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PubMed1993

Reliability of dynamic and isometric testing of shoulder external and internal rotators.

Advances in isokinetic technology allow the physical therapist to assess concentric, eccentric, and isometric muscle performance at the shoulder in various positions. Research is limited, however, on the reliability of isokinetic measurements. The purposes of this study were: 1) to determine the test-retest reliability of concentric, eccentric, and isometric muscle performance measurements of shoulder external and internal rotation in the scapular plane test position and 2) to compare this reliability between the involved and uninvolved limb of subjects with a history of unilateral shoulder pathology. Fourteen males and 10 females (17-58 years) were tested on two occasions at 1-week intervals with the Biodex isokinetic dynamometer. Peak torque, total work, and average power were recorded for concentric tests at angular velocities of 60 and 120 degrees/sec and for eccentric tests at 60 degrees/sec. Maximum average isometric torque was recorded in two positions. Means, standard deviations, and mean differences between sessions with 95% confidence intervals were calculated. Intraclass correlation coefficients (ICCs) were used to determine test-retest reliability. Isometric tests were generally most reliable (ICC = .81-.93), followed by concentric (ICC = .60-.95) and eccentric tests (ICC = .44-.92). Isokinetic and isometric reliability were usually higher for involved than uninvolved shoulders. The implication of these findings is that there appears to be greater variability with eccentric than concentric or isometric testing of shoulder rotation. Factors that possibly contributed to variability are discussed. Clinicians should recognize potential sources of testing error when obtaining isokinetic measurements for use in clinical decision-making. Further refinement of isokinetic testing protocols at the shoulder is recommended.

Adolescent↗
PubMed1993

Reliability of open and closed kinetic chain subtalar joint neutral positions and navicular drop test.

Subtalar joint (STJ) measurements are commonly made in the clinic to assess foot and ankle positions because of the high incidence of lower extremity dysfunctions. The purposes of this study were to investigate the intratester and intertester reliability of the open kinetic chain subtalar joint neutral (OKC STJN) and closed kinetic chain subtalar joint neutral (CKC STJN) positions and the navicular drop test (NDT). Two inexperienced testers performed repeated measurements on 15 subjects (N = 30 feet) during two testing sessions. Intratester and intertester reliability (ICC 1,1) and standard error of measurement (SEM) were determined for each dependent variable. For OKC STJN, the intratester ICC values were .06 and .27, and the intertester ICC value was .00. The intratester SEM values were 1.81 and 2.29 degrees, and the intertester was 2.51 degrees. The CKC STJN intratester ICC values were .14 and .18, with SEM values of 2.46 and 2.40 degrees. The intertester CKC ICC value was .15, with an SEM of 2.43 degrees. For the NDT, the intratester ICC values were .61 and .79, and the SEM values were 1.92 mm and 2.57 mm. The intertester ICC value was .57 and the SEM was 2.72 mm. The results reveal that both OKC and CKC STJN yield poor intratester and intertester reliability and the NDT yields poor to moderate intratester reliability and poor intertester reliability. We conclude that these foot and ankle measurements are not reliable when performed by inexperienced testers. Therefore, clinicians should practice these measurement techniques and determine their measurement error.

Adult↗
PubMed1997

Test-retest reliability of patient reports of low back pain.

Low back pain is, in large part, a subjective illness. Clinicians must use patient descriptions of the severity and location of low back pain and how it responds to various activities and positions to make diagnostic and treatment decisions. Therefore, it is important to understand how reliably patients describe these aspects of low back pain. The purpose of this study was to determine the test-retest reliability of a visual analogue scale measure of pain intensity, a pain drawing measure of pain location, and the pain response to activity and position questionnaire. Fifty-three subjects (28 men and 25 women) with a mean age of 54.2 years were recruited from an outpatient orthopaedic clinic. They completed the visual analogue scale, pain drawing, and pain response to activity and position questionnaire before and again immediately after seeing their physician. Thirty-three subjects also completed the visual analogue scale and pain drawing measure that evening and the next morning. Test-retest reliability of the visual analogue scale and pain drawing measure was examined using an intraclass correlation coefficient. Reliability of each item on the pain response to activity and position questionnaire was examined by calculating an unweighted Cohen's kappa. Overall, the three pain measures demonstrated fair to good test-retest reliability: 1) visual analogue scale = .66-.93, 2) pain drawing = .58-.94, and 3) pain response to activity and position questionnaire = .46-.89. The results of this study suggest that, although there is some variability in how consistently patients report various aspects of low back pain, the reliability of these pain measures is sufficient to permit their use in making clinical decisions and measuring treatment outcomes.

Female↗
PubMed1998

Reliability and validity of rigid lift and pelvic leveling device method in assessing functional leg length inequality.

Clinicians commonly include an assessment of leg length inequality (LLI) as a component of a musculoskeletal examination. Little research is available, however, documenting reliability and validity of clinical methods for assessing LLI. The purpose of this study was to determine the reliability and validity of assessing functional LLI using a pelvic leveling device. Subjects were 19 women and 13 men between the ages of 18 and 55 who reported having a diagnosed or suspected LLI. Clinical determination of LLI was made by placing rigid lifts under the suspected shorter lower extremity until the leveling device indicated that the iliac crests were level. This measurement was made twice by one investigator and once by a second investigator. Standing radiographic measurements of LLI using rigid lifts were used to establish validity of the clinical method. Intraclass correlation coefficients [ICC(2,1)] and absolute difference values were computed to assess reliability and validity. The mean absolute difference between the two clinical measurements of LLI by the same investigator was 0.29 cm (+/- 0.52), with an ICC = 0.84. The mean absolute difference between clinical measurements of LLI by the two investigators was 0.49 cm (+/- 0.46), with an ICC = 0.77. The ICC and mean absolute difference reflecting agreement between radiographic measurements and clinical measurements of LLI was 0.64 and 0.58 cm (+/- 0.58), respectively, for one investigator and 0.76 and 0.55 cm (+/- 0.37), respectively, for the second investigator. The intratester reliability, intertester reliability, and validity assessments included instances in which paired observations disagreed regarding which lower extremity was the shorter lower extremity. Factors that may be associated with the unacceptable reliability and validity of the clinical assessment method include asymmetric positioning of the ilia, body composition of the patient, and design of the clinical instrument. The authors discuss clinical implications related to assessment of LLI.

Adolescent↗
PubMed1999

Reliability of water volumetry and the figure of eight method on subjects with ankle joint swelling.

STUDY DESIGN: Single-group repeated measures with 2 raters. OBJECTIVES: To determine the interrater and intrarater reliability of water volumetry and the figure of eight method on subjects with ankle joint swelling. BACKGROUND: Measurements of ankle swelling are commonly performed to determine the nature and stage of injury and to monitor progress made during rehabilitation. Water volumetry and the figure of eight method are 2 techniques used to measure ankle swelling. METHODS AND MEASURES: Twenty-nine subjects with ankle swelling were measured by 2 raters with the hypothesis that both measurement techniques would be reliable. Each rater performed 3 measurements of the swollen ankle using both measurement techniques during a single test session. The order of the rater and of the measurement technique was randomized, and the raters were blinded to each other's measurements. RESULTS: We found high interrater reliability for both the water volumetry (ICC [intraclass correlation coefficient] = 0.99) and figure of eight methods (ICC = 0.98). Additionally, intrarater reliability was high for both raters using both methods (ICCs = 0.98-0.99). CONCLUSIONS: Both methods are reliable measures of ankle swelling. The authors recommend the figure of eight method because of its ease of use, time efficiency, and cost effectiveness. However, water volumetry may be more appropriate when measuring diffuse lower-extremity swelling. Reliability of these 2 methods was established using subjects with foot or ankle pathology. Therefore, the results are applicable and generalizable to the clinical setting.

Adolescent↗
PubMed2003

Test-retest reliability of an abbreviated self-report overall health status measure.

STUDY DESIGN: Test-retest reliability study. OBJECTIVE: To assess test-retest reliability and estimate minimal detectable change of an overall measure and 2 summary measures of patient self-report of health status. BACKGROUND: Change in patient self-report of health status is a common outcome measure following rehabilitation. Because collection of health status data takes time and clinicians are required to be productive, selected items from reliable instruments were used to form a new, abbreviated instrument of health status relevant to patients in outpatient rehabilitation. There are no test-retest reliability statistics of these health status measures in this population. METHODS AND MEASURES: A convenience sample of 71 patients (mean age +/- SD, 41.9 +/- 17.9 years; age range, 15-83 years; sex, 35% male), with a variety of orthopaedic diagnoses, seeking rehabilitation in 2 outpatient facilities, volunteered. Patients completed health status questionnaires at initial evaluation and at 24 to 72 hours following evaluation. Intraclass correlation coefficients (ICC2.1) were used to estimate test-retest reliability and to estimate measurement error and minimal detectable changes. RESULTS: ICCs with a 1-sided lower limit 95% confidence intervals (CI) of the Overall Health Status measure and the Physical and Mental Component Summary measures for patients with chronic symptoms were 0.92 (0.85), 0.82 (0.68), and 0.85 (0.74), respectively. Minimal detectable changes (90% CI) were +/-12 (scale range, 100), +/- 9 (scale range, 60), and +/- 9 (scale range, 60) scale points, respectively, for the same measures. CONCLUSIONS: Results support the test-retest reliability of the Overall Health Status measure and summary measures for patients with chronic symptoms and demonstrate ability of the Overall Health Status and Physical Summary Scale measures to detect improvement of patient self-report of health status within the first few days of rehabilitation.

Adolescent↗
PubMed2003

Reliability of classifications derived from Cyriax's resisted testing in subjects with painful shoulders and knees.

STUDY DESIGN: Intrarater and interrater reliability. OBJECTIVES: Examine intrarater and interrater reliability of the resisted-testing component of Cyriax's selective tension testing for patients with painful shoulders and knees. BACKGROUND: Clinicians make diagnostic and intervention decisions about lesions in contractile tissues based on resisted testing. Diagnostic and intervention decisions require reliable data gathering, especially when more than 1 physical therapist manages a patient. No studies have examined agreement of the results of the resisted tests used in selective tension testing, either within or between physical therapists, in subjects having pathology. METHODS AND MEASURES: Subjects with pain in 1 knee (18 male, 22 female; mean age +/- SD = 31.8 +/- 9.5 years) or shoulder (21 male, 25 female; mean age +/- SD = 34.3 +/- 12.9 years) were examined twice. Referring diagnoses included ligament injuries, overuse syndromes, joint instability, and postsurgical symptoms, with some subjects seeking initial diagnosis. Two physical therapists used standardized positions to evaluate 2 knee motions or 6 shoulder and elbow motions. Evaluators applied maximal isometric manual resistance and rated the contraction as strong or weak while subjects identified the presence or absence of pain during the contraction. Evaluators did not interview the subjects and were masked to previous test results. Analyses included percentage of agreement, kappa coefficients, confidence intervals, and maximum kappa coefficients. RESULTS: Intrarater kappa coefficients ranged from 0.44 to 0.82 and interrater coefficients ranged from 0.00 to 0.46. The small number of subjects who were classified as weak affected the kappa coefficients. In the intrarater condition, evaluators averaged 91% of maximum kappa for the knee and 66.5% for the shoulder. In the interrater condition, they averaged 60.4% of the maximum kappa for both the knee and the shoulder. CONCLUSIONS: Based on 2 physical therapist evaluators with previous education in the selective tension system and an additional 6 hours of formal training on the methods, intrarater reliability of resisted tests was generally acceptable for the knee but not for the shoulder. Interrater reliability of these tests, however, was generally not acceptable. Results were limited by subjects who were younger and had mostly chronic conditions that were mildly to moderately severe and by the small subject samples in the analyses. Reliability might be improved by more intensive training of the evaluators and by standardizing the magnitude of the applied resistance and stabilization of the subjects.

Adult↗
PubMed2004

The interrater reliability among physical therapists newly trained in a classification system for acute low back pain.

STUDY DESIGN: A prospective methodological interrater reliability study. OBJECTIVES: To calculate the interrater reliability among clinicians newly trained in a classification system for acute low back pain and to determine the level of agreement at key junctures within the classification algorithm. BACKGROUND: The utility of a classification system for patients with low back pain depends on its reliability and generalizability. To be practical, clinicians must be able to apply the system after a reasonable amount of training. Identifying key points in the classification algorithm where disagreement occurs can lead to better operational definitions. METHODS: Four physical therapists read an article and attended a 1-day training session in the classification system. Randomly paired therapists classified patients referred for treatment of acute low back pain and noted decisions at key junctures in the system algorithm. RESULTS: Forty-five patients were classified. Repeated examinations did not increase the patient's pain (P>.05). For 3 out of the 4 therapists, the interrater reliability showed a kappa value of 0.45. The fourth therapist, excluded from the overall analysis, exhibited a bias towards the immobilization classification. Among the 3 therapists, major disagreement occurred with the determination of symmetry with trunk side bending and the effects of repeated movements. CONCLUSIONS: Three out of 4 clinicians newly trained in the system showed moderate reliability. The reliability was slight when the fourth therapist was included. Refinement of the operational definitions and criteria for determining lumbar capsular patterns are needed. One day of training is probably not adequate for all therapists, especially for those biased towards specific low back pain syndromes.

Adult↗
PubMed2001

Approximation of reliabilities for multiple-trait model with maternal effects.

Reliabilities for a multiple-trait maternal model were obtained by combining reliabilities obtained from single-trait models. Single-trait reliabilities were obtained using an approximation that supported models with additive and permanent environmental effects. For the direct effect, the maternal and permanent environmental variances were assigned to the residual. For the maternal effect, variance of the direct effect was assigned to the residual. Data included 10,550 birth weight, 11,819 weaning weight, and 3,617 postweaning gain records of Senepol cattle. Reliabilities were obtained by generalized inversion and by using single-trait and multiple-trait approximation methods. Some reliabilities obtained by inversion were negative because inbreeding was ignored in calculating the inverse of the relationship matrix. The multiple-trait approximation method reduced the bias of approximation when compared with the single-trait method. The correlations between reliabilities obtained by inversion and by multiple-trait procedures for the direct effect were 0.85 for birth weight, 0.94 for weaning weight, and 0.96 for postweaning gain. Correlations for maternal effects for birth weight and weaning weight were 0.96 to 0.98 for both approximations. Further improvements can be achieved by refining the single-trait procedures.

Animals↗
PubMed2002

Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy.

OBJECT: Validity (the extent to which a test measures what it is intended to measure) and reliability (the stability and reproducibility of measures of the same concept over time or across methods of gathering data) are important characteristics of any outcomes instrument. Generic outcomes instruments are designed for use in any population; however, their validity and reliability in particular diseases should be verified to ensure their appropriateness for use in that disease. In this study the authors assessed the validity and reliability of the Medical Outcomes Study Short Form-36 (SF-36), a generic outcomes instrument, in a population of patients with cervical spondylotic myelopathy (CSM). METHODS: The SF-36 was administered to a cohort of patients with CSM on an outpatient basis. Symptom-related data derived from a structured interview and physical examination findings were used to classify cases according to the myelopathy scales of Nurick, Cooper, Harsh, and a Western modification of the Japanese Orthopaedic Association (JOA). Construct validity was assessed by determining whether SF-36 scores varied in accordance with predefined hypotheses relating to the myelopathy scores by using the Cuzick nonparametric test for trend. The reliability of the SF-36 scores was assessed using Cronbach alpha. Eighty-eight patients with CSM completed the SF-36 and interview. Construct validity was demonstrated by confirming the hypothesized relationship between SF-36 scales and the myelopathy scales of Nurick (p < or = 0.003), Cooper leg subscale (p < or = 0.012, except the general health perceptions domain [p = 0.091]), Harsh (p < or = 0.016), and the motor component of the modified JOA (p < or = 0.006). Reliability was demonstrated for all eight SF-36 domain scales and the physical component and mental component summary scales, in which Cronbach alpha satisfied the Nunnally criterion of 0.7. CONCLUSIONS: The SF-36 provides valid and reliable data on patients with CSM.

Activities of Daily Living↗
PubMedDate not supplied

Reliability and validity of two instruments designed to assess the walking and bicycling suitability of sidewalks and roads.

PURPOSE: Public health professionals hypothesize that when community environments provide suitable walking and bicycling conditions, community members will be more active. Measurement indicators and assessment instruments are needed to evaluate suitability. This study determined the reliability and validity of two instruments to assess the suitability of sidewalks for walking and roads for bicycling. METHODS: Two data collectors used walking and bicycling suitability assessment instruments to collect data on 31 road segments. In addition, three transportation experts used a 7-point Likert response system to subjectively evaluate walking and bicycling conditions for the same segments. Intraclass correlations determined the reliability of each assessment instrument and the reliability of the Likert response system. Pearson correlations (research staff assessments with expert assessments) were calculated to determine the criterion-related validity of the suitability measures. RESULTS: Intercoder reliability (intraclass) correlations for the walking and bicycling assessment instruments were r = .79 and .90, respectively. Intercoder reliability of the experts' Likert response system was r = .73 for the walking form and r = .77 for the bicycling form. Criterion-related validity (Pearson) correlations for the walking and bicycling assessment instruments were r = .58 and .62, respectively. CONCLUSION: Although some variables have lower reliability and validity than is ideal, the walking and bicycling suitability assessment instruments appear promising as instruments for community members and professionals to systematically assess key aspects of the physical environment.

Bicycling↗
PubMed2004

[Reliability of students' evaluations of university teaching: an analysis of four-facet data by a generalized model and structural equation modeling].

In our study, we examined the reliability of students' evaluation of university teaching. First, we analyzed four-facet data (teacher x rater x viewpoint x order) by the generalizability theory approach, and estimated the variance components for the facets as a G study. Then, we evaluated the reliability from the point of view of the generalizability coefficient (a reliability-like coefficient that is used when a decision concerns the relative ordering of individuals) and the index of dependability (an index that is used when a decision focuses on the absolute level of an individual's performance independent of others' performance), and examined how those indices change as the number of raters and viewpoints are changed. With these analyses we found conditions needed to maintain sufficient reliability of the evaluation for various situations. We also introduced a new method to evaluate the reliability at each level of facet by using structural equation modeling. By this method, one can examine the reliability of students' evaluation of university teaching more specifically.

Adult↗
PubMed1996

The reliability and validity of work measurement in Australian general practice consultations.

OBJECTIVES: To examine the reliability of relative work value assessment in general practice consultations and to determine whether different methods of assessing work produce consistent rankings. DESIGN: Cross-sectional observational assessment of general practice consulations. SETTING: General practices in Victoria between October 1991 and October 1992. PARTICIPANTS: 686 patients attending one of 58 general practitioners (GPs) drawn from a random, stratified sample. METHODS: Each participating GP had one day of consultations videotaped. They rated the work value of each consultation by using a magnitude estimation scale relative to a reference vignette. Three GP observers independently applied the same scale to the videotaped consultations. After three months, the observers applied a second measurement of work value, a compensation scale (also relative to the reference vignette), to the videotaped consultations. Duration of consultation was the third rating method. MAIN OUTCOME MEASURES: The reliability of work value assessment for each scale. Consultation rank order correlation coefficients among all rating methods. RESULTS: Observer reliability was high for both scales. Practising GPs showed lower levels of reliability in assessing the work value of their consultations. Strong positive correlations were found for consultation rankings among the observer scales and duration of the consultation. The duration of the consultation emerged as an important predictor of consultation work value. CONCLUSIONS: Scaling methods appear to be of little value to the practising GP in reliably assessing the relative work value of their consultations; training in the use of these scales may improve their reliability. However, the duration of consultation may be a reasonable proxy for relative work value assessment in general practice consultations.

Australia↗
PubMed1999

Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis.

OBJECTIVES: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and disease-specific rating system for elbow function assessment (EFA) in adult patients with RA, using a combination of self-reported subjective items and objective measures, and comparing its characteristics with the HSS and Mayo Clinic scales. METHODS: (1) Selection of elbow-specific items. (2) Investigation of reliability and validity of all separate items, as well as the total HSS and Mayo Clinic scores, in 42 patients with RA (mean age 60 yrs). Direct observation of functional elbow performance was defined as the gold standard against which criterion validity was compared. (3) Reaching agreement within a team of professionals on the different scale dimensions and the assigned weight. (4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and ambiguous items. Finally, the EFA scale was constructed by selecting the most reliable and accurate items. RESULTS: The EFA scale showed a superior or equal degree of reliability as reflected in intraclass correlation coefficients of more than 0.88, and also superior validity, compared with the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring systems currently available provide a reliable measure, they seem restricted in evaluating elbow-specific functional ability. The EFA scale was found to be most suitable to measure elbow functional ability in RA, and was also shown to be highly reliable and practical in clinical practice.

Activities of Daily Living↗
PubMed2000

Reliability and responsiveness of two physical performance measures examined in the context of a functional training intervention.

BACKGROUND AND PURPOSE: The reliability and responsiveness of 2 physical performance measures were assessed in this nonrandomized, controlled pilot exercise intervention. SUBJECTS: Forty-five older individuals with mobility impairment (mean age=77.9 years, SD=5.9, range=70-92) were sequentially assigned to participate in an exercise program (intervention group) or to a control group. METHODS: The intervention group performed exercise 3 times a week for 12 weeks that targeted muscle force, endurance, balance, and flexibility. Outcome measures were the 8-item Physical Performance Test (PPT-8) and the 6-minute walk test. Test-retest reliability and responsiveness indexes were determined for both tests; interrater reliability was measured for the PPT-8. RESULTS: The intraclass correlation coefficient for interrater reliability for the PPT-8 was. 96. Intraclass correlation coefficients for test-retest reliability were.88 for the PPT-8 and.93 for the 6-minute walk test. The intervention group improved 2.4 points and the control group improved 0.7 point on the PPT-8, as compared with baseline measurements. There was no change in 6-minute walk test distance in the intervention group when compared with the control group. The responsiveness index was.8 for the PPT-8 and.6 for the 6-minute walk test. CONCLUSION AND DISCUSSION: Measurements for both the PPT-8 and the 6-minute walk test appeared to be highly reliable. The PPT-8 was more responsive than the 6-minute walk test to change in performance expected with this functional training intervention.

Aged↗
PubMed1999

The reliability of two methods of utility assessment in dentistry.

OBJECTIVE: The objective of this study was to investigate the modification of two utility assessment techniques (visual analogue scale and daily time trade-off) used in medicine to the dental setting, with a focus on their test-retest reliability and ease of use. BASIC RESEARCH DESIGN: The study involved a postal questionnaire survey which incorporated a dental visual analogue scale (DVAS) to assess utility values for 12 specified tooth states, and a specifically designed instrument, the dental freetime trade-off (DFTO) to assess utility of the participants' current dental health state. PARTICIPANTS: A total of 582 regularly attending adolescent dental patients were sent the questionnaire. A further 100 of those who fully completed the relevant sections of the questionnaire were sent a repeat questionnaire to facilitate assessment of test-retest reliability. RESULTS: A final response rate of 74.7% was achieved with the mean age of respondents being 17 years. Fifty per cent of those sent a repeat questionnaire for the purposes of reliability assessment returned the questionnaire. Test-retest reliability of both utility assessment techniques appeared acceptable. Spearman correlation coefficients for the dental freetime trade-off (DFTO) and the dental visual analogue scale (DVAS) were (0.67 and 0.83 respectively. Promising results, in terms of utility values, were elicited from the DVAS whilst utility values elicited using the DFTO were highly skewed. CONCLUSIONS: The newly developed modification to the daily time trade-off technique, the DFTO, showed a good level of test-retest reliability and ease of completion although the highly skewed utility results produced may indicate a design flaw. The DVAS however, appears to show promise, in terms of test-retest reliability, ease of completion and resultant utility values.

Adolescent↗
PubMed2000

Alberta infant motor scale: reliability and validity when used on preterm infants in Taiwan.

BACKGROUND AND PURPOSE: The goal of this study was to examine the reliability and validity of measurements obtained with the Alberta Infant Motor Scale (AIMS) for evaluation of preterm infants in Taiwan. SUBJECTS: Two independent groups of preterm infants were used to investigate the reliability (n=45) and validity (n=41) for the AIMS. METHODS: In the reliability study, the AIMS was administered to the infants by a physical therapist, and infant performance was videotaped. The performance was then rescored by the same therapist and by 2 other therapists to examine the intrarater and interrater reliability. In the validity study, the AIMS and the Bayley Motor Scale were administered to the infants at 6 and 12 months of age to examine criterion-related validity. RESULTS: Intraclass correlation coefficients (ICCs) for intrarater and interrater reliability of measurements obtained with the AIMS were high (ICC=.97-.99). The AIMS scores correlated with the Bayley Motor Scale scores at 6 and 12 months (r=.78 and.90), although the AIMS scores at 6 months were only moderately predictive of the motor function at 12 months (r=.56). CONCLUSION AND DISCUSSION: The results suggest that measurements obtained with the AIMS have acceptable reliability and concurrent validity but limited predictive value for evaluating preterm Taiwanese infants.

Child Development↗
PubMed2000

Standardized initial head position in cervical range-of-motion assessment: reliability and error analysis.

OBJECTIVE: To assess the clinical reliability and precision of the OSI CA-6000 Spinal Motion Analyzer for measurement of range of motion in cervical spines of pain-free subjects by using a novel procedure designed to minimize variability and quantitatively evaluate sources of errors. METHODS: Twenty asymptomatic volunteer subjects were evaluated twice by each of two trained examiners in one session. Subject position was carefully standardized. Rotation, lateral bending, and flexion-extension were evaluated in repeated movements (cycles) from extreme to extreme. ANALYSIS: Descriptive statistics and reliability coefficients (interclass correlation coefficients [ICCs]) were calculated for all full- and half-cycle motions. Possible sources of systematic errors were evaluated, and random errors were estimated. RESULTS: ICCs indicate that the instrument performs very reliably for rotation and lateral bending (0.93-0.97) and acceptably for flexion-extension (0.75-0.93) measurements. Differences in instrument placement, subject posture, or both in different trials correlate neither with differences in measured values nor with variances. Within-trial errors did not correlate with ranges of motion. Standardizing head position resulted in increases in reliability of from 3% to 15% for axial rotation and lateral bending but actually decreased the ICCs for flexion-extension (up to 14%) compared with data collected under a less-stringent protocol. Errors in clinical use are estimated at 4.5 degrees. CONCLUSIONS: By using our modifications to the accessories and standardization of subject position, the CA-6000 is a highly precise and reliable instrument for measuring active cervical motion about the 3 Cartesian axes. Individuals can repeat the same patterns of motion in sequential trials on the same day with very little variation. Ease of repetitious measurement without examiner intervention contributes to the instrument's ability to obtain highly reliable data. Changes in instrument placement or subject body posture between trials do not give rise to systematic errors. Design of the instrument for flexion-extension could be improved.

Adult↗