Strong Intraclass Correlation Research Articles

In-vivo repeatability of three intra-oral spectrophotometers.

The objective was to assess the repeatability of three spectrophotometers, based on the CIELCh factors and shadeguide reference measurements. Color analysis was performed using three devices: Rayplicker, Easyshade 4, and Easyshade V. Five repeated measures were performed by the same operator, on the right central maxillary incisor of 30 patients. The CIELCh factors were retrieved and the intra-class correlation was calculated. The Vita Classical and Vita 3D Master shadeguides were used to evaluate the respective Fleiss' Kappa factors. Rayplicker and Easyshade V demonstrated strong intra-class correlation based on the CIELCh factors: 0.98, 0.99, and 0.91 for Rayplicker, and 0.95, 0.99, and 0.93 for Easyshade V, for the L*, C*, and h* parameters, respectively. Regarding the repeatability of the shadeguide data, while Easyshade 4 had the best repeatability when using the Vita Classical as a reference, Rayplicker and Easyshade V showed better repeatability when using the Vita 3D Master. These findings suggest that both Rayplicker and Easyshade V are reliable devices for measuring CIELCh parameters. In terms of shadeguide references, the reliability of spectrophotometers is generally lower compared to the CIELCh measurements. Given their good repeatability, both the Rayplicker and the Easyshade V spectrophotometers are reliable tools for prosthetic dental practices.

Premorbid glenoid anatomy reconstruction from contralateral shoulder 3-dimensional measurements: a computed tomography scan analysis of 260 shoulders

Total shoulder arthroplasty (TSA) aims to reconstruct the premorbid anatomy of a pathologic shoulder. A healthy contralateral shoulder could be useful as a template in planning TSA. The symmetry between the left and right shoulders in healthy patients remains to be proved. The purpose of this study was to compare the 3-dimensional anatomy of the glenoid between sides in a healthy population. A multinational computed tomography scan database was retrospectively reviewed for all healthy bilateral shoulders in patients aged between 18 and 50 years. One hundred thirty pairs of healthy shoulder computed tomography scans were analyzed, and glenoid version, inclination, width, and height, as well as glenoid lateral offset and scapula lateral offset, were measured. All anatomic measures were computed with Blueprint, validated 3-dimensional planning software. The intraclass correlation coefficient was determined for each measure between left and right shoulders. The minimal detectable change (MDC) was calculated using the following formula: MDC=2×1.96×Standarderrorofmeasurement. The comparison between 130 pairs of healthy scapulae showed statistically significant differences in absolute values between right and left glenoid version (-5.3° vs. -4.6°, P<.01), inclination (8.4° vs. 9.3°, P<.01), and width (25.6 mm vs. 25.4 mm, P<.01), as well as scapula offset (105.8 mm vs. 106.2 mm, P<.01). Glenoid height was comparable between right and left shoulders (33.3 mm vs. 33.3 mm, P=.9). The differences between the means were always inferior to the MDC regarding glenoid version, inclination, height, and width, as well as scapula offset. Very strong intraclass correlation coefficients between the left and right shoulders were found for all evaluated paired measures. Healthy contralateral scapulae are highly reliable to predict inclination, height, width, and scapula offset and are reliable to predict version of a given scapula. Paired right and left scapulae were not statistically symmetrical regarding mean glenoid version, inclination, and width, as well as scapula offset. Nevertheless, the reported differences were not higher than the MDC for this cohort, confirming that healthy contralateral shoulders can be a useful template in TSA preoperative planning.

Evaluation of brachial plexus stiffness in different arm and head positions by sonoelastography.

Intraoperative positioning-related nerve injuries, particularly those affecting the brachial plexus, are concerning complications believed to arise from stretching and/or compression of peripheral nerves. Although sonoelastography, a new ultrasound technology, is emerging as a valuable tool in the musculoskeletal system, its utility in evaluating peripheral nerves remains unclear. This study aimed to utilize sonoelastography to assess the brachial plexus during surgery, specifically investigating changes in its stiffness values in relation to different head and arm positions. In this prospective cohort study, bilateral brachial plexuses of 8 volunteers in 3 different positions were enrolled. Using a high-frequency linear probe, the stiffness of the brachial plexus was quantitatively measured in kilopascals (kPa) under 3 different positions: neutral, head rotated, and head rotated with arm hyperabducted. Intra-class agreement was evaluated. The stiffness of the brachial plexus was 7.39 kPa in the neutral position (NP), 10.28 kPa with head rotation, and 17.24 kPa when the head was turned, and the ipsilateral arm was hyperabducted. Significant increases were observed in stiffness values when the head was turned, whether ipsilaterally or contralaterally, and during hyperabduction of the arm while the head was turned (for all P < .001). Strong intra-class correlations were found for the measurements of stiffness values (ICC = 0.988-0.989; P < .001; Cronbach Alpha = 0.987-0.989). Sonoelastography revealed significant increases in the stiffness of the brachial plexus with various head rotations and arm positions compared to the neutral state. These findings suggest that sonoelastography could potentially serve as a valuable tool for assessing the risk of brachial plexus injury during surgery and for guiding optimal patient positioning. Further research with larger sample sizes is needed to establish definitive clinical applications.

The Correlation between Transperineal Shear-Wave Elastography and Transabdominal Ultrasound When Assessing Pelvic Floor Function in Nulliparous Women.

Pelvic floor muscles (PFMs) play a crucial role in maintaining pelvic organ support and continence. However, pelvic floor dysfunction (PFD), often resulting from insufficient PFM control, poses a substantial global health challenge for women. This study aims to explore the relationship between levator ani muscle elasticity when assessed through transperineal shear-wave elastography (SWE) and bladder base displacement, quantified using transabdominal ultrasonography (TAUS), as a means to comprehensively evaluate PFM function. A total of 42 nulliparous women participated in this study. Participants received instructions on proper PFM contractions using Kegel exercises. Levator ani muscle elasticity was assessed both at rest and during contractions using transperineal SWE, while bladder base displacement was simultaneously measured through TAUS. Repeated measures demonstrated strong intraclass correlation coefficients of 0.906 at rest and 0.687 during contractions for levator ani muscle elasticity. The mean elasticity values were 24.7 ± 4.5 kPa at rest and 62.1 ± 10.4 kPa during contractions. Additionally, the mean bladder base displacement was 7.2 ± 2.5 mm, and the normalized bladder base displacement via body mass index was 0.3 ± 0.1 mm. Significantly, a moderate correlation was identified between the PFM function, represented by the difference in levator ani elasticity during contractions and resting, and bladder base displacement (r = 0.486, p = 0.001). These findings underscore the potential utility of transperineal SWE as a reliable and noninvasive method to assess levator ani muscle elasticity and, consequently, PFM function. In conclusion, this study sheds light on the interplay between PFM elasticity and bladder base displacement, offering insights into PFM function assessments. The observed correlation suggests the clinical relevance of SWE in providing valuable information for treatment planning in PFD. These findings contribute to a deeper understanding of PFM dynamics, ultimately aiding in the effective management of PFD among women.

Frailty and Processing Speed Performance at the Cusp of Midlife in CATSLife.

Frailty is not an end state of aging, but rather represents physiological vulnerability across multiple systems that unfolds across adulthood. However, examinations of frailty at the midlife transition, and how frailty may impact other age-sensitive traits, such as processing speed (PS), remain scarce. Our research aims were to examine frailty and frailty-speed associations before midlife, a ripe developmental period for healthy aging interventions. Using data from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (N = 1,215; Mage = 33.23 years; standard deviation = 4.98), we constructed 25-item (FI25) and 30-item (FI30) frailty indices. PS was measured using the Colorado Perceptual Speed task and WAIS-III Digit Symbol (DS) subtest. Multilevel models accounted for clustering among siblings and adjusted for sex, race, ethnicity, adoption status, educational attainment, and age. Reliability of FI measures was apparent from strong intraclass correlations (ICCs) among identical twin siblings, although ICC patterns across all siblings suggested that FI variability may include nonadditive genetic contributions. Higher FI was associated with poorer PS performance but was significant for DS only (BFI25 = -1.17, p = .001, d = -0.12; BFI30 = -1.21, p = .001, d = -0.12). Furthermore, the negative frailty-DS association was moderated by age (BFI25×age = -0.14, p = .042; BFI30×age=-0.19, p = .008) where increasingly worse performance with higher frailty emerged at older ages. Frailty is evident before midlife and associated with poorer PS, an association that magnifies with age. These findings help elucidate the interrelationship between indicators of frailty and cognitive performance for adults approaching midlife, an understudied period within life-span development.

Comparison of the neuromuscular response to three different Turkish, semi-professional football training sessions typically used within the tactical periodization training model

This study examined the neuromuscular responses to three typical football (soccer) training sessions and the reliability of peak speed (PS) measured during a submaximal running test (SRT) for identifying neuromuscular fatigue (NMF) status. Jump height (CMJH) and peak velocity (CMJPV) were collected from a CMJ test, while peak speed (PS) was collected during an SRT before and after each training session. Large effect size (ES) decreases were observed in each variable post-training (ES; − 1.42 to − 2.32). Significant differences (> 0.001) were detected between each football session's external load variables. Coefficients of variations were small (< 10%) with moderate (CMJPV; 0.53, PS; 0.44) and strong (CMJH; 0.72) intraclass correlation coefficients between pre-test measures. The demands of each football session aligned with the principles of tactical periodization and were sufficient to produce the fatigue necessary to elicit physiological adaptations. PS was also shown to be a viable measure of monitoring NMF status.

Adapting an evidence-based physical activity questionnaire for people with physical disabilities: A methodological process

BackgroundPractitioners and researchers often adapt tools, practices, and programs to meet the needs of culturally diverse population groups, but do not consider populations with disability. While there is some research on guidelines for adapting evidence-based programs, there is no systematic process for adapting survey instruments. Rather than creating separate instruments for people with physical disabilities (PWD), it is critical that instruments are designed to capture data on people with and without disabilities for comparison purposes. Given the disproportionately high rates of physical inactivity and obesity in PWD, we developed a methodology to adapt an evidence-based physical activity instrument. ObjectiveTo create a methodology to adapt surveys to be inclusive of PWD and use the methodology to adapt an evidence-based physical activity survey. MethodsA framework was developed to adapt a physical activity survey instrument (International Physical Activity Questionnaire, IPAQ) to be inclusive of PWD. The framework, referred to as SAVe-IT, includes five steps: Step 1) Select survey instrument to adapt; Step 2) Adapt the survey instrument; Step 3) Verify adaptations with experts; Step 4) Implement pilot test; Step 5) Test the tool to confirm reliability. ResultsThe adapted IPAQ passed review by the expert panels and the pilot test (n = 20). Assessment of test-retest reliability (n = 30) yielded strong intraclass correlation coefficients of 0.950 for the total score for the whole sample, 0.950 for PWD (n = 15) and 0.952 for people without disability (n = 15). ConclusionsThe SAVe-IT framework resulted in the successful adaptation of the IPAQ and can be used in populations with and without physical disabilities.

Investigation of the Relationship between Right Coronary Artery-Aorta Angle and Coronary Artery Disease and Associated Risk Factors.

At the level of the left coronary artery tree, there is evidence showing an association between bifurcation angle and coronary artery disease (CAD), and this motivated us to explore similar associations at the level of the right coronary artery (RCA). The purpose of this study was to determine whether there is a relationship between RCA-aorta angle and CAD and age, sex, body mass index, smoking status, hypertension, and high blood cholesterol. The coronary computed tomography angiography datasets and CAD risk factor checklists of 250 patients were retrospectively reviewed, with RCA-aorta angles measured via multiplanar reformation images. Independent t-tests were used to compare mean RCA-aorta angle measurements between groups, correlations between continuous variables were assessed using Pearson and Spearman correlations, and a general linear model was used to adjust for potentially confounding variables. Coronary angle measurements were conducted by two independent assessors with very strong intraclass correlation (r=0.999, p<0.001). A significantly smaller mean RCA-aorta angle was observed in the CAD group (79.07 ± 24.88°) compared to the normal group (92.08 ± 19.51°, p=0.001), in smokers (76.63 ± 22.94°) compared to non-smokers (85.25 ± 23.84°, p=0.016), and a narrow RCA-aorta angle was negatively correlated with BMI (r=-0.174, p=0.010). This study suggests a relationship between narrow RCA-aorta angles and CAD, smoking, and increasing BMI.

Validity and reliability of handgrip dynamometry in older adults: A comparison of two widely used dynamometers.

BackgroundAmong older adults, decreased handgrip strength is associated with greater risk of frailty, and loss of physical function, mobility, lean mass, and overall muscular strength and power. Frailty is also associated with sarcopenia, for which handgrip strength measurement has been recommended for diagnostic purposes. Specific cutoff points for diagnosis have been identified, but use of different devices may affect measurement. Therefore to assess validity and reliability, we compared the two most frequently used devices, the Jamar hydraulic and Smedley spring handgrip dynamometers.MethodsSixty-seven older (76.2 ± 0.9 years) men (n = 34) and women (n = 33) completed two trials of handgrip strength measurement on sequential days (T1, T2) using both devices in random order. Intraclass correlations were used to assess test-retest reliability, and Bland-Altman analysis was used to assess validity as the level of agreement between devices.ResultsThere were significant (p < 0.001) relationships between devices at T1 (r = 0.94) and T2 (r = 0.94) and strong (p < 0.001) intraclass correlations were observed for both devices (Jamar = 0.98; Smedley = 0.96), indicating excellent reliability. However, there were significant differences between devices. Strength measured with Jamar was greater than Smedley at both T1 (27.4 ± 1.4 vs. 23.4 ± 1.1 kg, p < 0.001) and T2 (25.3 ± 1.4 vs. 21.8 ± 1.2 kg, p < 0.001). Bland-Altman analysis confirmed these differences. Subgroup analysis to evaluate the effect of gender and age indicated that in women and old-old (>75 years) participants, differences between devices were closer to zero for both measurements compared to men and young-old (65–75 years) participants.ConclusionsOur results demonstrate that despite excellent reliability, there is poor agreement between devices, indicating a lack of validity. For use as a diagnostic tool, standardization and device-specific cutoff points for handgrip dynamometry are needed.

3D MR fingerprinting using Seiffert spirals

PurposeSeiffert spirals were recently explored as an efficient way to traverse 3D k‐space compared to traditional 3D techniques. Several studies have shown the ability of 3D MR fingerprinting (MRF) techniques to acquire T1 and T2 relaxation maps in a short period of time. However, these sequences do not sample across a large region of 3D k‐space every TR, especially in the way that Seiffert trajectories can.MethodsA 3D MRF sequence was designed using 8 Seiffert spirals rotated in 3D k‐space, with flip angle modulation for T1 and T2 sensitivity. The sequence was compared to an MRF sequence using a 2D spiral rotated in 3D k‐space using the tiny golden angle acquisition with similar resolution/readout duration. Both sequences were evaluated using simulations, phantom validation, and in vivo imaging.ResultsIn all experiments, the Seiffert spiral MRF sequence performed similar to if not better than the multi‐axis 2D spiral MRF sequence. Strong intraclass correlation coefficients (&gt; 0.9) were found between conventional and MRF sequences in phantoms, whereas the in vivo results showed slightly less aliasing artifact with the Seiffert trajectory.ConclusionIn this study, Seiffert spirals were used within the MRF framework to acquire high‐resolution T1 and T2 relaxation time maps in less than 2.5 min. The reduced aliasing artifacts seen with the Seiffert sequence suggests that sampling over 3D k‐space evenly each TR can improve quantification or shorten scan times.

Are Unilateral Devices Valid for Power Output Determination in Cycling? Insights From the Favero Assioma Power Meter.

Some power meters are available in both bilateral and unilateral versions. However, despite the popularity of the latter, their validity remains unknown. We aimed to analyze the validity of a unilateral pedal power meter for estimating actual ("bilateral") power output (PO). Thirty-three male cyclists were assessed at different POs (steady cycling at 100-500 W, as well as all-out sprints), pedaling cadences (70, 85, and 100 repetitions·min-1), and cycling positions (seated and standing). The PO estimated by a left-only power meter (Favero Assioma Uno) was compared with the actual PO computed by a bilateral power meter (Favero Assioma Duo), and the level of bilateral asymmetry (most- vs least-powerful leg) with the latter system was also computed. Nonsignificant differences, high intraclass correlation coefficients (≥.90), and low coefficients of variation (consistently ≤5% except for low PO levels, ie, 5%-7% at 100 W) were found between Favero Assioma Uno and Favero Assioma Duo. However, although a strong intraclass correlation coefficient (.995) was found between both legs, asymmetry values of 4% to 6% were found for all conditions except when pedaling at the lowest PO (100 W), in which asymmetry increased up to 10% to 13%. Although cyclists tend to present some level of bilateral asymmetry during cycling (particularly at low PO), Favero Assioma Uno provides overall valid estimates of actual PO and is, therefore, an economical alternative to bilateral power meters. Caution is needed, however, when interpreting data at the individual level in cyclists with high levels of asymmetry.

Validity of the Wrist-Worn Polar Vantage V2 to Measure Heart Rate and Heart Rate Variability at Rest

Heart rate (HR) and heart rate variability (HRV) can be monitored with wearable devices throughout the day. Resting HRV in particular, reflecting cardiac parasympathetic activity, has been proposed to be a useful marker in the monitoring of health and recovery from training. This study examined the validity of the wrist-based photoplethysmography (PPG) method to measure HR and HRV at rest. Recreationally endurance-trained participants recorded pulse-to-pulse (PP) and RR intervals simultaneously with a PPG-based watch and reference heart rate sensor (HRS) at a laboratory in a supine position (n = 39; 5-min recording) and at home during sleep (n = 29; 4-h recording). In addition, analyses were performed from pooled laboratory data (n = 11344 PP and RR intervals). Differences and correlations were analyzed between the HRS- and PPG-derived HR and LnRMSSD (the natural logarithm of the root mean square of successive differences). A very good agreement was found between pooled PP and RR intervals with a mean bias of 0.17 ms and a correlation coefficient of 0.993 (p < 0.001). In the laboratory, HR did not differ between the devices (mean bias 0.0 bpm), but PPG slightly underestimated the nocturnal recordings (mean bias −0.7 bpm, p < 0.001). PPG overestimated LnRMSSD both in the laboratory (mean bias 0.20 ms, p < 0.001) and nocturnal recordings (mean bias 0.17 ms, p < 0.001). However, very strong intraclass correlations in the nocturnal recordings were found between the devices (HR: 0.998, p < 0.001; LnRMSSD: 0.931, p < 0.001). In conclusion, PPG was able to measure HR and HRV with adequate accuracy in recreational athletes. However, when strict absolute values are of importance, systematic overestimation, which seemed to especially concern participants with low LnRMSSD, should be acknowledged.

Telehealth‐based assessment of cognition in older adults during COVID‐19 and beyond

BackgroundEvidence supporting the use of telehealth techniques in the assessment and diagnosis of dementia has been growing steadily. This began with the use of telephone‐based cognitive screening in the 1980s and televideoconference‐based assessments in the 2000s. The COVID19 pandemic brought telehealth suddenly to the forefront of healthcare, particularly for aging and at‐risk populations, as well as for clinical providers and researchers. While clinicians have been challenged to continue to provide patient care in a safe manner, researchers have been faced with the challenge of maintaining study protocols and continuing to advance the science of dementia. Fortunately, a growing body of research has demonstrated the feasibility, reliability, validity, and consumer acceptability of telehealth‐based assessment procedures, including teleneuropsychological (teleNP) techniques.MethodWe first reported results from a study of 202 adults age 50‐85 using a brief battery of common neuropsychological tests administered via teleNP vs in‐person in counterbalanced fashion which showed generally strong intraclass correlations (Cullum et al., 2014). Additional studies have since examined the validity and consumer acceptability of teleNP assessment in older adults, including recent reviews and findings from surveys and observations using teleNP during the COVID19 pandemic.ResultOur initial investigation revealed essentially equivalent results across teleNP vs traditional in‐person test conditions, with intraclass correlations around .80 and high levels of satisfaction with the procedures. Additional findings revealed validity by the discrimination of impaired and non‐impaired older adults with and without cognitive impairment similar to traditional in‐person assessment. Subsequent studies and reviews have added to this growing body of literature supporting the use of teleNP in older adults.ConclusionIn this presentation, the literature supporting the evidence for telehealth applications in the assessment and diagnosis of dementia will be reviewed, along with commonly used assessment instruments. A critical review of the strengths and limitations of remote clinical/cognitive evaluations as applied to aging individuals with and without cognitive impairment will be provided, along with practical recommendations for application of these procedures, including in‐home and computerized evaluations. Last, needs, opportunities, and future directions for remote cognitive assessment in clinical and research settings, including large‐scale surveillance and treatment studies, will be discussed.

Is Infrared Thermography Reliable to Assess Pain in the Trapezius Muscle Region?

Objective: The aim of this study was to evaluate the inter- and intra-examiner reliability of infrared thermography (IT) in skin temperature analysis of people with pain complaints in the upper trapezius muscle. Methods: A total of 82 subjects (24.8 ± 6.9 years; 63.8 ± 13.1 kg) of both genders who had moderate (VAS-3) or severe pain in the upper trapezius muscle were evaluated. Skin temperatures of four areas (ROIs) were analyzed by IT using a FLIR camera (model T640SC - Sweden). Each evaluator performed two area analyses at different times. Results: The evaluation of the four areas indicated a very strong overall intraclass correlation coefficient (ICC) for both intra-examiner (Examiner 1: ICC = 0.936; 95% CI = 0.905–0.959; P &lt; 0.001; Examiner 2: ICC = 0.979; 95% CI = 0.968–0.987; P &lt; 0.001) and inter-examiner (Measurement 1: ICC = 0.933; 95% CI = 0.902–0.958; P &lt; 0.001; Measurement 2: ICC = 0.979; 95% CI = 0.968–0.987; P &lt; 0.001). The ICC was regular on ROI 3 in the measurement 1 inter-exam test, and the ROI 1, ROI 2, and ROI 4 values were strong; all points were very strong in measurement 2. The ICC was rated from strong to very strong for both examiners in the intra-examiner test at all points. Conclusion: IT was reproducible in measuring the upper trapezius muscle skin temperature, and the intra and inter-examiner agreement levels can be used as a reliable tool in clinical practice.

Phone-based monitoring to evaluate health policy and program implementation in Kenya.

Monitoring and evaluating policies and programs in low- and middle-income countries are often difficult because of the lack of routine data. High mobile phone ownership in these countries presents an opportunity for efficient data collection through telephone interviews. This study examined the feasibility of collecting data on medicines through telephone interviews in Kenya. Data on the availability and prices of medicines at 137 health facilities and 639 patients were collected in September 2016 via in-person interviews. Between December 2016 and December 2017, monthly telephone interviews were conducted with health facilities and patients. An unannounced in-person interview was conducted with respondents to validate the telephone interview within 24 h. A bottom-up itemization costing approach was used to estimate the costs of telephone and in-person data collection. In-depth interviews were conducted with data collectors and respondents to explore their perceptions on both modes of data collection. The level of agreement between data on medicines availability collected through phone and in-person interviews was strong at the health facility level [kappa = 0.90; confidence interval (CI) 0.88–0.92] and moderate at the household level (kappa = 0.50, CI 0.39–0.60). Price data from telephone and in-person interviews showed strong intra-class correlation at health facilities [intra-class correlation coefficient (ICC) = 0.96] and moderate intra-class correlation at households (ICC = 0.47). The cost per phone interview at health facilities and households were $19.73 and $16.86, respectively, compared to $186.20 for a baseline in-person interview. Participants considered telephone interviews to be more convenient. In countries with high cell phone penetration, telephone data collection should be considered in monitoring and evaluating public health programs especially at health facilities. Additional strategies may be needed to optimize this mode of data collection at the household level. Variations in cell phone ownership, telecommunication network and data collection costs across different settings may limit the generalizability of the findings from this study.

Flexor hallucis longus hypertrophy secondary to Achilles tendon tendinopathy: an MRI-based case\u2013control study

PurposeThe purpose of this study was to outline an indirect sign of advanced Achilles tendinopathy on magnetic resonance imaging (MRI), based on the hypothesis that these patients would present with secondary hypertrophy of the flexor hallucis longus muscle (FHL).MethodsMRI scans of Achilles tendon were analyzed retrospectively in two cohorts. The study group consisted of consecutive patients presenting with clinical signs of Achilles tendinopathy and no previous surgeries, while the control group were patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4–5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the FHL muscle. Ratios (FHL/TS) were calculated for area (Ar) and diameter (Dm) measurements. Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both ratios to assess potential cutoff points to differentiate between the groups.ResultsA total of 60 patients for each study group were included. Both ratios Ar(FHL/TS) and Dm(FHL/TS) showed significant higher values in the tendinopathy group (p < 0.001). There were strong to very strong intraclass correlation coefficients (ICC = 0.75–0.93). A diameter ratio Dm (FHL/TS) of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy.ConclusionIn our patient cohort, FHL hypertrophy was observed in patients with Achilles tendinopathy as a possible compensatory mechanism. Measuring a diameter ratio Dm(FHL/TS) of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.

Intraday and Inter-day Reliability of Sprinting Kinetics in Young Female Athletes Measured Using a Radar Gun

ABSTRACT The radar gun is a valid and practically feasible tool to measure sprinting speed and kinetics among athletes. However, its reliability in youth populations, particularly females, is unknown. Therefore, this study aimed to evaluate the intraday and inter-day reliability of sprinting kinetics using a radar gun to measure force (Fo), theoretical velocity (Vo), maximal velocity (Vmax), power max (Pmax) and split times (0–30 m) in young female athletes. Twenty-nine young female athletes aged 13.7 0.89 years (height 1.62 0.06 m; weight 51.7 8.41 kg) from sports teams at a private girl’s college participated. The assessment included four sprints over 30 m (separated by 7 days) for inter-day analysis and two sprints over 30 m on the same day for intraday analysis. Moderate to strong intraclass correlation coefficient 0.74 to 0.98 with a coefficient of variation ranging from 1.70% to 12.70% across all kinetic variables were reported for both intraday and inter-day reliability. The smallest worthwhile change ranged from 1.17% to 6.89%. All tests were identified as having acceptable reliability.

Is Handgrip Strength a Valid and Reliable Measure in Older Adults?

Handgrip strength is related to mortality, disability, functional independence, and quality of life in older adults, and cut points for diagnosis of sarcopenia have been proposed. However, there is no standardized procedure or device, so measurement may not be accurate. To assess validity and reliability we compared hydraulic (HD) versus digital (DD) handgrip dynamometers. Sixty-seven older (76.2 ± 0.9 years) men (n=34) and women (n=33) completed two measurements on sequential days (T1, T2) using both devices in random order. Participants sat in a chair with the device held in their dominant hand, their arm supported on a table or other stable surface, their wrist in a neutral position, and their elbow bent at a 90° angle. To avoid muscle fatigue that has been attributed to multiple attempts, participants squeezed the device one time as hard as possible for 3 seconds. Strong (p<0.001) intraclass correlations were observed for both devices (HD=0.98; SS=0.96) indicating good reliability. However, there were significant differences between devices and between measurements. Strength measured with HD was greater than DD at T1 (27.4 ± 1.4 vs. 23.4 ± 1.1 kg, p<0.001) and T2 (25.3 ± 1.4 vs. 21.8 ± 1.2 kg, p<0.001). Day-to-day measurements were also significantly different. Between T1 and T2 strength decreased 8% with HD (p<0.001) and decreased 7% with DD (p=0.001). In this group of older adults, significant differences in handgrip strength were observed between devices and timepoints indicating poor validity. As a diagnostic tool, standardization is needed for handgrip measurement procedures to improve accuracy.

Associations Between Nutrition Markers and Muscle Mass on Bioimpedance Analysis in Patients Receiving Parenteral Nutrition.

Parenteral nutrition (PN) is used for malnourished patients and those intolerant of enteral nutrition. This pilot study assessed repeatability of bioimpedance analysis (BIA) in critically ill patients and association with nutrition markers and patients' length of hospital stay. Twenty-two patients receiving PN, after major surgery or during critical illness, were enrolled and underwent serial BIA and Subjective Global Assessment (SGA) by a dietitian. Repeatability of BIA was assessed by repeating BIA measurements within 10 minutes in 18 of the 22 study patients (82%). All BIA parameters were repeatable with strong intraclass correlation coefficients (>0.78). Phase angle (PhA), reflective of muscle mass, was significantly associated with serum albumin (R2 = 0.198, P < .001), total lymphocyte count (R2 = 0.083, P = .018), and body mass index (R2 = 0.084, P = .015). Of the 48 SGAs performed, 4 were considered severely malnourished, and all were associated with low PhA (<5°) compared with only 53% and 33% for those considered to be moderately malnourished and well nourished, respectively (χ2 test: P = .042). Low PhA was significantly associated with an increased length of hospital stay compared with those without low PhA (median 36 vs 16 days, respectively; P < .001). BIA is repeatable in critically ill patients receiving PN. Low PhA was prevalent for those judged as severely malnourished and was associated with reduced total lymphocyte count and serum albumin and prolonged length of hospital stay compared with those with a higher PhA.

A Reliability and Comparative Analysis of the New Randomized King-Devick Test.

The King-Devick (K-D) test is a rapid visual screening tool that can assess underlying brain trauma such as concussion via impairments in saccadic rhythm. A new tablet version of the K-D test using randomized numbers is now available, but reliability for this new version and comparison to the traditional K-D test has not yet been reported. Known for learning effects in the test, the aim of this study was to determine test-retest reliability and to compare performance of the new "randomized" version to the "traditional" K-D test version. We hypothesized that the "traditional" K-D test would show a greater rate of improvement with repeat application, compared with the "randomized" K-D test. Using a cross-sectional, repeated measures design in a healthy university student cohort (n = 96; age 21.6 ± 2.8 years; 49 women, 47 men), participants were required to complete the K-D test twice with a one-week break between testing sessions. Participants were randomly assigned into a "traditional" group, where they completed a test-retest of the established K-D protocol, using the same numbers; or the "randomized" group, where they completed test-retest protocol using 2 different sets of numbers. Reliability testing showed a strong intraclass correlation coefficient for both the "traditional" test group (control group; 0.95 [CI: 0.91-0.97]) and the "randomized test group" (0.97 [CI: 0.95-0.98]). However, contrary to our hypothesis, no differences were found between "traditional" and "randomized" groups for baseline (control: 42.5 seconds [CI: 40.2-44.9 s] vs randomized: 41.5 [38.7-44.4], P = 0.23) and repeated testing between groups (control: 40.0 seconds [37.9-42.1 s] vs randomized: 39.5 [36.9-42.0], P = 0.55), with both groups showing improved times with repeated testing (control: 2.1 seconds [CI: 1.1-3.2 seconds] and randomized: 1.9 seconds CI: [0.9-2.9 seconds], P < 0.001). The "randomized" version of the K-D test, using different sets of numbers, demonstrates good reliability that is comparable to the traditional K-D testing protocol that uses the same number sets. However, similar to the "traditional" K-D test, learning effects were also observed in the "randomized" test, suggesting that learning effects are not because of content memorization, but rather familiarity of the test. As a result, although either test format is suitable for sideline concussion screening or return to play decisions, comparison of data should be made to the individual's baseline rather than to normative data sets.