Standard Error Of Measurement Research Articles

Measures of Joint Kinematic Reliability During Repeated Softball Pitching

Background/Objectives: Three-dimensional motion analysis is often used to evaluate improvements or decrements in movement patterns in athletes. The purpose of this study was to evaluate the reliability of joint flexion/extension angles of the pitching elbow and bilateral knees and hips in softball pitchers. Methods: Fourteen softball pitchers (17.9 ± 2.3 years) were tested in one session consisting of four sets of five consecutive fastballs and a second session of two sets of five fastballs. The magnitude of systematic bias and within-subject variation was calculated between pitches. An iterative intraclass correlation coefficient (ICC) process was used to determine intra- and inter-session reliability, standard error of measurement and minimal detectable change. Results: Reductions in within-subject variation were observed for all variables when the number of pitches used in calculations was increased. Intra-session ICC values ranged from an average of 0.643 for pitching elbow to 0.989 for stride leg knee. Inter-session ICC values ranged from an average of 0.663 for pitching elbow to 0.996 for stride leg knee. Conclusions: Joint flexion/extension angles during the softball windmill pitch can be measured with good to high reliability using three-dimensional motion analysis. Biomechanical analysis can be confidently used to detect changes in the pitching motion over the course of a season or following an intervention.

Reliability of a Low-Cost Inertial Measurement Unit (IMU) to Measure Punch and Kick Velocity.

Striking velocity is a key performance indicator in striking-based combat sports, such as boxing, Karate, and Taekwondo. This study aims to develop a low-cost, accelerometer-based system to measure kick and punch velocities in combat athletes. Utilizing a low-cost mobile phone in conjunction with the PhyPhox app, acceleration data was collected and analyzed using a custom algorithm. This involved strike segmentation and numerical integration to determine velocity. The system demonstrated moderate reliability (intraclass correlation coefficient (ICC) 3,1 = 0.746 to 0.786, standard error of measurement (SEM) = 0.488 to 0.921 m/s), comparable to commercially available systems. Biological and technical variations, as well as test standardization issues, were acknowledged as factors influencing reliability. Despite a relatively low sampling frequency, the hardware and software showed potential for reliable measurement. The study highlights the importance of considering within-subject variability, hardware limitations, and the impact of noise in software algorithms. Average strike velocities exhibited higher reliability than peak velocities, making them a practical choice for performance tracking, although they may underestimate true peak performance. Future research should validate the system against gold-standard methods and determine the optimal sampling frequency to enhance measurement accuracy.

Validity and Reliability of Kinovea® for Pelvic Kinematic Measurement in Standing Position and in Sitting Position with 45° of Hip Flexion

The anatomy of the pelvis may obscure differences in pelvic tilt, potentially underestimating its correlation with clinical measures. Measuring the total sagittal range of pelvic movement can serve as a reliable indicator of pelvic function. This study assessed the inter- and intra-examiner reliability of the Kinovea® version 0.9.5 and its agreement with the Qualisys System (3D motion capture) for measuring the total pelvic range of movement (ROM) in the sagittal plane, establishing Kinovea®’s validity in standing and sitting positions with 45° of hip flexion. A cross-sectional study was conducted with 13 asymptomatic participants. Pelvic kinematics were recorded using both systems. Pelvic posture, anterior and posterior tilt, and total pelvic ROM in the sagittal plane were analyzed. The Intraclass Correlation Coefficient (ICC) was used to evaluate reliability and validity. Additionally, the technical error of measurement (TEM), relative TEM, standard error of measurement, and minimal detectable change (MDC) were calculated to establish Kinovea®’s accuracy. Kinovea® demonstrated excellent inter- and intra-examiner reliability for total pelvic ROM in standing and sitting measurements (ICC > 0.90), with relative TEM values below 10% and MDC values between 1.60°and 11.20°. Validity showed good-to-excellent ICC values when comparing Kinovea® and the Qualisys System. This finding suggests that Kinovea® is a valid tool for obtaining reproducible measurements of total pelvic ROM in the sagittal plane in standing and sitting positions, demonstrating excellent-to-good inter- and intra-examiner reliability for pelvic kinematics.

Intra- and inter-rater reliability, standard error of measurement, and minimal detectable change of the cranio-cervical flexion test in individuals with non-specific chronic neck pain.

The cranio-cervical flexion test (CCFT) is used in clinical practice to measure the activation of deep cervical flexor muscles. However, the reliability of the test has not been conducted on an adequate sample size, specifically in individuals with non-specific chronic neck pain (CNP). The aim of the present study is to investigate the intra- and inter-rater reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of the CCFT in individuals with non-specific CNP. A cross-sectional study of reliability conducted at the UFSCar. Fifty-one individuals (17 men and 31 women) with non-specific CNP and aged over 18 years participated in this study. The CCFT was assessed with the Stabilizer pressure biofeedback device. Two raters conducted the test over two days, with a 5-7-days interval and a 10-min rest between raters. The activation score was determined by the level at which the participant kept activation for 10s in a single stage (22, 24, 26, 28 and 30mmHg). Appropriate statistical analysis was performed to calculate the intraclass correlation coefficient (ICC), SEM and MDC. Both intra-rater (ICC=0.65; 95% CI=0.46-0.78) and inter-rater reliability (ICC=0.72; 95% CI=0.55-0.83) were considered moderate. The SEM was 1.73 and 1.66 for intra-rater and inter-rater reliability, and the MDC was 4.81 to 4.60, respectively. The results of the present study indicate that CCFT is a reliable test to evaluate the activation score in individuals with chronic neck pain.

Reliability and Agreement of Hand-Held Dynamometry Using Three Standard Rater Test Positions.

The use of portable hand-held dynamometers is increasing in popularity due to their ease of use in different clinical settings, convenient size, portability, and overall affordability. Reported reliability for external fixation and rater-stabilized hand-held dynamometry (HHD) strength measurements have been found to be 'good' to 'excellent'. Inconsistent agreement has been found between the two stabilization methods and isokinetic HHD testing. Determine the reliability and agreement of HHD measurements in three different rater test positions against three different mechanically produced force magnitudes. The study compared measurements obtained by rater-stabilization to external fixation methods. Intra-rater and inter-rater reliability study. Ten raters took measurements in three different rater test positions against three different force magnitudes created by an external force. Raters were blinded to the randomized force magnitudes. The rater's measurements were compared to measurements taken against an external fixation stabilization device. To establish reliability, Intraclass Correlation Coefficient (ICC), and Standard Error of Measurement (SEM), and Minimal Detectable Change (MDC) were used. To establish agreement, error rates between the rater-stabilized and external fixation stabilization measurements were calculated. ICC's were found to be 'excellent' at .97 and above. The relative SEM ranged from 0.2% to 0.9 % and the relative MDC ranged from 0.7% to 2.8%. The overall error rate was 15.5% and was influenced by force magnitude. The use of standardized rater test positions resulted in 'excellent' intra-rater, inter-rater reliability, low SEM, and low MDC for rater-stabilized HHD measurements. A systematic error was observed, with rater-stabilized measurements resulting in higher values compared with values obtained with the external fixation method. 3.

Development, Measurement Properties and Reference Values of the Upper Extremity Motor Coordination Test: A New Motor Coordination Test of the Upper Limbs

ABSTRACTBackground and PurposeTo develop a new test to assess the motor coordination of the upper limbs, and to investigate the test‐retest and inter‐rater reliability, construct validity, standard error of measurement (SEM), minimum detectable change (MDC), and the reference values.MethodsThe Upper Extremity Motor Coordination Test (UEMOCOT)was applied for 20 s, with the individual touching two targets (one right and one left) as quickly as possible, first with the hand (manual task) and then with the index finger (finger task). To test‐retest reliability, the UEMOCOT was administered two times. To ensure inter‐rater reliability, the test was scored simultaneously by two assessors. For convergent construct validity, the Box and Block Test (BBT) and the Nine Hole Peg Test (NHPT) were applied. Reference values were established according to sex, age, and limb side (dominant/non‐dominant).ResultsInter‐rater and test‐retest reliability, for both tasks and limbs, were good with all the intraclass correlation coefficient above 0.90. Regarding convergent construct validity, the UEMOCOT manual task, for both sides, correlated moderately with BBT (0.59 ≤ r ≤ 0.64; p < 0.01), while the UEMOCOT finger task, for both sides, correlated moderately with NHPT (−0.57 ≤ r ≤ −0,58; p < 0.01). The SEM values were adequate, and the MDC for manual and finger tasks were 11/8 and 6/6 (dominant/non‐dominant), respectively. Young people, men, and the dominant limb showed higher scores, indicating better coordination.DiscussionThe results showed that UEMOCOT is valid and reliable for assessing the motor coordination of the upper limbs, with adequate SEM values and MDC values ranging from 6 to 11. Finally, UEMOCOT reference values were established according to sex, age, and upper limb side.

Can we reliably assess spine movement quality in clinics? A comparison of systems to evaluate reliability of spine movement quality in a healthy population

Inertial measurement units (IMUs) have the potential to facilitate a large influx of spine movement and motor control data to help stratify low back pain (LBP) diagnosis and care; however, uncertainties related to validity and equipment/movement reliability are preventing widespread use and acceptance. This study evaluated the concurrent validity of Xsens DOT IMUs relative to gold-standard optical motion capture equipment, and compared within- and between-day reliability of both systems to track spine range of motion (ROM) and movement quality (MQ) by evaluating intraclass correlation coefficients (ICC), standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable difference (MDD). ROM was evaluated during planar ROM movements, and local dynamic stability (LDS; λmax), mean absolute relative phase (MARP) and deviation phase (DP) were estimated from repetitive trunk flexion at 3 speeds, in 15 healthy controls to assess MQ. Results showed no statistically significant differences between systems for all metrics, and ICCs≥0.86; therefore, validity was confirmed for tracking primary axis ROM and MQ. IMU data revealed that absolute (C7, T12, and S1) and relative (thoracic, lumbar, and total) ROM was the most reliable metric, followed by λmax, DP, and MARP. Reliability was similar between systems, suggesting that the poorer between-day reliability (higher SEM and CV, lower ICC) observed is attributable to movement variability and sensor placement rather than equipment error. The MDDs can provide thresholds to researchers and clinicians for identifying changes in MQ. Further standardization of evaluated movements/metrics, and patient subgrouping are suggested to improve reliability assessments and refine MDDs in future work.

Recovery of the Medial Elbow Joint in the 24-Hour Period After Repetitive Pitching in High School Players

Background: Repetitive pitching causes immediate changes in the medial elbow joint. However, the recovery process from these changes is not clear. Purpose/Hypothesis: The purpose of this study was to investigate the recovery of the medial elbow joint in the 24-hour period after pitching. The hypothesis was that while some recovery will occur at 24 hours after repetitive pitching, this would not be a complete return to baseline. Study Design: Controlled laboratory study. Methods: A total of 26 high school baseball pitchers participated (mean age, 16.0 ± 0.5 years). Participants threw 100 pitches (5 sets of 20 pitches). Medial elbow joint width as well as strain ratios of the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) were measured and followed for 24 hours after pitching. The data before pitching and at each time point after pitching were compared. The standard error of measurement (SEM) and minimal detectable change with 95% confidence interval (MDC95) were calculated using measurements before pitching. Results: The medial elbow joint width significantly increased by 0.84 mm immediately after pitching (P < .05), but this was not maintained at 24 hours. The UCL strain ratio significantly decreased by 1.64 immediately after pitching (P < .05), but this was not maintained at 18 hours after pitching. The strain ratio of the FPMs significantly decreased by 0.09 immediately after pitching (P < .05) but significantly increased by 0.13 at 24 hours (P < .05). The SEM for medial elbow joint width was 0.06 mm, and the MDC95 was 0.18 mm (maximum change: 0.84 mm immediately after pitching). The SEM for UCL strain ratio was 0.85, and the MDC95 was 2.35 (maximum change: 1.64 immediately after pitching). The SEM for strain ratio of the FPMs was 0.08, and the MDC95 was 0.22 (maximum change: 0.13 at 24 hours). Conclusion: After 100 pitches, stability against elbow valgus laxity recovered within 24 hours. UCL and FPMs showed statistical characteristic changes, but those changes were within the minimal detectable change. Clinical Relevance: Pitchers’ medial elbow joint tissue recovered to baseline at 24 hours after pitching. This suggests that it may be acceptable to resume low-intensity throwing after a 24-hour rest period after 100 repetitive pitches while also considering the condition of the rest of the body.

Persian Version of the Modified Constant Score in Overhead Athletes: A Reliability and Validation Study.

Shoulder impingement syndrome (SIS) is the most common shoulder injury among overhead athletes. The Constant score (CS) is a combined scoring system to evaluate functional status of the shoulder in patients with shoulder pain. Cross-sectionalstudy. Cultural adaptation of the Persian version of CS was conducted using Beaton's guideline. Sixty-three overhead athletes (23.57 [7.50] y old) with SIS completed the final version for psychometric assessment. After 5 to 7 days, a group of 33 patients completed the Persian CS again to assess test-retest reliability. Internal consistency, floor/ceiling effects, and item-total correlation were evaluated in patients with SIS. Concurrent validity was assessed through comparison with the disability of the arm, shoulder, and hand questionnaire scores. Twenty-five healthy athletes (31.80 [7.32] y old) participated for determining discriminant validity. The Persian CS demonstrated good test-retest reliability, with subjective and objective intraclass correlation coefficients of .79 and .80, respectively. The internal consistency was satisfactory (Cronbach alpha = .74). No ceiling or floor effects were noted. The Pearson correlation coefficient between CS and disability questionnaire was -.68. The mean total score for patients was 67.02, while for the healthy group was 96.99 (P = .000). The standard error of measurement was 1.51 for patients and 0.7 for healthy group. The smallest detectable change was 16.95 for patients and 5.71 for healthy group. The translation and cross-cultural adaptation of CS into Persian were successful. The Persian version demonstrates sufficient reliability and validity to evaluate shoulder function in overhead athletes with SIS.

Upper Extremity Performance Test for the Older Adult (TEMPA) in Thai Version

The objectives of this study were to translate TEMPA into Thai (TEMPA-Thai) and to assess intra-rater reliability in older adults. The original TEMPA was translated into Thai in 2 copies by 2 translators (T1 and T2). The researcher combined both Thai versions into 1 Thai version (T12), which was then translated back into English by 2 native Thai speakers (BT1 and BT2). After that, 3 experts (the physical therapists) analyzed the final synthesis draft (TEMPA-Thai). The researcher then assessed the intra-rater reliability of TEMPA-Thai in 30 older adults. Intra-class correlation coefficients (ICC (3,1)) were used to measure intra-rater reliability. The TEMPA-Thai had excellent reliability (ICC = 0.956-1.00). Furthermore, the standard error of measurement in this study was calculated to be between 0.00 and 3.75. The TEMPA-Thai had a minimal detectable change value between 0.00 and 10.41 seconds. This study was registered at the Thai Clinical Trial Registry (TCTR 20230206004).

Translation, Validity, and Reliability of the Indonesian Version of the Shoulder Pain and Disability Index (SPADI).

The Shoulder Pain and Disability Index (SPADI) is a widely used 13-item shoulder-specific patient-reported outcome measure for shoulder pain disorders. The English version of SPADI is easy to use and demonstrates excellent measurement properties for clinical and research settings. To translate and culturally adapt an Indonesian version of SPADI (SPADI-IDN) and then validate its use in Indonesian patients. Cohort study (Diagnosis); Level of evidence, 2. Through a forward and a backward translation process, the validity of the questionnaire was investigated. The study population was 100 patients with shoulder pain who were treated in a hospital in Indonesia. The patients were asked to fill out the SPADI-IDN during their visit. To evaluate the validity of SPADI-IDN, the patients were also asked to fill out the Medical Outcomes Study 12-Item Short-Form Health Survey and the Oxford Shoulder Score. To assess the test-retest reliability, the same patients were asked to fill out the SPADI-IDN questionnaire again 1 week later. The assessment of construct validity, test-retest reliability, internal consistency, floor and ceiling effect, and measurement of error followed the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) guidelines. The Bland-Altman method was used to explore absolute agreement. Of the 100 eligible patients, all were used to assess construct validity, and 87 patients (87%) were used to assess test-retest reliability. Almost every established hypothesis about the correlations between SPADI-IDN and other questionnaires could be confirmed, implying good construct validity. No floor or ceiling effects were found. The intraclass correlation value was 0.99, indicating strong test-retest reliability. A Cronbach α was 0.95, indicating a good internal consistency. The Bland-Altman analysis did not reveal any bias. The standard error of measurement and the minimal detectable change at the individual and group levels were 2.65, 7.3, and 0.7, respectively. The SPADI-IDN represents a valid and reliable tool for measuring pain and disability in patients with shoulder pain disorders.

Assessing the Inter-Rater and Inter-Trial Reliability of the NeurOptics Pupillary Light Response-3000 Pupillometer.

An automated pupillometer is a handheld device used to stimulate the pupillary light response (PLR) and track the entirety of the response from constriction to dilation. Pupillometers provide objective data that clinicians can use to identify and assess brain injury. The validity of these devices has been previously established; however, the inter-rater and inter-trial reliability are unknown. The purpose of this study was to assess the inter-rater and inter-trial reliability of the NeurOptics PLR-3000 pupillometer device in measuring pupil size changes, constriction velocities, and dilation velocities. The authors hypothesized that inter-rater and inter-trial reliability would have intraclass correlation coefficients (ICC) greater than or equal to 0.70 for all PLR parameters. Design: Observational, reliability study Methods: Forty-eight healthy adults (age 18-40 years) without a history of neurological injury, optical surgery, or cognitive impairment participated. Two independent raters used the NeurOptics PLR-3000 to measure PLR parameters in the left and right eyes of each subject. Data for the average and individual trials of each PLR parameter were used to determine inter-rater and inter-trial reliability, respectively. Inter-rater and inter-trial reliability was evaluated using descriptive statistics, ICC, the standard error of measurement, Bland-Altman plots, and the minimal detectable change. Seven out of eight NeurOptics 3000-PLR parameters demonstrated moderate-to-excellent inter-rater (ICC range 0.72-0.96) and good-to-excellent inter-trial reliability (ICC range 0.76-0.98). The 75% recovery time parameter exhibited moderate inter-rater (ICC range 0.64-0.67) and poor-to-moderate inter-trial (ICC range 0.41-0.65) reliability. The NeurOptics 3000-PLR demonstrated acceptable reliability in measuring initial and end pupil size, constriction and dilation velocity, and latency to change between different users and trials. However, the device exhibited unacceptable reliability when measuring the time to 75% pupil size recovery. The device can be used in detecting and monitoring brain injury but should be limited to reliable measures only.

The Norwegian version of the Norwich Patellar Instability score has good validity and moderate reproducibility.

To translate and adapt the Norwich Patellar Instability (NPI) score into Norwegian, and second, to examine the psychometric properties of the Norwegian version (NPI-No). NPI was translated according to international guidelines. A cohort of 107 patients surgically treated for recurrent patellofemoral instability completed NPI-No, related questionnaires and functional tests prior to and six months post-surgery. Validity (face, content and construct validity), internal consistency (Cronbach's alpha [α]), test-retest reliability (intraclass correlation coefficient [ICC]], measurement error (standard error of measurement [SEM] and smallest detectable change at individual [SDCind] and group level [SDCgroup]) and construct validity (hypotheses testing; independent t tests, Pearson's r) were examined. NPI-No had good face and content validity. Internal consistency was satisfactory (α = 0.88), test-retest reliability was moderate ICC2.1 0.65 (95% confidence interval = 0.47-0.77) and measurement error low (SEM = 7.8). SDCind was 21.7 points and SDCgroup was 2.8. Seven of the 10 hypotheses about construct validity were confirmed. While there was no ceiling effect pre- or post-operatively, a substantial floor effect (28%) was observed at the 6-month follow-up. The NPI-No is valid for assessment of self-perceived patellar instability before and after surgery in Norwegian patients. However, reproducibility was found to be only moderate. This study adds further knowledge about the measurement properties of the NPI. Level II.

Validity and Reliability of the Spanish Version of the Athlete Psychological Strain Questionnaire.

This study aims to provide data on the reliability and validity of an adapted Spanish version of the Athlete Psychological Strain Questionnaire (APSQ) when administered to Spanish athletes. A cross-sectional study was developed. Data were collected from 128 athletes (males n = 71; females n = 57). The tools used in this study were the APSQ; Kessler Psychological Distress Scale; and Depression, Anxiety, and Stress Scales. The intraclass correlation coefficient was used to determine relative reliability, whereas standard error measurement and minimal detectable change were used to evaluate absolute reliability. Bland-Altman plots were employed to assess test-retest agreement and potential systematic bias. Data indicate that the Spanish version of the APSQ demonstrated satisfactory internal consistency (α: .77-.85) and generally fair to good test-retest reliability (intraclass correlation coefficient: .702; 95% CI, .602-.780). Significant associations were found between the APSQ Spanish version and the Depression, Anxiety, and Stress Scales (ρ = .64-.82), with fair to good agreement, whereas fair to moderate levels of agreement were established between the APSQ Spanish version and the Kessler Psychological Distress Scale (ρ = .53-.75). These results provide preliminary evidence supporting the use of the APSQ Spanish version for mental health screening among Spanish athletes. However, the lack of absolute reliability raises concerns about its utility for assessing the effects of interventions aimed at improving mental well-being.

Calculation of the Minimal Clinically Important Difference in Upper and Lower Limb Motor Assessment in Spinal Muscular Atrophy

Physical function assessments in patients with spinal muscular atrophy (SMA) are important indicators for assessing the effectiveness of treatment and changes over time in rehabilitation therapy. However, few reports exist on this indicator. This study calculated the minimal clinically important difference (MCID) for assessing motor function in the upper and lower limbs of individuals with SMA to estimate the degree of change within a functional score that is considered clinically meaningful. This cohort study relied on individual participant measurements. A distribution-based approach was used to calculate the MCID values, incorporating data from 26 patients with SMA for the 6-Minute Walk Test (6MWT), Hammersmith Functional Motor Scale Expanded (HFMSE), Revised Upper Limb Module (RULM), and grip and pinch strength. The standard errors of measurement for all patients were: 58.38 m for 6MWT; 4.71 points for HFMSE; 3.25 points for RULM; 10.93 N and 9.86 N for right and left grip strength, respectively; 5.42 N and 4.73 N for right and left Palmar pinch; and 11.96 N and 8.66 N for right and left Key pinch. Significant correlations were observed between the physical function assessments. We calculated MCID values for physical function evaluations of SMA and, as a sub-analysis, determined the SMA type and ambulatory status. These findings are expected to contribute to future SMA treatment and rehabilitation and promote the selection of appropriate physical function assessments.

Testing Consistency: Analyzing the Reliability of Two Lower Limb Isometric Force Measurements in Strength-Trained Athletes

This study aimed to examine the intra- and inter-session reliability of kinetic variables in the isometric mid-thigh pull (IMTP) and isometric belt squat test (IBSqT) in strength-trained individuals. Fifteen men (26.9 ± 8.9 years; 1.78 ± 0.05 m; 86.9 ± 10.5 kg) and six women (23.8 ± 4.6 years; 1.66 ± 0.06 m; 65.8 ± 10.3 kg), experienced in strength training, completed a familiarization session followed by two experimental sessions. The peak force (PF) and relative peak force to body weight (RPF), were collected for both isometric tests. Additionally, force (F), impulse (I), and rate of force development (RFD) were analyzed across different time windows (50, 100, 150, 200, and 250 ms). The intraclass correlation coefficient (ICC), coefficient of variation (CV), standard error of measurement (SEM), smallest worthwhile change (SWC) and Bland-Altman plots were calculated and displayed. Intra-session reliability was excellent for PF and RPF (ICC ≥ 0.98, CV ≤ 10%) in both IMTP and IBSqT. However, RFD and IMP displayed higher variability (CV &gt; 10%), with low to good reliability depending on time frames. Inter-session reliability was excellent for PF and RPF (ICC ≥ 0.96, CV ≤ 5.3%) in both tests. Force at various time points exhibited moderate to excellent reliability (ICC = 0.70–0.90). PF and RPF demonstrated the highest sensitivity to performance changes, with SWC0.2 values exceeding SEM. In contrast, RFD and impulse showed larger variabilities. These findings indicate that PF and RPF are the most reliable and sensitive metrics for monitoring performance. Coaches and practitioners can use IMTP and IBSqT to detect meaningful changes in maximal isometric force production.

CLINIMETRIC PROPERTIES OF THE ABC-6, ABC-16, AND MODIFIED FALLS EFFICACY SCALE WHEN DELIVERED ELECTRONICALLY

Abstract The Activities Specific Balance Confidence Scales (ABC, ABC-6) and the Modified Falls Efficacy Scale (M-FES) are outcome measures used to assess self-efficacy in maintaining balance in older adults. All three measures have established reliability and validity when delivered in a clinician-driven paper assessment. However, it is unknown what the clinimetric properties of these measures are when delivered electronically without verbal direction. Therefore, the purpose of this study is to establish the reliability, validity, standard error of measurement, and the minimal detectable change (95% confidence interval) of these measures when delivered electronically in community-dwelling older adults. 67 participants were recruited electronically through the University of Michigan’s Health Research platform. Older adult participants were English-speaking; aged 65+ years; had access to a computer or electronic device with reliable internet; and were diagnosed with various health conditions. A Qualtrics survey was distributed to participants that consisted of the ABC-16 and M-FES with written directions. Results from the 67 participants demonstrated excellent test-retest reliability (ICC2,1 = ≥0.94) and excellent internal consistency (α = ≥0.94) for all measures. The ABC-16 had a smaller SEM (3.85) and MDC95 (10.67) compared to the ABC-6 (SEM = 4.99, MDC95 = 13.83). For the MFES, the SEM was 0.27 and MDC95 was 0.75. All measures had significant Pearson correlations (p &amp;lt; 0.01) with the falls history indicating construct validity. These results indicate the ABC-16/6 and M-FES can be utilized in an electronic format when assessing older adults’ self-efficacy in balance.

Intra- and Inter-Rater Reliability, Measurement Error and Criteria and Convergent Validities of the Dualpex Plus for the Vaginal Manometry of Pelvic Floor Muscles in Women With Urinary Incontinence.

To test the Intra- and inter-rater reliability, measurement error and criteria and convergent validities of the Dualpex Plus (DP) for vaginal manometry in women with urinary incontinence (UI). This is a clinimetric properties study. University Hospital in Brazil. One hundred and two women with UI. Vaginal manometry was performed with DP and Peritron (Pr), in a random order. Intra-rater reliability was tested within a 1-week interval; inter-rater reliability was tested on the same day by two different evaluators. Perception of contraction and comfort with each device were assessed and compared with Chi-square or paired t tests. Reliability was evaluated by intraclass correlation coefficient (ICC) with a 95% confidence interval (CI). Criteria (with Pr) and convergent (with Oxford score) validities were evaluated by Pearson's correlation. The standard error of measurement (SEM) and the minimum detectable change were also calculated. Intra- and inter-rater reliability, measurement error and criteria and convergent validities of the Dualpex Plus. DP showed substantial inter-rater and excellent intra-rater reliability (ICC = 0.85; 95% CI 0.76-0.91 and 0.90; 95% CI 0.86-0.93, respectively); strong and positive criteria validity (r = 0.83; p < 0.001) and convergent validity (r = 0.45; p < 0.001). Pressure values for pelvic floor muscle contraction were different between DP and Pr [17.61 ± 12.22 vs. 34.91 ± 21.22 cmH2O; p < 0.001]. SEM was doubtful (19%) and the minimum detectable change was 0.152 cmH2O. DP was more comfortable than Pr and perception of contraction was higher for Pr. Dualpex Plus showed adequate clinimetric properties. Measurement error was considered doubtful. DP was more comfortable than Pr and perception of contraction was higher for Pr.

Expanded and independent validation of the NoMoFA scale for Parkinson's disease: the Italian version.

Non-motor symptoms (NMS) in Parkinson's disease (PD) can fluctuate daily, impacting patient quality of life. The Non-Motor Fluctuation Assessment (NoMoFA) Questionnaire, a recently validated tool, quantifies NMS fluctuations during ON- and OFF-medication states. Our study aimed to validate the Italian version of NoMoFA, comparing its results to the original validation and further exploring its clinimetric properties. The scale underwent translation, back-translation, and cognitive pretesting before being administered to a calculated sample of > 200 PD patients. Each patient was assessed using a set of validated measures for assessing PD and cognitive state. We explored NoMoFA's feasibility, acceptability, factorial structure, internal consistency, convergent validity, test-retest reliability (the latter performed on 50 patients after 14days), and the precision of the scale. 227 PD patients (mean age 65.34, disease duration 9.31years) were included, with 100% data computability. The scale was free from floor and ceiling effects, and included 7 factors (59.2% of the variance). Cronbach's alpha coefficient was 0.89, indicating strong internal consistency. The intraclass correlation coefficient (ICC) of 0.90 demonstrated satisfactory reproducibility. The NoMoFA Total score showed the strongest correlations with MDS-UPDRS Parts I (rS = 0.71) and II (rS = 0.60). Significant differences in NoMoFA scores were observed based on disease duration, H&Y score, and LEDD (p < 0.0001), but not age or sex. The Standard error of measurement (SEM) was 3.40 (for ½ SDpooled = 5.48). The Italian version of the NoMoFA scale demonstrated strong reliability, validity and precision, making it a robust tool for assessing non-motor fluctuations in PD.

Validity and Reliability of the Videoconference-Based Berg Balance Scale in Stroke Survivors: The Tele-Berg Balance Scale.

Telerehabilitation represents an alternative for individuals who have difficulty accessing services to receive care. Therefore, telerehabilitation measures must be studied for their reliability and validity. This study evaluated the validity and reliability of the videoconference-based Berg Balance Scale assessment in stroke survivors. Thirty-one stroke survivors were assessed. Rater A conducted in-person and remote assessments via videoconferencing at 2 different times (test-retest), and rater B conducted an assessment using the second recording made remotely. The validity and agreement between the in-person and remote assessments were analyzed using the Pearson's correlation coefficient and the Bland-Altman plots limits of agreement (LoA), respectively. Test-retest and inter-rater reliability were analyzed using the intraclass correlation coefficient (ICC) with a 95% confidence interval (95% CI), and individual item reliability was assessed by weighted Kappa. The standard error of measurement and minimal detectable change were computed. Cronbach's alpha was used for the analysis of internal consistency, and the ceiling effect was investigated. In-person and remote assessments showed a strong positive correlation (r =0.96) and less than a 1-point difference between the 2 assessments. Both the test-retest (ICC=0.96; 95% CI, 0.93-0.98) and inter-rater (ICC=0.93; 95% CI, 0.87-0.97) reliability were excellent. The standard error of measurement and minimal detectable change were 1.8 and 5.1 points, respectively. Results showed adequate internal consistency and no ceiling effect. The Tele-Berg demonstrated validity, excellent test-retest and inter-rater reliability, low measurement error, adequate internal consistency, and lack of ceiling effect. These findings suggest that the Tele-Berg is comparable to in-person Berg Balance Scale in stroke survivors.