Standard Error Of Measurement Research Articles

Evaluation of Reliability of Dynamic Scapholunate Distance Measured on 4D CT-Acquired Images

Abstract Purpose A technique to measure scapholunate distance based on four-dimensional computed tomography (4D CT)-acquired images is presented. Methods Intra-observer variability was evaluated through a repeated-measures study. A 4D CT of seven patients suspected of scapholunate lesion was performed. Anatomical landmarks were identified on a three-dimensional reconstructed model of the wrist. All 4D CT datasets were evaluated thrice by two observers. Standard deviation of the differences between two measurements, interclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. Results Intra-observer variability for the expert observer (ICC > 0.95) was lower than that of the novice observer (ICC > 0.77) and interobserver variability was low (ICC > 0.85). For the expert observer, measurement error (SEM < 0.13 mm and MDC < 0.36 mm) was smaller than that of the novice observer (SEM < 0.45 mm and MDC < 1.24 mm). Both SEM and MDC values were low, compared to the scan resolution and the absolute value of intervals. Conclusion The proposed assessment results in a reproducible and reliable measurement of scapholunate distance.

Validity and reliability of the modified four square step test in total HIP arthroplasty

IntroductionThe Modified Four Square Step Test (mFSST) evaluates dynamic stabilization by using tape instead of canes to prevent people from tripping over obstacles and losing their balance. There was no study investigating reliability and validity in primary total hip arthroplasty (THA). This study aimed to evaluate the test-retest reliability, concurrent validity, and minimum detectable change in the mFSST for individuals with primary THA. MethodThis study was cross-sectional in design. A total of 29 individuals aged 56.86 ± 10.14 years participated. The study used the test-retest method to determine the reliability of the mFSST and concurrent validity. The Timed Up and Go Test (TUGT) and Berg Balance Scale (BBS) were applied for concurrent validity. The minimum detectable change (MDC95) and the standard error measurement (SEM) were calculated. ResultsThe mFSST showed excellent intra-rater reliability (ICC = 0.925). The SEM and MDC95 of the mFSST were 1.56 and 4.32. The test had a strong correlation with TUGT (r = 0.881) and BBS (r = −0.718) (p < 0.001). ConclusionThe mFSST is a valid and reliable assessment tool that can be used for individuals with primary THA.

Reliability of Corticospinal and Motoneuronal Excitability Evaluation during Unfatiguing and Fatiguing Cycling Exercise.

Central nervous system excitability depends on the task performed, muscle group solicited, and contraction type. However, little is known on corticospinal and motoneuronal excitability measured during locomotor exercise. This study aimed at determining the reliability of motor-evoked potentials (MEP) and thoracic motor-evoked potentials (TMEP) in dynamic mode during unfatiguing and fatiguing cycling exercise. Twenty-two participants completed four visits. Visit 1 comprised familiarization and an incremental cycling test to determine maximal power output ( Wmax ). The remaining visits encompassed unfatiguing evaluations, which included a total of eight brief bouts of moderate- (50% Wmax ) and high-intensity cycling (80% Wmax ), four at each intensity. In each bout, a set of two TMEPs, five MEPs, and one M-max were obtained. Subsequently, a fatiguing exercise to exhaustion at 80% Wmax was performed, with four sets of measurements 3 min through the exercise and four additional sets at exhaustion, both measured at 50% Wmax . Intraclass correlation coefficients (ICCs) for 5, 10, 15, and 20 MEP·Mmax -1 revealed excellent reliability at both intensities and during cycling to exhaustion (ICC ≥0.92). TMEP·Mmax -1 showed ICCs ≥0.82 for moderate and high intensity, and it was not affected by fatigability. Overall standard error of measurement was 0.090 (0.083, 0.097) for MEP·Mmax -1 and 0.114 (0.105, 0.125) for TMEP·Mmax -1 . A systematic bias associated with the number of stimulations, especially at high intensity, suggested that the evaluation itself may be influenced by fatigability. A mean reduction of 8% was detected in TMEP·Mmax -1 at exhaustion. Motoneuronal and corticospinal excitability measured in dynamic mode presented good to excellent reliability in unfatiguing and fatiguing exercise. Further studies inducing greater fatigability must be conducted to assess the sensitivity of central nervous system excitability during cycling.

Cross-cultural validity of the Dutch sleep-related breathing disorder scale of the Pediatric Sleep Questionnaire in a general population

BackgroundPediatric sleep-disordered breathing is associated with multiple health problems. Polysomnography is the reference standard for identifying this disorder, but availability is limited. Therefore, an alternative screening tool is needed. Globally, the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ) has proven to be a feasible tool. Consequently, this study aimed to translate and culturally adapt the PSQ into Dutch and then to examine the cultural validity, internal consistency, and test-retest reliability of the Dutch version among a general population visiting oral healthcare centers. MethodsThe translation, review, adaptation, pretest, and documentation approach was used to ensure cross-cultural adaptation of the PSQ. Then, 220 children (2.4–18 years) were sampled for clinimetric evaluation. We estimated the cross-cultural validity by comparing the factor analyses of the original PSQ and the Dutch version. Reliability was assessed using Cronbach's alpha, Spearman's correlation, the intraclass correlation coefficient, the standard error of measurement, and a Bland-Altman plot. ResultsThe factor loading patterns of the Dutch version matched with the original study around the four predetermined factors: breathing, sleepiness, behavior, and other. The internal consistency, with a Cronbach's α of 0.77, was acceptable. The test-retest reliability with an intraclass correlation coefficient and Spearman's correlation of 0.89 and 0.93, respectively, was good to excellent. ConclusionsCultural adaptation was ensured and the results support cross-cultural validity, internal consistency, and test-retest reliability of the Dutch Sleep-Related Breathing Disorder scale of the PSQ. This questionnaire could therefore be a valuable tool for screening disordered breathing in Dutch children.

Physical performance tests have excellent reliability in frail and non-frail patients with prostate cancer

Purpose Our aim was to investigate the test-retest reliability of the 2-min walk test (2MWT), timed up and go test (TUG), and five times sit-to-stand test (FTSST) in prostate cancer (PC) patients. Methods This study was conducted with 73 patients who were classified into two groups as frail and non-frail determined by the Geriatric-8 questionnaire. Patients performed the 2MWT, TUG, and FTSST tests for two times. The test-retest reliability of the 2MWT, TUG, and FTSST was assessed by calculating the intraclass correlation coefficient (ICC). The standard error of measurement (SEM95) and minimal detectable change (MDC95) values were calculated. Results All tests showed excellent test-retest reliability for both groups (ICC(2.1) > 0.90). The SEM95 and MDC95 values of 2MWT were 3.09, 8.57, and 3.15 m, 8.73 m for frail and non-frail groups. The SEM95 and MDC95 values of TUG for the frail group were 0.6 and 1.66 and 0.43 and 1.19 for the non-frail group, respectively. The SEM95 and MDC95 values of FTST for the frail group were 0.68 and 1.88 and for the non-frail group 0.86 and 2.38. Conclusions The 2MWT, TUG, and FTSST showed excellent reliability in frail and non-frail older adults with PC which can be used to assess physical performance.

Psychometric Evaluation of the Bahasa Malaysia Version of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients with Breast Cancer-Related Lymphedema.

Background: Breast cancer-related lymphedema (BCRL) is the most prevalent comorbidity that occurs following breast cancer treatments and has negative impact on the patients' quality of life (QoL). The Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL) is a valid and reliable instrument in assessing the QoL of patients with BCRL. However, the Bahasa Malaysia (BM) version is not available yet. This study aimed to translate the Lymph-ICF-UL into BM and to evaluate its validity and reliability. Methods and Results: A forward-backward translation was performed based on Sousa's guideline, and then, the face, content, construct validity, internal consistency, and test-retest reliability were tested. Face validity was assessed by five patients, and content validity was evaluated by six experts. Then, construct validity and internal validity were assessed in 107 patients. Finally, test-retest reliability was analyzed in 21 patients. Two items were eliminated following suggestions from the patients and experts. All patients found the scoring system and items clear and relevant. The results showed sufficient content validity index and modified kappa statistics value. Confirmatory factor analysis showed acceptable fit indices. Cronbach's alpha values ranged from 0.67 to 0.95, intraclass correlation coefficient ranged from 0.88 to 0.99, standard error measurement was 2.29-6.15, and the Bland-Altman plot showed an agreement between two test occasions. Conclusion: These results suggested that the Lymph-ICF-UL BM has good validity and reliability in evaluating the QoL of patients with BCRL in Malaysia.

Measures of acromiohumeral distance with wireless ultrasound machine in subacromial impingement syndrome: an inter-machine reliability study

Aim: Shoulder pain is the third most prevalent musculoskeletal condition that impairs function. Subacromial impingement syndrome is among the most typical causes of shoulder pain. The aim of this study was to evaluate inter-machine reliability of acromiohumeral distance measurements performed with standard ultrasound and wireless ultrasound devices in patients with subacromial impingement syndrome. Material and methods: A total of 61 participants diagnosed with subacromial impingement syndrome were included. Acromiohumeral distance was measured with wireless and standard ultrasound devices in a neutral position and at 60-degree abduction, respectively. The inter-machine intraclass correlation coefficient, standard error of measurements, and minimum detectable changes were calculated. Results: Inter-machine reliability measured in the neutral position was excellent (ICC = 0.97, 95% CI = 0.95–0.98); the standard error of measurement was 0.23 mm, and the minimum detectable change was 0.63 mm. Inter-machine reliability measured at 60 degrees abduction was excellent as well (ICC = 0.96; 95% CI; 0.93–0.97). The standard error of measurements was 0.20 mm, and the minimum detectable change was 0.55 mm. The mean difference between the two machines was 0.04 mm for the neutral position and 0.02 mm for the 60-degree abduction position. Conclusions: The study showed that wireless ultrasound devices were similar to standard ultrasound devices in measuring the acromiohumeral distance in patients with subacromial impingement syndrome. The findings could contribute to a significant improvement in the clinical use of wireless ultrasound devices.

Self-assessment using 30-second chair stand test for patients with knee osteoarthritis – an intra- and inter-rater reliability study

Background We aimed to evaluate the intra-rater reliability in 30-second chair stand test (30CST) as a self-test, and the inter-rater reliability comparing a self-test with a physiotherapist-assessed 30CST for patients with knee osteoarthritis (KOA). The second purpose was to evaluate the classification ability of the 30CST as self-test to distinguish between reduced physical function and normal function. Methods Patients with KOA performed two self-tests of 30CST at home and thereafter a physiotherapist assessed the patient. Absolute agreements were presented with intraclass correlation coefficient (ICC), 95% confidence interval (CI) and standard error of measurement (SEM). Post-hoc analyses were conducted to calculate minimal detectable change (MDC). The classification ability was analysed with receiver operating characteristic (ROC)-curves and area under the ROC-curve (AUC). The significance level was p < 0.05. Results In total, 114 followed the protocol. Intra-rater and inter-rater reliability were good (ICC 0.97, CI 0.95–0.99, SEM 0.89 and ICC 0.81, CI 0.72–0.87, SEM 2.29 respectively). MDC were 2.5 stands when comparing self-test results individually and 0.23 on a group level. The MDC between self-tests and physiotherapist assessment were 6.4 stands for individual comparison and 0.59 for group comparison. The self-test was 80% likely to detect reduced physical function compared to a physiotherapist assessing physical function with 30CST (AUC = 0.79–0.80). Conclusions The results indicate that 30CST can be a reliable self-assessment of physical function in lower extremities for patients with KOA. These findings can be useful in areas such as self-screening for reduced physical function, self-assessment in digital physiotherapy, and as measurement in research projects.

Investigating the internal structure of multiple mini interviews-A perspective from Pakistan.

Healthcare professionals require many personal attributes in addition to cognitive abilities and psychomotor skills for competent practice. Multiple Mini- Interviews are being employed globally to assess personality attributes of candidates for selection in health professions education at all level of entry; these attributes are namely, communication skills, critical thinking, honesty, responsibility, health advocacy, empathy and sanctity of life. Considering the high stakes involved for students, faculty, institutions and the society, rigorous quality assurance mechanisms similar to those used for student assessment must be employed for student selection, throughout the continuum of medical education. It is a difficult undertaking as these psychological constructs are difficult to define and measure. Though considered to yield reliable and valid scores, studies providing multiple evidences of internal structure especially dimensionality of Multiple Mini-Interviews are sparse giving rise to questions if they are measuring a single or multiple constructs and even if they are measuring what they are purported to be measuring. The main objective is to provide statistical support of the multi-dimensional nature of our Multiple Mini Interviews, hypothesized a-priori, through CFA. Another objective is to provide multiple evidences for the internal structure. Our study highlights the link between content and internal structure evidences of the constructs, thus establishing that our Multiple Mini Interviews measure what they were intended to measure. After securing permission from the Institutional review board, an a-priori seven factor-model was hypothesized based on the attributes considered most essential for the graduating student of the institution. After operationally defining the attributes through extensive literature search, scenarios were constructed to assess them. A 5-point rating scale was used to rate each item on the station. A total 259 students participated in the multiple mini interviews over a period of three days. A training workshop had been arranged for the participating faculty. The reliability coefficient using Cronbach's alpha were calculated (range from 0.73 to 0.94), Standard Error of Measurement (ranged from 0.80 to1.64), and item to station-total correlation ranged from 0.43-0.50 to 0.75-0.83. Inter-station correlation was also determined. Confirmatory factor analysis endorsed the results of Exploratory factor analysis in the study revealing a seven model fit with multiple indices of Goodness-of-fit statistics such as Root mean square error of approximation (RMSEA) value 0.05, Standardized root mean square residual (SRMR) value with less than 0.08. All these indices showed that model fit is good. The Confirmatory factor analysis confirmed the multi-dimensional nature of our MMIs and also confirmed that our stations measured the attributes that they were supposed to measure. This study adds to the validity evidence of Multiple Mini-Interviews, in selection of candidates, with required personality traits for healthcare profession. It provides the evidence for the multi-dimensional structure of Multiple Mini interviews administered with multiple evidences for its internal structure and demonstrates the independence of different constructs being measured.

Shear wave elastography for assessing the anterior scalene elasticity in patients with neck pain

PurposeShear-wave elastography (SWE) provides quantitative and absolute metrics for analyzing the elasticity of soft tissues. Despite the anterior scalene muscle (AS) is a key structure in patients with neck pain and nerve compressive syndromes, the majority of SWE studies only included asymptomatic subjects. This study aimed to analyze the Young’s modulus and shear wave speed test–retest reliability in a sample of patients with neck pain symptoms to characterize the AS stiffness. MethodsA diagnostic accuracy study acquiring a set of ultrasound images at C7 level in 42 patients with mechanical neck pain by one experienced examiner. After blinding the participants’ identity, trial and side, the Young’s modulus and shear wave velocity were measured by an independent experienced rater in randomized order. Intra-class correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. ResultsThe sample reported moderate pain intensity (5.9/10 points) and disability (17.38/100 points). AS stiffness metrics assessed showed no significant differences between males and females, left and right side nor painful and non-painful side. (all, p > 0.05). Intra-examiner reliability was excellent for calculating the Young’s modulus for shear wave speed (ICC > 0.90). ConclusionThe results support the use of this procedure for assessing the AS stiffness in populations with mechanical neck pain as excellent reliability estimates were obtained. However, future research should analyze case-control differences and the association between SWE metrics with clinical severity indicators.

Test-Retest Reliability of a Bilingual Arabic-English Pittsburgh Sleep Quality Index among Adolescents and Young Adults with Good or Poor Sleep Quality

Abstract Introduction The Pittsburg Sleep Quality Index (PSQI) is widely used in different population groups to assess self-reported sleep quality over the previous month. As the Arabic language is spoken by more than 400 million people, the PSQI has been translated into Arabic for its optimal application to Arabic-speaking individuals. However, the test-retest reliability of the Arabic version of the PSQI has not been reported yet. Objective To examine the reliability and agreement of a bilingual Arabic-English version of the PSQI (AE-PSQI) among bilingual Arabic-English-speaking adolescents and young adults of the United Arab Emirates (UAE) with good or poor sleep quality. Materials and Methods We included 50 bilingual Arabic-English-speaking adolescents and young adults (mean age of 20.82 ± 2.7 years; 30/50 subjects classified as poor sleepers [PSQI &gt; 5] at baseline) who filled put the AE-PSQI twice, 7 days apart. The internal consistency of the AE-PSQI was assessed through the Cronbach's alpha. The intraclass correlation coefficient (ICC[3,1]) was used to assess the test-retest reliability. The standard error of measurement (SEM), the smallest real difference (SRD), and the Bland-Altman plots were used to report agreement measures. Results The global score on the AE-PQSI showed an acceptable level of internal consistency with a Cronbach's alpha value of 0.65, and no floor and ceiling effects were observed. The 95% confidence intervals (95%CI: 0.63-0.87) of the ICC(3,1) revealed moderate to strong reliability estimates for overall AE-PSQI scores. The SEM and SRD were of 1.6 and 4.5 respectively, and the Bland-Altman plots revealed a moderate agreement between the baseline and retest global AE-PQSI scores. Conclusion The AE-PSQI is a reliable instrument to assess sleep quality in bilingual Arabic-English-speaking adolescents and young adults with good or poor sleep quality. Further studies on the validity and responsiveness of the AE-PSQI are warranted in individuals with and without sleep disorders.

The Development and Evaluation of the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ) in Spanish Women.

Practitioners have begun using motor imagery (MI) for preventing and treating some pelvic floor disorders. Due to requirements for imagining before performing a MI intervention and because there are few instruments available for assessing this specific ability in the pelvic floor musculature, we sought to develop and test a new MI questionnaire, the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ). We focused in this study on the development and analysis of the instrument's factorial structure and internal reliability in a participant sample of 162 healthy Spanish women (M age = 20.1, SD = 2.2 years). We developed and evaluated the KMI-PFQ's psychometric properties, finding it to have good internal consistency, with Cronbach's α = .838, ω coefficient = .839, and an intraclass correlation coefficient = .809, with two factors ("ability" and "mental effort") explaining 58.36% of response variance. The standard error of measurement was 3.58, and the minimal detectable change was 9.92. No floor or ceiling effects were identified. There was also good convergent validity as seen by statistically significant positive correlations between KMI-PFQ scores and the revised-Movement Image Questionnaire and Vividness of Visual Imagery Questionnaire. There were no statistically significant correlations between KMI-PFQ scores and the Orientation to Life Questionnaire. The KMI-PFQ is a valid and reliable instrument for measuring kinesthetic ability to feel/imagine pelvic floor muscle contractions in healthy Spanish women.

Reliability of Voluntary Response Index Analysis Using Surface Electromyography in Professional Football Players

Background: Surface electromyography (sEMG) represents a widely utilized technique in medical research. The voluntary response index (VRI) introduces a novel method for analyzing the motor control of voluntary movements via sEMG. This study aimed to assess the reliability of VRI and breakpoint angles (BPA) among professional football players during the Nordic Hamstring test (NHT). Methods: This study included 24 healthy professional football players. Through the use of sEMG, two aspects of VRI [magnitude (MAG) and similarity index (SI)] were evaluated during the NHT. Additionally, BPAs were determined by capturing slow-motion videos of functional tasks. The test-retest reliability across three trials was determined using the intra-class correlation coefficient (ICC). Results: The reliability of the VRI components during the NHT was found to be excellent. The ICC for MAG was 0.9 and 0.81 for the SI. Breakpoint angles exhibited moderate reliability (ICC = 0.65) during a functional task. The SI displayed a lower standard error of measurement (SEM = 0.07). The MAG’s SEM was 0.25, while BPA’s SEM was 17.8. Conclusions: The analysis of the VRI via sEMG showed nearly perfect reliability in professional football players during the NHT, a functional task. Breakpoint angles demonstrated significant reliability. The findings of this study indicate that both VRI and BPA are reliable methods for estimating motor control during dynamic movement tasks in professional athletes.

Reliability of a New Digital Tool for Photographic Analysis in Quantifying Body Asymmetry in Scoliosis.

Background: Advancements in non-ionizing methods for quantifying spinal deformities are crucial for assessing and monitoring scoliosis. In this study, we analyzed the observer variability of a newly developed digital tool for quantifying body asymmetry from clinical photographs. Methods: Prospective observational multicenter study. Initially, a digital tool was developed using image analysis software, calculating quantitative measures of body asymmetry. This tool was integrated into an online platform that exports data to a database. The tool calculated 10 parameters, including angles (shoulder height, axilla height, waist height, right and left waistline angles, and their difference) and surfaces of the left and right hemitrunks (shoulders, waists, pelvises, and total). Subsequently, an online training course on the tool was conducted for twelve observers not involved in its development (six research coordinators and six spine surgeons). Finally, 15 standardized back photographs of adolescent idiopathic scoliosis patients were selected from a multicenter image bank, representing various clinical scenarios (different age, gender, curve type, BMI, and pre- and postoperative images). The 12 observers measured the photographs at two different times with a three-week interval. For the second round, the images were randomly mixed. Inter- and intra-observer variabilities of the measurements were analyzed using intraclass correlation coefficients (ICCs), and reliability was measured by the standard error of measurement (SEM). Group comparisons were made using Student's t-test. Results: The mean inter-observer ICC for the ten measurements was 0.981, the mean intra-observer ICC was 0.937, and SEM was 0.3-1.3°. The parameter with the strongest inter- and intra-observer validity was the difference in waistline angles 0.994 and 0.974, respectively, while the highest variability was found with the waist height angle 0.963 and 0.845, respectively. No test-retest differences (p > 0.05) were observed between researchers (0.948 ± 0.04) and surgeons (0.925 ± 0.05). Conclusion: We developed a new digital tool integrated into an online platform demonstrating excellent reliability and inter- and intra-observer variabilities for quantifying body asymmetry in scoliosis patients from a simple clinical photograph. The method could be used for assessing and monitoring scoliosis and body asymmetry without radiation.

Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study

Background and objectiveThe need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis.MethodsThis study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined.ResultsIn the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively.ConclusionThe results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.

Reliability and measurement error of a maximal voluntary toe plantarflexion measurement process

Despite the growing interest, information regarding the psychometric properties of maximal voluntary isometric toe plantarflexion force and rate of force development (RFD) is lacking. Hence, we investigate the test-retest reliability and measurement error of these outcome measurement instruments measured with a custom-built dynamometer. Twenty-six healthy adults participated in a crossed design with four sessions separated by 5–7 days. RFD was quantified using manual onset and calculating the impulse and the slope in the following time windows: 0–50 ms, 0–100 ms, 0–150 ms, 0–200 ms, 0–250 ms. We estimated the systematic bias of the mean, the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) from the agreement and consistency models. The ICC and the SEM agreement for maximal voluntary isometric toe plantarflexion force along the perpendicular axis were respectively 0.87 (95%CI: 0.76, 0.93) and 27 N (22, 32), while along the resultant of the perpendicular and anterior posterior axis they were 0.85 (0.73, 0.92) and 29 N (23, 35). The results of the consistency model were similar as the estimated variance for session was closer to zero. A systematic bias of the mean between session 1 and 3 was found. For the RFD variables, the ICC agreement ranged from 0.35 to 0.65. The measurement process was found to be reliable to assess maximal voluntary isometric toe plantarflexion force but not RFD. However, a familiarization session is mandatory and these results need to be confirmed in less coordinated (e.g. aging population) individuals.

Connor-Davidson Resilience Scale: a systematic review psychometrics properties using the COSMIN.

Psychometrical evaluation of persons of diverse contexts and different populations, including general or clinical. This review study aimed to evaluate the psychometrics quality of resilience scales. International and Iranian databases were searched with MESH terms, including "psychometric", "validity", "reliability", "Connor-Davidson resilience scale", "Resilience scale", for published articles up to 1 February 2023. For each of the selected studies, the risk of bias was evaluated using the COSMIN Risk of Bias Checklist. Then the COSMIN checklist was used to evaluate the entire text of the article for methodological quality. Considering the inclusion criteria, 80 documents were evaluated. According to the COSMIN's criteria for evaluating the risk of bias, the current study findings revealed the included studies' limitations in assessing the three versions of CD-RISC cross-cultural and content validity as well as their stability (e.g. conducting test re-test), whereas the majority of psychometric studies of CD-RISC-25, and CD-RISC-2 rated as very good or adequate in terms of structural validity. In terms of quality assessment of the included studies, the current study indicated that investigating the structural validity of the CD-RISC was mainly done based on exploratory factor analysis (EFA), and confirmatory factor analysis was absent. The general result indicates the acceptability of the quality of the studies. However, concerns for measurement properties such as responsiveness and criterion validity as well as the standard error of measurement have been neglected.

Psychometric properties of the Disability of Arm Shoulder and Hand (DASH) in subjects with frozen shoulder: a reliability and validity study

BackgroundFrozen Shoulder (FS) is a painful condition characterized by severe pain and progressive restriction of shoulder movement, leading to functional impairment and reduced quality of life. While different Patient Reported Outcome Measurements (PROMs) tools exist for assessing shoulder diseases, few specific PROMs are validated for FS patients.PurposeThis study aims to assess the psychometric properties of the Disability of Arm, Shoulder, and Hand (DASH) questionnaire in FS patients.MethodsOne hundred and twenty-four subjects (mean ± SD age = 55.4 ± 7.9 years; 55.6% female) diagnosed with FS were included and completed the DASH questionnaire, the Numerical Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), and the Short-Form Health Survey 36 (SF-36). Floor or ceiling effects were investigated. Structural validity was analysed through a unidimensional Confirmatory Factor Analysis (CFA), internal consistency through Cronbach’s alpha, test-retest reliability through the Intraclass Correlation coefficient (ICC), measurement error through the Standard Error of Measurement (SEM), and the Minimum Detectable Change (MDC), and construct validity through the hypothesis testing with the correlation with the other outcome measures used.ResultsNo floor or ceiling effects were observed. CFA confirmed a one-factor structure after addressing local item dependency (Root Mean Square Error of Approximation = 0.055; Standardized Root Mean Square Residual = 0.077; Comparative Fit Index = 0.970; Tucker-Lewis Index = 0.968). Cronbach’s alpha was high (= 0.951), and test-retest reliability was excellent (ICC = 0.999; 95% CI: 0.998-1.000). SEM was equal to 0.5 points, and MDC to 1.5 points. Construct validity was considered satisfactory as 80% of the a-priori hypotheses were met.ConclusionThe DASH questionnaire demonstrated good psychometric properties in FS patients, supporting its use as a valuable tool for assessing the impact of FS in clinical and research settings.

Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults

Introduction: Physical fitness is strongly associated with daily physical function, health, and longevity in older adults. Field-based tests may provide a reasonable alternative compared to advanced laboratory testing. Separating postexercise test scores from reactivity measurements requires sufficient test-retest reliability. Postexercise test scores with reliability analyses of field-based fitness tests in older adults are lacking. The present study aimed to examine the test-retest reliability of some novel easily accommodated fitness test measurements and compare pretest scores with postexercise results in these tests along with other field-based fitness tests in older adults. Methods: Totally 1,407 community-dwelling older adults (69% female), x̄ = 71.5 ± 5.0 (65–84 years), performed twelve field-based fitness tests at pretest 1, pretest 2 and a posttest after an 8-week exercise period (twice weekly 1 h of combined strength and aerobic training). T tests, intra-class correlation, limits of agreement, standard error of measurement, and coefficient of variance were performed between pre-1 and pre-2 tests, and repeated measures ANOVA and partial eta squared effect size for postexercise differences for men and women in 5-year age groups ranging from 65 to 84 years. Results: Between pre-1 and pre-2 tests a significant difference was noted in some of the novel fitness test measurements but generally not, e.g., in isometric trunk flexion and step-up height on either leg among all sex and age groups. In most of these novel fitness test measurements, no significant differences occurred between the two pretests. Examples of results from the pre-2 test to the posttest were isometric trunk flexion 45° endurance and isometric trunk extension endurance improved significantly for both sexes in age groups 65–74 years. Women, but not men, improved the maximal step-up height for both legs in most age groups. The speed in the 50 sit-to-stand improved significantly for most age groups in both sexes. Six-min walk distance improved significantly for most age groups in women but among men only in 65–69 years. In the timed-up-and-go test, significant improvements were seen for all age groups in women and in men 70–79 years. No postexercise improvements were generally observed for grip strength or balance. Conclusions: In most of the novel fitness test measures, no significant difference was noted between the two pretests in the assessed sex and age groups. Results after the 8-week exercise period varied between sex and age groups, with significant improvements in several of the twelve studied fitness tests. These findings may be valuable for future projects utilizing easily accommodated physical fitness tests in older adults.

The Reliability of the Rehabilitative Ultrasound Imaging Method for Assessing Pelvic Floor Muscles Function in Pregnant Women

Background: To our knowledge, there is scant research on the use of rehabilitative ultrasound imaging (RUSI) method for evaluating bladder base displacement in pregnant women. The RUSI is a non-invasive and simple method that assesses the function of pelvic floor muscles (PFM) based on the movement of the bladder base. Objectives: This study aims to assess the reliability of the RUSI for the assessment of PFM function in pregnant women during voluntary muscle contractions. Materials &amp; Methods: In this cross-sectional study, 18 pregnant women with different gestational ages participated. The amount of bladder base displacement during PFM contraction was assessed in all women and considered an indicator of PFM function. The test re-test reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plot. The percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were also calculated. Results: The mean amount of bladder base displacement during PFM contraction at time points 1 and 2 was 4.89±1.43 and 4.81±1.41, respectively. The ICC was 0.989 (95% CI, 0.969%, 0.996%), which indicates excellent reliability. The Bland-Altman plot showed that all the points were within the 95% limits of agreement with no considerable trend or bias. The SEM% and MDC% were 3.09% and 8.41%, respectively. Conclusion: The intra-rater reliability of the RUSI to assess PFM function in pregnant women is high, and can be useful for further studies on the PFMs in pregnant women.