Validity and reliability of upper extremity star excursion balance test in adolescent swimmers.

Background: Upper limb balance is one of the important physical fitness parameters for all populations, especially overhead athletes like swimmers. Upper extremity star excursion balance test (UESEBT) is a comprehensive dynamic balance assessment, this study aims to explore the reliability and validity of UESEBT among adolescent swimmers. Methods: This cross-sectional study recruited 70 adolescent swimmers. All participants were required to complete UESEBT, upper quarter Y-balance test (UQYBT), maximal isometric strength (MIS) tests in upper limb, closed kinetic chain upper extremity stability test (CKCUEST), trunk flexor endurance test (TFET) and lateral trunk endurance test (LTET). The intra- and inter-operator reliability and the correlation of UESEBT with other physical performances were conducted. Results: For reliability, the intra- and inter-operator reliability of all directions and composite score were high-to-excellent (ICC = 0.706-1.000) among all participants. For validity, the UESEBT has a moderate-to-strong correlation with UQYBT (r = 0.42-0.72, p < 0.001), and a weak-to moderate one with CKCUEST (r = 0.25-0.42, p < 0.05). Furthermore, the UESEBT performance showed weak-to-moderate correlations with MIS (r = 0.24-0.44, p < 0.05). UESEBT was correlated to LTET (r = 0.24-0.33, p < 0.05) whereas no relationship was found with TFET. Conclusions: UESEBT was a reliable and valid tool to screen upper extremity dynamic balance among adolescent swimmers. UESEBT provides more detailed information in eight directions to assess the upper limb sport performance. Further study should explore the prediction ability of UESEBT for injury.

Cross-cultural adaptation and psychometric validation of the Dutch version of the Core Outcome Measures Index for the back (COMI -back) in patients undergoing surgery for degenerative disease of the lumbar spine.

Introduction: Patient-reported outcome measures (PROMs) are the preferred outcomes measured in patients with lumbar spinal degenerative diseases. As PROMs can be lengthy and therefore pose a burden to patients and researchers, short and standardized PROMs are needed, such as the Core Outcome Measures Index (COMI). Research question: Is the Dutch version of the COMI-back a reliable and responsive PROM to measure outcomes in lumbar degenerative spinal surgery? Methods: After translating and cross-cultural adapting the COMI-back into Dutch, patients who were on the waiting-list for lumbar decompression surgery in a secondary referral center, were enrolled in the validation study. Patients completed a baseline booklet consisting of the COMI-back, likert scales measuring back and leg pain, the Roland-Morris Disability questionnaire, the EuroQoL-5 dimensions and the WHO-Quality-of-Life-BREF questionnaire to test construct validity. Within 2 weeks and before undergoing surgery, patients completed the COMI-back again, to measure test-retest stability. Three months after surgery, a global treatment outcome (GTO) question and the COMI-back were completed to test responsiveness. Results: The COMI-back was successfully translated and adapted into Dutch. One-hundred-thirty-five patients completed the baseline booklet, 93 the test-retest questionnaire and 102 the responsiveness questionnaire. The COMI-summary score and four of five COMI-domains, showed good to very good correlation to the reference questionnaires (ρ â€‹> â€‹0.41). The COMI-back showed a good test-retest stability with an intraclass correlation coefficient of 0.81 for the summary score. Furthermore, the standard error of agreement was 0.65 and the minimal detectable change was 1.8 points. The ROC-curve showed an area under the curve of 0.89 (95% CI 0.82 to 0.95). Conclusion: The Dutch version of the COMI-back has satisfactory psychometric properties and is a reliable and responsive patient-reported outcome measure in patients undergoing surgery for lumbar degenerative disease.

Accuracy and Reliability of Single-Camera Measurements of Ankle Clonus and Quadriceps Hyperreflexia.

OBJECTIVE: To evaluate the accuracy and reliability of a simple, single-camera smartphone-based method, named the Reflex Tracker (RT) system, for measuring reflex threshold angles related to ankle clonus and quadriceps hyperreflexia. DESIGN: A prospective comparison study using a high-fidelity reference standard was constructed employing a 2 × 2 × 2 factorial design, with factors of rater (tester) type (student and experienced physical therapist), joint (ankle and knee), and repetition (2 per condition). SETTING: This multicenter study was conducted at 4 outpatient rehabilitation clinics. PARTICIPANTS: A convenience sample of 14 individuals with a neurologic condition presented with 20 lower limbs that exhibited ankle clonus and/or quadriceps hyperreflexia and were included in the study. Also participating in the study were 8 student and 8 experienced physical therapist raters (testers) (N=16). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The plantar flexor reflex threshold angle (PFRTA) related to ankle clonus and the quadriceps reflex threshold angle (QRTA) related to quadriceps hyperreflexia were quantified. RESULTS: PFRTA and QRTA results were compared between the smartphone RT method and synchronous 3-dimensional inertial measurement unit (IMU) sensor motion capture. Mean difference (bias) was minimal between RT and IMU measurements for PFRTA (bias≤0.2°) and QRTA (bias≤1.2°). Intrarater reliability for PFRTA ranged from 0.85-0.90 using RT and from 0.85-0.87 using IMU; QRTA ranged from 0.97-0.98 using RT and from 0.96-0.99 using IMU. Intersensor reliability for PFRTA and QRTA was 0.97 and 0.99, respectively. Minimum detectable change for PFRTA ranged from 7.1°- 8.7° and for QRTA ranged from 6.1°-8.3°. CONCLUSIONS: RT performed comparable to IMU for accurate and reliable measurement of PFRTA and QRTA to quantify ankle clonus and quadriceps hyperreflexia in clinical settings.

Reliability and Validity of a New Eccentric Hamstring Strength Measurement Device.

OBJECTIVE: To investigate the reliability and establish validity of a new eccentric hamstring strength measurement device. DESIGN: A randomized double-crossover trial with intraclass correlation coefficients to analyze the outcomes. Participants attended 4 sessions, 7 days apart. They were randomly allocated into 2 groups. Session 1 was a familiarization session for all participants on the new eccentric hamstring strength measurement device and isokinetic dynamometer. The following 3 sessions were used to measure knee flexor (hamstring) eccentric strength on the isokinetic dynamometer and a further test-retest measurement using the new eccentric hamstring strength measurement device. SETTING: Institute of Technology Carlow, third level educational institution. PARTICIPANTS: Male intercollegiate field-sport players completed the trial (N=19). Participants were 21±2 years, weighed 78.6±4.6 kg, and were 179.6±6.4 cm in height. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: Peak torque (Nm) was recorded by the isokinetic device, and peak force (N) was recorded by the new eccentric hamstring strength measurement device and used to test for significant interdevice correlations (>0.7). Intraclass correlation coefficients were calculated using the peak force recorded from 2 separate trials of the new eccentric hamstring strength measurement device. RESULTS: High test-retest reliability was observed from the new eccentric hamstring strength measurement device, intraclass coefficient (ICC)=.910 (confidence interval [CI], .76-.96) and .914 (CI, .78-.96) for left and right peak forces, respectively. Typical error of measurement between trials was calculated to be 14.65 and 17.29N for the left and right limbs, respectively. Minimum detectable change (MDC) was also calculated to be 40.62N (MDC%=14.68%) and 39.63N (MDC%=13.31%) for left and right limbs, respectively. The interdevice correlation showed good validity, ICC=.823 (CI, .58-.93) and .840 (CI, .58-.93) for left and right peak torque/forces, respectively. CONCLUSIONS: The new eccentric hamstring strength measurement device is a reliable and valid device that provides an objective measurement of eccentric hamstring strength that may be used in combination with a comprehensive assessment to inform rehabilitation and management.

Concurrent Validity and Reliability of the Transfer Assessment Instrument Questionnaire as a Self-Assessment Measure.

OBJECTIVES: To evaluate the psychometric properties of the Transfer Assessment Instrument Questionnaire (TAI-Q), a self-assessment measure to evaluate transfer quality compared with clinician-reported measures. DESIGN: Participants self-assessed transfers from their wheelchair to a mat table using the TAI-Q. For session 1, participants self-assessed their transfer both before and after reviewing a video of themselves completing the transfer (session 1). Self-assessment was completed for another transfer after a 10-minute delay (session 2, intrarater reliability) and after a 1- to 2-day delay (session 3, test-retest reliability). Self-assessment was compared with a criterion standard of an experienced clinician scoring the same transfers with the Transfer Assessment Instrument (TAI) version 4.0 (concurrent validity). SETTING: 2017 National Veterans Wheelchair Games. PARTICIPANTS: Convenience sample of full-time wheelchair users (N=44). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: TAI-Q and TAI. RESULTS: After video review of their transfer, acceptable levels of reliability were demonstrated for total TAI-Q score for intrarater (intraclass correlation [ICC], 0.627) and test-retest reliability (ICC, 0.705). Moderate to acceptable concurrent validity was demonstrated with the TAI (ICC, 0.554-0.740). Participants tended to underestimate the quality of their transfer (reported more deficient items) compared with the TAI. However, this deficit decreased and reliability improved from pre-video review to post-video review and from session 1 to session 2. The minimum detectable change indicated that a change of 1.63 to 2.21 in the TAI-Q total score is needed to detect a significant difference in transfer skills. CONCLUSIONS: When paired with video review, the TAI-Q demonstrates moderate to acceptable levels of reliability and validity for the total score. Self-assessment was completed quickly (<5min) and could help to potentially screen for deficiencies in transfer quality and opportunities for intervention.