Intraclass Correlation Coefficient Values Research Articles

Development and stability analysis of carpal kinematic metrics from 4D magnetic resonance imaging.

To develop MRI-derived carpal kinematic metrics and investigating their stability. The study used a 4D MRI method to track scaphoid, lunate, and capitate movements in the wrist. A panel of 120 metrics for radial-ulnar deviation and flexion-extension was created using polynomial models of scaphoid and lunate movements relative to the capitate. Intraclass correlation coefficients (ICCs) analyzed intra- and inter-subject stability in 49 subjects, 20 with and 29 without wrist injury history. Comparable degrees of stability were observed across the two different wrist movements. Among the total 120 derived metrics, distinct subsets demonstrated high stability within each type of movement. For asymptomatic subjects, 16 out of 17 metrics with high intra-subject stability also showed high inter-subject stability. The differential analysis of ICC values for each metric between asymptomatic and symptomatic cohorts revealed specific metrics (although relatively unstable) exhibiting greater variability in the symptomatic cohort, thereby highlighting the impact of wrist conditions on the variability of kinematic metrics. The findings demonstrate the developing potential of dynamic MRI for assessing and characterizing complex carpal bone dynamics. Stability analyses of the derived kinematic metrics revealed encouraging differences between cohorts with and without wrist injury histories. Although these broad metric stability variations highlight the potential utility of this approach for analyzing carpal instability, further studies are necessary to better characterize these observations.

Dual-time-point dynamic 68Ga-PSMA-11 PET/CT for parametric imaging generation in prostate cancer.

To investigate the optimal dual-time-point (DTP) approaches using dynamic 68Ga-PSMA-11 PET/CT imaging to generate parametric images for prostate cancer patients. Fifteen patients with prostate cancer were intravenously administered 68Ga-PSMA-11 of 181.9 ± 47.2MBq, followed by an immediate 60min dynamic PET/CT scan. List-mode data were reconstructed into 25 timeframes (6 × 10s, 8 × 30s, and 11 × 300s) and corrected for motion and partial volume effect. DTP parametric images were generated using different interval time points of 5min and 10min, with a minimum of 30min time interval. Net influx rates (Ki) were calculated through the fitting of a single irreversible two-tissue compartmental model. Intraclass correlation coefficient (ICC) values between DTP protocols and 60min Ki were obtained. Lesion-to-background ratios (LBRs) of Ki and standardized uptake value (SUV) images in each DTP protocol were determined. The DTP protocol of 5-10min with a 40-45min interval showed the highest ICC of 0.988 compared with the 60min Ki, whereas the ICC values for the intervals of 0-5min with 55-60min and 0-10min with 50-60min were 0.941. The LBRs of the 60min Ki, 5-10min with 40-45min Ki, 0-5min with 55-60min Ki, 0-10min with 50-60min Ki, SUVmean, and SUVmax images were 29.53 ± 27.33, 13.05 ± 15.28, 45.15 ± 53.11, 45.52 ± 70.31, 19.77 ± 23.43, and 25.06 ± 30.07, respectively. The 0-5min with 55-60min DTP parametric imaging exhibits a comparable Ki to 60min parametric imaging and remarkable image quality and contrast than SUV imaging, enhancing prostate cancer diagnosis while maintaining time efficiency.

Artificial intelligence enhances whole-slide interpretation ofPD-L1 CPS in triple-negative breast cancer: Amulti-institutional ring study.

Evaluation of the programmed cell death ligand-1 (PD-L1) combined positive score (CPS) is vital to predict the efficacy of the immunotherapy in triple-negative breast cancer (TNBC), but pathologists show substantial variability in the consistency and accuracy of the interpretation. It is of great importance to establish an objective and effective method which is highly repeatable. We proposed a model in a deep learning-based framework, which at the patch level incorporated cell analysis and tissue region analysis, followed by the whole-slide level fusion of patch results. Three rounds of ring studies (RSs) were conducted. Twenty-one pathologists of different levels from four institutions evaluated the PD-L1 CPS in TNBC specimens as continuous scores by visual assessment and our artificial intelligence (AI)-assisted method. In the visual assessment, the interpretation results of PD-L1 (Dako 22C3) CPS by different levels of pathologists have significant differences and showed weak consistency. Using AI-assisted interpretation, there were no significant differences between all pathologists (P = 0.43), and the intraclass correlation coefficient (ICC) value was increased from 0.618 [95% confidence interval (CI) = 0.524-0.719] to 0.931 (95% CI = 0.902-0.955). The accuracy of interpretation result is further improved to 0.919 (95% CI = 0.886-0.947). Acceptance of AI results by junior pathologists was the highest among all levels, and 80% of the AI results were accepted overall. With the help of the AI-assisted diagnostic method, different levels of pathologists achieved excellent consistency and repeatability in the interpretation of PD-L1 (Dako 22C3) CPS. Our AI-assisted diagnostic approach was proved to strengthen the consistency and repeatability in clinical practice.

Reproducibility of Quantitative Double-Echo Steady-State T2 Mapping of Knee Cartilage.

Cartilage T2 can detect joints at risk of developing osteoarthritis. The quantitative double-echo steady state (qDESS) sequence is attractive for knee cartilage T2 mapping because of its acquisition time of under 5 minutes. Understanding the reproducibility errors associated with qDESS T2 is essential to profiling the technical performance of this biomarker. To examine the combined acquisition and segmentation reproducibility of knee cartilage qDESS T2 using two different regional analysis schemes: 1) manual segmentation of subregions loaded during common activities and 2) automatic subregional segmentation. Prospective. 11 uninjured participants (age: 28 ± 3 years; 8 (73%) female). 3-T, qDESS. Test-retest T2 maps were acquired twice on the same day and with a 1-week interval between scans. For each acquisition, average cartilage T2 was calculated in four manually segmented regions encompassing tibiofemoral contact areas during common activities and 12 automatically segmented regions from the deep-learning open-source framework for musculoskeletal MRI analysis (DOSMA) encompassing medial and lateral anterior, central, and posterior tibiofemoral regions. Test-retest T2 values from matching regions were used to evaluate reproducibility. Coefficients of variation (%CV), root-mean-square-average-CV (%RMSA-CV), and intraclass correlation coefficients (ICCs) assessed test-retest T2 reproducibility. The median of test-retest standard deviations was used for T2 precision. Bland-Altman (BA) analyses examined test-retest biases. The smallest detectable difference (SDD) was defined as the BA limit of agreement of largest magnitude. Significance was accepted for P < 0.05. All cartilage regions across both segmentation schemes demonstrated intraday and interday qDESS T2 CVs and RMSA-CVs of ≤5%. T2 ICC values >0.75 were observed in the majority of regions but were more variable in interday tibial comparisons. Test-retest T2 precision was <1.3 msec. The T2 SDD was 3.8 msec. Excellent CV and RMSA-CV reproducibility may suggest that qDESS T2 increases or decreases >5% (3.8 msec) could represent changes to cartilage composition. Stage 2.

Optical coherence tomography choroidal enhancement using generative deep learning

Spectral-domain optical coherence tomography (SDOCT) is the gold standard of imaging the eye in clinics. Penetration depth with such devices is, however, limited and visualization of the choroid, which is essential for diagnosing chorioretinal disease, remains limited. Whereas swept-source OCT (SSOCT) devices allow for visualization of the choroid these instruments are expensive and availability in praxis is limited. We present an artificial intelligence (AI)-based solution to enhance the visualization of the choroid in OCT scans and allow for quantitative measurements of choroidal metrics using generative deep learning (DL). Synthetically enhanced SDOCT B-scans with improved choroidal visibility were generated, leveraging matching images to learn deep anatomical features during the training. Using a single-center tertiary eye care institution cohort comprising a total of 362 SDOCT-SSOCT paired subjects, we trained our model with 150,784 images from 410 healthy, 192 glaucoma, and 133 diabetic retinopathy eyes. An independent external test dataset of 37,376 images from 146 eyes was deployed to assess the authenticity and quality of the synthetically enhanced SDOCT images. Experts’ ability to differentiate real versus synthetic images was poor (47.5% accuracy). Measurements of choroidal thickness, area, volume, and vascularity index, from the reference SSOCT and synthetically enhanced SDOCT, showed high Pearson’s correlations of 0.97 [95% CI: 0.96–0.98], 0.97 [0.95–0.98], 0.95 [0.92–0.98], and 0.87 [0.83–0.91], with intra-class correlation values of 0.99 [0.98–0.99], 0.98 [0.98–0.99], and 0.95 [0.96–0.98], 0.93 [0.91–0.95], respectively. Thus, our DL generative model successfully generated realistic enhanced SDOCT data that is indistinguishable from SSOCT images providing improved visualization of the choroid. This technology enabled accurate measurements of choroidal metrics previously limited by the imaging depth constraints of SDOCT. The findings open new possibilities for utilizing affordable SDOCT devices in studying the choroid in both healthy and pathological conditions.

Abstract PO5-07-02: AI-assisted interpretation of PD-L1 CPS improves the precision medicine in Triple-negative breast cancer

Abstract Objective: The IMpassion 031 and KEYNOTE-355 clinical trial demonstrated the advantages of atezolizumab and pembrolizumab in the treatment of Triple-negative breast cancer (TNBC). However, the application of CPS in assessing PD-L1 expression is challenging. Pathologists have great variability in interpretation of PD-L1 CPS, the daily diagnostic workload is too heavy and their diagnostic efficiency is low, and they still have deficiencies in terms of accurate enumeration. It is of necessity to establish an objective and effective method which is highly repeatable. Methods: In this study, we established a deep learning-based artificial intelligence-assisted (AI-assisted) model which using cell detection and region segmentation algorithm. Three rounds of ring studies (RSs) were conducted. 12 pathologists of different level evaluate the CPS of PD-L1 (DAKO 22C3) in TNBC patients by visual assessment and AI-assisted model. Compare the difference, consistency and accuracy of the interpretation. Our research evaluated PD-L1 CPS expression with continuous score. Shapiro-Wilk (S-W) method performs normality test, difference analysis using Friedman M and Bonferroni calibration tests, consistency analysis is studied by intraclass correlation coefficient (ICC) and heat maps and box plots. Results: In the visual assessment, the interpretation results of PD-L1 (DAKO 22C3) CPS in different level pathologists have significant differences (P &amp;lt; 0.05), and the consistency of all the pathologists interpretation results was weak. Due to this strong inconsistency, it may result in a number of patients losing the opportunity to use ICIs for treatment. Moreover, the internal consistency of all pathologists in the visual assessment is moderate, in which the repeatability of junior pathologists is the worst, the ICC value is 0.664 (95%CI: 0.564-0.762). Through AI-assisted interpretation, there is no significant difference between all pathologists (P = 0.425), and the ICC value increased to 0.883 (95%CI:0.836-0.922) which improved the consistency of the interpretation results. In addition, through AI-assisted interpretation, the repeatability and accuracy of the interpretation results has been further upgraded. At the same time, the acceptance of AI results by junior pathologists are high, and 80% of the AI results are accepted. Conclusions: With the help of the AI-assisted diagnostic model, different levels of all the pathologists have achieved excellent consistency and repeatability in the interpretation of PD-L1 (DAKO 22C3) CPS. Moreover, the level of interpretation has been sought the rapid enhancement. It can be seen that AI-assisted diagnostic model provides a good approach to strengthen the consistency and repeatability in clinical practice. Our research also shows that PD-L1 CPS can receive precise interpretation from pathologists, so more patients have the opportunity to use ICIs. Therefore, these patients can benefit from treatment and achieve better survival. The interpretation results and system diagram of PD-L1 CPS by AI-assisted model. The consistency and repeatability of the interpretation results. (A)-(C) The consistency of the PD-L1 CPS interpretation among the different level of pathologists in three ring studies. (D)The repeatability of the interpretation results between 12 pathologists in RS1 and RS2. Accuracies and acceptance rates of different experienced pathologists. (A) Boxplots of scoring accuracies for pathologists in different levels. (B) Acceptance rates of all pathologists in total 50 slides. (C) Percent stacked column chart of different levels of pathologists with AI score acceptance. Citation Format: Jinze Li, Xinran Wang, Yueping Liu. AI-assisted interpretation of PD-L1 CPS improves the precision medicine in Triple-negative breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-07-02.

Validity and reliability of the Thai version of the ASCRS SPEED II preoperative OSD questionnaire in Thai cataract surgery candidates.

To develop a Thai version of the American Society of Cataract and Refractive Surgery (ASCRS)-modified Standard Patient Evaluation of Eye Dryness (SPEED) II© preoperative ocular surface disease (OSD) questionnaire (ASCRS SPEED II-Thai) and evaluate its validity and reliability in Thai cataract surgery candidates. The original English version of the questionnaire was translated and adapted cross-culturally to Thai language. The ASCRS SPEED II-Thai was evaluated for content validity, internal consistency, and test-retest reliability. Five experts in the ocular surface field critically reviewed the ASCRS SPEED II-Thai to measure the content validity indexes (CVI). A total of 105 cataract surgery candidates were recruited from an ophthalmology clinic to complete the questionnaire. Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to assess internal consistency and test-retest reliability, respectively. During the translation and cross-cultural adaptation processes, only two minor modifications were made to the original version for clarification without changing their meaning. All items in the ASCRS SPEED II-Thai had an item-level CVI of 1.00, representing complete agreement among content experts. The scale-level CVI was 1.00, indicating excellent content validity of the questionnaire. The participants found no difficulty in understanding each question in the pilot test. Cronbach's alpha for the ASCRS SPEED II-Thai was 0.82, indicating good internal consistency. The test-retest reliability was good to excellent, with ICC values ranging from 0.83 to 1.00 (P < 0.001). The ASCRS SPEED II-Thai is a valid clinical tool with adequate reliability for preoperative OSD screening among Thai cataract surgery candidates.

Test–Retest Reliability of a Motorized Resistance Device for Measuring Throwing Performance in Volleyball Athletes

Throwing performance is a critical aspect of sports, particularly in overhead activities, necessitating reliable assessment methods. This study explores the test–retest reliability of throwing performance metrics measured by the 1080 Sprint, a robotic device integrating linear position technology and an electric motor. Specifically focusing on professional volleyball athletes with scapular dyskinesis, the study draws data from a previously published investigation on the impact of mirror cross exercise. Thirty-nine athletes were recruited, aged 21.9 ± 3.6 years, height 1.79 ± 0.3 m weight 68.5 ± 19.8 kg, and body mass index 21.3 ± 3.2 kg/m2, meeting stringent inclusion criteria. One-sample t-tests indicated no statistically significant differences between test–retest trials. The study revealed excellent reliability of the 1080 Sprint, with intraclass correlation coefficient (ICC) values exceeding 0.99 for all metrics, including speed, force, and power. The standard error of measurement (SEM) calculation revealed that the Sprint 1080 motorized resistance device demonstrates high precision in measuring throwing performance. Bland and Altman plots indicated minimal systematic bias across all metrics, encompassing speed, force, and power. The provision of the minimum detectable change (MDC) for each variable of the Sprint 1080 motorized resistance device offers coaches a valuable tool to identify performance improvements in volleyball athletes. In conclusion, the present study shows that the 1080 Sprint is valid and reliable for measuring throwing performance in volleyball athletes for monitoring purposes.

Psychometric properties of the Arabic Occupational Balance Questionnaire (OBQ11-A)

Background Occupational balance (OB) is a desirable outcome of rehabilitation because it is related to various health indices. The Occupational Balance Questionnaire (OBQ) is a self-report measure of occupational balance. Aims/Objectives To examine the test-retest reliability, participant-level content validity, construct validity, internal consistency, and convergent validity of an Arabic occupational balance questionnaire (OBQ11-A). Materials and Methods A total of 103 participants were recruited through convenience sampling. Test-retest reliability was examined using intraclass correlation coefficients, participant-level content validity using percentage of agreement in survey questions, construct validity using factor analysis, internal consistency using Cronbach’s alpha, and convergent validity by examining associations with quality-of-life. Results Intraclass Correlation Coefficient values for the total OBQ11-A scores and individual items were greater than 0.7 between the test and retest. The majority of respondents endorsed the relevance, comprehensiveness, and comprehensibility of the OBQ11-A. Cronbach’s alpha for the OBQ11-A total score was 0.899. Nine of the 11 OBQ11-A items had factor loadings greater than 0.7. Moderate associations were found between the total OBQ11-A scores and physical health (n = 101; ρ = .52, p < .001), psychological health (n = 101; ρ = .49, p < .001), social relationships (n = 101; ρ = .36, p < .001), and environmental domains (n = 101; ρ = .57, p < .001) of the quality-of-life measure. Conclusions OBQ11-A demonstrates acceptable psychometric properties for research purposes.

Deep learning-accelerated T2WI: image quality, efficiency, and staging performance against BLADE T2WI for gastric cancer.

The purpose of our study is to investigate image quality, efficiency, and diagnostic performance of a deep learning-accelerated single-shot breath-hold (DLSB) against BLADE for T2-weighted MR imaging (T2WI) for gastric cancer (GC). 112 patients with GCs undergoing gastric MRI were prospectively enrolled between Aug 2022 and Dec 2022. Axial DLSB-T2WI and BLADE-T2WI of stomach were scanned with same spatial resolution. Three radiologists independently evaluated the image qualities using a 5-scale Likert scales (IQS) in terms of lesion delineation, gastric wall boundary conspicuity, and overall image quality. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated in measurable lesions. T staging was conducted based on the results of both sequences for GC patients with gastrectomy. Pairwise comparisons between DLSB-T2WI and BLADE-T2WI were performed using the Wilcoxon signed-rank test, paired t-test, and chi-squared test. Kendall's W, Fleiss' Kappa, and intraclass correlation coefficient values were used to determine inter-reader reliability. Against BLADE, DLSB reduced total acquisition time of T2WI from 495min (mean 4:42 per patient) to 33.6min (18s per patient), with better overall image quality that produced 9.43-fold, 8.00-fold, and 18.31-fold IQS upgrading against BALDE, respectively, in three readers. In 69 measurable lesions, DLSB-T2WI had higher mean SNR and higher CNR than BLADE-T2WI. Among 71 patients with gastrectomy, DLSB-T2WI resulted in comparable accuracy to BLADE-T2WI in staging GCs (P > 0.05). DLSB-T2WI demonstrated shorter acquisition time, better image quality, and comparable staging accuracy, which could be an alternative to BLADE-T2WI for gastric cancer imaging.

Shoulder MRI parameters in anticipating anterior shoulder dislocation: Are they a reliable and reproducible tool in clinical practice?

BackgroundAnterior shoulder dislocation (ASD) is a frequently observed musculoskeletal injury that is often encountered in the context of sports activities or as a result of trauma. Several magnetic resonance imaging (MRI) parameters have been previously investigated for the purpose of characterizing the anatomical features, which could potentially be responsible for the episodes of instability. These measurements have the potential to identify patients who are susceptible to dislocation. Consequently, ensuring the reliability and consistency of these measurements is crucial in the diagnosis and the management of athletic or traumatic shoulder injuries. MethodsA group of four students, who had no previous experience in reading MRI series, were selected to perform radiographic measurements on specific parameters of MRI scans. These parameters were glenoid version, glenoid depth, glenoid width, humeral head diameter, humeral containing angle, and the ratio of humeral head diameter to glenoid diameter. The four participants conducted two distinct readings on a total of 28 sets of shoulder MRI scans. Simultaneously, the aforementioned measures were assessed by a consultant shoulder surgeon. ResultsA total of 1512 measurements were categorized into nine sets: eight from students’ measurements (two per student) and one from the consultant. Intra-rater reliability assessed by the intra-class correlation (ICC) test indicated excellent or good reliability for all parameters (p < 0.05), with glenoid depth showing the highest (0.925) and humeral-containing angles the lowest (0.675) ICC value. Inter-rater correlation, also evaluated using ICC, demonstrated strong correlation (p < 0.05), with glenoid diameter having the highest ICC score (0.935) and glenoid depth the lowest (0.849). Agreement analysis, expressed by Cohen's Kappa test, revealed substantial agreement (p < 0.05) for all parameters, with humeral head diameter having the highest agreement (0.90) and humeral-containing angle the lowest (0.73). ConclusionIn this study, intra- and inter-rater MRI parameters are substantially concordant. Credibility comes from these reliability and agreement analyses' statistical significance. Glenoid diameter and depth are the most reliable intrarater and interrater, respectively. Best agreement was with the humeral-containing angle. These data demonstrate repeatability and clinical relevance. Level of EvidenceLevel IV

The texture analysis of computed tomography studies in clear cell renal cell carcinoma: reproducibility of 2D and 3D segmentation

Background: Differentiation of tumor grade at the preoperative stage is of utmost importance for the modification of the treatment strategy and the extent of operation. However, the routine analysis of computed tomography (CT) data in clear cell renal cell carcinoma (ccRCC) does not allow for reliable determination of the tumor grade.&#x0D; Aim: To assess the reproducibility of the results of 2D and 3D segmentation of a kidney tumor in the cortico-medullary and nephrographic phases of CT studies, as well as the reproducibility of the first order texture parameters for 2D and 3D tumor segmentation in patients with verified ccRCC.&#x0D; Materials and methods: This retrospective study included the CT data of 50 patients with morphologically verified ccRCC obtained before their surgical treatment. The first patient group included the patients with the renal tumor size in the axial plane of ≥ 4 cm (28 patients, 29 CT studies), and the second patient group included those with the renal tumor size in axial plane of 4 cm (22 patients, 23 CT studies). Two radiologists independently performed segmentation of the renal tumor in the cortico-medullary and nephrographic phases of CT procedures done under a standard protocol with the bolus intravenous contrast enhancement. A two-dimensional region of interest (2D ROI) was selected by the investigators on a subjectively selected axial slice, where the tumor had the largest size. When forming a three-dimensional region of interest (3D ROI), the entire tumor volume was segmented. Next, the statistical analysis of the segmentation results and the results of calculation of the first order texture indices was performed with calculation of the intra-class correlation coefficient (ICC) to assess the strength of the data correlation. The ICC of ≥ 0.75 demonstrated the reproducibility of the segmentation results and the first order texture indices.&#x0D; Results: The 3D segmentation method for ccRCC demonstrated the best ROI reproducibility results, regardless of the tumor size and the phase of contrast enhancement, with the ICC values of 0.961 (95% confidence interval: 0.946–0.971) for the cortico-medullary phase and 0.969 (95% CI: 0.958–0.977) for the nephrographic phase. The 2D tumor segmentation method showed unsatisfactory ROI reproducibility, with the ICC values of ≤ 0.058; however, the unsatisfactory reproducibility of the segmentation results in the patients with ccRCC tumor size of ≥ 4 cm did not significantly affect the reproducibility of the Entropy and Energy texture indices (good to excellent correlation). With the 3D segmentation of ccRCC, most first-order texture metrics were reproducible, with the exception of the Kurtosis parameter. The Entropy and Energy scores in both patient groups demonstrated a high degree of reproducibility. In the 2D tumor segmentation, high reproducibility of the first order texture metrics was obtained for the Entropy and Energy indices.&#x0D; Conclusion: The 3D segmentation of the CT data for ccRCC has high reproducibility, the most first-order textural features were excellently reproducible when segmentations were performed in 3D. The 2D CT data segmentation method for ccRCC demonstrated low reproducibility; however, some of the first order texture indices were reproducible. Both segmentation methods can be used for the texture analysis of CT images.

Exploring transvaginal sonographic characteristics of the levator ani muscle in women with postpartum pelvic floor myofascial pain.

Pelvic floor myofascial pain is one of the pelvic floor dysfunction diseases disturbing women after delivery. There is a lack of objective standardization for the diagnosis of pelvic floor myofascial pain due to the various symptoms and the dependence on the palpating evaluation. Ultrasound imaging has the advantages of safety, simplicity, economy and high resolution, which makes it an ideal tool for the assistant diagnosis of pelvic floor myofascial pain and evaluation after treatment. This is a retrospective case-control study including women accepting evaluation of pelvic floor function at 6 weeks to 1 year postpartum. They were divided into pelvic floor myofascial pain group and normal control group. A BCL 10-5 biplane transducer was applied to observed their puborectalis. The length, minimum width, area, deficiency, deficiency length, deficiency width, deficiency area, rate of deficiency area, local thickening,angle between the tendinous arch of levator ani muscle and puborectalis of corresponding puborectalis in different groups were observed and measured. A total of 220 postpartum women participated in the study, with 77 in the pelvic floor myofascial pain group and 143 in the normal control group. The Intraclass correlation coefficient value was over 0.750, and Kappa ranged from 0.600 to 0.800. puborectalis deficiency (adjusted odds ratio = 11.625, 95% confidence interval = 4.557-29.658) and focal thickening (adjusted odds ratio = 16.891, 95% confidence interval = 1.819-156.805) were significantly associated with higher odds of having postpartum pelvic floor myofascial pain. Grayscale or the angle between the arch tendineus levator ani and puborectalis measurements on the pain side tended to be smaller than on the non-pain side in patients with unilateral puborectalis or iliococcygeus pain (P < 0.05). This study demonstrated that transvaginal ultrasound was a potentially efficient technique for evaluating postpartum pelvic floor myofascial pain due to its ability to assess various sonographic characteristics of the levator ani muscles.

The test-retest reliability of non-navigated transcranial magnetic stimulation (TMS) measures of corticospinal pathway excitability early after stroke

Purpose Motor evoked potential (MEP) characteristics are potential biomarkers of whether rehabilitation interventions drive motor recovery after stroke. The test-retest reliability of Transcranial Magnetic Stimulation (TMS) measurements in sub-acute stroke remains unclear. This study aims to determine the test-retest reliability of upper limb MEP measures elicited by non-neuronavigated transcranial magnetic stimulation in sub-acute-stroke. Methods In two identical data collection sessions, 1–3 days apart, TMS measures assessed: motor threshold (MT), amplitude, latency (MEP-L), silent period (SP), recruitment curve slope in the biceps brachii (BB), extensor carpi radialis (ECR), and abductor pollicis brevis (APB) muscles of paretic and non-paretic upper limbs. Test-retest reliability was calculated using the intra-class correlation coefficient (ICC) and 95% confidence intervals (CI). Acceptable reliability was set at a lower 95% CI of 0.70 or above. The limits of agreement (LOA) and smallest detectable change (SDC) were calculated. Results 30 participants with sub-acute stroke were included (av 36 days post stroke) reliability was variable between poor to good for the different MEP characteristics. The SDC values differed across muscles and MEP characteristics in both paretic and less paretic limbs. Conclusions The present findings indicate there is limited evidence for acceptable test-retest reliability of non-navigated TMS outcomes when using the appropriate 95% CI for ICC, SDC and LOA values. Clinical Trial Registration Current Controlled Trials: ISCRT 19090862, http://www.controlled-trials.com

Reliability and validity of the Turkish version of the Physical Activity Barrier Scale for people who are blind or visually impaired

Purpose: The aim of this study was to investigate the validity and reliability of the Turkish version of the Physical Activity Barrier Scale (PABS) for visually impaired individuals. Methods: People with visually impaired, low vision (n=53) and blind people (n=84), a total of 137, were participated in the present study. The physical activity barriers of the participants were evaluated with the PABS. The International Physical Activity Questionnaire (IPAQ-Long Form) was used to determine the physical activity level of the participants. Internal consistency was determined by using Cronbach’s alpha and test-retest reliability was determined by using the intra-class correlation coefficient (ICC). Results: The mean age of the participants was 43.03±13.75 years and the mean body mass index was 26.11±4.77 kg/m 2 . Cronbach’s alpha for the PABS was 0.933 for the test and 0.894 for the re-test measurements. The test-retest ICC values of the PABS varied between 0.563 and 0.950. The mean physical activity level of the participants was found as 4049.43±4956.59 METXminutes/week. There was no statistically significant correlation between the total scores of the PABS and the IPAQ (p&amp;gt;0.05). Conclusion: There is currently no specific questionnaire regarding physical activity and its barriers for visually impaired individuals in Turkey. The study showed the reliability of the Turkish version of the PABS for individuals with visual impairment.

The reliability and concurrent validity of goniometric and visual estimation in participants with unilateral shoulder pain

IntroductionThe Constant-Murley Score (CMS) uses universal goniometry (UG), and the Shoulder Functional Reach Score (SFRS) uses visual estimation (VE). The CMS has validity challenges, and the SFRS has been critiqued for using VE. This study sought to determine the reliability and concurrent validity of VE when compared to the UG for shoulder flexion and abduction. Differences between symptomatic and asymptomatic shoulder and expert and novice raters were also explored. MethodsParticipants were included if they were at least 18 years old with unilateral, symptomatic shoulder pain, with no post-surgical contraindications. All conditions were randomized, and raters were blinded. ResultsThe intertester reliability for UG had Intraclass Correlation Coefficient (ICC) values of 0.76–0.91 at visit one. VE had ICC values that ranged from 0.87 to 0.92 at visit one. VE test-retest reliability had ICC values from 0.81 to 0.94. At visit one, concurrent validity was demonstrated by rho values from 0.84 to 0.89. There were statistically significant differences between the shoulders (P ≤ 0.0448), and there were no differences between the raters (P ≥ 0.0960). DiscussionUG and VE of active shoulder flexion and abduction are reliable and concurrently valid. Additionally, there were differences between symptomatic and asymptomatic shoulders, and there were no differences between novice and expert raters. ConclusionThe SFRS may be reliable and valid for measuring shoulder motion using VE within and between treatment sessions. Future research should examine this in larger, more diverse participant populations.

Skeletal muscle architecture and aging: A comparison of ultrasound techniques and an assessment of intrarater reliability.

To assess intrarater reliability of ultrasound-determined measurements of skeletal muscle characteristics across different measurement outcomes, imaging techniques, and age groups. 2D ultrasound images (B-mode) of the quadriceps were obtained from young (26 ± 4 year, n = 8 M, 8 F) and older (70 ± 7 year, n = 7 M, 5 F) adults on two occasions, separated by 6 ± 3 days. With participants in both standing and supine postures, images were collected from five anatomical sites along the anterior (two sites) and lateral (three sites) compartments of the thigh corresponding to 56%, 39%, and 22% (lateral only) of femur length. Images were analysed for muscle thickness, pennation angle, and echogenicity. Intraclass correlation coefficients (ICC) were used to assess reliability. Muscle thickness values were higher (p < 0.05) on images collected in the stand versus supine posture only for muscles of the anterior compartment, independent of age. Echogenicity values were higher (p < 0.05) in the vastus intermedius on images collected in the supine versus stand posture only in older adults. Pennation angle values were not impacted by imaging posture (p > 0.05). ICC values for thickness, echogenicity, and pennation angle were generally higher for analyses conducted on images collected in the supine versus stand posture. Imaging posture generated a greater difference in ICC values in the lateral versus anterior muscles and in older versus younger participants. Our findings suggest that participant posture during imaging impacts the absolute values and intrarater reliability of ultrasound-determined muscle characteristics in a muscle-specific fashion, and this effect is greater in older compared to younger individuals.

Reliability and validity of the new portable Nordic hamstring test device (IVMES H-Bord)

The aim of this study is to determine the reliability and validity of the IVMES H-Bord eccentric hamstring strength measurement device. Thirty-eight healthy male athletes (age: 20.9 ± 2.11 years, height: 1.79 ± 0.03 m, body weight: 76.6 kg, body mass index: 22.6 ± 0.69 kg/m2) participated in this study. Each test protocol was applied in eccentric mode and isometric mode respectively. Between-session test-retest reliability of the IVMES H-Bord was analyzed for the intraclass correlation coefficient (ICC) with 95% coefficient intervals (CI). Validity of the IVMES H-Bord was examined for eccentric mode (NHTecc), and isometric mode (NHTiso) using Pearson’s correlation coefficient with 95% CI and limits of agreement. Bland-Altman plots were also created to provide a representation of the agreement between two test devices. Strong correlations, good ICC values and acceptable typical errors of the estimate were observed between the NHT and isokinetic strength testing (IST) during both limbs with no proportional bias for validity analysis. In conclusion, the “IVMES H-Bord” is a reliable and valid measurement device for eccentric hamstring muscle strength and it provides important advantages for medical staff, fitness coaches and practitioners because it is portable, low cost, and field-based assessment.

Reliability and Validity of the Turkish Translation of the PedsQL™ 3.0 Neuromuscular Module for 2-to 4-Year-Olds in Spinal Muscular Atrophy.

The Pediatric Quality of Life Inventory™ (PedsQL™) Neuromuscular Module (PedsQL™ 3.0 NM) evaluates the health-related quality of life in children who are affected by neuromuscular diseases. This study's aim is to assess the adaptation of the PedsQL™ 3.0 NM Turkish version (PedsQL™ 3.0 NM-TR) for 2- to 4-year-olds in spinal muscular atrophy (SMA). The procedure of translating the PedsQL™ 3.0 NM into Turkish was conducted in accordance with the translation methodology outlined by the PedsQL™ measurement model. The PedsQL™ 3.0 NM-TR was administered to 54 parents of children with SMA aged 2 to 4 years. The test-retest reliability and intraclass correlation coefficient (ICC) were measured for reliability analysis. Cronbach's α coefficient and item score correlations were calculated for internal consistency. Concurrent construct validity was evaluated by Pearson correlations between the outcomes of the PedsQL™ 4.0 Generic Core Scale (PedsQL™ 4.0 GCS) and the PedsQL™ 3.0 NM. The PedsQL™ 3.0 NM-TR total score shows excellent reliability. The Cronbach's α values for the PedsQL™ 3.0 NM ranged between 0.871 and 0.906, while those for the PedsQL™ 4.0 GCS ranged between 0.843 and 0.897. Test-retest ICC values for the PedsQL™ 3.0 NM-TR ranged between 0.812 and 0.917, and for the PedsQL™ 4.0 GCS ranged between 0.773 and 0.899. The relationship between the PedsQL™ 3.0 NM-TR and the subscores of the PedsQL™ 4.0 GCS demonstrated a range of correlations from excellent to fair, indicating the interplay between two scales. This study established the PedsQL™ 3.0 NM-TR as reliable, valid, and feasible for use in children aged 2 to 4 years with SMA.

CHANGES IN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY MEASURES THROUGHOUT THE DAY: Diurnal Variation or Test-Retest Variability?

To evaluate the repeatability and diurnal variation of the retinal vessel density and foveal avascular zone parameters using optical coherence tomography angiography. Forty-one healthy individuals were measured twice in the morning and once in the evening. Foveal avascular zone area, perimetry, foveal density; superficial and deep capillary plexus (superficial capillary plexus, deep capillary plexus) vessel density, and central macular thickness were evaluated with the intraclass correlation coefficient, coefficient of repeatability, and Bland-Altman plots. Repeatability was evaluated with two consecutive scans taken in the morning. The coefficient of repeatabilities (%) was 5.4; 4.3, and 8.8 for the foveal avascular zone area, perimetry, and foveal density, respectively, with excellent intraclass correlation coefficients. Intraclass correlation coefficient was poor for parafovea (0.33), whereas excellent for fovea (0.97) in superficial capillary plexus-vessel density. Coefficient of repeatability for fovea and parafovea was 19.19% and 10.43%, respectively. Intraclass correlation coefficient values were poor (0.3-0.4) with 10% to 16% measurement differences in deep capillary plexus-vessel density parameters. Coefficient of repeatabilities for central macular thickness was between 1% and 2% with excellent intraclass correlation coefficient. The analysis on diurnal variation yielded comparable results. Except for the parafoveal vessel density, optical coherence tomography angiography is a highly reproducible device for measuring foveal avascular zone and vessel density using 6 × 6 scans with undilated pupils. However, variation in optical coherence tomography angiography parameters observed throughout the day could be attributed to test-retest variation rather than diurnal rhythm.