• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.35-39
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• 2019

Purpose: The purpose of this study was to assess the intra-rater and inter-rater reliability and validity of pelvic tilting angle measurements using a smart phone-based inclinometer (Clino) compared to a palpation meter (PALM) in the standing and sitting position. This study used an interchangeable method with Clino to measure the pelvic tilting angle in the standing and sitting positions. Methods: Twenty healthy subjects were recruited. Measurements of the pelvic tilting angle in the standing and sitting positions were obtained by two examiners using the Clino and PALM. A resting session was conducted 10 minutes later to assess the intra and inter rater reliability. To assess validity of the measurement using Clino, a PALM was used as the gold standard. The intra-class correlation coefficient (ICC) was used to determine the intra and inter rater reliability of Clino and a PALM. To assess the validity, the Pearson correlation coefficients were used for two measurement techniques to measure the pelvic tilting angle in the standing and sitting positions. The statistical significance was set to ${\alpha}=0.05$. Results: Measurements of the pelvic tilt had high inter-rater reliability in the standing (ICC=0.82) and sitting (ICC=0.88) positions using Clino and intra-rater reliability in the standing (ICC=0.87) and sitting (ICC=0.91) positions using Clino. Measurements of the pelvic tilt had high validity by a comparison of PALM and Clino in the standing (r=0.83) and sitting (r=0.89) positions (p<0.05). Conclusion: The use of Clino can be recommended as a tool to replace the PALM and measure the pelvic tilt angle in the standing and sitting positions while maintaining the clinical reliability and validity.

• Journal of Korean Physical Therapy Science
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• v.26 no.1
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• pp.9-14
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• 2019

Background: Pes planus, or flat foot, causes lower limb malalignment and foot pain during walking or exercise. Therefore, a highly reliable evaluation method to accurately diagnose flat feet is necessary. This study investigated the intra-and inter-rater reliability of the navicular drop test in different postures. Design: Cross sectional study. Methods: Forty healthy volunteers performed the navicular drop test in three different combinations of non-weight-bearing and weight-bearing postures (standing/standing, sitting/sitting, and sitting/standing). Two examiners alternately performed the measurements five times in each subject, and in each posture. Significant differences in measurements were obtained among the three postures, with the highest navicular drop being observed in the sitting/standing posture. Results: Inter-rater reliability was high in the sitting/standing and sitting/sitting postures. Intra-rater reliability was high in all three postures. In the sitting/sitting and sitting/standing postures, large navicular drop values and high inter- and intra-rater reliability were observed. Conclusion: Therefore, the sitting/standing and sitting/sitting postures are recommended for use in navicular drop tests to diagnose flat feet.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.193-202
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• 2021

Purpose : The purpose of this study is to examine inter-and intra-rater reliabilities of myotonometric measurements of tone, elasticity and stiffness for the erector spinae muscles of the young and the elderly populations. Methods : A total of 102 (69 young adults from K university and 33 older adults from the D community center in Daejeon) were enrolled in this study. The two different raters measured each side of the erector spinae muscles at prone position. After each rater performed first measurement for a subject, 30 minutes of rest was given. The same rater then repeated the second myometric measurement on the subject. The collected data on the tone, elasticity, and stiffness of the erector spinae were analyzed using intraclass correlation coefficient (ICC) to determine inter- and intra- rater reliabilities. Results : The inter-and intra-rater reliabilities of the myotonometric measurement of the erector spinae for the total subjects were excellent (ICC > 0.9, p < 0.001). Within each of the elderly group and the young group, inter- and intra-rater reliabilities were also excellent (ICC > 0.8~0.9 / p < 0.001, ICC > 0.75~0.9 / p < 0.001, each). Conclusion : The measurement of muscle tone, elasticity, and stiffness for the erector spinae muscles using the myotonometer had excellent reliability. It was confirmed that a highly reliable myometric measurement on the erector spinae can be obtained regardless of whether it is from young or elderly people. This suggests that the myotonometer can be a useful tool to measure muscular properties of the erector spinae of the young and old as an evaluative instrument.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.7-13
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• 2017

Objective: The aim of this study was to investigate the inter-rater and intra-rater reliability of rehabilitative ultrasound imaging (RUSI) for measurement of muscle thickness with changes in angles of the gluteus maximus (GM) at rest and during contraction. Design: Cross-sectional study. Methods: Twenty-two healthy men volunteered for this study. GM muscle images were obtained in the resting position and during prone hip extension with knee flexion at hip abduction angles of $0^{\circ}$ and $30^{\circ}$, respectively. Two examiners randomly measured the thickness of the GM twice in three different positions. The first position was a comfortable prone position. The second position was prone hip extension with knee flexion (PHEKF) to $90^{\circ}$. The third position was achieved by hanging a 1-kg weight on the ankle of the lifted leg during PHEKF with the angle of the lifted leg the same as the second position. Intra-class correlation coefficients (ICCs), standard error measurements, and minimal detectable changes were used to estimate reliability. Results: The intra-rater reliability ICCs (95% confidence interval) of the GM were >0.870, indicating good reliability. Inter-rater reliability ICCs ranged from 0.668 to 0.913. The reliability of measurements of muscle thickness at each position was similar to the reliability of the angle change. Differences in muscle thickness and ratios for each position with $0^{\circ}$ and $30^{\circ}$ of hip abduction were not statistically significant. Conclusions: In the present study, the intra-rater reliability of muscle thickness measurements of the GM was good, and the inter-rater reliability was moderate to good. Reliable RUSI measurements of wide and large muscles, such as the GM muscle at rest and during contraction, are feasible. Further investigation is required to establish the reproducibility of the protocols presented in this study.

• Journal of the Korea Convergence Society
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• v.11 no.11
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• pp.443-450
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• 2020

The purpose of this study was to examine the inter-rater and intra-rater reliability of the oral mucosa pressure ulcer classification system based on the photographs. The study consisted of two stages; development and evaluation. In the developmental stage, 9 photographs of 82 were selected. In the evaluation stage, a total of 49 participants were invited web-based survey by e-mail. Cohen's weighted kappa and Krippendorff's alpha were used to define the inter-rater reliability. Nine photographs consisted of two, three, three, and one in normal, stage 1, stage 2, and stomatitis, respectively. The inter-rater reliabilities of wound care nurse specialist, intensive care nurse specialist, and dentist groups were 0.75, 0.70, and 0.78, respectively. The intra-rater reliability was 0.73. The inter-rater and intra-rater reliabilities of the oral mucosa pressure ulcer classification system showed substantially good agreement.

• Physical Therapy Korea
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• v.21 no.3
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• pp.73-79
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• 2014

The purposes of the current study were to (1) estimate the inter-rater agreement for visual assessment of scapular downward rotation (SDR), (2) develop the scapular downward rotation index (SDRI) as a method to measure SDR objectively and quantitatively, and (3) analyze the intra- and inter-rater reliability of the SDRI. Twenty subjects with scapular downward rotation syndrome (SDRS) were recruited for this study. The visual assessment and the measurement for the SDRI were conducted by two examiners in two sessions each. The SDRI [$(a-b){\div}a{\times}100$] is calculated with the measurement of two linear distances: One is a perpendicular distance from the root of the scapular spine to the thoracic mid-line (a), and the other is a perpendicular distance from the inferior angle of the scapula to the thoracic mid-line (b). Cohen's kappa coefficient was calculated to estimate the inter-rater agreement for visual assessment. Intra-class correlation coefficients (ICCs) with a 95% confidence interval (CI), the standard error of measurement, and minimal detectable differences were calculated to assess intra- and inter-rater reliability of SDR measurement using the SDRI. The results indicated that the kappa coefficient of inter-rater agreement for visual assessment was fair (${\kappa}=.21$). The intra-rater reliability of SDR measurement using the SDRI was excellent for examiner 1 (ICC=.92, 95% CI=.78~.97) and good for examiner 2 (ICC=.82, 95% CI=.55~.93). The inter-rater reliability was moderate (ICC=.73, 95% CI=.32~.89). These findings showed that SDR measurement using the SDRI for subjects with SDRS may be considered reliable and better than the visual assessment.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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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.

• Physical Therapy Korea
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• v.12 no.4
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• The Journal of the Korean dental association
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• v.58 no.5
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• pp.284-291
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• 2020

This study analyzed the change in the rater reliability based on the student's practice evaluation process conducted at Yonsei University College of Dentistry. Through this, we suggest the significance of the rater calibration training in the student's practical evaluation of dental college. Nine professors from the department of Conservative Dentistry, Yonsei University College of Dentistry, analyzed the results of class II restoration cases twice in 2017 and once in 2018. Intra Class Correlation (ICC) which is a statistic used to determine the consistency of raters with three or more scores, was also calculated. ICC values increased as raters participated in rater calibration meetings and grading experiences. This shows that the rater reliability is related to the grading experience and feedback from calibration meeting. Based on the results of previous studies that grading experiences and rater calibration training can cause a meaningful change in rater behavior, we propose to conduct rater calibration training to ensure the evaluator reliability.

• Physical Therapy Korea
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• v.21 no.3
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• pp.20-27
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• 2014

The purpose of this study was to compare the intra-rater and inter-rater reliability of three methods for measuring iliotibial tract length in 40 knees of 20 subjects. The measurements were performed by two examiners and one assistant. The length of the iliotibial tract was measured using three methods: the first used a modified Ober test with an inclinometer, the second used a modified Ober test with a marker, and the third used active adduction test with a marker in the supine position. Each examiner used the three methods in two sessions. For the first method, the inclinometer value was recorded manually. For the second and third methods, Image J analysis software was used to analyze the photographs taken. The intra-rater and inter-rater reliability of the measured value was assessed by means of intra-class correlation coefficients [ICC (3,1)] and the standard error of measurement. The intra-rater reliabilities of the three methods were excellent (ICC=.97, .95, and .94, respectively), and the inter-rater reliabilities of the first and second methods were fair to good (ICC=.64 and .65, respectively). The inter-rater reliability of the third method was excellent (ICC=.88). Our results suggest that the active adduction test is an objective and qualitative measurement method for measuring iliotibial tract length. We recommend that the active adduction test be used for measuring iliotibial tract length in the clinical setting.