• The Journal of Korean Physical Therapy
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• 제27권5호
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• pp.311-314
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• 2015

Purpose: This study attempted to determine intra-rater reliability and inter-rater reliability for measurement of foot form using the FPI-6 (Foot Posture Index) in patients with hemiplegia caused by stroke. Methods: Twenty two stroke patients were recruited into the research and their foot posture was evaluated using the FPI. Two raters assessed 6 items sequentially in accordance with the FPI-6 manual. This procedure involved asking the subject to take several steps in-place, prior to settling into a comfortable stance position with double limb support. Subjects were instructed to stand still with their arms by their sides and look straight ahead. FPI-6 values ranged from -2 to +2 for each of the six criteria and from -12 to +12 for the total score, indicating a position for each foot either along the supinated (negative score) to pronated (more than +6) continuum of foot posture. Results: The results showed that intra-rater reliability and inter-rater reliability for a total FPI-6 score was high: 0.807-0.888. An almost perfect agreement between the two raters was identified in the foot's morphological classification (Somer's D=0.712; p<0.05). Intra-percentage agreement was high (88.6%). Conclusion: The FPI-6 is a quick, simple, and reliable clinical tool with demonstrated good to excellent intra-rater reliability and good inter-rater reliability when used in assessment of the stroke patient's foot.

• 한국전문물리치료학회지
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• 제17권3호
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• pp.1-10
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• 2010

The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

• 한국과학교육학회지
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• 제22권1호
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• pp.176-189
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• 2002

본 연구의 목적은 초등학교 과학과 포트폴리오를 채점할 수 있는 다양한 채점기준을 개발하고, 개발된 각 채점기준의 신뢰도를 검증해 보고자 하는 것이다. 채점기준을 개발하기 위한 포트폴리오는 4학년 2학기 '단원 2. 지층과 화석', '단원 4. 열과 물체의 변화' 를 중심으로 청주교대 과학교육 연구실에서 2000년 여름에 개발한 체제를 같은 해 가을, 경기도 중도시의 한 초등학교 4학년 한 학급에 적용하여 얻은 것이다. 총괄-일반, 총괄-특수, 분석-일반, 분석-특수의 4가지 채점기준을 개발하고, 각 채점기준에 근거하여 학생들이 작성한 포트폴리오 증거물을 채점하여 각 채점 기준별 채점자간 신뢰도와, 채점자내 신뢰도를 구하였다. 1차 채점에서는 총 12명의 채점자들이 각 채점기준별로 3명씩 그룹을 나누어 그룹당 12권의 포트폴리오 증거물을 채점하였다. 단, 분석-특수 채점기준의 경우 6권의 포트폴리오 증거물만을 채점하였다. 채점자내 신뢰도를 알아보기 위해 실시한 채점시기별 신뢰도에서는 l차 채점에 참가한 채점자 중 각 채점기준별로 2명씩 총 8명이 2차 채점에 참가하여 l차 채점과 동일한 방식으로 채점을 실시하였다. 채점결과를 SPSS 통계 프로그램에 입력하여 상관계수를 구한 결과, 총괄-일반 채점기준은 채점자간 신뢰도가 높고 채점자내 신뢰도가 있는 것으로 나타났고 총괄-특수 채점기준은 채점자간 신뢰도와 채점자내 신뢰도가 있는 것으로 나타났다. 분석-일반 채점기준은 채정자간 신뢰도가 높고 채점자내 신뢰도는 있는 것으로 나타났으며, 분석-특수 채점기준은 채점자간 신뢰도와 채점자내 신뢰도가 모두 높은 것으로 나타났다. 일반적인 채점기준들(총괄-일반, 분석-일반)의 경우, 하나의 채점 기준으로 모든 포트폴리오 목표를 채점할 수 있으므로 매우 경제적이고 실용적이나, 채점자들은 채점시 모호함을 느낀다고 하였다. 반면에, 특수적인 채점기준들(총괄-특수, 분석-특수)의 경우, 채점은 더 명확하게 할 수 있으나, 목표별로 채점기준을 개발해야 하므로 많은 시간과 노력이 필요하게 된다. 채점기준의 실용도 측면에서는 분석-특수 채점기준이 다른 기준보다 2배 이상의 시간이 결려 실용도는 낮은 것으로 나타났다.

• Physical Therapy Rehabilitation Science
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• 제8권4호
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• pp.218-224
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• 2019

Objective: This reliability study examined the effects of applying varying induced inward pressures using a transducer placed at 0° neutral ankle position (NEU) and 15° ankle dorsiflexion (DF) on tibialis anterior (TA) muscle thickness using a custom-made device with a force indicator during rehabilitative ultrasound imaging. Design: Cross-sectional study. Methods: Twenty-four healthy subjects were recruited in this study. Two examiners measured the muscle thickness of the TA at 0° NEU and 15° DF in 3 conditions of inward pressures (1.0 N, 2.0 N, and 4.0 N) using a custom-made holder. The muscle thickness was measured three times for each of the conditions arranged in random order. For intra- and inter-rater reliability, the intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement, minimal detectable change, and coefficient of variation were analyzed. One-way repeated measures analysis of variance was conducted for investigating changes of TA muscle thickness according to the inward pressures of the transducers. Results: The intra-rater reliability of TA muscle thickness measurement was excellent (ICC_3,1: 0.92-0.96) for all conditions (at both ankle joint angles per varying inward pressure). Likewise, the inter-rater reliability of TA muscle thickness measurement was excellent (ICC_2,1: 0.89-0.97) under same conditions. The mean of TA thickness showed the trend of decreasing significantly with increased inward pressures at all ankle joint angles (p<0.05). Conclusions: Use of this custom-made device with a force indicator is useful to accomplish the high intra- and inter-rater reliability of TA muscle thickness measurement at both ankle joint angles in reducing the measurement error.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제13권8호
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• pp.4241-4254
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• 2019

The efficiency and accuracy of handwriting measurement could be improved by adopting digital image processing. This study developed a computer-based Korean Handwriting Assessment tool. Second graders participated in this study by performing writing tasks of consonants, vowels, words, and sentences. We extracted boundary parameters for each letter using digital image processing and calculated the variables of size, size coefficient of variation (CV), misalignment, inter-letter space, inter-word space, and ratio of inter-letter space to inter-word space. Children were also administered traditional handwriting and visuomotor tests. Digital variables from image processing were correlated with these previous tests. Using these correlations, we established a three-point scoring system that computed test scores for each variable. We analyzed inter-rater reliability between the computer rater and human rater and test-retest reliability between the first and second performances. The validity was examined by analyzing the relationship between the Korean Handwriting Assessment and previous handwriting and visuomotor tests. We suggested the Korean Handwriting Assessment to measure size, size consistency, misalignment, inter-letter space, inter-word space, and space ratio using digital image processing. This Korean Handwriting Assessment tool proved to have reliability and validity. It is expected to be useful for assessing children's handwriting.

• 한방안이비인후피부과학회지
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• 제30권4호
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• pp.97-103
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• 2017

Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

• The Journal of Korean Physical Therapy
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• 제25권4호
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• pp.174-179
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• 2013

Purpose: Visual gait analysis plays a pivotal role in determining the important gait problem of patients. A few studies have been published and have received little attention regarding visual gait analysis on patients with orthopedic problems. The purposes of this study were to investigate the difference of reliability levels according to experience of clinical physical therapists. Methods: Thirty-five clinical physical therapists, 5 high experienced, 15 experienced, and 15 inexperienced, were recruited and individually evaluated these videotaped gait patterns of the participants, and filled up the structured gait analysis form. The gait of nine participants was videotaped. Reliability levels were calculated by the Intraclass Correlation Coefficients (ICC). Results: The inter-rater reliability of high experienced group (ICC=0.56; 95% CI: 0.50-0.62) was comparable to that of the experienced raters (ICC=0.48; 95% CI: 0.43-0.53) and inexperienced group (ICC=0.42; 95% CI: 0.38-0.46). High experienced group reached a higher inter-rater reliability level. The average intra-rater reliability of the high experienced group was 0.70 (ICCs ranging from 0.54 to 0.82). The experienced group reached an average intra-rater reliability of 0.61 (ICCs ranging from 0.47 to 0.81). The inexperienced group attained average ICC values of 0.53 (ICCs ranging from 0.30 to 0.74). Conclusion: Use of a structured gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis.

• 대한물리의학회지
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• 제16권2호
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• pp.45-52
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• 2021

PURPOSE: This study examined the imaging procedure of pectoralis minor muscle thickness and assessed the intra- and inter-rater reliability of the muscle thickness measured by two raters using rehabilitative ultrasound imaging (RUSI) in healthy individuals. METHODS: Fifteen participants (aged 21 - 28, seven females, and eight males) were involved in the study. The primary rater palpated the coracoid process and the fourth rib, defined as the width of the index finger lateral to the sternum to avoid breast tissues, and lined the two landmarks. The second examiner checked 1 / 3 (1st point) and 1 / 2 (2nd point) of the line length as measurement points. The two raters obtained right side muscle images of the participants at a standardized sitting position using RUSI with a 7.5 MHz linear transducer at 40mm depth. For intra-rater reliability, the principal rater took three images per point and tried to take one more with an interval. For the inter-rater reliability, the other rater performed the same tasks as the principal rater on the same day. The reliability was analyzed using the intra-class correlation coefficient (ICC), the standard error of the measurement (SEM), and Bland and Altman plots. RESULTS: The reliability at all points was excellent for the same rater (ICC_3,1 = .973 - .978, SEM = .042 - .046), and between raters (ICC_2,1 = .939 - .959, SEM = .059 - .097). CONCLUSION: These findings show that the RUSI could be reliable for examining the pectoralis minor muscle thickness in healthy individuals at all measurement sites.

• 한국전문물리치료학회지
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• 제26권2호
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• pp.24-33
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• 2019

Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed ($n_1=20$), young left-handed ($n_2=21$), and older right-handed ($n_3=20$) groups. The AAUT was assessed by dividing 63 subjects into young right-handed ($n_1=25$), young left-handed ($n_2=18$), and older right-handed ($n_3=20$) groups. Student's t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.

• 대한통합의학회지
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• 제8권3호
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• pp.173-180
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• 2020

Purpose : The aim of this study was to assess the intra- and inter-rater reliability and validity of measurements of head, neck, and pelvis posture using a mobile application in subjects with forward head posture. Methods : Forty-eight volunteers (22 men, 26 women) participated in this study. Two raters independently examined whole body picture images in a lateral standing posture with arms crossed using a CA-Smart Posture Reminder (CA-SPR), and a rater took and calculated posture images twice to assess reliability. We measured five parameters: craniovertebral angle 1 (CVA1), anterior shoulder translation (AST), pelvic tilt (PT), knee angle (KA), and ankle angle (AA) in the subject's sagittal plane using CA-SPR. We examined whole spine X-ray images in the same position to assess validity. We measured four variables in the subjects: CVA2, translation distance (AHT), anterior pelvic plane (APP), and sacral slope (SS). The intra- and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC). Convergent validity was calculated using Pearson's correlation coefficient. Results : The intra-rater reliability (ICC=.889 -.989) and inter-rater reliability (ICC=.800 -.980) were excellent for all variables measured using CA-SPR. The variables measured using CA-SPR and X-ray were significantly positively correlated (r=.623, p<.01). However, the correlation of the variables in the pelvis was not statistically significant. Conclusion : This study shows that a mobile application (CA-SPR) is a useful tool for measuring head and neck posture in subjects with forward head posture. However, further study is needed to measure pelvic variables when using a mobile application.