3.65, P=.003) and in medial rotation ROM after DTM (X̄=0.97°, SD=1.45°, t=2.51, P=.026) at the end range of abduction. Discussion and Conclusion. The results indicate that both DTM and VTM procedures applied at the end range of abduction improved glenohumeral abduction range of motion. Whether these changes would result in improved function could not be determined because of the use of a cadaver model.

scholarly journals Validity and reliability of smartphone inclinometer applications for measurement of elbow range of motion in paediatric patients

2020 ◽  
Vol 14 (5) ◽  
pp. 488-494
Author(s):  
Denis P. Koong ◽  
Jillian Lee ◽  
Tegan L. Cheng ◽  
David G. Little
Keyword(s):  
Range Of Motion ◽  
Gold Standard ◽  
Assessment Tool ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Smartphone Application ◽  
Absolute Difference ◽  
Visual Estimation ◽  
Paediatric Patients ◽  
Flexion Extension

Purpose Precise measurement of elbow range of motion (ROM) post-injury or surgery forms an important part of determining prognosis and the need for further intervention. Clinicians are increasingly incorporating smartphone use in our medical practice; we sought to determine if a smartphone goniometer application is a valid and reliable tool for assessment of elbow ROM in the paediatric patient, compared to visual and goniometer assessment. Methods In total, 20 paediatric patients (40 elbows) between six and 15 years of age with an elbow or forearm injury were included in this prospective series. Elbow flexion, extension, pronation and supination were measured independently by two orthopaedic clinicians. Measurements were taken from injured as well as unaffected side using a standardized technique, first with visual estimation and then using a universal goniometer (UG) and smartphone goniometer application Angle Meter via Google Play store (Smart Tool Factory, Istanbul, Turkey). Results There was excellent interobserver reliability for all three modalities, with average intraclass correlation coefficient (ICC) values greater than 0.90. Visual estimation had the lowest average ICC of 0.92, compared to 0.97 for UG and smartphone. Overall, there was excellent intraobserver reliability between the smartphone application and the gold standard UG for all elbow movements with ICCs ranging between 0.98 to 0.99 and mean absolute difference ranging from 1.1 ± 1.0° to 2.6 ± 1.9°. The smartphone application showed superior agreement over visual estimation when compared to the gold standard UG with lower mean differences and 95% limits of agreement (LOA) falling within 10°. Conclusions Our study demonstrates that a smartphone application is a valid and reliable assessment tool for measurement of elbow ROM in paediatric patients, and better than visualization alone. Level of evidence III

Smartphone goniometer has excellent reliability between novice and experienced physical therapists in assessing knee range of motion

2021 ◽  
Vol 25 ◽  
pp. 67-74
Author(s):  
Saurabh P. Mehta ◽  
Hans Bremer ◽  
Hannah Cyrus ◽  
Ashely Milligan ◽  
Ali Oliashirazi
Keyword(s):  
Range Of Motion ◽  
Physical Therapists

scholarly journals Interrater Reproducibility of Knee Movement Analyses during the Stance Phase: Use of Anatomical Landmark Calibration with a Rigid Marker Set

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Takashi Fukaya ◽  
Hirotaka Mutsuzaki ◽  
Yasuyoshi Wadano
Keyword(s):  
Knee Joint ◽  
Measurement Method ◽  
Stance Phase ◽  
Physical Therapists ◽  
Maximum Error ◽  
Anatomical Landmarks ◽  
Joint Movement ◽  
Knee Movement ◽  
Measurement Results ◽  
Standard Error Of Measurement

Objective.Measurements of knee joint movement in gait analysis may result in large errors caused by misplacement of reflective markers by the testers. To properly understand the measurement results, it is important to guarantee the reliability of the measurement method used for the purpose. The aim of this study was to confirm the interrater reproducibility of a measurement method with a rigid marker set (RMS).Methods.The study subjects were four healthy adults, and the testers were three physical therapists. The interrater reproducibility of the measurements was verified by using the coefficient of multiple correlations (CMCs) and the standard error of measurement (SEM).Results.The average CMCs values of 4 subjects in knee joint movement at the stance phase were greater than 0.8, and the average SEM values of 4 subjects in knee joint movement at the stance phase were also relatively good (maximum error: 2.42°).Conclusion.Based on these results, the measurement method with estimation of anatomical landmarks using the RMS can prevent misplacement during attachment of the reflective markers, as long as the testers have sufficient experience in attaching reflective markers.

scholarly journals Use of Wearable Sensor Technology in Gait, Balance, and Range of Motion Analysis

2019 ◽  
Vol 10 (1) ◽  
pp. 234 ◽  
Author(s):  
Steven Díaz ◽  
Jeannie B. Stephenson ◽  
Miguel A. Labrador
Keyword(s):  
Range Of Motion ◽  
Neurological Disorders ◽  
Functional Outcomes ◽  
Quantitative Methods ◽  
Physical Therapists ◽  
State Of The Art ◽  
Sensor Technology ◽  
Future Research ◽  
Wearable Sensor ◽  
Rehabilitation Assessment

More than 8.6 million people suffer from neurological disorders that affect their gait and balance. Physical therapists provide interventions to improve patient’s functional outcomes, yet balance and gait are often evaluated in a subjective and observational manner. The use of quantitative methods allows for assessment and tracking of patient progress during and after rehabilitation or for early diagnosis of movement disorders. This paper surveys the state-of-the-art in wearable sensor technology in gait, balance, and range of motion research. It serves as a point of reference for future research, describing current solutions and challenges in the field. A two-level taxonomy of rehabilitation assessment is introduced with evaluation metrics and common algorithms utilized in wearable sensor systems.

The inter- and intraobserver reliability for the radiological parameters of flatfoot, before and after surgery

2018 ◽  
Vol 100-B (5) ◽  
pp. 596-602 ◽  
Author(s):  
P. Bock ◽  
M. Pittermann ◽  
M. Chraim ◽  
S. Rois
Keyword(s):  
Interobserver Reliability ◽  
Weight Bearing ◽  
Intraobserver Reliability ◽  
Foot Surgery ◽  
Postoperative Evaluation ◽  
Orthopaedic Resident ◽  
Radiological Parameters ◽  
Before And After ◽  
Sources Of Variation ◽  
Two Parameters

Aims Various radiological parameters are used to evaluate a flatfoot deformity and their measurements may differ. The aims of this study were to answer the following questions: 1) Which of the 11 parameters have the best inter- and intraobserver reliability in a standardized radiological setting? 2) Are pre- and postoperative assessments equally reliable? 3) What are the identifiable sources of variation? Patients and Methods Measurements of the 11 parameters were recorded on anteroposterior and lateral weight-bearing radiographs of 38 feet before and after surgery for flatfoot, by three observers with different experience in foot surgery (A, ten years; B, three years; C, third-year orthopaedic resident). The inter- and intraobserver reliability was calculated. Results Preoperative interobserver reliability was high for four, moderate for five, and low for two parameters. Postoperative interobserver reliability was high for four, moderate for five, and low for two parameters. Intraobserver reliability was excellent for all parameters preoperatively as recorded by observer A (PB) and B (MP), and for eight parameters as recorded by observer C (SR). Intraobserver reliability was excellent for ten parameters postoperatively as recorded by observer A and B, and for eight parameters as recorded by observer C. Conclusion The following parameters can be recommended. For preoperative and postoperative evaluation of flatfoot: anteroposterior, talonavicular coverage angle; lateral, talometatarsal I angle, calcaneal pitch angle, and cuneiform-medial height (high interobserver reliability); and anteroposterior, talometatarsal II angle; lateral, talocalcaneal angle,tibiocalcaneal angle (moderate interobserver reliability). For more experienced observers, we also recommend the anteroposterior talometatarsal I angle (moderate reliability). The inter- and intraobserver reliability for most parameters were similar pre- and postoperatively. The experience of the observer and the definition and ability to measure the parameters themselves were sources of variation. Cite this article: Bone Joint J 2018;100-B:596–602.

Cervical Spine Joint Hypermobility: A Possible Predisposing Factor for New Daily Persistent Headache

Cephalalgia ◽  
2006 ◽  
Vol 26 (10) ◽  
pp. 1182-1185 ◽  
Author(s):  
TD Rozen ◽  
JM Roth ◽  
N Denenberg
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Physical Therapists ◽  
Joint Hypermobility ◽  
New Daily Persistent Headache ◽  
Beighton Score ◽  
Predisposing Factor ◽  
Cervical Range Of Motion ◽  
Persistent Headache

The objective of this study was to suggest that joint hypermobility (specifically of the cervical spine) is a predisposing factor for the development of new daily persistent headache (NDPH). Twelve individuals (10 female, 2 male) with primary NDPH were evaluated by one of two physical therapists. Each patient was tested for active cervical range of motion and for the presence of excessive intersegmental vertebral motion in the cervical spine. All patients were screened utilizing the Beighton score, which determines degree of systemic hypermobility. Eleven of the 12 NDPH patients were found to have cervical spine joint hypermobility. Ten of the 12 NDPH patients had evidence of widespread joint hypermobility with the Beighton score. Based on our findings we suggest that joint hypermobility, specifically of the cervical spine, may be a predisposing factor for the development of NDPH.

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