Search

Objective: Fitbit Zip™ (FBZ) is a low-cost user-friendly device that could help motivate individuals post-stroke to increase their physical activity. However, inaccuracy in step counts from altered gait variables could cause dissatisfaction and reduce compliance. The aim of this study was to determine the influence of gait variables on the concurrent validity of the FBZ. Method: In a cross-sectional study, 19 community-dwelling stroke survivors (mean 66 (SD 8) years) wore a FBZ at the non-paretic hip, and were videoed completing a six minute walk test (6MWT). Steps recorded by the FBZ were compared against the criterion standard of manually counted steps from video-recordings. Spatio-temporal gait parameters were calculated, and gait quality was assessed using the Wisconsin Gait Analysis (WGA) tool. Concurrent validity of FBZ was determined using Kendall's Tau correlation coefficient. Linear regression analysis determined the association between gait parameters, quality, and FBZ accuracy. Results: A very strong correlation was observed between the FBZ steps and manual counting (τ = 0.80, p <.001). Step difference demonstrated significant negative association with gait velocity (R2 = 0.35, B = −59.94, p =.007), and positive association with WGA score (R2 = 0.69, B = 4.59, p <.001), indicating poor FBZ accuracy in participants with lower speed (≤0.8m/s) and poor gait quality (WGA score>16). Conclusions: FBZ is an accurate measure of step activity in independent ambulators with stroke walking at speeds > 0.8m/s, but accuracy can be compromised with lower speed and poor gait quality. Clinicians should consider gait velocity and quality before advising FBZ as a motivational tool to increase physical activity in individuals post-stroke. [ABSTRACT FROM AUTHOR]

Abstract Objectives To determine normal temperatures over the Achilles tendon over nine weeks. Design A prospective cohort study with nine weeks of observation. Setting University's Human Biomechanics and Physiology Laboratory. Participants Male or female competitive runners running at least 25 miles per week who did not report pain in the region of the Achilles over 9 weeks of data collection. Main outcome measure Thermal images taken at the same time and day of the week, were used to measure the temperature of the skin over the Achilles tendon. Results Seventeen athletes were eligible for analysis. The Achilles tendon temperatures were right 28.7 °C ± 1.3 °C, left 28.8 °C ± 1.3 °C. ICC demonstrated a very high consistency and minimal variations in temperatures (right 0.86 (95% CI = 0.58, 0.98), left 0.79 (95% CI = 0.38, 0.97). The mean difference between sides over the season was 0.50 °C ± 0.43 °C (p = 0.681). A decreasing trend in the Achilles tendon temperatures as the season progressed was observed. Conclusion This is the first report of normal thermal profiles over an extended period. Variations in Achilles temperatures left to right, and over time were not significant. The decreasing temperature trend over the season warrants further investigation. Highlights • The first report of thermal profiles over the Achilles tendon over an extended period of time. • Temperatures remained stable, with no significant differences between sides, or over time. • The observed trend of a decrease in temperature over the season indicates an area for further investigation. • This trend may be an indicator of increasing sympathetic drive and a higher risk of future injury. [ABSTRACT FROM AUTHOR]

Background Palpation-digitization technique for measurement of innominate motion involves repeated manual palpation-digitization of pelvic landmarks, which could introduce a systematic variation between subsequent trials and thereby influence final innominate angular measurement. Objectives The aim of this study is to quantify the effect of repeated palpation-digitization errors on overall variability of innominate vector length measurements; and to determine if there is a systematic variation between subsequent repeated trials. Method A single group repeated measures study, using four testers and fourteen healthy participants, was conducted. Four pelvic landmarks, left and right posterior superior iliac spine and anterior superior iliac spine, were palpated and digitized using 3D digitizing stylus of Polhemus electromagnetic tracking device, for ten consecutive trials by each tester in their random order. The ten individual trials of innominate vector lengths measured by each tester for each participant were used for the analysis. Results and conclusions Repeated measures ANOVA demonstrated a very small effect of repeated trial factor (≤0.66%) as well as error component (≤0.32%) on innominate vector length variability. Further, residual versus order plots demonstrated a random pattern of errors across zero; thus indicating no systematic variation between subsequent trials of innominate vector length measurements. [ABSTRACT FROM AUTHOR]

Background Innominate kinematic anomalies resulting in low back pain (LBP) of sacroiliac joint (SIJ) origin (SIJ-positive), has always been a topic of contention, owing to difficultly in its evaluation. Recent technique of electromagnetic palpation-digitization has been able to accurately quantify innominate kinematics in healthy individuals. Objectives The purpose of this study is to determine if participants with LBP of SIJ origin (SIJ-positive) demonstrate significantly different innominate kinematics than participants with LBP of non-SIJ origin (SIJ-negative). Design Single-blinded cross-sectional case–control study. Method Participants [n(122)] between the ages of 18 to 50 years, suffering from chronic non-specific LBP (≥3 months) volunteered in the study. An experienced musculoskeletal physiotherapist evaluated and classified participants into either SIJ-positive [n(45)] or SIJ-negative [n(77)] group, using the reference standard pain provocation tests [≥3 positive tests = SIJ-positive]. A research physiotherapist, blinded to clinical groups, conducted the innominate kinematic testing using a valid and reliable electromagnetic palpation-digitization technique, during prone lying incremental hip abduction-external rotation test positions. Results The results of the mixed model regression analyses demonstrated that SIJ-positive participants exhibited significantly different innominate movement patterns and trends of rotation, but not innominate ranges of motion, when compared with SIJ-negative LBP participants. Conclusions These findings demonstrate association between SIJ pain and altered innominate kinematics, and have led the groundwork for further exploration of clinical measurement, relevance, and management of these potentially important movement observations. [ABSTRACT FROM AUTHOR]

Aim The primary aim of the study is to determine if Hip Abduction and External Rotation (HABER) test is capable of reproducing familiar pain in individuals with low back pain (LBP) of sacroiliac joint (SIJ) origin (SIJ-positive) when compared with LBP of Non-SIJ origin (SIJ-negative). If so, the secondary aim is to determine the diagnostic accuracy of HABER test against the reference standard of pain provocation tests, and to determine which increments of the HABER test has highest sensitivity and specificity for identifying SIJ-positive individuals. Design Single-blinded diagnostic accuracy study. Method Participants [n(122)] between ages of 18–50 y, suffering from chronic non-specific LBP (≥3 months) volunteered in the study. An experienced musculoskeletal physiotherapist evaluated and classified participants into either SIJ-positive [n(45)] or SIJ-negative [n(77)], based on reference standard of pain provocation tests [≥3 positive tests = SIJ-positive]. Another musculoskeletal physiotherapist, blinded to clinical groups, evaluated participants for reproduction of familiar pain during each increment (10°, 20°, 30°, 40°, and 50°) of HABER test. Results The HABER test reproduced familiar pain in SIJ-positive individuals when compared with SIJ-negative individuals [ p (0.001), R 2 (0.38), Exp(β) (5.95–10.32)], and demonstrated moderate level of sensitivity (67%–78%) and specificity (71%–72%) for identifying SIJ-positive individuals. Receiver operator curve analysis demonstrated that the HABER increments of ≥30° have the highest sensitivity (83%–100%) and specificity (52%–64%). Conclusions The HABER test is capable of reproducing familiar pain in SIJ-positive LBP individuals and has moderate levels of sensitivity and specificity for identifying SIJ-positive LBP individuals. [ABSTRACT FROM AUTHOR]

Background Electromagnetic palpation-digitization technique for measurement of innominate motion involves calculation of innominate rotation using the innominate vector length in the neutral (NEUT) and combined hip abduction and external rotation (HABER) test positions. The innominate vector length [i.e., the segment between anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS)] is not a rigid structure and its deformation could introduce an error influencing the final innominate rotation measurement. Objectives The aim of this study is to determine if there is significant deformation occurring in innominate vector length when the hip is loaded into the HABER test position. Method A cross sectional study using sixteen healthy individuals and a single tester was conducted. Four pelvic landmarks, left and right PSIS and ASIS, were palpated and digitized using 3D digitizing stylus of Polhemus electromagnetic tracking device, in two hip test positions, NEUT and 50° HABER. The innominate vector lengths were calculated from the 3D coordinates of pelvic landmarks, for each hip test positions. Results and conclusion Paired t-tests demonstrated no significant differences (p > 0.05) in the innominate vector lengths at the side of the load as well as the opposite innominate when either the right or left hip was loaded; thus indicating no significant bone deformation in innominate segment during the HABER test position. [ABSTRACT FROM AUTHOR]

Abstract: Joint kinematic assessment using an electromagnetic tracking device (EMTD) requires palpation-digitization (PD) of bony landmarks to define the anatomical axes. Errors in PD of bony landmarks can perturb the anatomical axes and affect the validity and reliability of kinematic measurements. The validity and reliability of PD for kinematic measurement needs to be explored before recommending its wider use. A systematic search of 15 electronic databases located studies assessing validity and/or reliability of PD for joint kinematic assessment. Two independent reviewers used the QUADAS and QAREL tools to assess quality of validity and reliability studies respectively. The results were synthesized qualitatively using a level of evidence approach. Eight studies satisfied the final eligibility criteria and were included in the review. The validity, intra-rater reliability and inter-rater reliability were assessed in three, seven and one study respectively. The overall level of evidence for validity of PD technique was strong with high correlation (≥0.80) reported by three high (≥60%) quality studies. The overall level of evidence for intra-rater reliability was also strong with very high ICC (≥0.90) and satisfactory SEM (SEM% ≤ 10%) reported by four high quality studies. However the level of evidence for inter-rater reliability was limited and needs to be addressed by future research. [Copyright &y& Elsevier]

Abstract: Although the complex anatomical orientation and position of the sacroiliac joints (SIJ) has rendered their 3D kinematic evaluation difficult, recent techniques of palpation–digitization of pelvic landmarks using electromagnetic tracking device have been able to accurately and non-invasively quantify the subtle SIJ kinematics. While this technique demonstrates radiographic validity and high test-retest reliability, it is yet to be assessed with regards to inter-tester and trial-to-trial reliability. A single-group repeated measure design using 4 testers was conducted to evaluate the inter-tester and trial-to-trial reliability of palpation–digitization technique for innominate vector length measurements using the Polhemus electromagnetic tracking device. Fourteen young, healthy adults between the ages of 18–40 years participated in the study. The innominate vector length was calculated from 3D co-ordinates of palpated and digitized pelvic landmarks in two test positions of hip. A sensitivity analysis was conducted to determine how palpation–digitization errors for pelvic landmarks impacts on innominate angle calculation. Reliability indexes of Intraclass correlation coefficient (ICC) (≥0.97) and Standard error of measurement (SEM) (≤2.02 mm) demonstrated very high inter-tester and trial-to-trial reliability and accuracy of palpation–digitization technique for innominate vector length measurements, irrespective of the two test positions. A higher consistency of measurements was obtained within-testers as compared to between testers, and sensitivity analysis demonstrated a negligible influence of palpation–digitization errors on the innominate angle measurements. The results support clinical and research utility of this technique for non-invasive kinematic evaluation of SIJ motion for this population. Further research on the use of this palpation–digitization technique in symptomatic population is warranted. [Copyright &y& Elsevier]