Absolute Test-retest Reliability Research Articles

Construct validity and test-retest reliability of the Modified Agility T-Test in healthy adults

Abstract Background After a lower limb injury, adequate agility is decisive for safe direction changes and reduces the risk of re-injury upon return to sports. Experts recommend that patients should pass standardized return to sports testing which involves agility tests such as the Modified Agility T-Test. Aim Since the quality criteria of the Modified Agility T-Test have not been conclusively clarified, the objective of this study was to evaluate the construct validity and test-retest reliability of the Modified Agility T-Test. Methods The study was conducted as a single-center study in a cross-sectional design comparing the performance of the Modified Agility T-Test with the Illinois Agility Test to evaluate the construct validity of the Modified Agility T-Test. The construct validity was calculated with the Pearson’s correlation coefficient. Absolute and relative reliability were calculated based on the test-retest results. Each participant performed two counting trials of both agility tests. To determine the absolute test-retest reliability, the standard error of measurement, 95 % limits of agreement and the smallest detectable change were calculated. To determine the relative test-retest reliability, the intraclass correlation coefficient 2.1 was calculated. Results A total of 30 participants were recruited, with equal sex distribution and a mean age of 25.7 years. Our results showed a high construct validity of the Modified Agility T-Test (r = 0.89). The absolute test-retest reliability of the Modified Agility T-Test was 0.18 (-0.38–0.62) seconds, whereas the smallest detectable change was calculated to be 0.71 seconds. The relative test-retest reliability amounted to 0.84 (ICC 2.1). Conclusions Our findings support the construct validity and test-retest reliability of the Modified Agility T-Test as an agility test. Thus, it could be used as an alternative to the Illinois Agility Test, particularly in sports which require sideways or backwards movements and for sports with short or rapid displacements.

Consistency of spatial ability performance in children, adolescents, and young adults.

Spatial abilities are essential cognitive skills for many aspects of our everyday life that develop substantially throughout childhood and adolescence. While there are numerous measurement tools to evaluate these abilities, many of them have been designed for specific age groups hampering comparability throughout development. Thus, we determined test-retest-reliability and minimal detectable change for a set of tests that evaluate spatial ability performance in their variety in youth and compared them to young adults. Children (age: 11.4 ± 0.5 years, n = 26), adolescents (age: 12.5 ± 0.7 years, n = 22), and young adults (age: 26.1 ± 4.0 years, n = 26) performed a set of five spatial ability tests twice, 20 min apart: Paper Folding Test (PFT), Mental Rotation Test (MRT), Water Level Task (WLT), Corsi Block Test (CBT), and Numbered Cones Run (NCR). Relative and absolute test-retest reliability was determined by calculating the intraclass correlation coefficient (ICC3,1) and the standard error of measurement (SEM), respectively. Further, the minimal detectable change (MDC95%) was calculated to identify clinically relevant changes between repeated measurements. Irrespective of test, reliability was "excellent" (i.e., ICC3,1 ≥ 0.75) in all age cohorts and the SEM values were rather small. The MDC95% values needed to identify relevant changes in repeated measurements of spatial ability performance ranged between 0.8 and 13.9% in children, 1.1 and 24.5% in adolescents, and 0.7 and 20.8% in young adults. The determined values indicate that the investigated set of tests is reliable to detect spatial ability performance in healthy children, adolescents, and young adults.

Test-retest reliability of Bayesian estimations of the effects of stimulation, prior information and individual traits on pain perception.

There is inter-individual variability in the influence of different components (e.g. nociception and expectations) on pain perception. Identifying the individual effect of these components could serve for patient stratification, but only if these influences are stable in time. In this study, 30 healthy participants underwent a cognitive pain paradigm in which they rated pain after viewing a probabilistic cue informing of forthcoming pain intensity and then receiving electrical stimulation. The trial information was then used in a Bayesian probability model to compute the relative weight each participant put on stimulation, cue, cue uncertainty and trait-like bias. The same procedure was repeated 2 weeks later. Relative and absolute test-retest reliability of all measures was assessed. Intraclass correlation results showed good reliability for the effect of the stimulation (0.83), the effect of the cue (0.75) and the trait-like bias (0.75 and 0.75), and a moderate reliability for the effect of the cue uncertainty (0.55). Absolute reliability measures also supported the temporal stability of the results and indicated that a change in parameters corresponding to a difference in pain ratings ranging between 0.47 and 1.45 (depending on the parameters) would be needed to consider differences in outcomes significant. The comparison of these measures with the closest clinical data we possess supports the reliability of our results. These findings support the hypothesis that inter-individual differences in the weight placed on different pain factors are stable in time and could therefore be a possible target for patient stratification. Our results demonstrate the temporal stability of the weight healthy individuals place on the different factors leading to the pain response. These findings give validity to the idea of using Bayesian estimations of the influence of different factors on pain as a way to stratify patients for treatment personalization.

Upper extremity physical performance tests in female overhead athletes: a test–retest reliability study

ObjectiveDespite the studies that have investigated the reliability of Upper Extremity Functional Tests(UEFTs), the reliability of Closed Kinetic Chain Upper Extremity Stability(CKCUES), Seated Medicine Ball Throw(SMBT), push-up(PU) and Unilateral Seated Shot Put(USSP) tests in overhead athletes has yet to be assessed. The objective of this study was to determine both the relative and absolute test–retest reliability of the four UEFTs in female overhead athletes.MethodsTwenty-nine female overhead athletes (age: 26.6 ± 5.29 years) underwent the four UEFTs twice within a three- day interval. The upper limb stability was assessed through PU and CKCUES tests, while the power was assessed though SMBT and USSP tests. The Intraclass Correlation of Coefficient (ICC) was applied to assess the relative reliability. Absolute reliability was determined by calculating the Standard Error of Measurement (SEM) and the Minimal Detectable Change (MDC). Furthermore, Bland–Altman plots were used to detect the agreements between the two measurements.ResultsThe relative reliability of PU, CKCUES, SMBT, and non-dominant arm USSP tests was excellent (ICC = 0.83, 0.80, 0.91, and 0.83, respectively). SEM was within a range of 1.69 to 1.72 for stability tests and a range of 13.61 to 52.12 for power (based on a 95% confidence interval). The MDC was 4.68 for PU and 4.75 for CKCUES test. At least four repetitions are needed to be considered a real improvement on PU and CKCUES tests. This value was 144.04, in SMBT and 59.03, 37.62 cm (dominant and non-dominant arm, respectively) in USSP tests, which represents the minimum change that must occur to be considered an athlete’s progression.ConclusionThis study revealed that both the upper limb stability and power tests have acceptable relative and absolute intra-rater reliability in female overhead athletes. These can be considered as reliable tools in research and clinical settings.

Playfully Assessing Lower Extremity Selective Voluntary Motor Control in Children With Cerebral Palsy: Psychometric Study.

Objective measures specifically assessing selective voluntary motor control are scarce. Therefore, we have developed an interval-scaled assessment based on accelerometers. This study provided a preliminary evaluation of the validity and reliability of this novel gamelike assessment measuring lower limb selective voluntary motor control in children with cerebral palsy (CP). Children with CP and their neurologically intact peers were recruited for this psychometric evaluation of the assessgame. The participants played the assessgame and steered an avatar by selective hip, knee, or ankle joint movements captured with accelerometers. The assessgame's scores provide information about the accuracy of the selective movement of the target joint and the amplitude and frequency of involuntary movements occurring in uninvolved joints. We established discriminative validity by comparing the assessgame scores of the children with CP with those of the neurologically intact children, concurrent validity by correlations with clinical scores and therapists' opinions, and relative and absolute test-retest reliability. We included 20 children with CP (mean age 12 years and 5 months, SD 3 years and 4 months; Gross Motor Function Classification System levels I to IV) and 31 neurologically intact children (mean age 11 years and 1 month, SD 3 years and 6 months). The assessgame could distinguish between the children with CP and neurologically intact children. The correlations between the assessgame's involuntary movement score and the therapist's rating of the occurrence of involuntary movements during the game were moderate (Spearman ρ=0.56; P=.01), whereas the correlations of the assessgame outcomes with the Selective Control Assessment of the Lower Extremity and Gross Motor Function Classification System were low and not significant (|ρ|≤0.39). The intraclass correlation coefficients were >0.85 and indicated good relative test-retest reliability. Minimal detectable changes amounted to 25% (accuracy) and 44% (involuntary movement score) of the mean total scores. The percentage of children able to improve by the minimal detectable change without reaching the maximum score was 100% (17/17) for the accuracy score and 94% (16/17) for the involuntary movement score. The assessgame proved reliable and showed discriminative validity in this preliminary evaluation. Concurrent validity was moderate with the therapist's opinion but relatively poor with the Selective Control Assessment of the Lower Extremity. We assume that the assessment's gamelike character demanded various other motor control aspects that are less considered in current clinical assessments.

Test–retest reliability of upper limb robotic exoskeleton assessments in children and youths with brain lesions

In children with congenital or acquired brain lesions, impaired upper limb function can affect independence. Assessing upper limb function is important for planning and evaluating neurorehabilitative interventions. Robotic devices increase measurement-objectivity and enable measuring parameters reflecting more complex motor functions. We investigated the relative and absolute test–retest reliability of assessments to measure upper limb functions in children and adolescents with brain lesions with the exoskeleton ChARMin. Thirty children (9 females, mean age ± SD = 12.5 ± 3.3 years) with congenital brain injuries (n = 15), acquired (n = 14), both (n = 1) and impaired upper limb function participated. They performed the following ChARMin assessments and repeated them within three to seven days: active and passive Range of Motion (ROM), Strength, Resistance to Passive Movement, Quality of Movement, Circle, and Workspace. We calculated the systematic difference, Intraclass Correlation Coefficient (ICC) and Smallest Real Difference (SRD) for each parameter. Six parameters of three assessments showed systematic errors. ICCs ranged from little to very high and SRD values varied considerably. Test–retest reliability and measurement errors ranged widely between the assessments. Systematic differences indicated that random day-to-day variability in performance would be responsible for reduced reliability of those parameters. While it remains debatable whether robot-derived outcomes should replace certain routine assessments (e.g., ROM, strength), we recommend applying certain technology-based assessments also in clinical practice.Trial registration: This study was registered prospectively at ClinicalTrials.gov (identifier: NCT02443857) on May 14, 2015.

Self-assessed tactical skills in tennis players: Psychometric evaluation of the Tactical Skills Questionnaire in Tennis.

To our knowledge, no feasible, valid and reliable instrument exists to examine tactical skills over the course of multiple training and game situations in tennis yet. Therefore, the aim of this study was to develop and evaluate the psychometric properties of the Tactical Skills Questionnaire in Tennis (TSQT). The TSQT is a new instrument with closed-ended questions designed to examine tactical skills in tennis players. Participants were 233 competitive tennis players (age: 17.06 ± 4.74 years) competing on national or regional levels. With a principal component analysis (PCA) we identified four theoretically meaningful subscales for the 31-item TSQT: “Anticipation and positioning,” “Game intelligence and adaptability,” “Decision-making,” and “Recognizing game situations” and confirmed them with a confirmatory factor analysis (CFA) (χ2 = 527.02, df = 426, p < 0.001, CFI = 0.93, RMSEA = 0.045, SRMR = 0.079). Internal consistency was good, with Cronbach's alpha of 0.89 for the entire scale and McDonald's omega ranging from 0.69 to 0.78 for the separate subscales. A subsample of 57 players completed the TSQT twice to assess test-retest reliability. Absolute test-retest reliability of the subscales was good with no significant differences in mean scores between test and retest (p > 0.05). Relative test-retest reliability was moderate with ICC values ranging from 0.65 to 0.71. National players outperformed regional players on the subscales “Game intelligence and adaptability,” “Decision-making,” and “Recognizing game situations” (p < 0.05), and there was a trend toward significance for “Anticipation and positioning” (p = 0.07). This study supported the psychometric properties of the TSQT. Evaluating tactical skills with the TSQT provides players, coaches and other professionals with insight in players' self-assessed tactical skills over the course of multiple training and game situations. It creates the opportunity for players to reflect on their skills and detect personal development areas with their coach. We advise to use this information as input for tailor-made training programs.

Cross-Cultural Adaptation and Psychometric Validation of the Turkish Version of Pain Resilience Scale.

The Pain Resilience Scale (PRS) is a useful tool that evaluates behavioral engagement and adaptively regulates cognitions and emotions despite the pain. This study aimed to translate the PRS to Turkish and investigate its psychometric properties. The Turkish version of PRS was completed online by 332 healthy adults, and a subset of 105 respondents was re-assessed after 7-14days. The reliability of the adapted measure was evaluated in terms of internal consistency, relative, and absolute test-retest reliability. Validity was evaluated in terms of structural, construct, and known-group validity using positive and negative psychological scales. The Turkish version of PRS has a three-factor structure and its cumulative variance is 78.06%. The total PRS score and its subscales correlated positively with pain self-efficacy, general resilience, and quality of life, and negatively with pain catastrophizing, kinesiophobia, anxiety, depression, and disability. The PRS scores were significantly higher in those with high general resilience (p < 0.001). The PRS had high internal consistency and test-retest reliability. Standard Error of Measurement (SEM) and Minimum Detectable Difference (MDD) were calculated as 2.9 and 8.0, respectively. The Turkish version of PRS is a reliable and valid instrument for measuring pain resilience in terms of behavioral perseverance and cognitive positivity.

Absolute and relative reliability of SCRuM test battery components assembled for schoolboy rugby players playing competitive rugby in low-resource settings: A pragmatic in-season test-retest approach.

Schoolboy rugby is a popular sport which forms the bedrock of rugby development in many African countries, including Zimbabwe. With burgeoning talent identification programmes, the development of multi-dimensional, logically-validated, and reliable test batteries is essential to inform the objective selection of potentially talented young rugby athletes. This study sought evidence on the absolute and relative test-retest reliability of the component test items in the newly-assembled SCRuM test battery. Utilising a pragmatic test-retest experimental design, a sample of 41 Under-19 schoolboy players playing competitive rugby in the elite Super Eight Schools Rugby League in Harare, Zimbabwe, participated in the study. Physiological and game-specific skills tests which showed good to excellent relative reliability and acceptable absolute reliability, included: 20 m and 40 m speed, L-run, Vertical Jump (VJ), 60 s Push-Up, 2 kg Medicine Ball Chest Throw test (2 kg MBCT), Wall Sit Leg Strength test (WSLS), Repeated High Intensity Exercise test (RHIE), One Repetition Maximum Back Squat (1-RM BS) and Bench Press tests (1-RM BP), Yo-Yo Intermittent Recovery Level 1 test (Yo-Yo IRT L1), Tackling Proficiency test, Passing Ability Skill test and Running and Catching Ability skill test. All these tests are reliable and warrant inclusion in the SCRuM test battery for possible profiling of U19 schoolboy rugby players during the 'in-season' phase provided there is adequate participant familiarisation and test standardisation. The test-retest ICCs and measurement errors are generalisable to other young athletes in this population, making the tests useful for the evaluation of training and developmental effects of the measured constructs.

Test-retest reliability of force plate-derived measures of reactive stepping

Characterizing reactive stepping is important to describe the response’s effectiveness. Timing of reactive step initiation, execution, and termination have been frequently reported to characterize reactive balance control. However, the test–retest reliabilities of these measures are unknown. Accordingly, the purpose of this study was to determine the between- and within-session test–retest reliabilities of various force plate-derived measures of reactive stepping. Nineteen young, healthy adults responded to 6 small (~8–10% of body weight) and 6 large perturbations (~13–15% of body weight) using an anterior lean-and-release system. Tests were conducted during two visits separated by at least two days. Participants were instructed to recover balance in as few steps as possible. Step onset, foot-off, swing, and restabilization times were extracted from force plates. Relative test–retest reliability was determined through intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs). Absolute test–retest reliability was assessed using the standard error of the measurement (SEM). Foot-off and swing times had the highest between- and within-session test–retest reliabilities regardless of perturbation size (between-session ICC = 0.898–0.942; within-session ICC = 0.455–0.753). Conversely, step onset and restabilization times had lower ICCs and wider CIs (between-session ICC = 0.495–0.825; within-session ICC = -0.040–0.174). Between-session test–retest reliability was higher (ICC = 0.495–0.942) for all measures than within-session test–retest reliability (ICC = -0.040–0.753). Time to restabilization had the highest SEM, indicating the worst absolute reliability of the measures. These findings suggest multiple baseline sessions are needed for measuring restabilization and step onset times. The minimal detectable changes reported provide an index for measuring meaningful change due to an intervention.

Intersite reliability of vertebral bone marrow lipidomics-derived lipid composition among children with varying degrees of bone fragility undergoing routine orthopedic surgery.

Lipidomics, a branch of metabolomics, is an attractive technique to characterize bone marrow lipid composition, which may be associated with skeletal acquisition and homeostasis. However, the reliability of lipidomics-derived lipid composition of the bone marrow is unknown, especially for pediatric populations with bone fragility. The purpose of this study was to evaluate the intersite reliability and standard error of measurement (SEM) of vertebral bone marrow lipid composition at the thoracic (T11/T12) and lumbar (L1/L2) spine determined by targeted lipidomics among children with varying degrees of bone fragility undergoing routine orthopedic surgery. Children aged between 12 and 19years of age, with a confirmed diagnosis of adolescent idiopathic scoliosis or neuromuscular scoliosis and cerebral palsy, and undergoing routine posterior spinal fusion surgery at our institution were initially included in this study. Transpedicular vertebral body bone marrow samples were taken from thoracic (T) or lumbar (L) vertebrae. Further inclusion criteria involved having bone marrow extracted from both T11 and T12 (n=24) or L1 and L2 (n=19). Lipid composition was measured using a targeted lipidomics technique and examined as the saturated, monounsaturated, and polyunsaturated index and as individual fatty acids. Relative and absolute test-retest reliability was assessed using the intraclass correlation coefficient (ICC) and SEM. For the T11/T12 analysis: the ICC and SEM were 0.59 and 1.7% for the saturated index, 0.31 and 6.2% for the monounsaturated index, and 0.44 and 6.1% for the polyunsaturated index; the ICC showed a considerable range for individual fatty acids from 0.07 (fatty acid 20:2) to 0.82 (15:0) with 62.1% of the fatty acids having poor reliability (i.e., ICC<0.50). For the L1/L2 analysis: the ICC and SEM were 0.50 and 2.4% for the saturated index, -0.12 and 6.0% for the monounsaturated index, and 0.00 and 4.9% for the polyunsaturated index; the ICC showed a considerable range for individual fatty acids from -0.34 (18:1_n-9) to 0.88 (15:0 and 18:3_n-3) with 79.3% of the fatty acids having poor reliability. The intersite test-retest reliability was poor-to-moderate for index measures and generally poor for individual fatty acids for the thoracic and lumbar spine. At this time, it is not recommended to pool bone marrow adipose tissue across vertebral sites for bone marrow adiposity research or clinical monitoring for pediatric populations with bone fragility.

Test-Retest Reliability and Correlates of Vertebral Bone Marrow Lipid Composition by Lipidomics Among Children With Varying Degrees of Bone Fragility.

ABSTRACTThe reliability of lipidomics, an approach to identify the presence and interactions of lipids, to analyze the bone marrow lipid composition among pediatric populations with bone fragility is unknown. The objective of this study was to assess the test–retest reliability, standard error of measurement (SEM), and the minimal detectable change (MDC) of vertebral bone marrow lipid composition determined by targeted lipidomics among children with varying degrees of bone fragility undergoing routine orthopedic surgery. Children aged 10 to 19 years, with a confirmed diagnosis of adolescent idiopathic scoliosis (n = 13) or neuromuscular scoliosis and cerebral palsy (n = 3), undergoing posterior spinal fusion surgery at our institution were included in this study. Transpedicular vertebral body bone marrow samples were taken from thoracic vertebrae (T11, 12) or lumbar vertebrae (L1 to L4). Lipid composition was assessed via targeted lipidomics and all samples were analyzed in the same batch. Lipid composition measures were examined as the saturated, monounsaturated, and polyunsaturated index and as individual fatty acids. Relative and absolute test–retest reliability was assessed using the intraclass correlation coefficient (ICC), SEM, and MDC. Associations between demographics and index measures were explored. The ICC, SEM, and MDC were 0.81 (95% CI, 0.55–0.93), 1.6%, and 4.3%, respectively, for the saturated index, 0.66 (95% CI, 0.25–0.87), 3.5%, and 9.7%, respectively, for the monounsaturated index, and 0.60 (95% CI, 0.17–0.84), 3.6%, and 9.9%, respectively, for the polyunsaturated index. For the individual fatty acids, the ICC showed a considerable range from 0.04 (22:2n‐6) to 0.97 (18:3n‐3). Age was positively correlated with the saturated index (r 2 = 0.36; p = 0.014) and negatively correlated with the polyunsaturated index (r 2 = 0.26; p = 0.043); there was no difference in index measures by sex (p > 0.58). The test–retest reliability was moderate‐to‐good for index measures and poor to excellent for individual fatty acids; this information can be used to power research studies and identify measures for clinical or research monitoring. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Wales Anaerobic Test: Reliability and Fitness Profiles of International Rugby Union Players.

Beard, A, Ashby, J, Chambers, R, Millet, GP, and Brocherie, F. Wales Anaerobic Test (WAT): Reliability and fitness profiles of international rugby union players. J Strength Cond Res 36(9): 2589-2596, 2022-To provide strength and conditioning coaches a practical and evidence-based test for repeated-sprint ability (RSA) in rugby union players, this study assessed the relative and absolute test-retest reliability of the Wales Anaerobic Test (WAT) and its position-specific association with other fitness performance indices. Thirty-four players (forwards: n = 19; backs: n = 15) of the Welsh rugby union male senior national team performed the WAT (10 × 50-m distance, 25-30 seconds of passive recovery) twice within 4 days. Time for each repetition was recorded, with the best (WAT Best ) and total time (WAT TT ) retained for analysis. Relative (intraclass correlation coefficient [ICC]) and absolute ( SEM ) reliability of the WAT indices were quantified. Furthermore, association (Pearson's product-moment correlations and stepwise backward elimination procedure) with other fitness performance indices (10- and 40-m sprinting times, 30-15 intermittent fitness test [30-15 IFT ] and the Yo-Yo intermittent recovery test level 2 [YYIR2]) was investigated. Pooled values revealed "moderate" to "high" ICCs for WAT Best (ICC = 0.89, p = 0.626) and WAT TT (ICC = 0.95, p = 0.342). Good test sensitivity was reported for forwards and backs' WAT TT ( p > 0.101). Both WAT Best and WAT TT correlated with 10-m and 40-m sprinting times ( r > 0.69, p < 0.001) as well as with 30-15 IFT ( r < -0.77, p < 0.001) and YYIR2 ( r < -0.68, p < 0.001) for pooled values. The WAT proved to be a reliable and sensitive test to assess the rugby union specific RSA-related fitness of international players.

RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE UPPER QUARTER Y-BALANCE TEST IN HEALTHY ADOLESCENTS AGED 12 TO 17 YEARS

There are a few studies investigating the reproducibility of the Upper Quarter Y Balance Test (YBT-UQ) in adults. However, no study has determined test-retest reliability and the minimal detectable change of the YBT-UQ in adolescents from different age cohorts. The aim of the present study was to establish test-retest reliability and minimal detectable change of the YBT-UQ in a sample of healthy adolescents. In a school setting, 111 students (59 female, 52 male) aged 12-17 years performed the YBT-UQ twice, separated by one week. Normalized maximal reach distances (% arm length) for all three directions (i.e., medial, inferolateral, superolateral) and the composite score were used as outcome measures. Intraclass correlation coefficient (ICC3,1) and standard error of measurement (SEM) were calculated to assess both relative and absolute test-retest reliability. In addition, the minimal detectable change (MDC95%), an index that is defined as the minimal amount of change in performance that falls outside the measurement error or performance changes due to variability was determined. Irrespective of age cohort, reach arm, and reach direction, the measure of relative reliability ranged from "moderate-to-good" to "excellent" ICC values and the proxy of absolute reliability was rather small (i.e., SEM ≤ 7.6%). The MDC95% needed to identify relevant effects in repeated measurements of the YBT-UQ performance ranged between 4.8% and 21.1%, depending on age, reach arm, and reach direction. The detected values imply that the YBT-UQ is a reliable field test that can be used to detect changes of upper quarter mobility/stability in healthy adolescents aged 12-17 years. 2b.

Recommended motor assessments based on psychometric properties in individuals with dementia: a systematic review

BackgroundMotor assessments are important to determine effectiveness of physical activity in individuals with dementia (IWD). However, inappropriate and non-standardised assessments without sound psychometric properties have been used. This systematic review aims to examine psychometric properties of motor assessments in IWD combined with frequency of use and effect sizes and to provide recommendations based on observed findings.We performed a two-stage systematic literature search using Pubmed, Web of Science, Cochrane Library, ALOIS, and Scopus (inception - July/September 2018, English and German). The first search purposed to identify motor assessments used in randomised controlled trials assessing effectiveness of physical activity in IWD and to display their frequency of use and effect sizes. The second search focused on psychometric properties considering influence of severity and aetiology of dementia and cueing on test-retest reliability. Two reviewers independently extracted and analysed findings of eligible studies in a narrative synthesis.ResultsLiterature searches identified 46 randomised controlled trials and 21 psychometric property studies. While insufficient information was available for validity, we observed sufficient inter-rater and relative test-retest reliability but unacceptable absolute test-retest reliability for most assessments. Combining these findings with frequency of use and effect sizes, we recommend Functional Reach Test, Groningen Meander Walking Test (time), Berg Balance Scale, Performance Oriented Mobility Assessment, Timed Up & Go Test, instrumented gait analysis (spatiotemporal parameters), Sit-to-Stand assessments (repetitions> 1), and 6-min walk test. It is important to consider that severity and aetiology of dementia and cueing influenced test-retest reliability of some assessments.ConclusionThis review establishes an important foundation for future investigations. Sufficient relative reliability supports the conclusiveness of recommended assessments at group level, while unacceptable absolute reliability advices caution in assessing intra-individual changes. Moreover, influences on test-retest reliability suggest tailoring assessments and instructions to IWD and applying cueing only where it is inevitable. Considering heterogeneity of included studies and insufficient examination in various areas, these recommendations are not comprehensive. Further research, especially on validity and influences on test-retest reliability, as well as standardisation and development of tailored assessments for IWD is crucial.This systematic review was registered in PROSPERO (CRD42018105399).

Walking increases pain tolerance in humans: an experimental cross-over study.

Exercise is commonly used as treatment for chronic pain with positive long-term effects on pain and pain-related disability. In pain-free subjects, hypoalgesia following an acute bout of exercise compared with a control condition has consistently been demonstrated also known as exercise-induced hypoalgesia (EIH). Walking exercise, a low intensity aerobic exercise, is frequently used in clinical practice as an easily applicable intervention for patients with chronic pain. Walking exercise is furthermore recommended as an effective treatment for patients with chronic musculoskeletal pain conditions to alleviate pain and reduce disability, however, the effect of walking on pain sensitivity is currently unknown. The aims of the present study were to investigate (1) the acute effect of walking on pain sensitivity, and (2) the relative (between-subjects) and absolute (within-subject) test-retest reliability of the hypoalgesic response across two sessions separated by 1 week. In this randomised experimental cross-over study including two identical sessions, 35 pain-free subjects performed a standardized 6 min walking test and a duration-matched quiet rest condition in a randomized and counterbalanced order in each session. Before and after both conditions, handheld pressure pain thresholds (PPTs) were assessed at the thigh and shoulder, and pressure pain thresholds (cPPT) and pain tolerance (cPTT) were assessed with computer-controlled cuff algometry at the lower leg. Change in the pain sensitivity measures were analysed with repeated-measures ANOVAs, and test-retest reliability with intraclass correlation coefficients (ICC) and agreements in classification of EIH responders/non-responders between the two sessions. All subjects completed the walking conditions in both session 1 and session 2. The perceived intensity of walking assessed with rating of perceived exertion (RPE) and walking distance did not differ significantly between session 1 (distance: 632.5 ± 75.2 meters, RPE: 10.9 ± 1.9) and session 2 (distance: 642.1 ± 80.2 meters, RPE: 11.0 ± 2.4) (p > 0.11). Moreover, RPE showed excellent relative reliability with an ICC value of 0.95 [95%CI: 0.90-0.97]. Walking increased pain tolerance (mean difference: 2.6 kPa [95%CI: 0.5-4.9 kPa; p = 0.02]), but not pain thresholds compared with rest in both sessions. Hypoalgesia after walking demonstrated fair to good relative reliability (ICC = 0.61), however the agreement in classification of EIH responders/non-responders (absolute reliability) across sessions was low and not significant (κ = 0.19, p = 0.30). Walking consistently increased pain tolerance but not pain thresholds compared with a duration-matched control condition with fair to good relative reliability between sessions. Based on classification of EIH responders/non-responders the absolute reliability between the two sessions was low indicating individual variance in the EIH response. Future studies should investigate the hypoalgesic effect of a walking exercise in a clinical pain population.

Performance and reliability of the Lower Quarter Y Balance Test in healthy adolescents from grade 6 to 11

BackgroundThe Lower Quarter Y Balance Test (YBT-LQ) has been widely used in the field to assess dynamic balance performance in various populations. However, no study has demonstrated test-retest reliability of the YBT-LQ in adolescents including several age cohorts, even though reliability is necessary to provide repeatable performance data. ObjectiveThus, we examined test-retest reliability of the YBT-LQ in healthy adolescents. MethodsIn a school setting, 178 secondary school students (93 female, 85 male) in sixth to eleventh grades (11–19 years) performed the YBT-LQ twice, 7 days apart. Normalized maximal reach distances (% leg length) for all three directions (i.e., anterior, posterolateral, posteromedial) and both legs and the composite score were used as outcome measures. Intraclass correlation coefficient (ICC3,1) and standard error of measurement (SEM) were calculated to assess relative and absolute test-retest reliability, respectively. Practical relevance of the YBT-LQ was determined by calculating the minimal detectable change (MDC95%). ResultsIrrespective of grade, test-retest reliability for all distances reached was predominately "excellent" (i.e., ICC3,1 > 0.75) and the rather small SEM values ranged from 1.77 to 5.81%. Depending on grade and reach direction, MDC values of 4.90 to 16.10% represent the minimum amount of change needed to identify clinically relevant effects in repeated measurements of the YBT-LQ performance. ConclusionsThe observed values suggest that the YBT-LQ is a reliable test and suitable to detect changes of dynamic balance performance in healthy adolescents from grade six to eleven (i.e., aged 11–19 years).

Exercise-Induced Hypoalgesia After Isometric Wall Squat Exercise: A Test-Retest Reliabilty Study.

Isometric exercises decrease pressure pain sensitivity in exercising and nonexercising muscles known as exercise-induced hypoalgesia (EIH). No studies have assessed the test-retest reliability of EIH after isometric exercise. This study investigated the EIH on pressure pain thresholds (PPTs) after an isometric wall squat exercise. The relative and absolute test-retest reliability of the PPT as a test stimulus and the EIH response in exercising and nonexercising muscles were calculated. In two identical sessions, PPTs of the thigh and shoulder were assessed before and after three minutes of quiet rest and three minutes of wall squat exercise, respectively, in 35 healthy subjects. The relative test-retest reliability of PPT and EIH was determined using analysis of variance models, Person's r, and intraclass correlations (ICCs). The absolute test-retest reliability of EIH was determined based on PPT standard error of measurements and Cohen's kappa for agreement between sessions. Squat increased PPTs of exercising and nonexercising muscles by 16.8% ± 16.9% and 6.7% ± 12.9%, respectively (P < 0.001), with no significant differences between sessions. PPTs within and between sessions showed moderately strong correlations (r ≥ 0.74) and excellent (ICC ≥ 0.84) within-session (rest) and between-session test-retest reliability. EIH responses of exercising and nonexercising muscles showed no systematic errors between sessions; however, the relative test-retest reliability was low (ICCs = 0.03-0.43), and agreement in EIH responders and nonresponders between sessions was not significant (κ < 0.13, P > 0.43). A wall squat exercise increased PPTs compared with quiet rest; however, the relative and absolute reliability of the EIH response was poor. Future research is warranted to investigate the reliability of EIH in clinical pain populations.

Test-Retest Reliabilty of Exercise-Induced Hypoalgesia After Aerobic Exercise.

Exercise increases pressure pain thresholds (PPTs) in exercising and nonexercising muscles, known as exercise-induced hypoalgesia (EIH). No studies have investigated the test-retest reliability of change in PPTs after aerobic exercise. Primary objectives were to compare the effect on PPTs after an incremental bicycling exercise compared with quiet rest and to investigate the relative and absolute test-retest reliability of the test stimulus (PPT) and the absolute and relative EIH response in exercising and nonexercising muscles. Laboratory. In two sessions, PPTs in the quadriceps and trapezius muscles were assessed before and after 15 minutes of quiet rest and 15 minutes of bicycling in 34 healthy subjects. Habitual physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). Bicycling increased PPTs in exercising and nonexercising muscles in both sessions (P < 0.05). The magnitude of the EIH response in the exercising muscle was, however, larger in the second compared with the first session (P < 0.015). PPTs showed excellent (intraclass correlation [ICC] ≥ 0.84) within-session and between-session test-retest reliability. The EIH response in exercising and nonexercising muscles demonstrated fair (ICC = 0.45) between-session relative test-retest reliability, but agreement in EIH responders between sessions was not significant (quadriceps: κ = 0.24, P = 0.15; trapezius: κ = 0.01, P = 0.97). Positive correlations between the IPAQ score and PPTs were found (quadriceps: r = 0.44, P = 0.009; trapezius: r = 0.31, P = 0.07) before exercise. No significant association was found between IPAQ and EIH. Incremental bicycling exercise increased PPTs with fair relative and absolute reliability of the EIH response. These data might have an impact on future studies investigating EIH and for clinicians designing exercise programs for pain relief.

Test-retest reliability and criterion validity of a new Taekwondo Anaerobic Intermittent Kick Test.

The aim of this study was to determine the relative and absolute test-retest reliability and criterion validity of a new Taekwondo Anaerobic Intermittent Kick Test (TAIKT). Twenty Tunisian elite Taekwondo athletes participated in this study (15 males and 5 females). Participants performed the TAIKT and the Running-based Anaerobic Sprint Test (RAST), twice (test and retest), on separate occasions three-week apart. Peak heart rate (HRpeak), blood lactate concentration [La־], and rating of perceived exertion (RPE) were measured during each session. There was no significant difference between the test and retest of TAIKT and RAST for all performances and physiological variables, except for the absolute mean power (Pmean) of RAST. Test-retest results showed that the TAIKT and RAST were reliable. All TAIKT and RAST parameters had an ICC>0.90, SEM<5%, with the smallest worthwhile change slightly higher than SEM, with very small limits of concordance. Strong significant correlations were found between TAIKT and RAST parameters (Ppeak (r=0.81; r=0.70), Pmean (r=0.72; r=0.60) in (W and W·Kg-67 respectively), fatigue index (r=0.81), [La־] (r=0.89) and RPE (r=0.78) at P<0.01, and HRpeak (r=0.55, at P<0.05)). The findings showed that the TAIKT can be considered as a valid and reliable specific test for assessing anaerobic power of Taekwondo athletes.