• 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.

• 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.

• Physical Therapy Rehabilitation Science
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• 제5권1호
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• pp.22-28
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• 2016

Objective: The Back Mapper is one type of Rasterstereography and it can be used in the clinic without radiation exposure. The purpose of our study was to prove the reliability and validity of the Back Mapper and to compare it with the Spinal Mouse, which is an assessment tool for spinal curvatures using a wheeled mouse, and the Cobb angle by X-ray. Design: Cross-sectional study. Methods: Twenty healthy adults participated in the test to investigate for the inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with assessment devices for scoliosis such as the Back Mapper, Spinal Mouse and Cobb's angle. Data was analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement for reliability and correlation analysis for validity. Results: Intra-rater reliability of the Back Mapper was good (Cronbach's ${\alpha}$=0.821-0.984, ICC=0.696-0.969) except for assessing the lordotic angle. Inter-rater reliability was good (Cronbach's ${\alpha}$=0.870-0.958, ICC=0.770-0.919) in assessment for trunk imbalance, rotation of scapulae, thoracic angle, lumbar angle, and kyphotic angle. The kyphotic angle in the Spinal Mouse had a significant correlation icompared with the Back Mapper (r=0.510, p<0.05), and the Cobb's angle from an X-ray had a significant correlation with trunk inclination (r=0.532, p<0.05). Conclusions: These findings provide good intra-reliability of the Back Mapper in healthy subjects, but the Back Mapper requires more experienced practice to have good inter-reliability. Also, the variables of the Back Mapper does not seem as appropriate compared with the Cobb angle by X-ray.

• 한국전문물리치료학회지
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• 제19권4호
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• pp.46-54
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• 2012

Ely's test is commonly used to assess rectus femoris muscle flexibility. however, a reliability limit of this test was demonstrated by a previous study. In this study, we present an alternative method using an application for a digital horizontal level in a smartphone (DHLS) to complement the reliability limit of Ely's test. The aim of this study was to examine the reliability of Ely's test using DHLS on the pelvis, compared to using visual observation (VO) of pelvic and hip motions. Nineteen patients with lumbar extension-rotation syndrome were recruited for this study. An examiner examined the rectus femoris flexibility (both pass/fail and goniometer scoring) through Ely's test using both DHLS and VO. A retest session was completed two hours later for within-day reliability and seven days later for between-day intra-rater test-retest reliability. Results showed higher Kappa values for pass/fail scoring and higher intraclass correlation coefficient values for goniometer scoring in Ely's test using DHLS, compared to using VO. Measurement error and Bland and Altman plots further demonstrated the degree of intra-rater variance during Ely's test using DHLS in a clinical setting, compared to using VO. These results demonstrated that Ely's test using DHLS showed acceptable reliability compared to using VO. Ely's test using DHLS could be widely used for measuring the rectus femoris muscle flexibility in patients with lumbar extension-rotation syndrome, although the inter-rater reliability needs to be established first.

• 대한물리의학회지
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• 제16권1호
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• pp.1-7
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• 2021

PURPOSE: The purpose of this study is to conduct inter-rater and intra-rater reliability tests in patients with low back pain (LBP) using the prone instability test (PIT) and side-lying instability test (SIT). We have analyzed the Korean version Oswestry disability index (K-ODI) correlations and radiograph finding (RF) for validity. METHODS: Individuals (n = 51) (mean age of 40.27 ± 13.28) with LBP for at least over a week were recruited, together with two participating physical therapist examiners. The measurement consisted of PIT, PST, K-ODI, and RF. Sensitivity (Sn), specificity (Sp), positive predictive value, negative predictive value, prevalence index, agreement %, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa (PABAK) were calculated. The PIT and SIT were compared with RF for validity analysis, while PIT, SIT, K-ODI, and RF were calculated for the correlation analysis. RESULTS: The intra-rater reliability test measured for the PIT (kappa = .79, PABAK = .88) and SIT (kappa = .73, PABAK = .84), and inter-rater reliability test measured for the SIT (kappa = .80, PABAK = .88) showed good agreements. The PIT (Sn = .65, Sp = .63) and SIT validities (Sn = .68, Sp = .70) were compared with RF, showing a significant correlation in PIT and RF (r = .69), SIT and RF (r = .73), and PIT and K-ODI (r = .53). CONCLUSION: The SIT is a more comfortable position test than the PIT in patients. Both PIT and SIT have acceptable reliability and validity.

• 한국전문물리치료학회지
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• 제14권2호
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• pp.29-36
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• 2007

Muscle tone (stiffness/hardness) or muscle compliance changes during muscle contraction. The purposes of this study were to assess the intrarater and interrater reliabilities of the Myotonometer$^{(R)}$, electronic device that quantifies muscle tone. Two raters used the Myotonometer to assess the right bicep brachia and quadriceps muscles of 30 voluntary persons without any orthopedic or neurological problems (age range, 18~21 yrs). Muscles were measured in a relaxed state and during brief sustained voluntary maximal isometric contraction. Intrarater correlation coefficients were calculated for each muscle and for each condition (relaxed and contracted). Intrarater reliabilities (intraclass correlation coefficients, ICCs) ranged from .778 to .954, relaxed, biceps brachia), .926 to .963 (contracted, biceps brachia), .935 to .990 (relaxed, quadriceps) and .679 to .952(contracted, quadriceps). Interrater reliabilities ranged from .652 to .790 (relaxed, biceps brachii), .813 to .907 (contracted, biceps brachii), .831 to .950 (relaxed, quadriceps) and .849 to .937 (contracted, quadriceps). Myotonometer measurements had high to very high intrarater and interrater reliability for measurements of the biceps brachia and quadriceps muscles.

• 대한물리치료과학회지
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• 제4권1호
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• pp.265-289
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• 1997

The purpose of this studied was to examine the reliability analysis of the GMFM in children with C.P. The subject of this study were 40 C. P patient who had been hospitalized Department of Sam-Yook Rehabilitation Hospital. Subjects were 28 boys and girls, aged 6 to 8 years. Reliability of each dimension of the GMFM were analyzed using Cronbach coefficients and to examine the intra-rater reliability were using Pearson correlation coefficients. The result of reliability analysis of the GMFM revealed higher reliability values. The reliability of the total dimension score was 95. Test-retest revealed intra-rater correlation coefficients from .71 to .98. The study presents that GMFM is useful in assessment of function of children with C. P by the quantitative description of the function.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.488-492
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• 2022

Objective: The purpose of this study is to find out the reliability and validity of the newly updated Balancia 2.5 program using Wii balance board through equipment that can measure center of pressure data with the precision. Design: Cross-sectional study Methods: Twenty-seven healthy adults participated in the study. The subjects were assessed for static balance ability by Accusway, and were assessed for static balance ability on Wii balance board connected to theBalancia 2.5 program.To limit postural fluctuations due to stare, the subjects were asked to look at a 15 cm dot drawn 3 m in front of them for 30 seconds with their eyes open. Static balance ability data such as path length and sway velocity were extracted from all measurement tools.Intra-rater and inter-rater reliability and validity were extracted through intraclass correlation coefficient (ICC) and 95% confidence interval (CI). Results: The intra-rater reliability that the same rater shows consistent results through test-retest was a high level at ICC=0.968 (0.926~0.986), and inter-rater reliability that the requires consistent results even when measured by different raters was a high level at ICC=0.943 (0.870~0.975). The validity was a high level at ICC=0.948 (0.881~0.977), which shows whether the measurement tool is properly measuring what it is intended to measure. Conclusions: The Balancia 2.5 program, newly updated through this study, proved to be a program with high reliability and validity in evaluating static balance ability like the existingBalancia 2.0 program.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.454-463
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• 2022

Objective: The purpose of this study was to compare concurrent validity and test-retest reliability based on Craniovertebral angle of 'Angles video goniometer', a smart phone application for convenient range of motion measurement, and 'Image J', an analysis software with high reliability and validity. This was conducted to find out whether 'Angle video goniometer' can be used clinically. Design: Cross-sectional study Methods: Fifty subjects were imaged laterally, and the angle of the head and spine was measured using Image J and the Angles video goniometer, respectively, in a resting posture and a chin in posture. The level of concurrent validity between the two measurement methods and the level of inter-rater reliability and intra-rater reliability were analyzed. Results: For forty participants, the concurrent validity between Image J and Angles video goniometer showed very high validity with ICC of 0.997(0.995~0.999) and 0.994(0.994~0.998), CVME% 0.71~0.72%, SEM% 0.31~0.34, MDC% 0.86~0.94. The test-retest intra-rater reliability showed very high reliability ICC 0.994(0.991~0.996), CVME% 0.71%, SEM% 0.31~0.43, MDC% 0.86~1.19%. The test-retest inter-rater showed very high reliability ICC 0.995(0.992~0.997), CVME% 0.71%, SEM% 0.43~0.59%, MDC% 1.20~1.62% Conclusions: Angles video goniometer', a smartphone application, is a device with very high reliability and validity for craniovertebral angle measurement in healthy adults, and it is a device that can be easily used in clinical practice.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.37-46
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• 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.