scholarly journals Test-Retest, Inter-Rater and Intra-Rater Reliability for Spatiotemporal Gait Parameters Using SANE (an eaSy gAit aNalysis systEm) as Measuring Instrument

2020 ◽  
Vol 10 (17) ◽  
pp. 5781
Author(s):  
Betsy D. M. Chaparro-Rico ◽  
Daniele Cafolla

Studies have demonstrated the validity of Kinect-based systems to measure spatiotemporal parameters of gait. However, few studies have addressed test-retest, inter-rater and intra-rater reliability for spatiotemporal gait parameters. This study aims to assess test-retest, inter-rater and intra-rater reliability of SANE (eaSy gAit aNalysis system) as a measuring instrument for spatiotemporal gait parameters. SANE comprises a depth sensor and a software that automatically estimates spatiotemporal gait parameters using distances between ankles without the need to manually indicate where each gait cycle begins and ends. Gait analysis was conducted by 2 evaluators for 12 healthy subjects during 4 sessions. The reliability was evaluated using Intraclass Correlation Coefficients (ICC). In addition, the Standard Error of the Measurement (SEM), and Smallest Detectable Change (SDC) was calculated. SANE showed from an acceptable to an excellent test-retest, inter-rater and intra-rater reliability; test-retest reliability ranged from 0.62 to 0.81, inter-rater reliability ranged from 0.70 to 0.95 and intra-rater ranged from 0.74 to 0.92. The subject behavior had a greater effect on the reliability of SANE than the evaluator performance. The reliability values of SANE were comparable with other similar studies. SANE, as a feasible and markerless system, has large potential for assessing spatiotemporal gait parameters.

2017 ◽  
Vol 62 (6) ◽  
pp. 615-622 ◽  
Author(s):  
Katja Orlowski ◽  
Falko Eckardt ◽  
Fabian Herold ◽  
Norman Aye ◽  
Jürgen Edelmann-Nusser ◽  
...  

AbstractGait analysis is an important and useful part of the daily therapeutic routine. InvestiGAIT, an inertial sensor-based system, was developed for using in different research projects with a changing number and position of sensors and because commercial systems do not capture the motion of the upper body. The current study is designed to evaluate the reliability of InvestiGAIT consisting of four off-the-shelf inertial sensors and in-house capturing and analysis software. Besides the determination of standard gait parameters, the motion of the upper body (pelvis and spine) can be investigated. Kinematic data of 25 healthy individuals (age: 25.6±3.3 years) were collected using a test-retest design with 1 week between measurement sessions. We calculated different parameters for absolute [e.g. limits of agreement (LoA)] and relative reliability [intraclass correlation coefficients (ICC)]. Our results show excellent ICC values for most of the gait parameters. Midswing height (MH), height difference (HD) of initial contact (IC) and terminal contact (TC) and stride length (SL) are the gait parameters, which did not exhibit acceptable values representing absolute reliability. Moreover, the parameters derived from the motion of the upper body (pelvis and spine) show excellent ICC values or high correlations. Our results indicate that InvestiGAIT is suitable for reliable measurement of almost all the considered gait parameters.


Sensors ◽  
2021 ◽  
Vol 21 (14) ◽  
pp. 4795
Author(s):  
Marco Bravi ◽  
Carlo Massaroni ◽  
Fabio Santacaterina ◽  
Joshua Di Tocco ◽  
Emiliano Schena ◽  
...  

The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerViewTM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.


Sensors ◽  
2021 ◽  
Vol 21 (17) ◽  
pp. 5972
Author(s):  
Efthymios Ziagkas ◽  
Andreas Loukovitis ◽  
Dimitrios Xypolias Zekakos ◽  
Thomas Duc-Phu Chau ◽  
Alexandros Petrelis ◽  
...  

The new smart insole PODOSmart®, is introduced as a new tool for gait analysis against high cost laboratory based equipment. PODOSmart® system measures walking profile and gait variables in real life conditions. PODOSmart® insoles consists of wireless sensors, can be fitted into any shoe and offer the ability to measure spatial, temporal, and kinematic gait parameters. The intelligent insoles feature several sensors that detect and capture foot movements and a microprocessor that calculates gait related biomechanical data. Gait analysis results are presented in PODOSmart® platform. This study aims to present the characteristics of this tool and to validate it comparing with a stereophotogrammetry-based system. Validation was performed by gait analysis for eleven healthy individuals on a six-meters walkway using both PODOSmart® and Vicon system. Intraclass correlation coefficients (ICC) were calculated for gait parameters. ICC for the validation ranged from 0.313 to 0.990 in gait parameters. The highest ICC was observed in cadence, circumduction, walking speed, stride length and stride duration. PODOSmart® is a valid tool for gait analysis compared to the gold standard Vicon. As PODOSmart®, is a portable gait analysis tool with an affordable cost it can be a useful novel tool for gait analysis in healthy and pathological population.


Author(s):  
Gunjan Patel ◽  
Rajani Mullerpatan ◽  
Bela Agarwal ◽  
Triveni Shetty ◽  
Rajdeep Ojha ◽  
...  

Wearable inertial sensor-based motion analysis systems are promising alternatives to standard camera-based motion capture systems for the measurement of gait parameters and joint kinematics. These wearable sensors, unlike camera-based gold standard systems, find usefulness in outdoor natural environment along with confined indoor laboratory-based environment due to miniature size and wireless data transmission. This study reports validation of our developed (i-Sens) wearable motion analysis system against standard motion capture system. Gait analysis was performed at self-selected speed on non-disabled volunteers in indoor ( n = 15) and outdoor ( n = 8) environments. Two i-Sens units were placed at the level of knee and hip along with passive markers (for indoor study only) for simultaneous 3D motion capture using a motion capture system. Mean absolute percentage error (MAPE) was computed for spatiotemporal parameters from the i-Sens system versus the motion capture system as a true reference. Mean and standard deviation of kinematic data for a gait cycle were plotted for both systems against normative data. Joint kinematics data were analyzed to compute the root mean squared error (RMSE) and Pearson’s correlation coefficient. Kinematic plots indicate a high degree of accuracy of the i-Sens system with the reference system. Excellent positive correlation was observed between the two systems in terms of hip and knee joint angles (Indoor: hip 3.98° ± 1.03°, knee 6.48° ± 1.91°, Outdoor: hip 3.94° ± 0.78°, knee 5.82° ± 0.99°) with low RMSE. Reliability characteristics (defined using standard statistical thresholds of MAPE) of stride length, cadence, walking speed in both outdoor and indoor environment were well within the “Good” category. The i-Sens system has emerged as a potentially cost-effective, valid, accurate, and reliable alternative to expensive, standard motion capture systems for gait analysis. Further clinical trials using the i-Sens system are warranted on participants across different age groups.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wei Xia ◽  
William Ho Cheung Li ◽  
Tingna Liang ◽  
Yuanhui Luo ◽  
Laurie Long Kwan Ho ◽  
...  

Objectives: This study conducted a linguistic and psychometric evaluation of the Chinese Counseling Competencies Scale-Revised (CCS-R).Methods: The Chinese CCS-R was created from the original English version using a standard forward-backward translation process. The psychometric properties of the Chinese CCS-R were examined in a cohort of 208 counselors-in-training by two independent raters. Fifty-three counselors-in-training were asked to undergo another counseling performance evaluation for the test-retest. The confirmatory factor analysis (CFA) was conducted for the Chinese CCS-R, followed by internal consistency, test-retest reliability, inter-rater reliability, convergent validity, and concurrent validity.Results: The results of the CFA supported the factorial validity of the Chinese CCS-R, with adequate construct replicability. The scale had a McDonald's omega of 0.876, and intraclass correlation coefficients of 0.63 and 0.90 for test-retest reliability and inter-rater reliability, respectively. Significantly positive correlations were observed between the Chinese CCS-R score and scores of performance checklist (Pearson's γ = 0.781), indicating a large convergent validity, and knowledge on drug abuse (Pearson's γ = 0.833), indicating a moderate concurrent validity.Conclusion: The results support that the Chinese CCS-R is a valid and reliable measure of the counseling competencies.Practice implication: The CCS-R provides trainers with a reliable tool to evaluate counseling students' competencies and to facilitate discussions with trainees about their areas for growth.


2019 ◽  
Vol 33 (10) ◽  
pp. 1682-1687 ◽  
Author(s):  
Christian Werner ◽  
Georgia Chalvatzaki ◽  
Xanthi S Papageorgiou ◽  
Costas S Tzafestas ◽  
Jürgen M Bauer ◽  
...  

Objective: To assess the concurrent validity of a smart walker–integrated gait analysis system with the GAITRite® system for measuring spatiotemporal gait parameters in potential users of the smart walker. Design: Criterion standard validation study. Setting: Research laboratory in a geriatric hospital. Participants: Twenty-five older adults (⩾65 years) with gait impairments (habitual rollator use and/or gait speed <0.6 m/s) and no severe cognitive impairment (Mini-Mental State Examination ⩾17). Main measures: Stride, swing and stance time; stride length; and gait speed were simultaneously recorded using the smart walker–integrated gait analysis system and the GAITRite system while participants walked along a 7.8-m walkway with the smart walker. Concurrent criterion-related validity was assessed using the Bland–Altman method, percentage errors (acceptable if <30%), and intraclass correlation coefficients for consistency (ICC3,1) and absolute agreement (ICC2,1). Results: Bias for stride, swing and stance time ranged from −0.04 to 0.04 seconds, with acceptable percentage errors (8.7%–23.0%). Stride length and gait speed showed higher bias (meanbias (SD) = 0.20 (0.11) m; 0.19 (0.13) m/s) and not acceptable percentage errors (31.3%–42.3%). Limits of agreement were considerably narrower for temporal than for spatial-related gait parameters. All gait parameters showed good-to-excellent consistency (ICC3,1 = 0.72–0.97). Absolute agreement was good-to-excellent for temporal (ICC2,1 = 0.72–0.97) but only poor-to-fair for spatial-related gait parameters (ICC2,1 = 0.37–0.52). Conclusion: The smart walker–integrated gait analysis system has good concurrent validity with the GAITRite system for measuring temporal but not spatial-related gait parameters in potential end-users of the smart walker. Stride length and gait speed can be measured with good consistency, but with only limited absolute accuracy.


2018 ◽  
Vol 63 (4) ◽  
pp. 453-460 ◽  
Author(s):  
Vahid Abdollah ◽  
Eric C. Parent ◽  
Michele C. Battié

Abstract Degenerated discs have shorter T2-relaxation time and lower MR signal. The location of the signal-intensity-weighted-centroid reflects the water distribution within a region-of-interest (ROI). This study compared the reliability of the location of the signal-intensity-weighted-centroid to mean signal intensity and area measurements. L4-L5 and L5-S1 discs were measured on 43 mid-sagittal T2-weighted 3T MRI images in adults with back pain. One rater analysed images twice and another once, blinded to measurements. Discs were semi-automatically segmented into a whole disc, nucleus, anterior and posterior annulus. The coordinates of the signal-intensity-weighted-centroid for all regions demonstrated excellent intraclass-correlation-coefficients for intra- (0.99–1.00) and inter-rater reliability (0.97–1.00). The standard error of measurement for the Y-coordinates of the signal-intensity-weighted-centroid for all ROIs were 0 at both levels and 0 to 2.7 mm for X-coordinates. The mean signal intensity and area for the whole disc and nucleus presented excellent intra-rater reliability with intraclass-correlation-coefficients from 0.93 to 1.00, and 0.92 to 1.00 for inter-rater reliability. The mean signal intensity and area had lower reliability for annulus ROIs, with intra-rater intraclass-correlation-coefficient from 0.5 to 0.76 and inter-rater from 0.33 to 0.58. The location of the signal-intensity-weighted-centroid is a reliable biomarker for investigating the effects of disc interventions.


2019 ◽  
Vol 91 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Leonhard A Bakker ◽  
Carin D Schröder ◽  
Harold H G Tan ◽  
Simone M A G Vugts ◽  
Ruben P A van Eijk ◽  
...  

ObjectiveThe Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is widely applied to assess disease severity and progression in patients with motor neuron disease (MND). The objective of the study is to assess the inter-rater and intra-rater reproducibility, i.e., the inter-rater and intra-rater reliability and agreement, of a self-administration version of the ALSFRS-R for use in apps, online platforms, clinical care and trials.MethodsThe self-administration version of the ALSFRS-R was developed based on both patient and expert feedback. To assess the inter-rater reproducibility, 59 patients with MND filled out the ALSFRS-R online and were subsequently assessed on the ALSFRS-R by three raters. To assess the intra-rater reproducibility, patients were invited on two occasions to complete the ALSFRS-R online. Reliability was assessed with intraclass correlation coefficients, agreement was assessed with Bland-Altman plots and paired samples t-tests, and internal consistency was examined with Cronbach’s coefficient alpha.ResultsThe self-administration version of the ALSFRS-R demonstrated excellent inter-rater and intra-rater reliability. The assessment of inter-rater agreement demonstrated small systematic differences between patients and raters and acceptable limits of agreement. The assessment of intra-rater agreement demonstrated no systematic changes between time points; limits of agreement were 4.3 points for the total score and ranged from 1.6 to 2.4 points for the domain scores. Coefficient alpha values were acceptable.DiscussionThe self-administration version of the ALSFRS-R demonstrates high reproducibility and can be used in apps and online portals for both individual comparisons, facilitating the management of clinical care and group comparisons in clinical trials.


2020 ◽  
Vol 9 (4) ◽  
pp. 926
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Lidia Perenc ◽  
Justyna Podgórska-Bednarz

To investigate whether a simple observational tool may be a substitute to the time-consuming and costly 3-dimensional (3D) analysis, the study applied the Wisconsin Gait Scale (WGS), enabling assessment which is highly consistent with 3D gait parameters in patients after a stroke. The aim of this study was to determine whether, and to what extent, observational information obtained from WGS-based assessment can be applied to predict results of 3D gait analysis for selected symmetry indicators related to spatiotemporal and kinematic gait parameters. Fifty patients at a chronic stage of recovery post-stroke were enrolled in the study. The spatiotemporal and kinematic gait parameters were measured using a movement analysis system. The symmetry index (SI), was calculated for selected gait parameters. The patients’ gait was evaluated by means of the WGS. It was shown that stance % SI, as well as hip and knee flexion-extension range of motion SI can most effectively be substituted by WGS-based estimations (coefficient of determination exceeding 80%). It was shown that information acquired based on the WGS can be used to obtain results comparable to those achieved in 3D assessment for selected SIs of spatiotemporal and kinematic gait parameters. The study confirms that observation of gait using the WGS, which is an ordinal scale, is consistent with the selected aims of 3D assessment. Therefore, the scale can be used as a complementary tool in gait assessment.


Author(s):  
Alexandra de Raadt ◽  
Matthijs J. Warrens ◽  
Roel J. Bosker ◽  
Henk A. L. Kiers

AbstractKappa coefficients are commonly used for quantifying reliability on a categorical scale, whereas correlation coefficients are commonly applied to assess reliability on an interval scale. Both types of coefficients can be used to assess the reliability of ordinal rating scales. In this study, we compare seven reliability coefficients for ordinal rating scales: the kappa coefficients included are Cohen’s kappa, linearly weighted kappa, and quadratically weighted kappa; the correlation coefficients included are intraclass correlation ICC(3,1), Pearson’s correlation, Spearman’s rho, and Kendall’s tau-b. The primary goal is to provide a thorough understanding of these coefficients such that the applied researcher can make a sensible choice for ordinal rating scales. A second aim is to find out whether the choice of the coefficient matters. We studied to what extent we reach the same conclusions about inter-rater reliability with different coefficients, and to what extent the coefficients measure agreement in a similar way, using analytic methods, and simulated and empirical data. Using analytical methods, it is shown that differences between quadratic kappa and the Pearson and intraclass correlations increase if agreement becomes larger. Differences between the three coefficients are generally small if differences between rater means and variances are small. Furthermore, using simulated and empirical data, it is shown that differences between all reliability coefficients tend to increase if agreement between the raters increases. Moreover, for the data in this study, the same conclusion about inter-rater reliability was reached in virtually all cases with the four correlation coefficients. In addition, using quadratically weighted kappa, we reached a similar conclusion as with any correlation coefficient a great number of times. Hence, for the data in this study, it does not really matter which of these five coefficients is used. Moreover, the four correlation coefficients and quadratically weighted kappa tend to measure agreement in a similar way: their values are very highly correlated for the data in this study.


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