Intraobserver reliability and validity of a single ultrasonic measurement of the lateral condyle-capsule distance in the temporomandibular joint.

PURPOSE: The purpose of the study was to examine the reliability and validity of a single lateral condyle-capsule distance (LCCD) measurement while saving on economic costs and clinical resources. METHODS: A longitudinal test-retest design was used to assess the reliability and validity of single-examiner measures over 72 TMJ sonographic analyses. Intraclass correlation coefficients (ICC) and a Bland-Altman plot were used to study reliability and validity, comparing the first measurement of the LCCD to the mean of 3 measurements taken one week later by the same examiner. RESULTS: ICC show intraobserver reliability of 0.981, 95% confidence intervals (CI) of 0.969 to 0.988. The mean difference between the ultrasound measurements is 0.019 mm (95% CI 0.0005-0.0383) with a standard deviation of 0.080 mm, demonstrating robust validity. The 95% Limits of Agreement (LoA) are - 0.138 for the lower limit and 0.177 for the upper. Mean relative error is 0.009 mm. CONCLUSION: Intraobserver reliability of a trained examiner is very high in the single measurement of the LCCD and validity is significant compared to more complex methods. The risk of bias is low since the mean of three LCCD measurements is calculated as opposed to recording only one single measurement.

Intra- and inter-observer concordance of a fascial standing flexion test in children.

INTRODUCTION: Manual clinical tests must be highly reliable and valid to help in diagnosing, monitoring, and treating patients. Recent research highlighted the role of the fascia; thus, it is important to develop inexpensive, easy-to-use, and clinically valid procedures to assess this tissue in the field of manual therapy. The purpose of this study was to determine the level of inter- and intra-examiner concordance when performing a fascial standing flexion test in children. DESIGN: The present study is a descriptive observational study. METHODS: Two examiners tested 24 healthy children between 11 and 12 years of age performing two trials with the proposed fascial test. Inter- and intra-examiner data were analyzed using unweighted kappa coefficients and percentage agreement. RESULTS: We observed zero inter-examiner reliability in the fascial standing flexion test (mean κ = -0.071, mean percentage agreement of 43.7%), and moderate intra-examiner reliability (mean κ = 0.693, mean percentage agreement of 85.4%). CONCLUSION: The reliability and validity of the fascial standing flexion test must be improved before it can be recommended for use in a clinical setting.

Acoustic Environmental Conditions (Do Not?) Affect the Static Posturography Diagnostic Accuracy: A Test-Retest Reliability Study.

Static posturography assessed with force platforms is a procedure used to obtain objective estimates related to postural adjustments. However, controlling multiple intrinsic and extrinsic factors influencing the diagnostic accuracy is essential to obtain reliable measurements and recommend its use with clinical or research purposes. We aimed to analyze how different environmental acoustic conditions affect the test−retest reliability and to analyze the most appropriate number of trials to calculate a valid mean average score. A diagnostic accuracy study was conducted enrolling 27 healthy volunteers. All procedures were taken considering consistent device settings, posture, feet position, recording time, and illumination of the room. Three trials were recorded in a silent environment (35−40 dB) and three trials were recorded in a noisy environment (85−90 dB). Results showed comparable reliability estimates for both acoustic conditions (ICC = 0.453−0.962 and 0.621−0.952), but silent conditions demonstrated better sensitivity to changes (MDC = 13.6−76%). Mean average calculations from 2 and 3 trials showed no statistically significant differences (p > 0.05). Cross-sectional studies can be conducted under noisy or silent conditions as no significantly different scores were obtained (p > 0.05) and ICC were comparable (except oscillation area). However, longitudinal studies should consider silent conditions as they demonstrated better sensitivity to real changes not derived from measurement errors.

Anatomical and physiological considerations in the 'hip rotators test' related to the stomatognathic system: a brief commentary / Consideraciones anatomofisiológicas en el "test de rotadores de cadera" relacionado con el sistema estomatognático: un breve comentario

Manual tests in clinical investigation must be supported by anatomical and physiological findings in order to obtain an objective information. The application of different mandibular positions in children obtains a variation in the 'hip rotators test' (p < 0.001). The possible relationships behind the muscle tone of the external rotators of the hips and the stomatognathic system are exposed, with special attention on the fascial tissue and its morphological characteristics. Despite these anatomical and physiological connections, there is no further evidence of a strong cause-effect relationship in this test.

Las pruebas manuales en la investigación clínica deben estar respaldadas por hallazgos anatómicos y fisiológicos para obtener una información objetiva. La aplicación de diferentes posiciones mandibulares en niños muestra una variación en la "prueba de rotadores de cadera" (p <0,001). Se exponen las posibles relaciones del tono muscular de los rotadores externos de las caderas y el sistema estomatognático, con especial atención en el tejido fascial y sus características morfológicas. A pesar de estas conexiones anatomofisiológicas, no existe una evidencia mayor de una relación importante causa-efecto en esta prueba.