Standard Error Of The Measurement Research Articles

Greek Cross-Cultural Adaptation, Reliability, and Validity of the Quick Foot and Ankle Ability Measure Questionnaire.

An easy-to-administer, function-based questionnaire to assess patients with various foot problems was required for a Greek-speaking population. This study aimed to translate and cross-culturally adapt the Quick Foot and Ankle Ability Measure (Quick-FAAM) into Greek and evaluate its reliability and validity. Cross-sectional study. Established international guidelines for the cross-cultural adaptation of questionnaires were followed. The face and content validity of the Greek version of the Quick-FAAM (Quick-FAAM-GR), as well as the internal consistency and test-retest reliability upon repeated administration after 5days, were examined. In addition, the construct validity of the scale was examined via exploratory factor analysis as well as by testing for associations with the Manchester Foot Pain and Disability Index, the 12-item Short-Form Survey (version 2), and a functional balance assessment test-the Y-Balance Test. Sixty participants (18 women) with self-reported chronic ankle instability symptoms, with a median (interquartile range) age of 27 (7.7) years, participated in the study. Half of the participants were included in the test-retest reliability study. The Quick-FAAM-GR demonstrated face and content validity. Excellent internal consistency (Cronbach α = .961) and intrarater test-retest reliability (intraclass correlation coefficient ICC[2,1] = .93) were demonstrated, with a comparable error margin to the original version (standard error of the measurement = 2.1, 95% minimum detectable change = 5.9). Associations of the Quick-FAAM-GR scores to other questionnaires ranged from weak to strong (Spearman rho), all being statistically significant (Manchester Foot Pain and Disability Index from -.26, P = .04, to -.67, P < .001, and 12-item Short-Form Survey, version 2, between .41 and .72, P < .001), and to the Y-Balance Test between lower-limb differences (-.35 to -.58, P < .001). The exploratory factor analysis confirmed the single-factor structure of this scale. No floor/ceiling effects were observed. The Greek Quick-FAAM has proven to be a valid and reliable tool for evaluating chronic ankle instability and can be used for clinical and research purposes in Greek-speaking individuals.

Face validity and reliability test of the Danish version of the compliance questionnaire rheumatology in patients with early rheumatoid arthritis

BackgroundSupporting adherence to medication is an essential part of the treatment and care of patients with rheumatic and musculoskeletal diseases. The Compliance Questionnaire Rheumatology (CQR) measures adherence in rheumatic diseases through 19 items covering drug-taking behaviour to identify the reasons for adhering to treatment and the factors that contribute to suboptimal adherence. The objective of this study was to present the translation of the CQR into Danish and the face validity and reliability test.MethodsThe CQR was translated into Danish according to international guidelines, followed by a face validity test among 10 patients with rheumatoid arthritis in 2009. The test–retest reliability of the Danish CQR was evaluated in 49 patients with rheumatoid arthritis in 2020 - 2021 using the standard error of the measurement (SEM) converted into the minimally detectable change (MDC) and the intraclass correlation coefficient (ICC). Questionnaires were administered with a minimum of 10 days between assessments.ResultsThe participants in the reliability test had a mean age of 57.4 years (SD 16.1) and a mean disease duration of 1.13 years (range 2 months–2 years). The mean CQR score in the test and retest was 62.7 (confidence interval (CI) 58.8; 66.6) and 62.5 (CI 58.9; 66.1), respectively, with a SEM of 8.59 (7.16; 10.73) and an MDC of 16.83. A satisfactory test–retest reliability was confirmed by an ICC value of 0.79 (CI 0.68; 0.89).ConclusionThe Danish CQR has satisfactory test–retest reliability in patients newly diagnosed with rheumatoid arthritis and is considered a reliable tool to measure adherence in this group.

Reliability and Validity of Different Lower-Limb Strength Tests to Determine 1RM in the Keiser A300 Leg Press.

Larsen, F, Loturco, I, Sigvaldsen, E, Strand, MF, Kalhovde, JM, and Haugen, T. Reliability and validity of different lower-limb strength tests to determine 1RM in the Keiser A300 leg press. J Strength Cond Res 37(10): 1963-1968, 2023-The aim of this study was to explore the reliability and validity of different lower-limb strength tests to determine the one-repetition maximum (1RM) value in the Keiser A300 leg press. Twenty-eight recreationally active subjects performed load-velocity (L-V) relationship, 1RM, isometric midthigh pull (IMTP), and maximal repetitions to failure (MRF) tests on 3 separated sessions. Predicted 1RMs for the L-V relationship were estimated from a linear regression equation, correlating movement velocity and relative loads. The number of repetitions from the MRF tests (at loads relative to bodyweight) and peak force from the IMTP tests were used in regression equations to predict 1RM. The level of significance was set to ρ ≤ 0.05. All 1RM prediction methods were highly comparable with the traditional 1RM test, as only trivial and nonsignificant differences were observed. Furthermore, the L-V relationship was the most reliable (intraclass correlation coefficient [± 95% confidence interval] = 0.99 [0.98, 0.996]; effect size = -0.01 [-0.38, 0.36], standard error of the measurement = 6.4 kg; coefficient of variation = 3.0 [2.2-3.8]% and valid (r = 0.95 [0.89, 0.98], effect size = 0.08 [-0.29, 0.45], standard error of the estimate = 20.4 kg; coefficient of variation = 7.4 [5.5-9.3]%) when compared with direct 1RM measurements. The L-V relationship test showed a significant change score relationship (r = 0.41 [0.04, 0.68]) against the direct 1RM measurements. In conclusion, the tests used in this study cannot be used interchangeably, but they represent a good alternative in training settings where 1RM testing is not feasible.

Test-retest reliability of joint position sense in the elbow among healthy adults

BackgroundProprioception of the elbow is necessary for daily activities. Proprioception can be impaired with injury or pathology, and rehabilitation efforts seek to improve proprioception for improved upper extremity functioning. In clinical practice, joint position sense (JPS) testing is often utilized to assess conscious proprioception; however, varying methods exist with little evidence of psychometric properties, especially for the elbow. PurposeThe primary aim of this study was to create a standardized elbow JPS test protocol using goniometry measurement to determine the most reliable testing position. The secondary aim was to determine if the elbow JPS test had acceptable test-retest reliability in healthy adults. Study DesignThis was a cross-sectional study using a convenience sample of healthy adults. MethodsThree elbow positions (45°, 60°, and 75° of elbow flexion) were measured twice on the same day by a single rater using a universal goniometer. We calculated the absolute error in degrees between each position and reposition and the intraclass correlation coefficient (3,1) for relative reliability. We also calculated the standard error of the measurement and visually inspected Bland-Altman plots for absolute reliability. ResultsSixty-eight healthy adults (mean age 27.9 years, standard deviation 8.59) were assessed. The mean absolute error for all positions for test and retest was 5.7°. The intraclass correlation coefficients were moderate to good (0.57-0.75), and the standard error of the measurement was 2° (rounded) for all positions. The limits of agreement were moderately narrow, and the Bland-Altman plots showed a random distribution of errors for each position, indicating clinically acceptable measurement error. ConclusionsThe joint position reproduction test for JPS using goniometry demonstrated moderate to good test-retest reliability and acceptable measurement error in healthy adults. The elbow joint angle of 60° flexion was the most reliable for JPS testing, providing insight for JPS assessment in clinical practice.

The reliability and validity of the Norwegian version of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire (VISA-G-Norwegian) for patients with greater trochanteric pain syndrome

BackgroundGreater Trochanteric Pain Syndrome (GTPS) is a common chronic musculoskeletal condition that may affect physical function, quality of life and sleep. The Victorian Institute of Sport Assessment-Gluteal questionnaire (VISA-G) has been developed as a Patient-Reported Outcome Measurement (PROM) to address pain, everyday activities, physical activities, and difficulty with weight bearing activities. The aim of the study was to test the reliability, validity and floor and ceiling effects of the Norwegian version of the VISA-G (VISA-G-Norwegian) in a population with GTPS in a specialist health care setting.MethodsThis psychometric evaluation of the VISA-G-Norwegian questionnaire were conducted with a prospective observational design. The VISA-G was translated into Norwegian following recommended guidelines. A subgroup repeated the VISA-G-Norwegian a week after the initial submission. For the reliability, the Intraclass Correlation Coefficient (ICC2.1), Standard Error of the Measurement (SEM) and the Smallest Detectable Change (SDC95%) were calculated. Internal consistency was measured using a Cronbach´s alpha. Floor and ceiling effects were evaluated, and construct validity was assessed with three a priori hypotheses.Results78 participants were included in the study of which 47 stable participants undertook the test-retest reliability arm of the study. The ICC2.1 for the total score was 0.85 (95% CI 0.68, 0.92), SEM was 6.6 points and SDC95% 18.4 points. Cronbach`s alpha was 0.77 (95% CI 0.69, 0.84). No floor or ceiling effects were found in the total score, but ceiling effect was found in three of the eight items. For construct validity, one of the three hypotheses were confirmed. VISA-G-Norwegian correlated to the modified Harris Hip Score (mHHS), Oswestry Disability Questionnaire (ODI) and Numeric Pain Rating Scale (NPRS), 0.64, -0.75 and − 0.63 respectively.ConclusionThe VISA-G-Norwegian has acceptable reliability and validity, despite ceiling effect of individual items. The large SDC95% should be considered when measuring change in similar cohorts with GTPS. For a potential future version, it would be recommended to consider response options for questions with ceiling effect and the comprehensibility of question eight.Trial registrationRegistered at ClinicalTrials.gov the 28/02/2020 (NCT04289922).

The reliability of clinical tools with and without ultrasound guidance to measure leg-length inequality.

To determine and compare the reliability and efficiency of various methods of leg-length measurement. A total of 88 leg-lengths were measured among 50 subjects (79%-84% female, mean age = 30-33 years). Leg-lengths were measured in both supine and standing positions using multiple devices, including a tape measure, a LASER distance meter, and diagnostic ultrasound. All methods of leg-length measurement using the middle of the femoral head as a reference point, identified via ultrasound, demonstrated excellent reliability (intraclass correlation coefficient = 0.95-1.00). Measurements performed in supine, using the anterior superior iliac spine as a reference point, with a tape measure, demonstrated good-to-excellent reliability (intraclass correlation coefficient = 0.86-0.95, standard error of the measurement = 16.1-19.9 cm). Standing measurements using the anterior superior iliac spine as a reference point, using a tape measure, demonstrated fair-to-excellent reliability (intraclass correlation coefficient = 0.71-0.95). Ultrasound-guided landmark identification appear to be a more reliable method compared to palpation of the anterior superior iliac spine for measurement of leg-length using clinical tools. When coupled with ultrasound guidance, a hand-held LASER distance meter/pitch locator apparatus or a retractable tape measure appears to be acceptable alternatives to a fixed LASER distance meter on a linear actuator for leg-length measurement.

Test-retest reliability of joint position sense in the carpometacarpal joint among healthy adults

BackgroundAccurate proprioception in the thumb carpometacarpal (CMC) joint is necessary during activities such as performing fine manipulative tasks, such as coin handling, opening doors, using keys, and pressing control buttons. PurposeThe primary aim of the present study was to examine the test-retest reliability of CMC joint position sense (JPS) in healthy subjects. The secondary aim was to determine the most reliable JPS testing position for the thumb CMC joint. Study DesignThis was a cross-sectional study of a convenience sample of healthy adults. MethodsThree thumb positions (20°, 30°, and 40° of thumb abduction) were measured twice on the same day by a single rater using a universal goniometer. The absolute error in degrees between each position and reposition was calculated. The intraclass correlation coefficient (2,1) was calculated for relative reliability. The standard error of the measurement was calculated. ResultsSixty-four healthy adults (mean age 27.8 years, standard deviation = 8.7) were assessed. The intraclass correlation coefficients were poor (−0.08 to 0.22), and the standard error of the measurement was 1.4° for all positions. ConclusionsThe joint position reproduction test for JPS using goniometry demonstrated poor test-retest reliability and acceptable measurement error in healthy adults.

Cross-Cultural Adaptation, Reliability, and Validity of the Greek Version of the Fremantle Shoulder Awareness Questionnaire (FreSHAQ-GR) in Patients with Chronic Shoulder Pain.

Shoulder pain is one of the most common musculoskeletal pathologies. The association of shoulder pain with impaired proprioception and bodily self-awareness called for the cross-cultural adaptation of the Fremantle Shoulder Awareness Questionnaire (FreSHAQ) in Greek. The FreSHAQ is a relatively new self-assessment 9-item scale for impaired somatic awareness in patients with shoulder pain. The study included 100 participants (54 women) between 20 and 80 years old, with chronic shoulder pain (>3 months duration), able to comprehend and speak Greek, and recruited from three private physical therapy practices. The cross-cultural adaptation process was followed to develop the Greek version of the questionnaire (FreSHAQ-GR). Further testing for construct validity via exploratory factor analysis and correlational analysis with the Shoulder Pain and Disability Index (SPADI), the Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH), the pain catastrophizing scale (PCS), a pain intensity visual analog scale (PI-VAS) in the last week, and the demographic characteristics followed. Test-retest reliability of the FreSHAQ-GR in a sub-sample of patients (n = 25) was tested upon repeated completion of the scale after a week and examined with the intraclass correlation coefficient (ICC2,1), the standard error of the measurement (SEM), and the minimum detectable change (MDC) indices. The internal consistency of the scale was also assessed. The factor analysis revealed that the scale comprised one factor relevant to shoulder awareness but with fewer items (first 6 items) than the original FreSHAQ. Additionally, the FreSHAQ-GR (both versions) demonstrated statistically significant correlations (Spearman's r) with participants' age (r = -0.31/-0.29, p < 0.002), the PI-VAS (r = 0.54/0.52, p < 0.001), the SPADI total score and both of its subscales (r = 0.39-0.45/0.34-0.39, p < 0.001), the QuickDASH (r = 0.37/0.34, p < 0.001), and the PCS (r = 0.50/0.40, p < 0.001). The questionnaire's internal consistency (Cronbach's α/McDonald's ω) was 0.833/0.827 for the 9-item and 0.871/0.867 for the 6-item FreSHAQ-GR. Test-retest reliability was excellent for both versions of the FreSHAQ-GR (ICC2,1(95% CI) = 0.97/0.98 (0.91-0.99/0.94-0.99), and with a low error margin (SEM = 1.31/0.94 and MDC95% = 3.63/2.61). Therefore, the FreSHAQ-GR (6-item version) possesses very good measurement properties and can be administered to Greek-speaking patients with chronic shoulder pain.

Development and Reliability of a Visual-Cognitive Reactive Triple Hop Test.

Current lower-extremity return to sport testing primarily considers the physical status of an athlete; however, sport participation requires continuous cognitive dual-task engagement. Therefore, the purpose was to develop and evaluate the reliability of a visual-cognitive reactive (VCR) triple hop test that simulates the typical sport demand of combined online visual-cognitive processing and neuromuscular control to improve return to sport testing after lower-extremity injury. Test-retest reliability. Twenty-one healthy college students (11 females, 23.5 [3.7]y, 1.73 [0.12]m, 73.0 [16.8]kg, Tegner Activity Scale 5.5 [1.1] points) participated. Participants performed a single-leg triple hop with and without a VCR dual task. The VCR task incorporated the FitLight system to challenge peripheral response inhibition and central working memory. Maximum hop distance, reaction time, cognitive errors, and physical errors were measured. Two identical testing visits were separated by 12 to 17days (14 [1]d). Traditional triple hop (intraclass correlation coefficients: ICC(3,1) = .96 [.91-.99]; standard error of the measurement = 16.99cm) and the VCR triple hop (intraclass correlation coefficients(3,1) = .92 [.82-.97]; standard error of the measurement = 24.10cm) both demonstrated excellent reliability for the maximum hop distance, and moderate reliability for the VCR triple hop reaction time (intraclass correlation coefficients(3,1) = .62 [.09-.84]; standard error of the measurement = 0.09s). On average, the VCR triple hop resulted in a hop distance deficit of 8.17% (36.4 [5.1]cm; P < .05, d = 0.55) relative to the traditional triple hop. Hop distance on the VCR triple hop had excellent test-retest reliability and induced a significant physical performance deficit when compared with the traditional triple hop assessment. The VCR triple hop reaction time also demonstrated moderate reliability.

Analysis of Individual V˙O2max Responses during a Cardiopulmonary Exercise Test and the Verification Phase in Physically Active Women.

This study aimed to investigate the test-retest reliability, mean, and individual responses in the measurement of maximal oxygen consumption (V˙O2max) during a cardiopulmonary exercise test (CPET) and the verification phase during cycle ergometry in women. Nine women (22 ± 2 yrs, 166.0 ± 4.5 cm, 58.6 ± 7.7 kg) completed a CPET, passively rested for 5 min, and then completed a verification phase at 90% of peak power output to determine the highest V˙O2 from the CPET (V˙O2CPET) and verification phase (V˙O2verification) on 2 separate days. Analyses included a two-way repeated measures ANOVA, intraclass correlation coefficients (ICC2,1), standard errors of the measurement (SEM), minimal differences (MD), and coefficients of variation (CoV). There was no test (test 1 versus test 2) × method (CPET vs. verification phase) interaction (p = 0.896) and no main effect for method (p = 0.459). However, test 1 (39.2 mL·kg-1·min-1) was significantly higher than test 2 (38.3 mL·kg-1·min-1) (p = 0.043). The V˙O2CPET (ICC = 0.984; CoV = 1.98%; SEM = 0.77 mL·kg-1·min-1; MD = 2.14 mL·kg-1·min-1) and V˙O2verification (ICC = 0.964; CoV = 3.30%; SEM = 1.27 mL·kg-1·min-1; MD = 3.52 mL·kg-1·min-1) demonstrated "excellent" reliability. Two subjects demonstrated a test 1 V˙O2CPET that exceeded the test 2 V˙O2CPET, and one subject demonstrated a test 1 V˙O2verification that exceeded the test 2 V˙O2verification by more than the respective CPET and verification phase MD. One subject demonstrated a V˙O2CPET that exceeded the V˙O2verification, and one subject demonstrated a V˙O2verification that exceeded the V˙O2CPET by more than the MD. These results demonstrate the importance of examining the individual responses in the measurement of the V˙O2max and suggest that the MD may be a useful threshold to quantify real individual changes in V˙O2.

Further psychometric validation and test-retest reproducibility of the WOUND-Q.

WOUND-Q is a condition-specific patient-reported outcome measure developed for all types of chronic wounds, located anywhere on the body. To establish reliability and validity of a patient-reported outcome measure, multiple pieces of evidence are required. The purpose of this study was to examine the measurement properties of 9 of the 13 WOUND-Q scales and perform a test-retest reproducibility study in an international sample. In August 2022, we invited members of an international online community (Prolific.com) with any type of chronic wound to complete a survey containing the WOUND-Q scales, the Wound-QoL and EQ-5D. A test-retest survey was performed 7 days after the first survey. It was possible to examine the reliability and validity of eight of the nine WOUND-Q scales by Rasch Measurement Theory (RMT). To examine test-retest reproducibility intraclass correlation coefficients (ICCs), the standard error of the measurement and the smallest detectable change were calculated. In total, 421 patients from 22 different countries with 11 different types of chronic wounds took part in this study. Our analyses provided further evidence of the reliability and validity of the scales measuring wound characteristics (assessment, drainage, smell), health-related quality of life (life impact, psychological, sleep, social) and wound treatment (dressing).

Comparing the reliability of muscle oxygen saturation with common performance and physiological markers across cycling exercise intensity.

Wearable near-infrared spectroscopy (NIRS) measurements of muscle oxygen saturation (SmO2) demonstrated good test-retest reliability at rest. We hypothesized SmO2 measured with the Moxy monitor at the vastus lateralis (VL) would demonstrate good reliability across intensities. For relative reliability, SmO2 will be lower than volume of oxygen consumption (V̇O2) and heart rate (HR), higher than concentration of blood lactate accumulation ([BLa]) and rating of perceived exertion (RPE). We aimed to estimate the reliability of SmO2 and common physiological measures across exercise intensities, as well as to quantify within-participant agreement between sessions. Twenty-one trained cyclists completed two trials of an incremental multi-stage cycling test with 5 min constant workload steps starting at 1.0 watt per kg bodyweight (W·kg-1) and increasing by 0.5 W kg-1 per step, separated by 1 min passive recovery intervals until maximal task tolerance. SmO2, HR, V̇O2, [BLa], and RPE were recorded for each stage. Continuous measures were averaged over the final 60 s of each stage. Relative reliability at the lowest, median, and highest work stages was quantified as intraclass correlation coefficient (ICC). Absolute reliability and within-subject agreement were quantified as standard error of the measurement (SEM) and minimum detectable change (MDC). Comparisons between trials showed no significant differences within each exercise intensity for all outcome variables. ICC for SmO2 was 0.81-0.90 across exercise intensity. ICC for HR, V̇O2, [BLa], and RPE were 0.87-0.92, 0.73-0.97, 0.44-0.74, 0.29-0.70, respectively. SEM (95% CI) for SmO2 was 5 (3-7), 6 (4-9), and 7 (5-10)%, and MDC was 12%, 16%, and 18%. Our results demonstrate good-to-excellent test-retest reliability for SmO2 across intensity during an incremental multi-stage cycling test. V̇O2 and HR had excellent reliability, higher than SmO2. [BLa] and RPE had lower reliability than SmO2. Muscle oxygen saturation measured by wearable NIRS was found to have similar reliability to V̇O2 and HR, and higher than [BLa] and RPE across exercise intensity, suggesting that it is appropriate for everyday use as a non-invasive method of monitoring internal load alongside other metrics.

The gait abnormality index: A summary metric for three-dimensional gait analysis

BackgroundThis paper proposes an easy to calculate and adaptable summary gait metric, the Gait Abnormality Index (GAI), which is capable of simultaneously including kinematic and kinetic data, overcoming a key limitation of existing metrics. Research questionTo determine the validity, reliability and sensitivity of the GAI. MethodsThe GAI is calculated by averaging Gait Abnormality Scores, which are normalised distance metrics used to describe the deviation of pathological gait data from that of healthy controls. Validity was assessed using Pearson’s correlation analysis to explore relationships between the GAI and the Gait Profile Score. Test-retest reliability of the GAI was assessed using intra-class correlation coefficients (ICC) and standard error of the measurement (SEM), and data from total hip arthroplasty patients. An independent samples t-test was used to compare GAI scores between knee osteoarthritis and total hip arthroplasty patients to explore the metrics sensitivity. ResultsA strong positive correlation (r ≥ 0.896; p < 001) was reported between the GAI and the Gait Profile Score. Good test-retest reliability (ICC =0.830) was reported for the GAI. Knee osteoarthritis patients displayed significantly (p = .017; Hedge’s g effect size = 0.98) greater GAI scores compared to total hip arthroplasty patients, with the mean difference (0.34 a.u) above the SEM (0.15 a.u). SignificanceThe GAI offers an easy to calculate summary metric for three-dimensional gait analysis, which displays good validity and reliability, and is sensitive to different pathological conditions.

Evaluation of inter-rater and test-retest reliability for near-infrared spectroscopy reactive hyperemia measures.

Near-infrared spectroscopy (NIRS) is a non-invasive tool used to measure blood flow in peripheral tissues. More information on inter-rater agreement and test-retest reliability of NIRS-based reperfusion assessments is needed. To assess inter-rater agreement for NIRS based data analysis, and evaluate the measurement's reliability across days. On three separate days (average days between visits 1 and 3: 19.4±6.9days), participants' (N=15 males, 22±2yr.) post-occlusion reactive hyperemia (PORH) was measured in the left gastrocnemius muscle using Continuous-Wave NIRS (CW-NIRS). A blood pressure cuff was placed proximal to the knee and inflated to occlude lower leg blood flow for 5min. The following CW-NIRS parameters were selected: (1) percent saturation in HbO2 (StO2%) at baseline; (2) the O2Hb range used to normalize the NIRS signal; (3) the time for the O2Hb signal to reach 50% peak post-occlusion hyperemia (T1/2), and (4) the post peak hyperemic O2Hb recovery slope (O2REC-SLP). Absolute agreement between the two analysts was calculated using two-way random effects Intraclass Correlation Coefficients (ICC2,1). Consistency between analysts and across days was calculated using two-way mixed models (ICC3,1). Mean and 95% confidence intervals (CI) of ICCs are reported. Coefficient of variation (CV) and standard error of the measurement (SEM) are reported. The ICC2,1 data indicated "adequate" to "excellent" absolute agreement between the two NIRS analysts. ICC2,3 data indicated "adequate" to "good" reliability across visits. The CV and SEM for rater 1 and rater 2 across visit were StO2 (CV: 3.79%±2.71% and 4.50%±2.37%; SEM: 3.42 and 3.82), O2Hb range (CV: 10.50±5.93 and 12.79±12.41; SEM: 3.26 and 4.71), T1/2 (CV: 11.15%±5.52% and 10.96%±4.50; SEM: 1.22 and 1.11), and O2REC-SLP (CV: 19.49%±9.99% and 18.45%±9.48%; SEM: 0.04 and 0.04). It is concluded that NIRS parameters assessed show adequate reliability between analysts and across three visits. It is recommended, when feasible and because of the absence of 100% reliability, that investigators employ more than one rater for scoring at least a portion of the data across each trial in a study's control condition in order to have the ability to estimate the magnitude of error attributable to imperfect reliability.

Reliability and validity of two-dimensional motion capture to assess ankle dorsiflexion motion and heel raise work

ObjectivesTo determine the inter-rater reliability and criterion validity of two-dimensional (2D) measures of ankle function in the sagittal plane for participants with Achilles tendinopathy (AT). DesignCohort study. SettingUniversity Laboratory, Participants, Adults with AT (N = 18, Women: 72.2%, Age = 43.4 ± 15.8 years, BMI = 28.7 ± 8.9 kg/m2) Main outcome measuresReliability and validity were determined with intra-class correlation coefficients (ICC), standard error of the measurement (SEM), minimal detectable change (MDC), and Bland-Altman plots for ankle dorsiflexion and positive work during heel raises. ResultsInter-rater reliability between three raters for all 2D motion analysis tasks was good to excellent (ICC = 0.88 to 0.99). Criterion validity between 2D and 3D motion analyses for all tasks was good to excellent (ICC = 0.76 to 0.98). 2D motion analysis overestimated ankle dorsiflexion motion by 1.0–1.7° (3% of mean sample value) and positive ankle joint work by 76.8 J (9% of mean) compared to 3D motion analysis. ConclusionAlthough 2D and 3D measures are not interchangeable, the good to excellent reliability and validity of 2D measures in the sagittal plane support the use of video analysis to quantify ankle function for individuals with foot and ankle pain.

Upper extremity soft tissue stiffness measured with shear wave elastography: A between-day reliability study.

Imbalances in soft tissue stiffness (STS) of the pectoralis and common wrist extensors (CWEs) can adversely alter upper extremity function. Shear wave elastography (SWE) has the capacity to provide precise, repeatable, objective data on STS. The purpose of this study was to determine the between-day intrarater reliability for the pectoralis and CWE tendon stiffness as measured by SWE. STS measured by the shear wave modulus (kilopascals (kPa)) was captured bilaterally on the pectoralis major, pectoralis minor, and CWE tendon using 2D SWE ultrasound imaging (GE Logiq S8, 9 L transducer) on two separate days. Within examiner intraclass correlation coefficients (ICC (3, 3)) with 95% confidence intervals, standard error of the measure, and minimal detectable changes were calculated. The investigators recruited 10 healthy participants (mean age = 23.50 ± 1.43). Between day intrarater reliability values were obtained for the dominant pectoralis major ICC = 0.70 (-0.15, -0.93), nondominant pectoralis major ICC = 0.63 (-0.30, -0.91), dominant pectoralis minor ICC = 0 .72(-0.04, -0.93), nondominant pectoralis minor ICC = 0.75(0.08, -0.94), dominant CWE tendon ICC = 0.75(-0.08, -0.94), and nondominant CWE tendon ICC = 0.75(-0.12, -0.94). Our data demonstrate acceptable reliability but future studies should include methods that control for variables known to effect STS.

Translation, cultural adaptation and psychometric properties of the Persian version of Occupational Balance Questionnaire in healthy adults

Introduction: Occupational balance is a fundamental concept that plays an influential role in enhancing health and well-being. Method: The Persian Occupational Balance Questionnaire-11 was administered to 157 healthy individuals in the test phase and 80 healthy individuals in the retest phase. Floor or ceiling effects, construct validity, discriminant validity, internal consistency reliability, test–retest reliability, standard error of the measurement and smallest detectable change were examined. Results: The Persian Occupational Balance Questionnaire-11 showed no missing responses. There were no floor or ceiling effects for the total score. The independent t-test did not show a statistically significant difference between groups (based on age category, marital status and job status) that didn’t support discriminant validity. Factor analysis demonstrated a three-factor solution for the Persian Occupational Balance Questionnaire-11 which jointly accounted for 57.62% of the total variance. There was high internal consistency for test (α = 0.813) and retest (α = 0.853). The test–retest reliability for Persian Occupational Balance Questionnaire-11 with a 1-week interval was excellent (ICCagreement = 0.880). The standard error of the measurement and smallest detectable change were 2.02 and 5.60, respectively. Conclusion: Persian Occupational Balance Questionnaire-11 is a valid and reliable instrument for assessing occupational balance in healthy Persian-speaking participants.

A Beta Version of an Application Based on Computer Vision for the Assessment of Knee Valgus Angle: A Validity and Reliability Study.

In handball, the kinematics of the frontal plane seem to be one of the most important factors for the development of lower limb injuries. The knee valgus angle is a fundamental axis for injury prevention and is usually measured with 2D systems such as Kinovea software (Version 0.9.4.). Technological advances such as computer vision have the potential to revolutionize sports medicine. However, the validity and reliability of computer vision must be evaluated before using it in clinical practice. The aim of this study was to analyze the test-retest and inter-rater reliability and the concurrent validity of a beta version app based on computer vision for the measurement of knee valgus angle in elite handball athletes. The knee valgus angle of 42 elite handball athletes was measured. A frontal photo during a single-leg squat was taken, and two examiners measured the angle by the beta application based on computer vision at baseline and at one-week follow-up to calculate the test-retest and inter-rater reliability. A third examiner assessed the knee valgus angle using 2D Kinovea software to calculate the concurrent validity. The knee valgus angle in the elite handball athletes was 158.54 ± 5.22°. The test-retest reliability for both examiners was excellent, showing an Intraclass Correlation Coefficient (ICC) of 0.859-0.933. The inter-rater reliability showed a moderate ICC: 0.658 (0.354-0.819). The standard error of the measurement with the app was stated between 1.69° and 3.50°, and the minimum detectable change was stated between 4.68° and 9.70°. The concurrent validity was strong r = 0.931; p < 0.001. The computer-based smartphone app showed an excellent test-retest and inter-rater reliability and a strong concurrent validity compared to Kinovea software for the measurement of the knee valgus angle.

P038 A psychometric evaluation of the Musculoskeletal Health Questionnaire (MSK-HQ): validation and sensitivity to change in inflammatory arthritis

Abstract Background/Aims The Musculoskeletal Health Questionnaire (MSK-HQ) is a patient-reported outcome measure developed for use across the spectrum of musculoskeletal diseases. This study assesses the validity of the MSK-HQ. Specifically, it analyses convergent validity, construct validity, reliability and sensitivity to change in inflammatory arthritis in a national prospective cohort, with a minimum clinically important difference (MCID) defined. Methods The study sample included patients recruited to the National Early Inflammatory Arthritis Audit (NEIAA) between May 2018 and March 2020, with a diagnosis of inflammatory arthritis, returning a baseline PROM with at least half of the MSK-HQ items completed. Patients also completed PROMs at 3 and 12 months, contemporaneously to their clinic visits. Convergent validity was assessed in relation to the Health Assessment Questionnaire (HAQ)-II, Patient Health Questionnaire (PHQ)-4 and Disease Activity Score (DAS)-28. Construct validity was assessed using confirmatory factor analysis. Due to lack of an appropriate anchor, MCID was estimated based on two estimates for reliable change: standard error of the measurement (SEM) and one-third of a standard deviation (SD). Results A total of 13,129 patients were recruited to NEIAA, of whom 5,106 met the inclusion criteria. Of these 73% had rheumatoid arthritis, 13% psoriatic arthritis, 2% axial spondyloarthritis, and 12% undifferentiated arthritis. The MSK-HQ total score was approximately normally distributed, without floor or ceiling effects. The MSK-HQ correlated well with the HAQ-II (r = -0.79), PHQ-4 (r = -0.66) and moderately with the DAS-28 (r = -0.42). A unidimensional structure for the MSK-HQ was confirmed only when items 12 and 13, corresponding to disease understanding and self-efficacy, were excluded. The factor structure was found to be equivalent across disease subtypes with no major indications for differential item functioning. The MSK-HQ total score demonstrated good sensitivity to change with baseline to 12-month change having a large effect size (standardised response mean 1.01; 95%CI 0.95 to 1.07). This change compared well against the DAS-28 (-1.23; 95%CI -1.29 to -1.17) and was stronger than the HAQ-II (-0.62; 95%CI -0.68 to -0.56) and PHQ-4 (-0.57; 95%CI -0.63 to -0.51). MCID for the overall sample was 3.9 based on SEM and 3.6 assessed with one-third of an SD, both rounding to an integer of 4-points across the inflammatory arthritis subtypes. Conclusion This study provides evidence for the validity and sensitivity to change of the MSK-HQ in patients with inflammatory arthritis. In these patients, a change of more than 4 units is likely to be clinically meaningful. The MSK-HQ has high convergent and construct validity and is sensitive to change, providing a valuable tool for clinical care and research studies. Disclosure N. Arumalla: None. J. Galloway: Consultancies; AbbVie, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Pfizer, Roche and UCB. J. Ledingham: Other; BSR trustee. T. Garrood: None. S. Norton: None.

Reliability of ankle dorsiflexor muscle strength, rate of force development, and tibialis anterior electromyography after stroke

Background: Measures of hemiparetic ankle dorsiflexor muscle strength and rate of force development (RFD) are often used to determine the efficacy of rehabilitation interventions after stroke. However, evidence supporting the reliability of these measures is limited. This brief report provides a secondary analysis investigating the between-session reliability of isometric ankle dorsiflexor muscle strength, rate of force development (RFD), and tibialis anterior electromyography (TA EMG), in people with chronic stroke. Method: Participants (n=15) completed three maximal isometric contractions of the ankle dorsiflexor muscles as fast as possible using a rigid dynamometer. Tests were repeated seven days later. Outcomes included ankle dorsiflexor isometric maximal voluntary contraction (MVC), RFD in the first 200ms (RFD200ms), time to reach 90% MVC, and peak TA EMG. Data were analysed for 13 participants using intra-class correlation coefficients (ICC) and standard error of the measure (SEM). Results: When the mean of three trials was analysed, there was excellent reliability for isometric dorsiflexor MVC (ICC 0.97 [95% CI 0.92-0.99]), moderate reliability for TA EMG (ICC 0.86 [0.60-0.96]) and time to reach 90% MVC (ICC 0.8 [0.53-0.93]) and poor reliability for dorsiflexor RFD200ms (ICC 0.79 [0.48-0.92]). Conclusion: Given the functional significance of the ankle dorsiflexors, future research should investigate more reliable methods for measuring rapid force production in the dorsiflexor muscles after stroke.