Intraclass Coefficient Values Research Articles

The inter- and intra-rater reliability of the manual diaphragm assessment scale in healthy participants

ObjectiveThe main aim of this study was to test the inter and intra-rater reliability of the Manual Diaphragm Assessment (MED) scale and compared with chest expansion (CE) in healthy participants. MethodsA reliability study, with a sample of 45 healthy participants, composed of 30 women and 15 men. Participants were evaluated by two raters. The MED assesses seven different points on the diaphragm and rates its degree of restriction on a scale of 1–5. Upper and lower CE were measured in centimeters with a measuring tape, which is a valid and reliable method. The intraclass coefficients (ICC) for inter and intra-rater reliability for CE and MED were calculated for mean measurement consistency using a two-way random effects model. ResultsThe intra- and inter-rater reliability of MEDs ranged from low to moderate. The majority of the ICC values in intra-rater reliability were greater than in inter-rater reliability, and the majority of the ICC values in both were higher at the left assessment point. CE inter- and intra-reliability ICC varied from moderate to good. For the upper and lower CE, the inter-rater reliability ICC values were greater than 0.74, and the intra-rater reliability was greater than 0.71. ConclusionThe manual evaluation diaphragm scale had poor to moderate intra and inter-reliability. The chest expansion's intra and inter-reliability ranged from moderate to good, which was consistent with previous studies. Measuring chest expansion with a tape is a reliable method of evaluating the diaphragm in a clinical setting.

Measuring the outcomes of lateral ridge augmentation using cone-beam computed tomography.

Lateral ridge augmentation (LRA) is a surgical technique to gain bone prior to implant placement. Performing cone-beam computed tomography (CBCT) pre- and post-surgery allows for quantitative comparison of the buccal-lingual width and the vertical height of the edentulous ridges. This study used CBCT images to evaluate the bone regeneration following surgery. A total of 30 cases from adult patients who underwent LRA and had high-quality CBCT images taken pre- and post-surgery from the same CBCT scanner were available for the retrospective study. Study data included linear measurements of the bone ridge width and height obtained from the middle of the edentulous ridge and a volumetric measurement of bone growth at the edentulous site observed on the CBCT scan. The reliability of the measurements was excellent as indicated by Intra-Class Coefficient values of 0.974 or higher. There was a significant mean bone increase from pre-surgery compared to post-surgery for both the linear and volumetric measurements. The linear bone gain ranged from 1.5 to 2.5 mm and volumetric gain from 250 to 750 mm3 . However, two patients did not gain any bone. Multivariate regression showed the strongest predictors of bone gain post-surgery were the pre-surgery bone volume and a surgical site being in the mandible. For maxillary surgical sites, particularly anterior areas, the LRA surgeries were the least successful. LRA before implant placement helped to increase bone for the majority of patients, particularly for surgical sites in the mandible. The quantitative analyses in the CBCT images showed excellent intra-examiner agreement.

DEVELOPMENT AND VALIDATION OF A CLINICAL TOOL TO SEMI-AUTOMATIC MEASURE TAR ALIGNMENT AND MIGRATION ON RADIOGRAPHS

Malalignment is often postulated as the main reason for the high failure rate of total ankle replacements (TARs). Only a few studies have been performed to correlate radiographic TAR malalignment to the clinical outcome, but no consistent trends between TAR alignment parameters and the clinical outcome were found. No standard TAR alignment measurement method is present, so reliable comparison between studies is difficult. Standardizing TAR alignment measurements and increasing measurable parameters on radiographs in the clinic might lead to a better insight into the correlation between malalignment and the clinical outcome. This study aims to develop and validate a tool to semi-automatic measure TAR alignment, and to improve alignment measurement on radiographs in the clinic.A tool to semi-automatically measure TAR alignment on anteroposterior and lateral radiographs was developed and used by two observers to measure TAR alignment parameters of ten patients. The Intraclass Coefficient (ICC) was calculated and accuracy was compared to the manual measurement method commonly used in the clinic.The tool showed an accuracy of 76% compared to 71% for the method used during follow-up in the clinic. ICC values were 0.94 (p<0.01) and higher for both inter-and intra-observer reliability.The tool presents an accurate, consistent, and reliable method to measure TAR alignment parameters. Three-dimensional alignment parameters are obtained from two-dimensional radiographs, and as the tool can be applied to any TAR design, it offers a valuable addition in the clinic and for research purposes.

Exploring the Assessment Tool ICO OSCAR. A Comparison of Reliability of Whole of the Operation with Its Parts

Purpose: To compare the reliability of Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR: phaco) between assessment of whole of the operation and its parts. Study Design: Mixed method study design. Place and Duration of Study: Mughal Eye Hospital, Lahore from January 2020 to January 2021. Methods: Three raters assessed six anonymized phaco video operations with the help of ICO OSCAR phaco first as whole operations and then as parts of the operation. Inter rater reliability of the assessments of parts of the operation were compared with inter rater reliability of whole of the operation. Intra class coefficient (ICC) was used in SPSS – version 20. Raters also filled a survey form to detect how satisfied they were with the rubric. Raters’ feedback was taken to describe shortcomings/faults found during the use of ICO OSCAR phaco form. Results: In the quantitative part, the ICC for the combined parts of the operation (0.910) was better than the value of ICC for the whole operation (0.904). In the questionnaire part, raters were satisfied with ICO OSCAR phaco rubric as a useful tool for learning and assessment of phacoemulsification surgical skills. In the qualitative part, many deficiencies were observed by the assessors in the rubric during videos analysis with the rubric ICO OSCAR phaco. This rubric is more accurate for assessment of operations in the operation theater. Conclusion: Parts of the operations can be used instead of the whole operations for the assessment of surgical skills of phacoemulsification with the help of ICO OSCAR phaco rubric. For assessment of videos, it requires some modifications as it is more valid for the assessment of surgical skills during live surgery than in operation theater.

Development and validation of a clinical tool to semi-automatic measure three-dimensional TAR alignment on two-dimensional radiographs

BackgroundMalalignment is often postulated as an important reason for the high failure rate of total ankle replacements (TARs). The correlation between TAR malalignment and clinical outcome, however, is not fully understood. Improving and expanding radiographic TAR alignment measurements in the clinic might lead to a better insight into the correlation between malalignment and the clinical outcome. This study aims to develop and validate a tool to semi-automatic measure TAR alignment, and to improve alignment measurements on radiographs in the clinic.MethodsA tool to semi-automatically measure TAR alignment on anteroposterior and lateral radiographs was developed in MATLAB. Using the principle of edge contouring and the perpendicular relationship between the anteroposterior and lateral radiographs, the exact configuration of the TAR components can be found. Two observers validated the tool by measuring TAR alignment of ten patients using the tool. The Intraclass Coefficient (ICC) was calculated to assess the reliability of the developed method. The results obtained by the tool were compared to clinical results during radiographic follow-up in the past, and the accuracy of both methods was calculated using three-dimensional CT data.ResultsThe tool showed an accuracy of 76% compared to 71% for the method used during follow-up. ICC values were 0.94 (p < 0.01) and higher for both inter-and intra-observer reliability.ConclusionsThe tool presents a reproducible method to measure TAR alignment parameters. Three-dimensional alignment parameters are obtained from two-dimensional radiographs, and as the tool can be applied to most TAR designs, it offers a valuable addition in the clinic and for research purposes.

Measuring resonance frequency of the middle ear in school-aged children: potential applications for detecting middle ear dysfunction

Objective This study established a normative range of resonance frequency (RF) values as estimated using Wideband Tympanometry (WBT) and determined the ability of WBT-estimated RF to predict the presence of middle ear dysfunction in school-aged children. Design Cross-sectional data were collected using a hearing screening test battery consisting of WBT, Pure Tone Screening (PTS), 226- kHz tympanometry, and ipsilateral Acoustic Stapedial Reflexes (ASR). Study sample About 1590 children aged 4–13 years. Results RF significantly decreased from 4 to 13 years of age (4–6 years, 928.95 kHz; 7–9 years, 872.80 kHz; 10–13 years, 863.68 kHz). RF had area under the receiver operating characteristic curve (AROC) values between 0.589 and 0.626 to predict ears that failed PTS or 226- kHz tympanometry. RF below 627 kHz accurately predicted the presence of a Type B tympanogram (AROC 0.945). RF had high test-retest reliability with Intra-Class Coefficient value of 0.817 and good agreement according to Bland-Altman plot analysis. Conclusions WBT-estimated RF had fair diagnostic accuracy for predicting PTS and tympanometry results, but had excellent accuracy for predicting the presence of middle ear dysfunction, indicated by a Type B tympanogram. WBT-estimated RF does not require age-, gender-, ear- or ethnicity-specific normative data for clinical use with children.

Objective Observer vs. Patient Motor State Assessments Using the PD Home Diary in Advanced Parkinson's Disease.

BackgroundThe Parkinson Disease (PD) Home Diary (HD) is a commonly used clinical outcome measure, but it has not been extensively compared to direct assessments by experienced observers.ObjectiveValidation of patient-reported HD by investigating the agreement between motor state assessments by patients and observers.MethodsThis observational study included patients with PD and motor fluctuations. Observers were physicians or research nurses. Patients completed a screening visit, one day of diary ratings at home, and then two days of ratings on-site during which patients and observers simultaneously judged the participants' motor state.ResultsObservers and 40 patients completed 1,288 pairs of half-hourly blinded motor state assessments. There were significant differences between observer and patient ratings (P < 0.001) and the temporal agreement was poor (Cohen's κ = 0.358). The agreement between patient and observer ratings was 71.1% for observed “On without dyskinesia”, 57.3% for observed “Off”, and 49.4% for observed “On with dyskinesia”. Daily times spent in the three motor states as aggregated diary data showed fair to excellent reliability with intraclass coefficient values ranging from 0.45 to 0.52 for “On” and 0.77 for “Off”.ConclusionThere were significant differences between observer and patient ratings. Patients and observers generally agreed on when the patients was in the “On” state (with or without dyskinesia). Patient ratings on the hour level seem to be influenced by other aspects of the patients' experience than the observed motor state, but assessment of daily time spent in the different motor state provides reasonable reliability.

Convergence of patient- and physician-reported outcomes in the French National Registry of Facioscapulohumeral Dystrophy

BackgroundFacioscapulohumeral muscular dystrophy (FSHD) is among the most prevalent muscular dystrophies and currently has no treatment. Clinical and genetic heterogeneity are the main challenges to a full comprehension of the physiopathological mechanism. Improving our knowledge of FSHD is crucial to the development of future therapeutic trials and standards of care. National FSHD registries have been set up to this end. The French National Registry of FSHD combines a clinical evaluation form (CEF) and a self-report questionnaire (SRQ), filled out by a physician with expertise in neuromuscular dystrophies and by the patient, respectively. Aside from favoring recruitment, our strategy was devised to improve data quality. Indeed, the pairwise comparison of data from 281 patients for 39 items allowed for evaluating data accuracy. Kappa or intra-class coefficient (ICC) values were calculated to determine the correlation between answers provided in both the CEF and SRQ.ResultsPatients and physicians agreed on a majority of questions common to the SRQ and CEF (24 out of 39). Demographic, diagnosis- and care-related questions were generally answered consistently by the patient and the medical practitioner (kappa or ICC values of most items in these groups were greater than 0.8). Muscle function-related items, i.e. FSHD-specific signs, showed an overall medium to poor correlation between data provided in the two forms; the distribution of agreements in this section was markedly spread out and ranged from poor to good. In particular, there was very little agreement regarding the assessment of facial motricity and the presence of a winged scapula. However, patients and physicians agreed very well on the Vignos and Brooke scores. The report of symptoms not specific to FSHD showed general poor consistency.ConclusionsPatient and physician answers are largely concordant when addressing quantitative and objective items. Consequently, we updated collection forms by relying more on patient-reported data where appropriate. We hope the revised forms will reduce data collection time while ensuring the same quality standard. With the advent of artificial intelligence and automated decision-making, high-quality and reliable data are critical to develop top-performing algorithms to improve diagnosis, care, and evaluate the efficiency of upcoming treatments.

California Sexually Violent Predator (SVP) Evaluations in the Field: Static-99R and Diagnostic Field Reliability.

Tests and diagnoses used in sexually violent predator (SVP) evaluations must be reliable, as reliability is foundational to validity. The current study contained a stratified sample of evaluations of 395 individuals referred as potential SVPs between 2012 and 2017. Each individual was initially evaluated by at least two experts. The sample included three groups: individuals not meeting SVP criteria (N = 200, or 400 evaluations), individuals meeting SVP criteria (N = 95, with 190 evaluations), and individuals where evaluators disagreed (N = 100, with 200 evaluations). The sample also included 200 subsequent independent evaluations on these "disagree" cases. Static-99R score intraclass coefficient (ICC) interrater reliability was good to excellent within each group and overall. Evaluators scored the Static-99R within one point of each other 87% of the time. Cohen's kappa diagnostic agreement for Pedophilic Disorder was substantial. ASPD and substance abuse kappa were in the "fair" range, while OSPD diagnoses in the positive group were at the "moderate" level of agreement. Ethnic differences in diagnoses were consistent with other studies, with equivalent Static-99R ICC values across ethnic groups. There were no significant differences between state civil servants versus contracted experts in Static-99R ratings or final determinations. The results suggest that Static-99R scores have acceptable reliability in these evaluations, and Pedophilic Disorder (the most common paraphilic disorder in our study) and OSPD can be reliably diagnosed. We discuss limitations of the study, as well as the need for care in high-stakes evaluations given the imperfect reliability of psychological measurements.

CIEL*a*b* values in vita classical and vita 3d master by two dental spectrophotometers.

To compare the CIE L*a*b* values of two different dental shade guides using two shade-matching spectrophotometers. SpectroShade Micro (MHT) and Easyshade (VITA Zahnfabrik) were tested. One calibrated operator performed 30 measurements of each tab from three batches of two guides, VITA Classical (VC) and VITA 3D-Master (VM). Receiver operating characteristic (ROC) curves and intraclass coefficients (ICC) between the different batches were calculated. Results were given as mean and SD of the L*a*b* values and the respective color differences according to the CIEDE 2000 formula (ΔE00) for each of the shade tabs in the two spectrophotometers, then analyzed with independent student t test (α = .05). A total of 1,440 and 2,610 measurements for VC and VM, respectively, were performed per spectrophotometer. There were statistically significant differences between the two devices for all L*a*b* values, with the exception of: L* for 3R1.5; a* for 2R1.5, 3L1.5, 2L2.5, 3M2, 3L2.5, 4L1.5, and 4L2.5; and b* for D3, 1M2, and 3M2. When assessing the same shade guide, differences in ΔE00 were detected between devices above the acceptability threshold (ΔE00 ≥ 1.8) for all shade tabs except for VC (C1, C2, D3, A3.5, C3, and A4) and VM (4M1, 3R2.5, 4L2.5, and 4M3). The overall mean of the inter-device ΔE00 was 2.2 ± 1.0 for VC and 2.5 ± 1.0 for VM. The two dental spectrophotometers presented high ICC and ROC values, which validates their indication as auxiliary tools. However, there are discrepancies in the hues D (VC) and R (VM) with interdevice variability when evaluated for the L*a*b* component.

To evaluate the disk position of the temporomandibular joint using calcium suppressed spectral-based CT images in the patients with temporomandibular disorder

Objective: To evaluate the application of calcium suppressed (CaSupp) spectral CT technique in evaluating disk position and measuring the thickness of the posterior band of temporomandibular joint (TMJ). Methods: The twenty-three temporomandibular disorder patients [mean age 23(12~62) years, male/female=14/9] were performed with oblique sagittal and coronal proton density weighted imaging (PDWI) and spectral CT scans from February to July, 2019 in Department of Radiology, Hainan Hospital of General Hospital of Chinese PLA, and 45 TMJ joints were evaluated. The subjects were classified into two groups according to the scanning modalities: MRI measurement group and CaSupp spectral-based CT group. The CaSupp technique were applied with the spectral-based CT images and CaSupp images were generated. The oblique sagittal and coronal CaSupp imaged were reformatted by perpendicular to the long axis of the condyle. The TMJ disk positions were evaluated on oblique sagittal and coronal images, and the maximal disk thickness were measured on the oblique sagittal images. Results: The joint position was basically consistent on MRI and CaSupp images for the 45 TMJ joints. The intra-class coefficient value was 0.843 (0.712, 0.914) for the measurement of the posterior band of the TMJ disk between MRI and CaSupp images. Bland-Altman presented that the [95.6% (43/45)] points with the difference located in the 95% agreement interval. Wilcoxon paired text demonstrated that there was no significant different for the thickness of the posterior band between MRI [2.57 (1.76, 3.65) mm] and CaSupp images [2.67 (1.74, 4.56) mm] (P=0.07). Conclusions: The CaSupp spectral-based CT could be used to evaluated the TMJ disk position and the thickness of the posterior band.

Accuracy in Detecting Artificial Root Resorption in Panoramic Radiography versus Tomosynthetic Panoramic Radiographs

IntroductionThe aim of this study was to compare the detection accuracy of panoramic radiography (PAN) and tomosynthetically reconstructed panoramic radiography (TPAN) for the detection of artificial external root resorption in a multiobserver approach. MethodsThirty-six teeth in 5 dry human mandibles were prepared with artificial root resorption by means of diamond bur defects (0.8, 1.0, and 1.2 mm). The samples were exposed in a digital panoramic radiographic unit in a predetermined appropriate position using a wax layer (6.25 mm thickness) as soft tissue scatter equivalent and a water-filled plastic bottle to mimic the absorption of the cervical spine. This resulted in 5 panoramic radiographs and 5 tomosynthetically reconstructed panoramic radiographs, which were evaluated by 13 observers regarding the visibility of artificial root resorption by means of a 5-point confidence scale. Seven of these observers repeated the process after a minimum interval of 30 days. A receiver operating characteristic analysis was conducted with the area beneath the receiver operating characteristic curves (Az) as the main accuracy parameter. Inter- and intrarater reproducibility were calculated by means of the intraclass coefficient using a 2-way random effects model. ResultsThe mean Az for TPAN (0.76; median = 0.77; range, 0.70–0.85) was slightly yet significantly higher (P < .05, Wilcoxon test) than for PAN (0.75; median = 0.75; range, 0.69–0.82). The Az values for both methods were highest in the premolar and lowest in the molar region. The mean sensitivity for TPAN was 0.54 (specificity = 0.96) and 0.50 (specificity = 0.96) for PAN. Intraclass coefficient values indicated that intra- (PAN: mean = 0.53 ± 0.088; TPAN: mean = 0.55 ± 0.102; P < .05,Wilcoxon test) and interrater (PAN: mean = 0.47 [0.43–0.51], TPAN: mean = 0.47 [0.42–0.51]) reproducibility were both moderate. ConclusionsFrom our ex vivo study, we observed slightly higher accuracy in the detection of artificial root resorption from tomosynthetically reconstructed panoramic radiographs compared with conventional digital panoramic radiographs.

Intra-rater reproducibility of shear wave elastography in the evaluation of facial skin.

IntroductionRecently, esthetic medicine has been gaining its momentum worldwide, mostly due to the development of minimally invasive techniques. In our opinion, elastography can be a candidate for an objective quantitative method to evaluate facial skin condition. The aim of this study was to determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment.AimTo determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment.Material and methodsThe study included 57 women between 40 and 67 years of age (mean: 51.5 ±7.3 years). Prior to the laser treatment, all participants were subjected to ultrasonographic examination and elastography of the skin. Upon visualization of the area of interest, the thickness of the dermis, subcutaneous tissue and superficial muscular aponeurotic system (SMAS) in millimeters was measured. Then, SWE was performed.ResultsNo statistically significant differences were found in intraclass coefficient values (ICC) for elastographic parameters of the skin on the right and left side of the face (0.953 ±0.001 vs. 0.953 ±0.001, p = 0.992). Moreover, no significant differences were observed in the ICC values for the SWE parameters of various skin layers: dermis, subcutaneous tissue and SMAS (0.945 ±0.001 vs. 0.953 ±.001 vs. 0.961 ±0.001, p = 0.597). Women with normal body weight and overweight did not differ significantly in terms of their elastographic parameters of facial skin.ConclusionsShear wave elastography is a reliable method for the evaluation of facial skin elasticity, providing highly reproducible results in all patients, regardless of their age and body weight.

Exploring the validation of a Japanese version of the International Hip Outcome Tool 12: Reliability, validity, and responsiveness

BackgroundsThe International Hip Outcome Tool 12 (iHOT12) was authorized by the Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN). iHOT12 is increasingly being adopted in orthopedic studies to report patient outcomes. This study aimed to develop a Japanese version of the International Hip Outcome Tools “iHOT12J”, and to establish its reliability, validity, and responsiveness. MethodsTo assess test-retest reliability, an identical set of patients reported outcome measures with five qualitative scoring measures including iHOT12; these were filled out by each patient twice. Reliability was explored using Cronbachss alpha and intraclass correlation coefficient. The Bland–Altman plot was used to explore the absolute agreement. To evaluate validity, we examined the relationships between SF36 and iHOT12. Responsiveness was assessed by comparing the smallest detectable change to the minimal important change by applying an anchor-based approach. ResultsFifty patients (51 joints) were analyzed from March 2016 to October 2017 in Japanese four facility. The Cronbach α coefficient was 0.90 and the average value of intraclass coefficient (ICC) was 0.89. Bland–Altman plot analysis showed a solid agreement. Regarding the validity, the Spearman rank correlation coefficients were strong with PF (r = 0.69, p < 0.01), BP (r = 0.71, p < 0.01) and PCS (r = 0.69, p < 0.01). The smallest detectable change (3.19) was smaller than the minimum important change (12.40). ConclusionsWe developed iHOT12J, which seems to show sufficient reliability, validity, and responsiveness. We believe that this patient reported outcome measure is beneficial in studying Japanese patients with femoroacetabular impingement.

MRI Classification of subtalar and talonavicular joint osteoarthritis

Category: Hindfoot Introduction/Purpose: The sublatar joint is formed by the articulation of the talus and the calcaneus. The Calcaneus had three facets; posterior, middle and anterior that articulate with the talus. The anterior facet is also continuous with the Talonavicular joint. Plain radiography of the foot and ankle is the usual method to detect degeneration in these joints, however plain films do not permit full characterisation of non-ossified structures, such as articular cartilage, marrow tissue and synovial fluid. MRI is a better way to detect these changes. The aim of this study was to develop a quantitative way to score arthritic changes to the subtalar and talonavicular joints using MRI that was usable, repeatable and reliable. Methods: The MRI scans of thirty consecutive subjects with foot and ankle pain were retrospectively evaluated. MRI images were obtained using 1.5-T MRI. Images were interpreted independently by three musculoskeletal radiologists. In order to determine intra-observer reliability as well as the inter-observer reliability two of the readers independently scored the studies twice, more than 14 days apart. Five features of osteoarthritis were scored in the Subtalar joint and the Talonavicular joint. These were; cartilage morphology, subarticular marrow, subarticular cyst, marginal osteophytes and synovitis. The Subtalar joint was scored in eight different regions and Talonavicular joint in two The maximum score for both regions was 100. Scores were summarised and Inter- and Intra-observer agreement was calculated. Intraclass coefficient values less than 0.40 were poor, fair between 0.40 and 0.59 were fair, values between 0.60 and 0.74 were good, and values between 0.75 and 1 excellent. Results: For the 30 MRI scans the mean score for the Subtalar joint ranged from 11.7 to 14.4 and for the Talonavicular joint ranged from 3.7 to 5.6. The inter-observer correlation for the Subtalar joint between the three readers ranged between 0.53 and 0.83 for the individual features but overall was excellent at 0.76. For the Talonavicular joint the total correlation was good at 0.67. The inter-observer ICC for the total score was 0.75 which showed excellent agreement between the three readers. The total intra-observer correlation was excellent. Conclusion: We have designed a novel scoring system subtalar and talonavicular arthritis that is easy to perform and demonstrates excellent reliability and may be an extremely useful tool for clinical trials on ankle arthritis and other studies to diagnose and monitor disease progression.

Profiling Shoulder Strength in Competitive Surfers.

The shoulder region has the highest incidence of acute injuries in the sport of surfing. Little is known about the strength profile at the shoulder in a surfing cohort. The primary aim of this study was to establish the reliability of a rotator cuff strength testing procedure for surfers with a secondary aim of providing a profile of internal and external rotation strength in a competitive surfing cohort. Shoulder internal rotation and external rotation isometric strength was measured using a hand-held dynamometer in 13 competitive surfers. Intra-class coefficient values ranged from 0.97 to 0.98 for intra-rater reliability and were lower for inter-rater reliability ranging from 0.80 to 0.91. Internal rotation strength was greater than external rotation strength bilaterally (dominant, p = 0.007, non-dominant, p < 0.001). No differences (p < 0.79) were found in internal rotation strength between the dominant and non-dominant arms. External rotation strength was weaker on the non-dominant arm compared with the dominant arm (p < 0.02). The non-dominant arm external rotation to internal rotation ratio (0.82 ± 0.15) was lower (p = 0.025) than the dominant arm (0.88 ± 0.14). The current procedure is reliable with the same clinician, and results indicate musculature asymmetry specific to the external rotators.

Reproducibility of the measurements taken with swept source optical coherence tomography

PurposeTo evaluate the measurements reproducibility of the macular area and of the retinal nerve fiber layer (RNFL) taken with different protocols with swept source optical coherence toography (SS‐OCT) Triton.Methods108 eyes from 108 healthy subjects were included whose macular thickness and RFNL thickness were analyzed by SS‐OCT Triton (Topcon, Japan). To study the reproducibility of the device, three measurements were taken followed by different protocols: 3D (H) + 5LineCross and 3D Macular (H) protocols (macular thickness) and 3D Disc protocol (RNFL and optic nerve morphometric values). The coefficients of variation (COV) and intraclass coefficients (ICC) were calculated.ResultsA high reproducibility was obtained with mean COV by type of protocol used of 8.31 ± 13.54% to 1 ± 1, 6% being the less reproducible protocol for the measurement of RNFL 8.31 ± 13.54%. The macular area data in all ETDRS quadrants (11.6% to 37%) were more accurate than those of RNFL (2% macular vs 8% RNFL). The ICC of the optic nerve morphometric values presented a range of 0.91 to 0.53, being the vertical diameter disk value the less accurate. The ICC values of the total macular thickness were the most accurate (0.963 to 0.839). Little variability was observed in the RNFL thickness (ICC 0.946 to 0.750).ConclusionsThere is a high reproducibility of the protocols performed with Triton OCT. The total value of the RNFL protocol is much more variable than the macular protocols, being the temporal quadrants less reproducible than the nasal ones. These results could influence negatively in the evaluation of patients with neurodenegerative diseases where the most affected area is the temporal one.

Reproducibility and Validity of the 6-Minute Walk Test Using the Gait Real-Time Analysis Interactive Lab in Patients with COPD and Healthy Elderly.

BackgroundThe 6-minute walk test (6MWT) in a regular hallway is commonly used to assess functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, treadmill walking might provide additional advantages over overground walking, especially if virtual reality and self-paced treadmill walking are combined. Therefore, this study aimed to assess the reproducibility and validity of the 6MWT using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly.Methodology/ResultsSixty-one patients with COPD and 48 healthy elderly performed two 6MWTs on the GRAIL. Patients performed two overground 6MWTs and healthy elderly performed one overground test. Differences between consecutive 6MWTs and the test conditions (GRAIL vs. overground) were analysed. Patients walked further in the second overground test (24.8 m, 95% CI 15.2–34.4 m, p<0.001) and in the second GRAIL test (26.8 m, 95% CI 13.9–39.6 m). Healthy elderly improved their second GRAIL test (49.6 m, 95% CI 37.0–62.3 m). The GRAIL 6MWT was reproducible (intra-class coefficients = 0.65–0.80). The best GRAIL 6-minute walk distance (6MWD) in patients was shorter than the best overground 6MWD (-27.3 ± 49.1 m, p<0.001). Healthy elderly walked further on the GRAIL than in the overground condition (23.6 ± 41.4 m, p<0.001). Validity of the GRAIL 6MWT was assessed and intra-class coefficient values ranging from 0.74–0.77 were found.ConclusionThe GRAIL is a promising system to assess the 6MWD in patients with COPD and healthy elderly. The GRAIL 6MWD seems to be more comparable to the 6MWDs assessed overground than previous studies on treadmills have reported. Furthermore, good construct validity and reproducibility were established in assessing the 6MWD using the GRAIL in patients with COPD and healthy elderly.

Comparison of accelerometry stride time calculation methods

Inertial sensors such as accelerometers and gyroscopes can provide a multitude of information on running gait. Running parameters such as stride time and ground contact time can all be identified within tibial accelerometry data. Within this, stride time is a popular parameter of interest, possibly due to its role in running economy. However, there are multiple methods utilised to derive stride time from tibial accelerometry data, some of which may offer complications when implemented on larger data files. Therefore, the purpose of this study was to compare previously utilised methods of stride time derivation to an original proposed method, utilising medio-lateral tibial acceleration data filtered at 2Hz, allowing for greater efficiency in stride time output. Tibial accelerometry data from six participants training for a half marathon were utilised. One right leg run was randomly selected for each participant, in which five consecutive running stride times were calculated. Four calculation methods were employed to derive stride time. A repeated measures analysis of variance (ANOVA) identified no significant difference in stride time between stride time calculation methods (p=1.00), whilst intra-class coefficient values (all >0.95) and coefficient of variance values (all <1.5%) indicate good reliability. Results indicate that the proposed method possibly offers a simplified technique for stride time output during running gait analysis. This method may be less influenced by “double peak” error and minor fluctuations within the data, allowing for accurate and efficient automated data output in both real time and post processing.

Telemetry-derived heart rate variability responses to a physical stressor.

To assess the validity and reliability of telemetry-derived HRV responses to an orthostatic challenge. Twenty healthy adults (26+5years, 45% male) were tested on three separate mornings. Following 20-min supine rest, R-R intervals were recorded using a telemetric device during three conditions: BASE, TILT and RECOVERY. ECG was simultaneously used on 1day for validity comparison. Measures of HRV included the following: standard deviation of normal-to-normal intervals (SDNN), the root-mean-square of successive differences (RMSSD) and the low-frequency (LF) and high-frequency (HF) spectral power. For all parameters, there was excellent agreement between devices for BASE (r=0·96-0·99), TILT (r=0·89-1·00) and RECOVERY (r=0·96-1·00). For the telemetric device, between-day intraclass coefficient values for RMSDD, SDNN and HF were all above the 0·75 criterion for each condition, indicating excellent between-day reliability. For each condition, the reliability coefficient, expressed as a percentage of the mean (RC%), was marginally lower (greater reliability) for RMSDD (RC% 11-13) and SDNN (RC% 10-12) compared to HF (RC% 12-17). However, SDNN did not significantly respond to the orthostatic challenge. Telemetric HRV, particularly RMSDD and HF, can be used to provide a sensitive, valid and reliable assessment of autonomic control of heart rate.