• Journal of Biomedical Engineering Research
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• v.41 no.3
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• pp.121-127
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• 2020

The purpose of this paper is to review the validation on the application of low frequency IMU(Inertial Measurement Unit) sensors by replacing high frequency motion analysis systems. Using an infrared-based 3D motion analysis system and IMU sensors (22 Hz) simultaneously, the gait cycle and knee flexion angle were measured. And the accuracy of each gait parameter was compared according to the statistical analysis method. The Bland-Altman plot analysis method was used to verify whether proper accuracy can be obtained when extracting gait parameters with low frequency sensors. As a result of the study, the use of the new gait assessment system was able to identify adequate accuracy in the measurement of cadence and stance phase. In addition, if the number of gait cycles is increased and the results of body anthropometric measurements are reflected in the gait analysis algorithm, is expected to improve accuracy in step length, walking speed, and range of motion measurements. The suggested gait assessment system is expected to make gait analysis more convenient. Furthermore, it will provide patients more accurate assessment and customized rehabilitation program through the quantitative data driven results.

• Journal of Korean Foot and Ankle Society
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• v.20 no.4
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• pp.145-151
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• 2016

Purpose: To evaluate the reliability of preoperative and postoperative distal metatarsal articular angle (DMAA) measurements and to determine whether such reliability is different in accordance with the foot and ankle fellowship and the number of years in practice. Materials and Methods: Between July 2012 and June 2014, a total of 20 patients (24 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic hallux valgus deformity. DMAA were measured twice with an interval of two weeks between the preoperative and postoperative dorsoplantar radiographs by four observers; two of whom were foot and ankle surgeons (A and B), one knee surgeon, and one senior resident. The intraobserver reproducibility and interobserver reliability were assessed by intraclass correlation coefficients. Moreover, the limit of agreement between the preoperative and postoperative DMAA measurements were assessed using a Bland-Altman plot. Results: The intraobserver reproducibility of the foot and ankle surgeon A, knee surgeon, and senior resident improved from 0.796, 0.575, and 0.586 preoperatively to 0.968, 0.864, and 0.864 postoperatively, respectively. The interobserver reliability of foot and ankle surgeon A-B, foot and ankle surgeon A-knee surgeon, and foot and ankle surgeon A-senior resident improved from 0.874, 0.688, and 0.677 preoperatively to 0.971, 0.917, and 0.838 postoperatively, respectively. Conclusion: The intra- and interobserver reliabilities for DMAA measurement improved after proximal chevron osteotomy. Therefore, the necessity of additional procedures to correct the increased DMAA should be reevaluated after proximal chevron osteotomy in the hallux valgus with an increased DMAA.

• Journal of the Korean Dietetic Association
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• v.22 no.3
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• pp.214-224
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• 2016

The purpose of this study was to assess the physical activity of preschool children using an accelerometer and investigate differences related to epoch length setting during use of the accelerometer. Subjects of the study were 26 children (12 boys and 14 girls) at the age of 5, enrolled in one preschool located in Gangneung. From 9:00 a.m. to 4:00 p.m. (7 hours period), every child wore a total of four accelerometers (ActiGraph $GT3X^+$, USA), including three attached to the left hip (with epoch length set at 5 seconds, 15 seconds, and 30 seconds). For comparison purposes, a forth was attached to the opposite position, with epoch length set at 5 seconds. Data collected using 15s epoch and 30s epoch (single larger epoch) were compared with those obtained after reintegration of 5s to 15s epoch, 5s to 30s epoch, and 15s to 30s epoch, respectively (smaller epochs reintegrated). According to the results of this study, there were no significant differences in VM between 30s epoch and 5s to 30s epoch reintegrated and in MVPA (moderate-to-vigorous physical activity), between 15s epoch and 5s to 15s epoch reintegrated. From the Bland-Altman plot, reintegration of 15s to 30s epoch in VM and reintegrations of 15s to 30s epoch and 5s to 15s epoch in MVPA can be recommended for assessing physical activity in preschool children. Further research is needed into the reintegration method while using an accelerometer for assessment of energy expenditure in children.

• Biomedical Science Letters
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• v.22 no.3
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• pp.83-97
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• 2016

The measurement of viral load in HIV-1 infected patients is essential for the establishment of a therapeutic strategy. Several commercial assays have shown shortcomings in quantifying rare genotypes of HIV-1 such as minor groups of N and O. In this study, the HIV-1 RT-qPCR assay was developed. The primers and probe of HIV-1 were designed to target the pol gene and to increase the detection efficiency of various subtypes including group N and O. The HIV-1 quantitative RT-qPCR assay was assessed for its analytical performance and clinical evaluation. The LoD was determined to 33.9 IU/ml. The LoD of several subtypes including A, C, D, CRF_01AE, F, CRF_02AG, G and H, were determined to less than 40 IU/ml. The HIV-1 quantitative RT-qPCR assay was evaluated using the China National Reference Panel of HIV-1 RNA to determine the analytical performance. The results were all within the acceptable range. The clinical evaluation was performed at Hunan CDC in China. The clinical evaluation results were compared with those of the China domestic commercial kit. A significant correlation (fresh samples; $R^2=0.84$, P<0.001, frozen samples; $R^2=0.76$, P<0.001) between the two systems was observed for 64 fresh samples and 76 frozen samples with viral loads, and the Bland-Altman plot showed good agreement (98.4%, 96.1%, respectively). In conclusion, the HIV-1 quantitative RT-qPCR assay had comparable analytical performance with several commercial kits. The study provides basic data for the research of HIV-1 diagnosis and the development of P < HIV-1 molecular diagnostic assay.

• Knee surgery & related research
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• v.30 no.4
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• pp.326-333
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• 2018

Purpose: To evaluate the reliability and validity of the femorotibial mechanical axis angle from radiographs in the weight bearing (WB) and supine positions compared with navigation-measured values. Materials and Methods: Sixty-eight cases of navigation-assisted total knee arthroplasty (TKA) were included. The pre- and postoperative whole leg radiographs (WLRs) in WB and supine positions were compared with the initial and final navigation values. Results: The mean mechanical axis angle from the preoperative WBWLR and navigation were not statistically different (p=0.079) and were correlated strongly with each other (intraclass correlation [ICC], 0.818). However, on postoperative measurements, although the WBWLR and navigation values were not different (p=0.098), they were not correlated with each other (ICC, 0.093). The standard error of measurement was $1.8^{\circ}{\pm}3.6^{\circ}$ for the preoperative WBWLR and $2.5^{\circ}{\pm}4.8^{\circ}$ for the postoperative WBWLR. The validity that was determined by the Bland-Altman plot was not acceptable for both pre- and postoperative measurements. Conclusions: The preoperative WBWLR could provide accurate but not precise measurement value of the femorotibial mechanical axis angle for navigation-assisted TKA, and postoperative measurements in navigation were not comparable with radiographic measurements. The lack of agreement was found between the radiographic and navigation measurements of the coronal alignment regardless of pre- or postoperative evaluation although the accuracy was found acceptable. Level of Evidence : Level 4.

• The Korean Journal of Physiology and Pharmacology
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• v.26 no.3
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• pp.195-205
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• 2022

Determining blood loss [100% - RBV (%)] is challenging in the management of haemorrhagic shock. We derived an equation estimating RBV (%) via serial haematocrits (Hct₁, Hct₂) by fixing infused crystalloid fluid volume (N) as [0.015 × body weight (g)]. Then, we validated it in vivo. Mathematically, the following estimation equation was derived: RBV (%) = 24k / [(Hct₁ / Hct₂) -1]. For validation, non-ongoing haemorrhagic shock was induced in Sprague-Dawley rats by withdrawing 20.0%-60.0% of their total blood volume (TBV) in 5.0% intervals (n = 9). Hct₁ was checked after 10 min and normal saline N cc was infused over 10 min. Hct₂ was checked five minutes later. We applied a linear equation to explain RBV (%) with 1 / [(Hct₁ / Hct₂) -1]. Seven rats losing 30.0%-60.0% of their TBV suffered shock persistently. For them, RBV (%) was updated as 5.67 / [(Hct₁ / Hct₂) -1] + 32.8 (95% confidence interval [CI] of the slope: 3.14-8.21, p = 0.002, R² = 0.87). On a Bland-Altman plot, the difference between the estimated and actual RBV was 0.00 ± 4.03%; the 95% CIs of the limits of agreements were included within the pre-determined criterion of validation (< 20%). For rats suffering from persistent, non-ongoing haemorrhagic shock, we derived and validated a simple equation estimating RBV (%). This enables the calculation of blood loss via information on serial haematocrits under a fixed N. Clinical validation is required before utilisation for emergency care of haemorrhagic shock.

• Physical Therapy Korea
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• v.29 no.3
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• pp.225-234
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• 2022

Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke. Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients. Methods: This is an observational study, in which twenty participants were clinically diagnosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland-Altman plot and 95% limit of agreement (LoA) was calculated. Results: The intrarater reliability (rotation with DG: 0.96-0.98, SP: 0.98; lateral flexion with DG: 0.97-0.98, SP: 0.96) was excellent. A strong and significant correlation was found between DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, -5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, -7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, -3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, -8.68°]). Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.414-420
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• 2022

Objective: In this study, the test-retest reliability and validity were presented to evaluate the usability of isokinetic rehabilitation equipment for the knee joint. Design: Cross-sectional design, reliability & validity study. Methods: Thirty healthy adults participated in the study. A CSMI dynamometer was used as a standardized measuring device to present the validity of the equipment. It was measured based on the dominant leg. The average peak torque value was selected as the measurement variable. After the measurement, a questionnaire was conducted on safety, satisfaction, and performance through the usability evaluation questionnaire. Results: The knee joint isokinetic rehabilitation equipment showed high reliability with Intraclass Correlations Coefficients (ICC) =0.883~0.956. In order to check the validity of the equipment, the 95% confidence interval of the mean difference limit was confirmed by the Bland & Altman plot. As a result, all three angular velocities showed a smaller confidence interval in the flexion than in extension. There were less than 10 plots that were not included in 2 Standard Deviation (SD) between all measurements. As a result of the usability evaluation questionnaire, the average of the safety domain(4.9±0.4), satisfaction domain(4.1±0.8), performance domain(4.3±0.8). Conclusions: If the product is improved by supplementing the items identified in the usability evaluation process, it is judged that it can be used as a useful device in various knee joint rehabilitation fields.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.7-14
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• 2011

Purpose: The purpose of this study was to analyze the correlation between the medial joint space on weight bearing simple X-ray and the ultrasonographic articular cartilage thickness. Materials and Methods: The articular cartilage thickness of 91 osteoarthritic knees of 73 patients were measured with weight bearing simple X-ray and ultrasonography between June 2010 and September 2010. Male were 13 and female were 60. Right knees were 35, left knees were 20 and bilateral involvements were 18. Medial joint spaces on X-ray were measured in full extension view and $45^{\circ}$ PA(Rosenberg) view. Femoral cartilage thicknesses at and those at the point between the middle 1/3 and posterior 1/3 area were measured by ultrasonography, that were scanned coronally at $30^{\circ}$ flexion and $130^{\circ}$ flexion respectively. The results were analyzed statistically by Pearson correlation test and Bland-Altman plot test. Results: Medial joint spaces measured in full extension view and femoral articular cartilage thicknesses at the point between the anterior 1/3 and middle 1/3 area measured with sonography were statistically correlated and medial joint spaces measured in $45^{\circ}$ PA view and those at the point between the middle 1/3 and posterior 1/3 area measured with sonography were also correlated (P<0.05, $SD{\pm}2$). Conclusion: The measurement of articular cartilage thicknesses by the ultrasonography was easy even in the patient who are unable to take weight bearing view and was thought to be a useful diagnostic and follow up method to examine the degenerative change in addition to simple radiographic examination in the knee osteoarthritis.

• Journal of health informatics and statistics
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• v.41 no.1
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• pp.49-56
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• 2016

Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.