• Physical Therapy Korea
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• v.19 no.4
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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.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.177-184
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• 2023

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of 'KPIMT Torticollis Protractor', a smart phone and I-pad application for convenient range of motion measurement, and 'Image J', an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of 'KPIMT Torticollis Protractor'. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CV_ME% 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 0.911 (0.911-0.966), CV_ME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CV_ME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion: The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.4
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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.

• Physical Therapy Korea
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• v.26 no.2
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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.

• Journal of Korean Physical Therapy Science
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• v.4 no.1
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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 Korea
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• v.18 no.4
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• pp.60-67
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• 2011

Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

• Journal of the Korean Society of Physical Medicine
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• v.6 no.4
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• pp.475-488
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• 2011

Purpose: The aims of the study were to develop and to establish reliability in Korean versions of World Health Organization Disability Assessment Schedule 2.0(KWHODAS 2.0): 12 item-self(12-self) and 12 item-interviewer(12-interviewer) versions. Methods: KWHODAS 2.0: 12-item versions were developed in idiomatic modern Korean with a process involving independent translation, synthesis of the translations, independent back translation, and review by an expert committee to achieve equivalence with the original English. 88 participants were included in the study. 33 of participants filled the 12-self version twice to examine test-retest reliability and 55 of participants were assessed simultaneously by four interviewers using the 12-interviewer version. Intra-rater reliability was evaluated using the intra-class correlation coefficient(ICC) and inter-rater reliability was evaluated using both the ICC and k statistic. Results: Test-retest reliability for the 12-self version was excellent with $ICC_{(2,1)}$ value ranged from 0.94(CI 0.88-0.98) to 0.96(CI 0.90-0.98). Inter-rater reliability for the 12-interviewer version showed excellent agreement with $ICC_{(2,1)}$ from 0.94(CI 0.91-0.96) to 1(CI 1.0-1.0). K value was observed from 0.95 to 1. Conclusion: KWHODAS 2.0: 12-self and 12-interviewer versions were successfully translated and both scales showed excellent reliability. It is now suitable for use in clinical and research applications.

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.155-161
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• 2016

Objective: This study aimed to investigate the reliability and validity of a personal computer-based muscle viewer (PC-BMW) compared with that of a portable ultrasound (P-US) for measuring upper trapezius (UT) and transversus abdominis (TrA) muscle thickness at rest and during contraction. Design: Observational inter-rater reliability study. Methods: Fifty-five healthy participants (25 men, 30 women) participated in this study. PC-BMW and P-US were randomly measured at the UT and TrA muscles. Two examiners randomly obtained the images of all participants in 3 test sessions lasting 2 days. Intra-class correlation coefficients (ICCs), standard error of measurement, contraction ratio, and correlation were used to estimate reliability and validity. Pearson's correlation coefficients were used to analyze the relationship between muscle thickness measures taken from PC-BMW and P-US. Results: The intra-rater reliability ICCs of UT and TrA muscle thickness for the PC-BMW were >0.995, indicating excellent reliability. Inter-rater reliability ICCs for the PC-BMW ranged from 0.963 to 0.987. The P-US also exhibited high reliability. A high correlation was found between the measurements of the two muscles in PC-BMW and P-US (p<0.01). Conclusions: PC-BMW provides clear and excellent images, is pocket-sized and less expensive than a conventional ultrasound imaging system. PC-BMW can be utilized variously and has the advantage of rehabilitative ultrasound imaging. More research is needed to evaluate the utility of PC-BMW for rehabilitation.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.137-143
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• 2022

Purpose : The purpose of this study was to evaluate the reliability analysis of the deep tendon reflex by using electromyography (EMG). Methods : The study was tested on 30 volunteers who are women in their 20s. Using an electronic reflective hammer of EMG, deep tendon reflex was measured on all subjects with the participation of three trained physical therapists as raters. First, the subjects were comfortably seated on a table with their knees bent at 90 °. The three raters tapped the electric hammer at intervals of 10 seconds to avoid habituation until a total of 10 compound muscle action potential records were collected. Intraclass correlation coefficients (ICCs) were calculated to assess the inter-rater reliability of the deep tendon reflex with the use of EMG. The items of analysis included amplitude (mV), latency (ms), duration (ms), and area (mV × ms) of the compound evoked potentials. Results : Based on the average records of 10 compound muscle action potential, excellent reliability (ICC: .912) was achieved in terms of area, and there was good reliability in terms of latency (ICC: .795) and duration (ICC: .800). In the shortest latency of the compound muscle action potential, good reliability was achieved in terms of amplitude (ICC: .865), duration (ICC: .781), and area (ICC: .832). In the amplitude of peak-to-peak of compound muscle action potential, excellent reliability was recorded in terms of amplitude (ICC: .924), and good reliability was recorded in terms of duration (ICC: .801) and area (ICC: .874). Conclusion : The findings in this study indicate that electromyography via an electric hammer is a reliable method of assessing and measuring deep tendon reflexes. Especially, it may be an excellent gauge in the area of average values of the compound muscle action potentials and the amplitude of peak-to-peak of compound muscle action potentials.

• The Journal of Korean Physical Therapy
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• v.34 no.6
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• pp.283-291
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• 2022

Purpose: The purpose of this study was to compare and analyze the method of measuring the angle of the trunk rotation using a smartphone with 3D smartphone holder compared to a scoliometer, which is a measuring tool used as a method for diagnosing scoliosis in scoliosis patients. Methods: Angle of trunk rotation was measured in 21 subjects diagnosed with scoliosis. scoliometer measurement method, a smartphone measurement method with a 3D smartphone holder, a smartphone blind measurement method with a 3D smartphone holder, a smartphone measurement method without a smartphone holder, a smartphone blind measurement method without a smartphone holder, and a total of five measurement methods were repeated three times for comparison and analysis. Results: The smartphone measurement method with a 3D smartphone holder has excellent intra-rater reliability of angle of trunk rotation (Rater A; ICC3, 2≥0.993, Rater B; ICC3, 2≥0.992). The smartphone blind measurement method with a 3D smartphone holder has excellent inter-rater reliability of angle of trunk rotation (ICC2, 2≥0.968). The scoliometer measurement method had the highest validity (r=0.976) with the smartphone measurement method with a 3D smartphone holder, and the blind measurement method without a smartphone holder had the lowest validity (r=0.886). Conclusion: These findings, the angle of trunk rotation measured by the smartphone measurement method with a 3D smartphone holder in scoliosis patients showed high reliability and validity compared to the scoliometer measurement method.