scholarly journals Reliability of Isometric Lower-Extremity Muscle Strength Measurements in Children With Cerebral Palsy: Implications for Measurement Design

2013 ◽  
Vol 93 (7) ◽  
pp. 935-941 ◽  
Author(s):  
Lydia Willemse ◽  
Merel A. Brehm ◽  
Vanessa A. Scholtes ◽  
Laura Jansen ◽  
Hester Woudenberg-Vos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Measurement Error ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Muscle Group ◽  
Children With Cerebral Palsy ◽  
Measurement Design

Background Children with cerebral palsy (CP) typically show muscle weakness of the lower extremities, which can be measured with the use of handheld dynamometry (HHD). Objective The purposes of this study were: (1) to determine test-retest reliability and measurement error of isometric lower-extremity strength measurements in children with CP with the use of HHD and (2) to assess implications for measurement design. Design A test-retest design was used. Methods Fourteen children with hemiplegic (n=6) or diplegic (n=8) spastic CP (Gross Motor Function Classification System levels I–III), ages 7 to 13 years, were assessed for isometric strength on 2 separate days (occasions) with the use of HHD, with 3 trials per muscle group. The intraclass correlation coefficient, standard error of measurement, and smallest detectable difference (SDD) were calculated for different measurement designs. Results Intraclass correlation coefficient values of single measurements for all muscle groups ranged from .70 to .90, and the SDD was large (>30%). Regarding measurement error, the largest source of variability was found for occasion. A 2-occasion mean decreased the SDD by 9% to 14%. For trials, a greater improvement in SDD was found when 2 trials were averaged instead of 3. A measurement design of 2 trials–2 occasions was superior to the often-used approach of 3 trials–1 occasion. Limitations The small sample size was the major study limitation. Conclusions Handheld dynamometry is reliable and can be used to detect changes in isometric muscle strength in children with CP when using the mean of at least 2 trials. To further improve reliability, taking the average of 2 occasions on separate days is recommended, depending on group size and muscle group.

Reliability of the Clinical Outcome Variables Scale for children with cerebral palsy

2021 ◽  
Vol 28 (9) ◽  
pp. 1-8
Author(s):  
Sharon Merin Varghese ◽  
Thangavelu Senthilvelkumar ◽  
Noble Koshy ◽  
Gokilam Devaraj ◽  
Grace Rebekah ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Clinical Outcome ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Functional Mobility ◽  
Outcome Variable ◽  
Minimally Clinically Important Difference ◽  
Rater Reliability ◽  
Children With Cerebral Palsy

Background/aims It can be difficult for rehabilitation professionals to use lengthy scales and different outcome measures for diverse clinical conditions in busy outpatient settings. The Clinical Outcome Variables Scale is a functional mobility measure that is applied to various neurological conditions. Determining the inter- and intra-rater reliability of clinical outcome variable scale for children with cerebral palsy will further enhance its utility. Methods A total of 30 children aged between 3 and 16 years with cerebral palsy, who could obey single-step commands, were recruited for the study. Two independent assessors scored the children using the Clinical Outcome Variable Scale to determine inter-rater reliability. A repeat assessment was done by the principal assessor after 24 hours to establish intra-rater reliability. Reliability was estimated using intra-class correlation coefficient values. Results The Clinical Outcome Variables Scale had high Inter- and intra-rater reliability for the composite score (intraclass correlation coefficient=1), the general mobility subscale (intraclass correlation coefficient=0.99), and the ambulation subscale (intraclass correlation coefficient=0.99). The intraclass correlation coefficient for the individual test items were also showed a high correlation, with the variance between the tests and physiotherapists ranging from 0.95 to 1. Conclusions The Clinical Outcome Variables Scale demonstrated high inter- and intra-rater reliability when assessing functional mobility in children with cerebral palsy. Further studies should establish criterion validity and minimally clinically important difference values to maximise the use of the scale.

scholarly journals Intra-rater reliability of transversus abdominis measurement by a novice examiner: Comparison of “freehand” to “probe force device” method of real-time ultrasound imaging

Ultrasound ◽  
2019 ◽  
Vol 27 (3) ◽  
pp. 156-166 ◽  
Author(s):  
Vanessa L Kennedy ◽  
Carol A Flavell ◽  
Kenji Doma
Keyword(s):  
Measurement Error ◽  
Real Time ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Coefficient Of Variation ◽  
Repeated Measures ◽  
Intraclass Correlation ◽  
Transversus Abdominis ◽  
Rater Reliability ◽  
Transverse Abdominis

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.

Assessment of Scapular Position

1993 ◽  
Vol 2 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Lynne Neiers ◽  
Teddy W. Worrell
Keyword(s):  
Measurement Error ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Therapeutic Intervention ◽  
Intraclass Correlation ◽  
Accurate Method ◽  
Force Development ◽  
Experienced Clinician ◽  
Reliability Coefficients ◽  
Shoulder Musculature

Assessment of posture is an integral component of the evaluation of patients with neck and shoulder dysfunctions. Protraction of the scapulae has been postulated to produce weakness of the shoulder musculature. Therefore, an accurate method is needed to assess scapular position in order to determine the effect of therapeutic intervention and classify dysfunction. The purpose of this study was to determine if an experienced clinician would accurately determine scapular position. Fifty subjects (age = 26 ±5.7 years, weight = 69.2 ±14.09 kg; height = 173.9 ±13.91 cm) participated in this study. The results revealed the following reliability coefficients: scapular distance (SD) intraclass correlation coefficient (ICC) = .80, scapular size (SS) ICC = .96, and normalized scapular abduction (NSA) (SD/SS) ICC = .34. These data demonstrate that NSA was not reproducible in this study. The authors hypothesize that NSA contains more measurement error because NSA is a ratio value in which both the numerator and denominator contain measurement error. Further study is needed before NSA values are used to determine scapular position or correlated NSA is used to force development of shoulder musculature.

scholarly journals The assessment of muscle strength symmetry in kayakers and canoeists

2013 ◽  
Vol 5 (1) ◽  
pp. 65-71
Author(s):  
Michał Wietrzyński ◽  
Joanna Mazur-Różycka ◽  
Jan Gajewski ◽  
Radosław Michalski ◽  
Sebastian Różycki ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Correlation Coefficient ◽  
Body Mass ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Asymmetry Coefficient ◽  
Muscle Torque ◽  
Left And Right ◽  
Muscle Groups ◽  
Static Conditions

Summary Study aim: To determine and compare the muscle strength profile and muscle strength symmetry of kayakers and canoeists. Material and methods: A total of 36 male participants participated in the study, including 25 kayakers and 9 canoeists. Measurements of maximum muscle torque were taken under static conditions for 10 muscle groups: flexors and extensors of the elbow, shoulder, knee, hip, and trunk. Muscle torque was allometrically scaled by body mass. To determine the muscle strength profiles of athletes in both disciplines, residual analysis was used. Two methods were utilized to assess and compare the muscle strength symmetry between left and right limbs. The first one is known as intraclass correlation coefficient (ICC). The second one is an asymmetry coefficient proposed by authors. Results: The study showed that kayakers obtained lower rates of asymmetry indicators than canoeists in most muscle groups. An overall asymmetry coefficient amounted to 0.77 ± 0.20 and 0.99 ± 0.31 (p < 0.05) for kayakers and canoeists, respectively. Moreover, it was observed that the kayakers and canoeists had similar strength profile. The symmetry assessment of maximum muscle torque corresponds to the characteristics of the studied disciplines. Conclusions: The intraclass correlation coefficient is recommended as a measure of strength symmetry for muscle groups comparisons. The asymmetry coefficient is recommended for comparison of individuals.

Lower Extremity Muscle Strength and Endurance in Ambulatory Children with Cerebral Palsy

2019 ◽  
Vol 31 (1) ◽  
pp. 75-84
Author(s):  
Triveni Shetty ◽  
Shrutika Parab ◽  
Sailakshmi Ganesan ◽  
Bela Agarwal ◽  
Rajani Mullerpatan
Keyword(s):  
Cerebral Palsy ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy

scholarly journals Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

2019 ◽  
Vol 43 (6) ◽  
pp. 609-617 ◽  
Author(s):  
Katherine Fuller ◽  
Humberto Adolfo Omaña Moreno ◽  
Courtney Frengopoulos ◽  
Michael W Payne ◽  
Ricardo Viana ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Construct Validity ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Internal Consistency ◽  
Short Form ◽  
Intraclass Correlation ◽  
Balance Confidence ◽  
Absolute Reliability ◽  
Confidence Scale

Background: Clinicians use the Activities-specific Balance Confidence Scale to understand balance confidence. A short-form Activities-specific Balance Confidence scale, was developed using the six most difficult tasks from the original Activities-specific Balance Confidence scale; however, short-form the short-form scale psychometrics and agreement with the original scale have yet to be explored in people with lower extremity amputations. Objective: To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale. Study design: Test–retest with a 2-week interval. Methods: Analysis for relative reliability and internal consistency was intraclass correlation coefficient and Cronbach’s α, respectively. Absolute reliability was measured using standard error of measurement and minimal detectable change. Bland–Altman plots measured agreement between scales. Construct validity was evaluated against the L Test using a Pearson-product moment correlation. Results: The short-form Activities-specific Balance Confidence (intraclass correlation coefficient = 0.92) and Activities-specific Balance Confidence (intraclass correlation coefficient = 0.91) scales had excellent relative reliability. Both scales demonstrated good internal consistency. Worse absolute reliability was observed in the short-form Activities-specific Balance Confidence scale. Construct validity against the L Test was confirmed. Bland–Altman plots indicated poor agreement between scales. Conclusion: Both scales exhibit excellent relative reliability and good internal consistency and construct validity. Poor agreement between short-form Activities-specific Balance Confidence and Activities-specific Balance Confidence indicates the scales should not be used interchangeably. Inadequate absolute reliability of the short-form Activities-specific Balance Confidence scale suggests the Activities-specific Balance Confidence should be the balance confidence scale of choice. Clinical relevance: Balance confidence is an important metric for our understanding of rehabilitation and community re-integration in people with lower extremity amputations. Due to inferior absolute reliability and a lack of appropriate items composing the short-form Activities-specific Balance Confidence scale, the full-scale Activities-specific Balance Confidence is recommended for the assessment of balance confidence in this population.

scholarly journals Biomechanical Measurement of Rabbit Cornea by a Modified Scheimpflug Device

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Bo Zhang ◽  
Jianjun Gu ◽  
Xiaoxiao Zhang ◽  
Bin Yang ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Bulk Modulus ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Anterior Segment ◽  
Intraobserver Reliability ◽  
Rabbit Cornea ◽  
Deformation Response ◽  
Biomechanical Measurements ◽  
Biomechanical Measurement

Purpose. To explore the probability and variation in biomechanical measurements of rabbit cornea by a modified Scheimpflug device.Methods. A modified Scheimpflug device was developed by imaging anterior segment of the model imitating the intact eye at various posterior pressures. The eight isolated rabbit corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at posterior pressures of 15, 30, 45, 60, and 75 mmHg by the device. The repeatability and reliability of the parameters including CCT, ACD, ACV, and CV were evaluated at each posterior pressure. All the variations of the parameters at the different posterior pressures were calculated.Results. All parameters showed good intraobserver reliability (Cronbach’s alpha; intraclass correlation coefficient,α, ICC > 0.96) and repeatability in the modified Scheimpflug device. With the increase of posterior pressures, the ratio of CCT decreased linearly and the bulk modulus gradually reduced to a platform. The increase of ACD was almost linear with the posterior pressures elevated.Conclusions. The modified Scheimpflug device was a valuable tool to investigate the biomechanics of the cornea. The posterior pressure 15–75 mmHg range produced small viscoelastic deformations and nearly linear pressure-deformation response in the rabbit cornea.

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