Inter-instrument Reliability Research Articles

Comparison of Intraocular Lens Power Prediction Accuracy Between 2 Swept-Source Optical Coherence Tomography Biometry Devices

To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power. Retrospective, interinstrument reliability study. Setting: Institutional. Two hundred twenty-five eyes of 225 cataract surgery patients. Patients underwent measurements by both devices preoperatively. Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.

Measuring handgrip strength in school children: inter-instrument reliability between Takei and Jamar

The aim of this study was to determine inter-instrument reliability between Takei and Jamar dynamometers in school children. Fifty-six five grade participants aged eleven to twelve (n = 32 boys, n = 24 girls) performed handgrip strength test on two different occasions, with a 5-day gap between them, as test–retest. The Pearson correlation coefficient showed very large to almost perfect correlation between both devices (r = 0.76–0.91) which was graphically confirmed by Bland–Altman method. Test–retest also showed high reliability (ICC = 0.78–0.85) for Jamar and Takei. Trivial, nonsignificant differences (p > 0.05) were observed between for test–retest trials for Takei left hand (ES = 0.04), right hand (ES = 0.12) and Jamar left hand (ES = 0.15). According to the results, both the Jamar and Takei dynamometers are valid and reliable for measuring schoolchildren, and both devices may be used to assess a student's handgrip strength for this age group.

Interinstrument Reliability Between the Squegg® Smart Dynamometer and Hand Grip Trainer and the Jamar® Hydraulic Hand Dynamometer: A Pilot Study.

Occupational therapists need dependable and accurate instruments for remote assessments and monitoring of hand functionality. These assessments monitor progress, evaluate interventions, and guide independence goals. To assess the interinstrument reliability and concurrent validity of the Squegg® Smart Dynamometer and Hand Grip Trainer and the Jamar® Hydraulic Hand Dynamometer. Repeated-measures design. Individual clinic in Bucharest, Romania. Forty middle-age and older adult volunteers, healthy and free from any neuromuscular, orthopedic dysfunction that affected hand strength. Participants' maximal grip strength (MGS) for both their dominant and nondominant hands was measured with both devices. Participants with odd-numbered IDs were measured with the Squegg first and the Jamar second, and those with even-numbered IDs were measured in opposite sequence. Paired-samples t tests on overall mean MGS and mean MGS (three measures on each hand) showed no statistically significant differences between the two devices. Intraclass correlation analysis showed good to excellent interinstrument agreement. Pearson correlations between measurements across all participants, and hands, indicated strong agreement. The Squegg shows promise for health care professionals, including occupational therapists, for grip strength assessment in clinical contexts. What This Article Adds: These results offer initial psychometric data for a new remote MGS measurement device. MGS is crucial for assessing the physical function of aging adults. Reliable measurements from such a device are vital for occupational therapists to guide treatment interventions and assess hand function's impact on daily activities.

Reliability and Validity of the Clinometer™ Smartphone Application for Measuring Knee Flexion

The purpose of this study was to investigate the reliability and validity of the Clinometer™ smartphone application. Intrarater and interrater reliability were calculated for devices (i.e., goniometer, Clinometer™, bubble inclinometer) using intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Interinstrument reliability and Clinometer™ validity were also assessed. Intrarater reliability was good (intraclass correlation coefficients = .70 − .83) and interrater reliability was moderate (intraclass correlation coefficient = .63 − .72) across devices. Interinstrument reliability and Clinometer™ validity were supported across analyses. The Clinometer™ is comparable to a goniometer or bubble inclinometer for measuring prone knee flexion.

A portable and reliable tool for on-site physical reaction time (RT) measurement

The drop-stick test system (DTS) invention has the capability to measure reaction accurately for sideline mild traumatic brain injury (mTBI) assessment. The reaction time (RT) measurements showed moderate to good inter-instrument reliability with an overall ICC of 0.82 (95 % CI 0.78–0.85). RT is a useful biomarker of mTBI or concussion, but existing technologies in controlled laboratory environments are not feasible for assessments in the field. With wearable technologies and wireless connection with smartphones, it is now easier to conduct RT assessments on the field. The purpose was to develop a portable DTS involving wearable inertial sensors translatable from the laboratory to the sideline assessments on athletic fields. This project investigated if RT measurements using sensors are reliable metrics when compared to the gold-standard motion capture laboratory-test. The intent was to invent and assess the reliability of a clinical DTS using sensors in conjunction with an easy RT measurement protocol. The integrated inertial sensors in the DTS have the potential to reliably capture RT, allowing it to more easily translate into the training room or field environment.

Reliability and Validity of Inertial Sensor Assisted Reaction Time Measurement Tools among Healthy Young Adults

The assessment of movement reaction time (RT) as a sideline assessment is a valuable biomarker for mild TBI or concussion. However, such assessments require controlled laboratory environments, which may not be feasible for sideline testing during a game. Body-worn wearable devices are advantageous as being cost-effective, easy to don and use, wirelessly transmit data, and ensure unhindered movement performance. This study aimed to develop a Drop-stick Test System (DTS) with a wireless inertial sensor and confirm its reliability for different standing conditions (Foam versus No Foam) and task types (Single versus Dual), and postures (Standing versus sitting). Fourteen healthy young participants (seven females, seven males; age 24.7 ± 2.6 years) participated in this study. The participants were asked to catch a falling stick attached to the sensor during a drop test. Reaction Times (RTs) were calculated from data for each trial from DTS and laboratory camera system (gold standard). Intraclass correlation coefficients (ICC 3,k) were computed to determine inter-instrument reliability. The RT measurements from participants using the camera system and sensor-based DTS showed moderate to good inter-instrument reliability with an overall ICC of 0.82 (95% CI 0.78-0.85). Bland-Altman plots and 95% levels of agreement revealed a bias where the DTS underestimated RT by approximately 50 ms.

Assessment of Inter-Instrument Reliability for Dominant Handgrip Dynamometry and Spirometry

Purpose: The aim of this study was to determine the inter-instrument reliability of different dynamometers and spirometers commonly used in clinical practice. Methods: The study involved 113 healthy volunteers across three facility sites. At each site, dominant handgrip strength (DHGS), and lung function (forced expiratory volume in one second [FEV1], forced vital capacity [FVC] and peak expiratory flow rate [PEFR]), were compared using a local and reference device. Assessments were randomized with five minutes rest between measurements. Significant differences between devices were assessed using paired t-test while relative reliability between devices was determined via intra-class correlations (ICC). Accuracy index and variability between measurements were assessed using the technical error of measurement (TEM%) and coefficient of variation (CV), respectively. Agreement between devices was determined using the Bland Altman’s plot with limits of agreement (LOA). Results: The local devices recorded significantly (p1 (3.1%-8.4%), FVC (3.1%-13%) compared to the reference devices. Good-excellent correlations (ICC=0.89-0.96), unacceptable CV (5.8-9.9%) and TEM% (6.6-9.9%), and large mean biases (3-9kg) and LOA (3-23kg) were identified between the local and reference dynamometers. Excellent correlations (ICC=0.91-0.99), and mostly unacceptable CV and TEM% were identified between the local and reference spirometers for FVC and PEFR. Compared to the reference device, all local spirometers showed unacceptable (-0.134 to -0.536 liters) and acceptable (-0.12 to 0.05 liters/second) mean biases for FVC and PEFR, respectively. Conclusion: Unacceptable inter-instrument reliability was identified between local and reference dynamometers and spirometers for measuring DHGS and all lung function indices, respectively. Across clinical settings, comparing DHGS and lung function between different brands of devices may lead to the reporting of erroneous results with corrective adjustments required for clinical practice.

1042 COMPARISON BETWEEN CAMRY AND JAMAR DYNAMOMETERS IN MEASURING HAND GRIP STRENGTH AMONG OLDER POST-ACUTE COVID-19 OUTPATIENTS

Abstract Introduction Hand grip strength is a useful measure of muscle function. Many hand dynamometers that are less costly than the gold standard Jamar dynamometer are available but their use in clinical outpatient setting has yet to be validated. This study aimed to determine the inter-instrument reliability between Camry electronic and Jamar hydraulic dynamometers. Method A cross-sectional study was conducted on patients aged ≥65 years during their post COVID-19 follow up clinic visit. Hand grip strength was assessed using both Jamar and Camry dynamometers following standard protocol while information on participants’ demographics, health and COVID-19 hospitalizations were collected from hospital electronic medical records. Reliability between both devices was determined using intraclass correlation coefficient (ICC) and devices were compared based on subcategories of participants’ demographics and clinical characteristics. Results Ninety-three participants (mean age: 73 ± 6 years, 52.7% males) were recruited in this study. Average grip strength recorded with Jamar dynamometer (18.1 ± 7.4 kg) was higher than Camry dynamometer (19.5 ± 6.6 kg). Sub categorical comparison depicted no significant discrepancy between the devices discovered among male participants (p = 0.262), Malay participants (p = 0.243) and participants aged &amp;gt;70 years (p = 0.090). According to the diagnostic cut-off recommended by Asian Working Group for Sarcopenia (AWGS) 2019, similar number of participants had low grip strength using Jamar (n = 69, 74.2%) and Camry (n = 68, 73.2%) dynamometers. The odds of Camry detecting low grip strength was 0.946 times (95% CI: 0.493–1.817) as compared to Jamar dynamometer. Readings measured using both dynamometers were highly correlated to each other (r = 0.88) with ICC of 0.92, indicating an excellent inter-instrument reliability. Conclusion Comparable measures between Jamar and Camry hand dynamometers support the interchangeable use of the devices among older population. Hence, the alternative use of Camry dynamometer is appropriate for the outpatient setting.

Equivalency of four research-grade movement sensors to assess movement behaviors and its implications for population surveillance

the benefits of physical activity (PA) and sleep for health, accurate and objective population-based surveillance is important. Monitor-based surveillance has potential, but the main challenge is the need for replicable outcomes from different monitors. This study investigated the agreement of movement behavior outcomes assessed with four research-grade activity monitors (i.e., Movisens Move4, ActiGraph GT3X+, GENEActiv, and Axivity AX3) in adults. Twenty-three participants wore four monitors on the non-dominant wrist simultaneously for seven days. Open-source software (GGIR) was used to estimate the daily time in sedentary, light, moderate-to-vigorous PA (MVPA), and sleep (movement behaviors). The prevalence of participants meeting the PA and sleep recommendations were calculated from each monitor’s data. Outcomes were deemed equivalent between monitors if the absolute standardized difference and its 95% confidence intervals (CI95%) fell within ± 0.2 standard deviations (SD) of the mean of the differences. The participants were mostly men (n = 14, 61%) and aged 36 (SD = 14) years. Pairwise confusion matrices showed that 83–87% of the daily time was equally classified into the movement categories by the different pairs of monitors. The between-monitor difference in MVPA ranged from 1 (CI95%: − 6, 7) to 8 (CI95%: 1, 15) min/day. Most of the PA and sleep metrics could be considered equivalent. The prevalence of participants meeting the PA and the sleep guidelines was 100% consistent across monitors (22 and 5 participants out of the 23, respectively). Our findings indicate that the various research-grade activity monitors investigated show high inter-instrument reliability with respect to sedentary, PA and sleep-related estimates when their raw data are processed in an identical manner. These findings may have important implications for advancement towards monitor-based PA and sleep surveillance systems.

A Photogrammetric Method for the Measurement of Three-Dimensional Cervical Range of Motion.

Cervical spondylosis has gradually become a high-incidence disease in today's society. The cervical range of motion (CROM) is widely used as the evaluation criterion of cervical status, whereas the existing methods of CROM measuring are not humanized enough. Consequently, the purpose of this study was to develop a novel photogrammetric method to assess three-dimensional CROM. Three smartphone cameras were controlled to simultaneously capture three-direction photographs of the subject wearing the special designed device with three mark lines. The obtained photographs were uploaded to a PC and the mark lines in each photograph were extracted by utilizing both the Radon transform and the Hough transform. By calculating and combining the tilt angles of three mark lines, the CROM of the subject was indirectly determined. The performance of our method was compared with the goniometer-based method: the inter-instrument reliability was excellent for all six cervical movements with intraclass correlation coefficients 0.99; the degree of agreement between the two methods was high with Pearson's coefficients 0.98; and the Bland-Altman plots also revealed the validity of our method. Moreover, the concept of a cervical motion curve was put forward to describe the movement track of the neck in order to reflect the cervical health status. The proposed approach is feasible, automatic and convenient for the measurement of CROM and the generated cervical motion curve can intuitively exhibit the trajectory of the neck. This technique that can easily acquire the biomedical information of the cervical spine has tremendous potential in the diagnosis, healthcare and wellness management of the neck.

Modernising grip dynamometry: Inter-instrument reliability between GripAble and Jamar

IntroductionMaximum grip strength (MGS) is a reliable biomarker of overall health and physiological well-being. Therefore, an accurate and reliable measurement device is vital for ensuring the validity of the MGS assessment. This paper presents GripAble, a mobile hand grip device for the assessment of MGS. GripAble’s performance was evaluated using an inter-instrument reliability test against the widely used Jamar PLUS+ dynamometer.MethodsMGS data from sixty-three participants (N = 63, median (IQR) age = 29.0 (29.5) years, 33 M/30 F) from both hands using GripAble and Jamar PLUS+ were collected and compared. Intraclass correlation (ICC), regression, and Bland and Altman analysis were performed to evaluate the inter-instrument reliability and relationship in MGS measurements between GripAble and Jamar PLUS+ .ResultsGripAble demonstrates good-to-excellent inter-instrument reliability to the Jamar PLUS+ with ICC3,1 = 0.906 (95% CI [0.87—0.94]). GripAble’s MGS measurement is equivalent to 69% (95% CI [0.67—0.71]%) of Jamar PLUS+’s measurement. There is a proportional difference in mean MGS between the two devices, with the difference in MGS between GripAble and Jamar PLUS+ increasing with MGS.ConclusionThe GripAble is a reliable tool for measuring grip strength. However, the MGS readings from GripAble and Jamar PLUS+ should not be interchanged for serial measurements of the same patient, nor be translated directly from one device to the other. A new normative MGS data using GripAble will be collected and accessed through the software for immediate comparison to age and gender-matched subpopulations.

Agreement in anterior segment measurements between swept-source and Scheimpflug-based optical biometries in keratoconic eyes: a pilot study.

Background:Cataract surgery in keratoconic patients is challenging because of the corneal distortion, which can lead to inaccurate keratometry readings. This study is a comparison of the accuracy of keratometry readings by two types of devices in a tertiary hospital.Purpose:To evaluate the comparability of corneal power measurements, anterior chamber depth (ACD), and white-to-white (WTW) distance between Scheimpflug-based tomography (Pentacam AXL; OCULUS GmbH, Wetzlar, Germany) and swept-source optical biometry (IOLMaster 700; Carl Zeiss Meditec AG, Jena, Germany) in patients with keratoconus.Methods:This pilot, prospective, interinstrument reliability study included 30 keratoconic eyes of 15 individuals who had not undergone any kind of corneal surgery. Standard K and total refractive power (TK®) of the flattest and steepest axes of the IOLMaster 700 were compared with the standard keratometry (SimK), true net power (TNP), equivalent keratometer readings (EKR), and total corneal refractive power (TCRP) of the Pentacam. The Bland–Altman analysis was used to evaluate the agreement between the measurements of both devices. The paired-samples t-test and the Wilcoxon signed-rank test were performed to compare the mean values of the variables obtained with the devices.Results:The K1 value of the IOLMaster 700 was significantly higher from EKR K1 along the 3-mm (mean difference: 0.79 diopters, p = 0.01), 4-mm (mean difference: 1.01 D, p = 0.01), and 4.5-mm zones (mean difference: 1.20 D, p = 0.01) and TNP K1 along the 3-mm (mean difference: 0.88 D, p < 0.001) and 4-mm zones (mean difference: 0.97 D, p < 0.001). The TK1 value was significantly higher from EKR K1 along the 2-mm (mean difference: 0.42 D, p = 0.04), 3-mm (mean difference: 0.83 D, p = 0.003), 4-mm (mean difference: 1.05 D, p = 0.004), and 4.5-mm zones (mean difference: 1.24 D, p = 0.005) and TNP K1 along the 3-mm (mean difference: 0.92 D, p < 0.001) and 4-mm zones (mean difference: 1.01 D, p < 0.001). The K2 value of the IOLMaster 700 was significantly higher from TK2 (mean difference: 0.11 D, p = 0.04) and all the corresponding variables of the Pentacam device. The TK2 value was significantly higher from all the corresponding variables of the Pentacam device. The Pentacam also yielded significantly lower values for the WTW distance (mean difference: 0.31 mm, p < 0.001) and no significant difference in terms of ACD values (p = 0.9).Conclusion:The IOLMaster measured significantly greater keratometry readings in the steep axis for all the variables studied. The keratometry and WTW measurements of the investigated devices cannot be used interchangeably in keratoconus.

Agreement between swept-source optical biometry and Scheimpflug-based tomography in eyes with previous myopic refractive surgery.

PURPOSE:The purpose of the study is to evaluate the comparability of corneal power measurements, anterior chamber depth (ACD), and white-to-white (WTW) distance between a high-resolution Scheimpflug-based tomography (Pentacam HR; Oculus GmbH, Wetzlar, Germany) and a swept-source optical biometry, IOL Master 700; Carl Zeiss Meditec AG, Jena, Germany) in patients having undergone a myopic refractive surgery.METHODS:This prospective, interinstrument reliability analysis included 31 individuals with a previous myopic laser refractive correction. Standard keratometry and total keratometry (TK) of the flattest and steepest axis of the IOL Master 700 were compared with standard keratometry (simulated keratometry [SimK]), true net power (TNP), equivalent keratometer readings (EKR), and total corneal refractive power of the Pentacam. The Bland–Altman analysis evaluated the agreement between the measurements of both devices. A paired t-test was performed to compare the mean values of the variables obtained by the two devices.RESULTS:Mean age of the participants was 31.87 ± 13.17 years. Ten patients (32.3%) had undergone laser in situ keratomileusis surgery, and 21 (67.7%) had undergone photorefractive keratectomy surgery. The two devices generated statistically significant differences in almost all the comparisons between their corneal keratometry values, ACD, and WTW. The two devices agreed in some of the flat axis values and more specifically on SimK1 and K1, EKR K1 along 1 mm-zone and K1, as well as on the comparison between the EKR keratometry values along 1, 2, and 3 mm-zone with their corresponding TKs.CONCLUSION:IOL Master 700 and Pentacam HR do not show good concordance and cannot be used interchangeably when measuring keratometry values in postrefractive eyes, rendering the IOL power calculation in postrefractive eyes really challenging.

Skin measurement devices to assess skin quality: A systematic review on reliability and validity.

BackgroundMany treatments aim to slow down or reverse the visible signs of skin aging and thereby improve skin quality. Measurement devices are frequently employed to measure the effects of these treatments to improve skin quality, for example, skin elasticity, color, and texture. However, it remains unknown which of these devices is most reliable and valid.Materials and methodsMEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched. Instruments were scored on reporting construct validity by means of convergent validity, interobserver, intraobserver, and interinstrument reliability.ResultsFor the evaluation of skin color, 11 studies were included describing 16 measurement devices, analyzing 3172 subjects. The most reliable device for skin color assessment is the Minolta Chromameter CR‐300 due to good interobserver, intraobserver, and interinstrument reliability. For skin elasticity, seven studies assessed nine types of devices analyzing 290 subjects in total. No intra and interobserver reliability was reported. Skin texture was assessed in two studies evaluating 72 subjects using three different types of measurement devices. The PRIMOS device reported excellent intra and interobserver reliability. None of the included reviewed devices could be determined to be valid based on construct validity.ConclusionThe most reliable devices to evaluate skin color and texture in ordinary skin were, respectively, the Minolta Chromameter and PRIMOS. No reliable device is available to measure skin elasticity in ordinary skin and none of the included devices could be determined to be designated as valid.

The ASQ-TRAK: Validating a culturally adapted developmental screening tool for Australian Aboriginal children

BackgroundDevelopmental monitoring, performed using culturally relevant tools, is of critical importance for all young children. The ASQ-TRAK is the culturally and linguistically adapted Ages and Stages Questionnaire (ASQ-3), a developmental screening tool, for Australian Aboriginal children. While the ASQ-TRAK has been well received in practice, investigating its psychometric properties will enable professionals to make informed decisions about its use. AimsTo conduct a rigorous validation study of the ASQ-TRAK by applying Kane's argument-based approach. SubjectsThe ASQ-TRAK, Bayley-III and/or BDI-2 were administered cross-sectionally to 336 Australian Aboriginal children aged 2–48 months across ten participating sites in the Northern Territory and South Australia. A sample of staff and caregivers completed feedback surveys about the ASQ-TRAK. ResultsASQ-TRAK domain scores were moderately positively correlated with corresponding domain scores on the Bayley-III or BDI-2. Inter-rater and inter-instrument reliability were high. Sensitivity (83%), specificity (83%) and negative predictive value (99%) were acceptable. Staff and caregivers expressed high levels of satisfaction with the ASQ-TRAK. ConclusionsRegular developmental screening can provide important information about developmental vulnerability and the need for services. The ASQ-TRAK should be administered by trained Aboriginal community-based workers and the implementation approach carefully planned. Areas for future research include longitudinal follow-up of children, investigating existing norms and cut-off scores, and considering the appropriateness of the ASQ-TRAK with Aboriginal people from different locations. The ASQ-TRAK has the potential to fill an important gap by enabling better access to high-quality developmental monitoring and targeted early intervention.

Comparison of the BTE tech EVJ handgrip to the Jamar hand dynamometer for measuring grip strength

INTRODUCTION: This study compared the inter-instrument reliability of the Jamar Hand Dynamometer (Jamar) to the BTE EVJ Handgrip tool (EVJ). The EVJ is a new digital handgrip instrument designed by BTE Technologies Inc. (BTE Tech) utilizing Bluetooth technology to automatically upload data to a computer or electronic health record. METHOD: This repeated measure study engaged 338 participants (N= 199 females, N= 139 males) ages 20 to 50. All participants were tested on both devices following the protocol established by the American Society of Hand Therapists (ASHT). RESULTS: Comparative statistics included ICC values (0.81–0.84), Pearson R (correlation coefficient) (0.68–0.77), and Bland Altman plots (93–95% of data within 2 SD), indicating good inter-instrument agreement. CONCLUSIONS: The EVJ Handgrip, developed by BTE Technologies, demonstrated good inter-instrument reliability with the Jamar Hand Dynamometer and may be reliable to use when referencing the published normative values in the clinical environment.

Dyspnea could be accurately assessed by a caregiver in hospitalized patients with respiratory diseases: Interrater reliability and agreement study

BackgroundThe perception of dyspnea is a subjective feeling typically self-assessed by the patient. However, the assessment by a caregiver is sometimes required. ObjectivesThe primary aim was to compare patient self-assessment and caregiver assessment of dyspnea (interrater reliability) using the modified Borg and visual analog scale (VAS) in hospitalized patients. The secondary aim was to compare dyspnea assessment between the two scales for patients and caregiver (inter-instrument reliability). MethodsSelf-assessment of dyspnea intensity of hospitalized patients with respiratory diseases was compared with caregiver's assessment. Dyspnea intensity was measured using two scales, the modified Borg scale (0–10 scale) and the 10 cm VAS. Mean difference and 95% confidence interval (CI) between assessors (i.e. patient versus caregiver) were calculated for each scale. Inter- and intra-rater reliability was calculated using intraclass correlation coefficients (ICCs). ResultsA total of 254 patients were recruited. The mean differences between patient and caregiver ratings were 0.31 (95% CI: 0.09, 0.53) for the modified Borg scale and 0.36 (95% CI: 0.06, 0.65) for the VAS scale. Interrater reliability was good for both scales with ICC of 0.79 (95% CI: 0.73, 0.84) for VAS and 0.82 (95% CI: 0.77, 0.86) for the modified Borg scale. The mean differences in scores between scales were 0.93 (95% CI 0.69, 1.17) for patients' ratings and 0.88 (95% CI 0.72, 1.04) for caregiver's rating. The inter-instrument reliability was moderate to good and similar for both assessors. ConclusionDyspnea can be accurately estimated by caregivers when patients with lung diseases cannot self-report. Scores on the VAS to rate dyspnea were higher than the scores on the Borg scale.

Validity and Interinstrument Reliability of a Medical Grade Physical Activity Monitor in Older Adults

Wearable physical activity monitors are associated with an increase in user’s habitual physical activity levels. Most of the older adult population do not meet the national moderate- to vigorous-intensity physical activity (MVPA) recommendations and may benefit from being prescribed a physical activity monitor. The PiezoRx is a class one medical grade device that uses step rate thresholds to measure MVPA. The validity and reliability of the PiezoRx in measuring MVPA has yet to be determined in older persons. We assessed the validity and interinstrument reliability of the PiezoRx to measure steps and MVPA in older adults. Participants (n = 19; 68.8 ± 2.3 years) wore an Omron HJ-320 pedometer, ActiGraph GT3X accelerometer, and four PiezoRx monitors during a five-stage treadmill walking protocol. The PiezoRx devices were set at moderate physical activity and vigorous physical activity step rate thresholds (steps per minute) of 100/120, 110/130, adjusted for height and adjusted for height + fitness. The PiezoRx exhibited a stronger correlation (intraclass correlation coefficient = .82) with manually counted steps than the ActiGraph (intraclass correlation coefficient = .53) and Omron (intraclass correlation coefficient = .54) and had a low absolute percentage error (3 ± 6%). The PiezoRx with moderate physical activity/vigorous physical activity step thresholds adjusted to 110/130 was strongly correlated to indirect calorimetry (0.84, p &lt; .001) and best distinguished each walking stage as MVPA or not (sensitivity: 88%; specificity: 95%). The PiezoRx monitor is a valid and reliable measure of step count and MVPA among older adults. The device’s ability to measure MVPA in absolute terms was improved when step rate thresholds for moderate physical activity/vigorous physical activity were increased to 110/130 steps per minute in this population.

Inter-Instrument Reliability and Agreement of Fitbit Charge Measurements of Heart Rate and Activity at Rest, during the Modified Canadian Aerobic Fitness Test, and in Recovery.

Purpose: We determined the inter-instrument reliability and agreement parameters of the Fitbit Charge Heart Rate (Charge HR) device during three phases: rest, modified Canadian Aerobic Fitness Test (mCAFT), and recovery. Method: We recruited 60 participants for this cross-sectional measurement study using convenience and snowball sampling approaches. The performance of the Charge HR was assessed throughout the rest, mCAFT, and recovery phases. To establish inter-instrument reliability, the Charge HR variables - heart rate, steps taken, and energy expenditures - were compared with those for two other devices: the Zephyr BioHarness (ZB) for heart rate and the Fitbit One for steps taken and energy expenditure. Measurements were recorded every 30 seconds. Results: At rest, the inter-instrument intra-class correlation coefficient (ICC) (standard error of measurement [SEM]) for the Charge HR versus the ZB was ≥ 0.97 (range, min-max, 1.02-1.32). During the mCAFT and in recovery, the ICCs (SEMs) for the Charge HR and the ZB were ≥ 0.89 (range, min-max, 1.30-3.98) and ≥ 0.68 (range, min-max, 3.58-8.35), respectively. During the mCAFT only, the number of steps taken and the energy expenditure recorded by the Charge HR and the Fitbit One displayed ICCs (SEMs) of 0.97 (83.00) and 0.77 (14.70), respectively. The average agreement differences in heart rate in this pair-wise device comparison indicated mean differences of -0.20, 4.00, and 1.00 beats per minute at rest, during the mCAFT, and in recovery, respectively. Conclusions: The Charge HR heart rate variable demonstrated excellent inter-instrument reliability compared with the ZB and provided good levels of agreement. The steps taken and energy expenditure variables displayed excellent reliability measures between Charge HR and Fitbit One. Our findings may be used to capture field-based wireless measures of heart rate in various phases and provide information about possibly using the Charge HR and ZB devices interchangeably.

Effects of the type of exercise performed on the vibration delivered during whole-body vibration exercises

While the internal load factors of whole-body vibration training have been widely investigated, the study of external load magnitude has been overlooked. Thus, the aim of the present study was to evaluate differences in whole-body vibration stimulus magnitude between static/dynamic whole-body vibration training at various vibration conditions. Four Pro 5 Plate vibration platforms were exposed to twelve different vibration conditions and a triaxial USB Impact X250-2 accelerometer was used to measure platform acceleration during each condition. Paired samples t-test was calculated to evaluate differences among amplitude, frequency, time of acceleration and time of deceleration of each platform at each vibration condition and during static (squat of 90° knee flexion) or dynamic exercise (from stand to 90° knee flexion squat). Also, the intra-class correlation coefficients were examined in order to assess the inter-instrument reliability. Peak-to-peak amplitude, frequency, time of acceleration and deceleration of the vibration platform were not modified by the type of exercise performed. Moreover, the four platforms tested showed high repeatability values during the execution of free vibration, static or dynamic squat in all vibration conditions. This study confirms that the vibration delivered by the Pro 5 Plate vibration platform is not modified during the realization of static or dynamic exercises.