Standard Error Of Measurement Research Articles

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 a maximal incremental test to determine maximal power output (Wmax). The remaining visits encompassed unfatiguing evaluations, which included 8 brief bouts of moderate (50% Wmax) and high intensity cycling (80% Wmax). 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 4 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 fatiguing exercise (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 to the number of stimulations, especially at high intensity, suggested 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.

Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home.

Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measureof perceived self-care ability (PSCA) in stroke patients. A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020-2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.

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.

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.

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 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.

Connor-davidson resilience scale: A systematic review psychometrics properties using the COSMIN

Background: Psychometrical evaluation of persons of diverse contexts, and different populations, including general or clinical. Objective: This review study aimed to evaluate the psychometrics quality of resilience scales. Methods: International and Iranian databases were searched with MESH terms included “psychometric”, “validity”, “reliability”, “Connor-Davidson resilience scale”, “Resilience scale”, for published articles up to February 1, 2023. For each of the selected studies, 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. Results: 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-RISC25, 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 EFA (Exploratory Factor Analysis), and confirmatory factor analysis was absent. Conclusion: 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 post-exercise scores from a physical fitness test battery in older adults.

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 post-exercise test-scores from reactivity measurements requires sufficient test-retest reliability. Post-exercise 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 pre-test scores with post-exercise results in these tests along with other field-based fitness tests in older adults. Totally 1,407 community-dwelling-older-adults (69%-female), x̄=71.5±5.0 (65-84 years), performed twelve field-based-fitness-tests at pre-test-1, pre-test-2 and a post-test after an 8-week-exercise-period (twice weekly 1 hour 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 post-exercise differences, for men and women in five-year age groups ranging from 65 to 84 years. 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 pre-tests. Examples of results from the pre-2-test to the post-test 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 post-exercise improvements were generally observed for grip-strength or balance. In most of the novel fitness-test measures no significant difference was noted between the two pre-tests 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.

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 on 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 27.07N (22.08, 32.43), while along the resultant of the perpendicular and anterior posterior axis they were 0.85 (0.73, 0.92) and 29N (23, 35). The results of the consistency model were similar as the estimated variance for session was closer to zero. A systematic bias on 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.

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.

Defining tibial anterior muscle morphology in first-ever chronic stroke patients using three-dimensional freehand ultrasound

ABSTRACT Background Drop foot is common post-stroke, elevating fall risks and mobility limitations. It is caused by weakness and lack of control of the tibialis anterior muscle (TA), for which various rehabilitation treatments are used. A reliable objective estimate of changes in TA muscle morphology and composition can enhance treatment optimization. Objectives We aimed to ascertain 3D freehand ultrasound (3DfUS) reliability in measuring TA muscle volume, length, and echo intensity in stroke patients and healthy controls and its validity by comparing these features across legs, between patients and controls, and between clinical subgroups (i.e. patients with and without ankle contracture, spastic muscle overactivity, and foot dorsiflexor paresis). Methods We included 9 stroke patients and 9 healthy controls to define reliability and 26 stroke patients and 28 healthy controls to define validity. For reliability, data were collected and processed by 2 different operators and processors. For inter- and intra-rater reliability, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used. For validity, Wilcoxon-Signed-Ranked and Mann-Whitney U tests were used for comparisons between groups and subgroups. Results All measurements showed good to excellent inter- and intra-rater reliability (ICC: 0.816 to 0.997, SEM: 0.5% to 7.8%). Comparison analyses revealed no differences in muscle features among legs, groups, or subgroups. Conclusion While the 3DfUS is a reliable method to define TA morphology and composition, its clinical validity needs further investigation into factors influencing muscle property changes across various age groups and post-stroke time points. MeSH terms Stroke; Skeletal muscle morphology; muscle composition; 3D freehand ultrasonography, Anterior Tibial Muscle

The Sprint Mechanics Assessment Score: A Qualitative Screening Tool for the In-field Assessment of Sprint Running Mechanics.

Qualitative movement screening tools provide a practical method of assessing mechanical patterns associated with potential injury development. Biomechanics play a role in hamstring strain injury and are recommended as a consideration within injury screening and rehabilitation programs. However, no methods are available for the in-field assessment of sprint running mechanics associated with hamstring strain injuries. To investigate the intra- and interrater reliability of a novel screening tool assessing in-field sprint running mechanics titled the Sprint Mechanics Assessment Score (S-MAS) and present normative S-MAS data to facilitate the interpretation of performance standards for future assessment uses. Cohort study (diagnosis); Level of evidence, 3. Maximal sprint running trials (35 m) were recorded from 136 elite soccer players using a slow-motion camera. All videos were scored using the S-MAS by a single assessor. Videos from 36 players (18 men and 18 women) were rated by 2 independent assessors blinded to each other's results to establish interrater reliability. One assessor scored all videos in a randomized order 1 week later to establish intrarater reliability. Intraclass correlation coefficients (ICCs) based on single measures using a 2-way mixed-effects model, with absolute agreement with 95% CI and kappa coefficients with percentage agreements, were used to assess the reliability of the overall score and individual score items, respectively. T-scores were calculated from the means and standard deviations of the male and female groups to present normative data values. The Mann-Whitney U test and the Wilcoxon signed-rank test were used to assess between-sex differences and between-limb differences, respectively. The S-MAS showed good intrarater (ICC, 0.828 [95% CI, 0.688-0.908]) and interrater (ICC, 0.799 [95% CI, 0.642-0.892]) reliability, with a standard error of measurement of 1 point. Kappa coefficients for individual score items demonstrated moderate to substantial intra- and interrater agreement for most parameters, with percentage agreements ranging from 75% to 88.8% for intrarater and 66.6% to 88.8% for interrater reliability. No significant sex differences were observed for overall scores, with mean values of 4.2 and 3.8 for men and women, respectively (P = .27). The S-MAS is a new tool developed for assessing sprint running mechanics associated with lower limb injuries in male and female soccer players. The reliable and easy-to-use nature of the S-MAS means that this method can be integrated into practice, potentially aiding future injury screening and research looking to identify athletes who may demonstrate mechanical patterns potentially associated with hamstring strain injuries.

Concurrent Validity and Reliability of Video-Based Approach to Assess Physical Function in Adults with Knee Osteoarthritis.

The aim of this study was to determine the concurrent validity and reliability of the Osteoarthritis Research Society International recommended performance-based tests delivered by video-based in adults with knee osteoarthritis. Thirty-two participants (aged 40 to 70 years; 15 men) undertook assessments of 4 performance-based tests via both video-based (real-time and recorded) and face-to-face approaches, on the same day. Outcome measures were performance-based test and the number of technical issues encountered. The performance-based tests included the 40-Meter Fast-Paced Walk Test (velocity, m/s), the 30-Second Chair Stand Test (number of repetitions), the Stair Climb Test (time, seconds), and the Timed "Up & Go" Test (TUG; time, seconds). The Bland-Altman limit of agreement measures, standard error of measurement (SEM), coefficient of variation (CV), minimal detectable changes (MDCs), and bias (mean difference) were employed to analyse the concurrent validity between video-based and face-to-face approaches of the performance-based tests. Reliability was measured using intraclass correlation coefficients (ICC), CV, and SEM. A high degree of concurrent validity for the TUG (bias = -0.22), the 30-Second Chair Stand Test (bias = -0.22), the Stair Climb Test (bias = -0.31), and the 40-Meter Fast-Paced Walk Test (bias = -0.06) was found. SEM and CV values were within the acceptable level for concurrent validity. There was a high degree of reliability demonstrated for all tests analysed. ICC measures ranged from 0.95 to 1.00 for intrarater reliability, and from 0.95 to 0.99 for interrater reliability. Video-based assessment of physical performance tests is a valid and reliable tool for measuring physical function among adults with knee osteoarthritis via Microsoft Teams (Microsoft Corp, Redmond, WA, USA). Video-based assessment is a promising public health tool to measure physical function in adults with knee osteoarthritis.

The Reliability of 44-Item Big Five Personality Inventory (Malay Version) to Measure Readiness to Breastfeed

The 44-item Big Five Personality Inventory (BFI-44) helps in simplify a wide range of complex personality features, including how personality affects breastfeeding. The aim of this study was to examine the reliability of the Malay version of the BFI-44. A cross-sectional study was conducted using the convenience sampling of female respondents. A total of 96 female public university students participated in this study. Cronbach’s alpha, intraclass correlation coefficient, limit of agreement, and standard error of measurement (SEM) were used in determining the reliability of the questionnaire. Cronbach’s alpha value for Extraversion subscale obtained the highest internal consistency (0.723) and the lowest internal consistency was obtained in the subscale of Openness to Experience (0.543). The intraclass correlation coefficient (ICC) value for all dimensions exceeded 0.70 (ICC= 0.792-0.883). The Bland-Altman plots showed high reliability in all dimensions except Neuroticism. For SEM, Extraversion scored the lowest (0.773) while Neuroticism scored the highest (1.199). Overall, the BFI-44 in Malay version had moderate to good internal consistency and igh test-retest reliability. These findings may give positive implications for the implementation of the questionnaire in future evaluation of Malaysians’ personality traits

Long-Acting and Permanent Family Planning Methods Attitude Scale: The Instrument Development and Cross-Sectional Validation Study.

Background and Purpose: This study aims to develop and validate a tool to measure women's attitudes toward long-acting and permanent family planning methods (LAPMs). Methods: Participants were 500 women of childbearing age who were 18 years of age or older and voluntarily agreed to participate in the study. The study was carried out in two phases: instrument development and psychometric testing. After a comprehensive literature review, 30 preitems of the scale were created. Item analysis was performed using adjusted item-total correlations. Factor analyses were performed to confirm construct validity. Cronbach's alpha, standard error of measurement, and intraclass correlation coefficient (ICC) were used to assess reliability. Results: The analyses revealed that the eight-item, three-factor structure had acceptable fit values. The Cronbach's alpha value of the scale was found to be .73. The ICC value was .997. Conclusions: The scale is a valid and reliable tool used to assess women's attitudes toward LAPMs.