The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.
Ji Young Lee;Se Won Oh;Mi Sun Chung;Ji Eun Park;Yeonsil Moon;Hong Jun Jeon;Won-Jin Moon
Korean Journal of Radiology
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제22권3호
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pp.405-414
/
2021
Objective: To compare two clinically available MR volumetry software, NeuroQuant® (NQ) and Inbrain® (IB), and examine the inter-method reliabilities and differences between them. Materials and Methods: This study included 172 subjects (age range, 55-88 years; mean age, 71.2 years), comprising 45 normal healthy subjects, 85 patients with mild cognitive impairment, and 42 patients with Alzheimer's disease. Magnetic resonance imaging scans were analyzed with IB and NQ. Mean differences were compared with the paired t test. Inter-method reliability was evaluated with Pearson's correlation coefficients and intraclass correlation coefficients (ICCs). Effect sizes were also obtained to document the standardized mean differences. Results: The paired t test showed significant volume differences in most regions except for the amygdala between the two methods. Nevertheless, inter-method measurements between IB and NQ showed good to excellent reliability (0.72 < r < 0.96, 0.83 < ICC < 0.98) except for the pallidum, which showed poor reliability (left: r = 0.03, ICC = 0.06; right: r = -0.05, ICC = -0.09). For the measurements of effect size, volume differences were large in most regions (0.05 < r < 6.15). The effect size was the largest in the pallidum and smallest in the cerebellum. Conclusion: Comparisons between IB and NQ showed significantly different volume measurements with large effect sizes. However, they showed good to excellent inter-method reliability in volumetric measurements for all brain regions, with the exception of the pallidum. Clinicians using these commercial software should take into consideration that different volume measurements could be obtained depending on the software used.
Pablo Bellosta-Lopez;Victor Domenech-Garcia;Thorvaldur Skuli Palsson;Pablo Herrero;Steffan Wittrup Mcphee Christensen
The Korean Journal of Pain
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제36권2호
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pp.173-183
/
2023
Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.
This study was to determine the reliability and validity of manual measurements of patellar height to standard radiographic measurements in 30 knees of 15 subjects. Patellar height was measured using manual and radiographic methods. The manual measurements were performed by two examiners using digital vernier calipers with the subject sitting and the knees in $30^{\circ}$ of flexion. The radiographic measurements were performed in the same position. The reliability of the manual measurements was assessed by means of intraclass correlation coefficients [ICC(3,1)], and the validity was investigated using the Pearson's product-moment correlation coefficient and an independent t-test. The intra- and inter-rater reliabilities of the manual measurement of patellar height were excellent (ICC=.86 and .88 respectively). The validity of patellar height measured manually compared to the radiographic method was good (Pearson's r=.69). In conclusion, the manual method is an objective, qualitative measurement of patella height.
Purpose: Ultrasound imaging is commonly used to measure the pennation angle of human skeletal muscles in vivo. However, manual assessment of the pennation angle using ultrasound images is subjective and time-consuming and requires a high level of examiner skill. The architectural analysis of human skeletal muscles is thus challenging. Automated approaches using image processing techniques are therefore required to estimate the pennation angle in ultrasound images. The purpose of this study was thus to assess the intra-tester and inter-tester reliability and validity of the pennation angle using an automatic measurement program. Methods: Twenty-two healthy young adults (mean age = 22.55 years) with no medical history of neurological or musculoskeletal disorders voluntarily participated in this study. Ultrasound imaging was used to measure the pennation angle of the gastrocnemius muscle at rest. One examiner acquired images from all the participants. The intra-tester and inter-tester reliability were evaluated using the intraclass correlation coefficient (ICC) to estimate reliability. Validity was measured using Pearson's correlation coefficient. Results: The intra-rater reliability was excellent for the automatic pennation angle measuring program and the manual pennation angle assessment method (ICC>0.95). The inter-rater reliability was also excellent for both methods (ICC>0.93). All the correlation coefficients for the automatic pennation angle measuring program and the manual pennation angle assessment method were 0.79, which indicated a significantly positive correlation (p<0.05). Conclusion: Pennation angle measurement using the automatic pennation angle measuring program showed acceptable reliability and validity. This study therefore demonstrated that the automatic measuring program was able to automatically measure the pennation angle of skeletal muscles using ultrasound images, and thus made it easy to investigate skeletal muscle architecture.
Background: The purpose of this study was to assess the test-retest reliability of balance measurements in older adults using balance measurement system(Good Balance). Methods: The subjects consisted of 49 female and 20 male in community-dwelling older adults. This study used a repeated-measure design. Each subject completed all the different tests once and they were then repeated with 2 minutes in between. Repeated two-ways analysis of variance(ANOVA), representing two test times and both sexes, was calculated for each of the two dependent variables. Intraclass correlation coefficients(ICCs) were used to assess the test-retest reliability. Results: 1) There was not significant difference between test and retest for mediolateral sway speed and anterioposterior sway speed under conditions of normal standing with eyes open, normal standing with eyes closed and semitandem standing with eyes open. There was not significant difference between males and females for mediolateral sway speed and anterioposterior sway speed under conditions of normal standing with eyes open, normal standing with eyes closed and semitandem standing with eyes open. There were not the interaction effects between genders and test time under three conditions. 2) The reproducibility between test and retest was excellent for anterioposterior sway speed(ICC=.77) under condition of normal standing with eyes open, and for mediolateral sway speed(ICC=.76) and anterioposterior sway speed(ICC=.84) under condition of semitandem standing with eyes open. The reproducibility between test and retest was fair to good for mediolateral sway speed(ICC=.64) under condition of normal standing with eyes open, for mediolateral sway speed(ICC=.63) and anterioposterior sway speed(ICC=.75) under condition of normal standing with eyes closed. Conclusion: Balance tests in older adults using balance measurement system(Good Balance) demonstrated acceptable levels of reliability.
PURPOSE: The purpose of this was to translate Patient-Rated Tennis Elbow Evaluation(PRTEE) into Korean and identify the reliability and validity of a Korean version of PRTEE. METHODS: The subjects of this study were 32 patients diagnosed with lateral epicondylitis. The subjects were surveyed using a Korean version of PRTEE three times: at the first visit, one week after, and two weeks after. This questionnaire consisted of 15 questions including 5 questions about pain and 10 questions about functions. Intraclass correlation coefficients were used to measure reliability and Cronbach's alpha coefficients were used to assess internal consistency. In addition, the validity of the survey results was examined by correlating a visual analogue scale with the outcome of holding without pain. RESULTS: Test-retest reliability of Korea version PRTEE was good total ICC= .962 (CI=.922-,982). Cronbach's alpha value for PRTEE was found to be .955 and it was statistically significant (p<.05). The positive correlation between PRTEE and VAS was moderate to high (r=.753, P=.00) and statistically significant. There was also a low significant negative correlation between PRTEE and PFG (r=-.362, P=.042). CONCLUSION: The Korean version of PRTEE had reliability and validity. Therefore, it is a useful measure to evaluate the conditions of patients with lateral epicondylitis.
The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the "Clinometer + bubble level", a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at $90^{\circ}$ abduction; ER90 and internal rotation at $90^{\circ}$ abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75~.87] and excellent in ER90 [ICC (2,1)=.90~.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.
The reliability of the thickness measurement of the lumbar multifidus (LMD using real-time ultrasonography (US) was determined in only the superficial fiber of the lumbar multifidus (SM). However, previous studies have not examined the reliability of the deep fiber of the LM (DM). The purpose of this study was to determine the intrarater and the interrater reliability of the thickness measurements of DM using US. Eleven heathy males participated in the study. The thickness of the DM was measured with an US in the prone position. Reliability was examined using intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and the Bland and Altman plot. ICC(3,1) was used to calculate the interrater reliability of the thickness measurement of DM using the values from both the first and second test sessions. Additionally, ICC(3,1) was used to calculate the intrarater reliability of the measurements over two days using the measurements obtained in test session 1 and lest session 2. The results of this study were as follows: 1) the ICC(3,1) value for interrater reliability was .94 in the first test session, and .93 in the second test session. 2) the ICC(3,1) values for intrarater reliability of the measurements over two days was .90 in both the first examiner and the second examiner. The interrater reliability and interrater reliability of the DM measurements, obtained via the US protocol used in this research was excellent. Therefore, we conclude that the thickness measurement of the DM obtaioned from the US protocol used in this research would be useful for clinician assessment of the thickness of the DM.
Purpose: The purpose of this study was to propose a new reference point for measurement of the infrasternal angle and to investigate the intra- and inter-rater reliabilities of infrasternal angle measurement using photographs. Methods: Twenty-four healthy male college students participated as subjects in this study. Photographs were taken of subjects in two postures, one standing with the shoulders relaxed and one standing with the shoulders at $150^{\circ}$ abduction. All photographs were analyzed using Image J software. Raters used the photographs to measure the infrasternal angle between the xiphoid process, the medial margin of rib and navel on the right and left sides. The reliability of the infrasternal angle measurement was assessed by means of intraclass correlation coefficients [ICC (3,1)]. The level of statistical significance was set at p<0.05. Results: The intra- and inter-rater reliabilities of the infrasternal angle measurement for the right side at rest were excellent (ICC=0.866 and 0.813, respectively), as were those for the left side at rest (ICC=0.919 and 0.846, respectively). At $150^{\circ}$ shoulder abduction, the intra- and inter-rater reliabilities for measurement of the infrasternal angle on the right side were excellent (ICC=0.972 and 0.778, respectively), as were those for the left side (ICC=0.914 and 0.826, respectively). Conclusion: These findings suggest that this technique can be successfully used to measure the infrasternal angle, thus suggesting a new reference point for determining the length of the internal oblique and external oblique muscles in clinical situations.
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