• 한국전문물리치료학회지
• /
• 제18권1호
• /
• pp.37-46
• /
• 2011

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

• 대한기계학회논문집B
• /
• 제41권2호
• /
• pp.125-133
• /
• 2017

본 연구에서는 환자의 손가락 경직을 모사하는 손가락 시뮬레이터를 통해 손가락 경직도 검진에서의 검진자간 신뢰도에 대해 연구하였다. 시뮬레이터를 제어하기 위해 경직에서 나타나는 토크를 간단하게 모델링 하고 손가락 경직 환자로부터 간단한 측정 모듈을 이용해 각각의 Modified Ashworth Scale(MAS) 등급에 맞는 파라미터를 얻어냈다. 또한 중수지 관절에 모터가 위치한 손가락 형태의 로봇을 설계하여 경직 토크 모델을 따르는 시뮬레이터를 개발하였다. 이 시뮬레이터를 통해 일곱 명의 재활의학과 전문의들의 검진 결과를 평가해본 결과 중수지 관절에서 0.619, 근위지간 관절에서 0.514의 Cohen's Kappa 값을 보였다. 검진자간의 Fleiss' Kappa 값은 중수지 관절에서 0.513, 근위지간 관절에서 0.486으로 나타났다. 또한 검진자들은 각각의 주관적인 MAS 검진 기준을 가진다는 것을 확인하였다. 결과적으로 같은 환자에 대한 MAS 검진 신뢰도가 높지 않기 때문에 개발된 로봇 시뮬레이터는 검진자의 신뢰도를 높일 수 있는 교육용 도구로서 활용 가능함을 확인하였다.

• PNF and Movement
• /
• 제19권2호
• /
• pp.279-285
• /
• 2021

Purpose: This study aimed to develop new digital navicular drop test (ND-NDT) equipment and to determine its validity and reliability. Methods: A total of 24 healthy male and female adults, who fully understood the purpose of the study and gave consent to participate in the study, were selected as participants. The NDT and ND-NDT were conducted in the dominant foot of the participants in a random order. For the NDT, the position of the navicular bone was marked with a pen first; then, the height of the navicular bone from the ground was measured in both sitting and standing positions. For the ND-NDT, after the sticker-type reflection markers were attached to the position of the navicular bone, the height of the navicular bone from the ground was measured in both sitting and standing positions. To assess the validity of the diagnostic tests, the same examiner measured the height of the medial longitudinal arch (MLA) three times in both the sitting and standing positions. To assess the inter-rater reliability of the ND-NDT, three examiners, in a random order, attached the sticker-type reflection markers to the position of the navicular bone and then measured the height of the MLA in both positions. Results: In the sitting position, the Pearson correlation coefficient (r) between the two diagnostic tests was very high (r = 0.97) and statistically significant. In the standing position, the Pearson correlation coefficient (r) between the two tests was 0.95, which was also statistically significant. The ICC_2,1 values in the sitting and standing positions were 0.93 and 0.95, respectively, indicating significantly high inter-rater reliability. Conclusion: The ND-NDT equipment showed very high diagnostic validity, as well as excellent inter-rater reliability, indicating the clinical usefulness of the equipment as a diagnostic system for confirming pes planus.

• Journal of Preventive Medicine and Public Health
• /
• 제55권4호
• /
• pp.334-341
• /
• 2022

Objectives: This study was conducted to develop the Mobility to Participation Assessment Scale for Stroke (MPASS) and assess its content validity, internal consistency, inter-rater and intra-rater reliability, and convergent validity in people with stroke living in the community. Methods: The MPASS was developed using published data on mobility-related activity and participation timing in elderly individuals, and then reviewed by community physical therapists. Content validity was established by reaching a consensus of experienced physical therapists in a focus group. The MPASS was scored for 32 participants with stroke (mean age 61.75±4.92 years) by 3 individual testers. Reliability was examined using the intraclass correlation coefficient (ICC), internal consistency using the Cronbach alpha coefficient (α), and convergent validity using the Pearson correlation coefficient (r) to compare the MPASS to the Modified Rivermead Mobility Index as a referent test of mobility. Results: The MPASS consists of 8 items, and its scoring system provides information on the ability of people with stroke to reach a movement level enabling them to live in society, including interactions with other people and safe living in the community. The interrater and intra-rater reliability were excellent (ICC, 0.948; 95% confidence interval [CI], 0.893 to 0.982 and ICC, 0.967; 95% CI, 0.933 to 0.989, respectively). Internal consistency was good (α=0.877). The convergent validity was moderate (r=0.646; p<0.001). Conclusions: The newly developed MPASS showed acceptable construct validity and high reliability. The MPASS is suitable for use in people with stroke, especially those who have been discharged and live in the community with the ability to initiate sitting.

• 대한통합의학회지
• /
• 제10권4호
• /
• pp.137-143
• /
• 2022

Purpose : The purpose of this study was to evaluate the reliability analysis of the deep tendon reflex by using electromyography (EMG). Methods : The study was tested on 30 volunteers who are women in their 20s. Using an electronic reflective hammer of EMG, deep tendon reflex was measured on all subjects with the participation of three trained physical therapists as raters. First, the subjects were comfortably seated on a table with their knees bent at 90 °. The three raters tapped the electric hammer at intervals of 10 seconds to avoid habituation until a total of 10 compound muscle action potential records were collected. Intraclass correlation coefficients (ICCs) were calculated to assess the inter-rater reliability of the deep tendon reflex with the use of EMG. The items of analysis included amplitude (mV), latency (ms), duration (ms), and area (mV × ms) of the compound evoked potentials. Results : Based on the average records of 10 compound muscle action potential, excellent reliability (ICC: .912) was achieved in terms of area, and there was good reliability in terms of latency (ICC: .795) and duration (ICC: .800). In the shortest latency of the compound muscle action potential, good reliability was achieved in terms of amplitude (ICC: .865), duration (ICC: .781), and area (ICC: .832). In the amplitude of peak-to-peak of compound muscle action potential, excellent reliability was recorded in terms of amplitude (ICC: .924), and good reliability was recorded in terms of duration (ICC: .801) and area (ICC: .874). Conclusion : The findings in this study indicate that electromyography via an electric hammer is a reliable method of assessing and measuring deep tendon reflexes. Especially, it may be an excellent gauge in the area of average values of the compound muscle action potentials and the amplitude of peak-to-peak of compound muscle action potentials.

• 한국산학기술학회논문지
• /
• 제18권5호
• /
• pp.467-474
• /
• 2017

본 연구의 목적은 만성 뇌졸중 환자 8자 모양 경로 보행 검사(Figure-of-Eight Walk Test, F8WT)의 측정자간 절대적 신뢰도와 타당도를 알아보고자 하였다. 만성 뇌졸중 환자 36명을 대상으로 하였으며 F8WT 소요 시간의 측정자간 신뢰도는 급간내상관계수(Intra Class Coefficient, $ICC_{2,1}$)를 구하였고, 절대적 신뢰도는 측정의 표준 오차값(Standard Error Measurment, SEM)과 최저 실제 차이(Small Real Difference, SRD)를 구하였다. F8WT 소요시간의 타당도는 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke, PASS)와 체간 장애 척도(Trunk Impairment Scale, TIS)간의 스피어만 상관 계수(Spearman Correlation Coefficient)를 구하였다. 연구 결과 F8WT 소요 시간의 측정자간 신뢰도 ICC=0.95(0.91~0.97)로 매우 높았고, SEM과 SRD는 각각 1.02점, 2.82점으로 수용할 만 하였다. F8WT 소요 시간은 PASS(r=-0.82), TIS(r=-0.85)와 유의한 상관관계가 있는 것으로 나타났으며, 뇌졸중 환자의 특이성 장애인 자세 및 체간 조절과 유의한 관련성이 있는 것으로 확인되었다. 따라서 F8WT는 만성 뇌졸중 환자의 보행 능력을 평가하는데 유용한 평가 도구로 사용될 수 있을 것이다.

• 재활복지공학회논문지
• /
• 제10권1호
• /
• pp.37-45
• /
• 2016

이 연구의 목적은 래스터입체사진술이 적용된 ABW-mapper를 사용하여 얻은 관상면 상에서의 하지 정렬 측정에 대하여 측정자 내, 측정자 간, 측정-재측정 간 각각의 신뢰도와 타당도를 조사하고 평가하는 것이다. 열여덟 명의 대상자가 이 연구에 참여하였다. 일주일간격으로 두 번의 세션에 걸쳐서 두 사람의 측정자가 각각 ABW-mapper를 사용하여 기립자세에서의 S각(입체사진 각-래스터입체사진 촬영을 통해 측정한 관상면상의 하지 정렬 측정 각)을 측정하였고, 첫 번째 세션에서는 짧은 시간 간격으로 한 측정자가 같은 대상자에 대하여 두 번씩 측정하였다. Q각은 디지털카메라로 기립자세를 촬영한 사진에서 고니어미터로 측정하였다. HKA각은 컴퓨터 기반 디지털 방사선 영상사진 위에서 측정 소프트웨어를 사용하여 측정하였다. 급내상관계수(ICC)를 통해 신뢰도를 분석하였고, 피어슨 상관계수를 사용하여 타당도를 검사하였다. 그 결과, S각 측정은 매우 높은 측정자 내 (ICC=0.956~0.974), 측정자 간 (ICC=0.962) 검사-재검사 간 (ICC=0.945) 신뢰도를 나타냈으며, S각과 Q각, S각과 HKA각 사이에는 강한 음의 상관관계(각각 r=-0.739, -0.702)를 나타냈다. 따라서, ABW-mapper에 의한 래스터입체사진법을 통한 S각 측정은 관상면에서의 하지정렬의 측정에 대하여 Q각이나 HKA각 측정에 관련하여 예비적 또는 보완적 도구로 사용될 수 있을 것이라 생각된다.

• 대한한의학회지
• /
• 제17권1호
• /
• pp.48-83
• /
• 1996

Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

• 대한지역사회작업치료학회지
• /
• 제7권1호
• /
• pp.17-24
• /
• 2017

목적 : 건강한 성인을 대상으로 목의 관절가동범위를 측정하는데 임상에서 간편하게 적용할 수 있는 스마트폰 어플리케이션의 유용성을 확인하고자 한다. 연구방법 : 목의 관절가동범위는 스마트폰 어플리케이션과 각도계로 목의 굽힘, 폄, 오른쪽 돌림, 왼쪽 돌림, 오른쪽 가쪽 굽힘, 왼쪽 가쪽 굽힘의 움직임을 각각 측정하였다. 검사자내 신뢰도와 검사자간 신뢰도를 측정하기 위해 같은 검사자가 두 번, 다른 검사자가 한 번으로 총 세 번 측정을 실시하였다. 검사 순서는 무작위로 하였으며, 두 검사자는 서로 측정한 결과를 알지 못하게 하였다. 결과 : 연구에 참여한 대상자는 남자 9명, 여자 21명이었다. 실험 결과 스마트폰 어플리케이션과 각도계의 평균 각도 비교에서 오른쪽 가쪽 굽힘을 제외한 모든 항목에서 유의한 차이가 없는 것으로 나타났다(p>.05). 스마트폰 어플리케이션과 각도계의 검사자내 신뢰도는 전 움직임에서 ICC값이 .841~.958로, 검사자간 신뢰도는 전 움직임에서 ICC값이 .720~.944로 나타나 모두 높은 수준의 신뢰도를 보였다. 결론 : 스마트폰 어플리케이션과 각도계는 목의 관절가동범위를 측정하는데 신뢰할 수 있는 것으로 나타나, 스마트폰 어플리케이션은 관절가동범위에 신속하고 정확한 측정으로 인해 임상에서 유용한 도구로 활용할 수 있을 것이다.

• Korean Journal of Radiology
• /
• 제25권4호
• /
• pp.325-327
• /
• 2024