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Background: Three-dimensional motion analysis using optoelectronic cameras and force platforms is typically used to quantify gait disorders. However, these systems have various limitations, particularly when assessing patients in an ecological environment. To address these limitations, several wearable devices have been developed. However, few studies have reported metrological information regarding their repeatability and sensitivity to change. Methods: A healthy adult performed 6 min walking tests with FeetMe® system insoles under different walking conditions overground and on a treadmill. The standard error of measurement (SEM), the minimum detectable differences (MDDs), and the effect size (ES) were calculated for spatio-temporal parameters, and the ground reaction force was calculated from the 16,000 steps recorded. Results: SEM values were below 3.9% for the ground reaction force and below 6.8% for spatio-temporal parameters. ES values were predominantly high, with 72.9% of cases between overground and treadmill conditions with induced asymmetry, and 64.5% of cases between treadmill conditions with and without induced asymmetry exhibiting an ES greater than 1.2. The minimum detectable differences ranged from 4.5% to 10.7% for ground reaction forces and 2.1% to 18.9% for spatio-temporal parameters. Conclusion: Our study demonstrated that the FeetMe® system is a reliable solution. The sensitivity to change showed that these instrumented insoles can effectively reflect patient asymmetry and progress. [ABSTRACT FROM AUTHOR]

The reliability of tests to be used in research or clinical practice should be established for each population specific to their intended use. Reliability is important because it allows correct evaluations to be made about treatment effects or about the amount of changes. To evaluate the test-retest reliability and minimal detectable change of the L-test in patients with advanced knee osteoarthritis (OA). The intraclass correlation coefficient (ICC2,1) was used to assess the test-retest reliability of the L-test. The minimal detectable change with 95% confidence interval (MDC95) was calculated to determine the true change. The inclusion criteria were diagnosis of knee OA, had Kellgren Lawrence Grade IV and age of ≥40 years. Twenty-five participants who met the inclusion criteria were included. Five were male and the mean age was 62.32±9.77 years. All of the participants had radiographic findings indicative of Kellgren-Lawrence Grade IV. The L-test showed excellent test-retest reliability. The ICC was 0.99, the SEM and the MDC95 was 1,90 and 5.28 seconds, respectively. The L-test is a reliable outcome measurement for the assessment of walking ability in patients with advanced knee OA, and it showed very high test-retest reliability in these patients. This test may assist clinicians and researchers in assessing the functional mobility of patients and planning rehabilitation in patients with advanced knee OA. [ABSTRACT FROM AUTHOR]

Medial tibiofemoral joint contact forces can be estimated using musculoskeletal models. To assess change in these forces that accompany load-modifying interventions, minimum detectable change (MDC) thresholds must be established. The primary study purpose was to derive MDCS for medial tibiofemoral peak force and force impulse during walking. The secondary purpose was to identify the proportions of individuals exhibiting reductions greater than these MDCs when walking with lateral foot wedging. Eight healthy individuals provided 3-dimensional gait data over 3 test sessions to serve as inputs for an inverse dynamics-driven medial tibiofemoral contact force model, from which MDCs for peak force and impulse were derived. The MDC was 0.246 BW (8.7%) for peak force and 0.0385 BWs (3.7%) for impulse. Then, 25 healthy individuals provided gait data by walking with and without 6° laterally wedged foot orthoses, and the proportion of individuals exhibiting changes in medial tibiofemoral contact peak force and impulse values exceeding the MDC threshold was determined. For impulse and peak force, 52% and 4% of participants exhibited a decrease exceeding the MDC, respectively. In summary, medial tibiofemoral contact force MDCs were derived, with impulse showing greater sensitivity than peak force to the effects of a biomechanical intervention. [ABSTRACT FROM AUTHOR]

Abstract Background The Unilateral Seated Shot-Put Test (USSPT) consists of pushing an overweight ball as far as possible to assess upper extremity power unilaterally and bilateral symmetry. Literature however reports various body positions and upper limb pushing patterns to perform USSPT, demanding to provide additional guideline to achieve overweight ball push. This study therefore aimed at assessing the reliability and agreement of USSPT outcome measures when pushing an overweight ball in a horizontal direction. Methods Twenty-seven healthy male athletes performed two sessions, one week apart, of three unilateral pushes per upper limb using a 3-kg medicine ball, for which the distances were measured. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change at a 95 % confidence level (MDC95 %) and coefficient of variation (CV) were assessed for the pushing distances based on one, two or three trials per side to produce two outcome measures: the pushing distance per limb and USSPT Limb Symmetry Index (LSI) when dividing pushing distance of the dominant side by that of the non-dominant side. Results The most reliable pushing distance per limb was obtained when averaging three pushing distances, normalized by body mass with the exponent 0.35. The mean USSPT LSI was 1.09 ± 0.10 for the first session and 1.08 ± 0.10 for the second session, highlighting good reliability and agreement (ICC = 0.82; SEM = 0.045; MDC95 % = 0.124; CV = 5.02 %). Conclusions When the overweight ball is pushed in a horizontal direction, averaging the distances of three trials for both the dominant and non-dominant limbs is advised to provide the most reliable USSPT distance per limb and USSPT LSI.

Background and Purpose: To determine intra‐session test‐retest reliability, agreement and minimum detectable change (MDC) of the 30 CST across three tests in people with knee osteoarthritis (OA). Methods: A test–retest reliability study was performed with 93 people with mild radiological knee OA. Participants were asked to complete three attempts of the 30 CST 1–2 min apart according to a standardised protocol. Participants completed three attempts on two occasions: baseline and 6 months later. Change between tests within each session was assessed with ANOVA's and post‐hoc t‐tests. Reliability was assessed with intra‐class correlation coefficients (ICC[2,1]). Measurement error was expressed as MDC for an individual (MDCind) and a group (MDCgroup). Floor effects were considered present if more than 15% of participants scored zero for a test. Results: Scores increased by 0.5 and 0.8 stands between the first and second test (p < 0.05) at the baseline and 6‐month assessments respectively, and then stabilised between the second the third tests at the baseline assessment (p > 0.05) or decreased (0.3 stands) at the 6‐month assessment (p < 0.05). Scores demonstrated excellent reliability (ICCs >0.9). MDCind was approximately 2.5 stands and MDCgroup was 0.3–0.4 stands. No floor effects were apparent. Discussion: The 30CST demonstrated a practice effect between the first and second tests, which was no longer apparent by the third test. Despite this, scores demonstrated excellent intra‐session reliability. MDC estimates provide clinicians and researchers with the smallest change that can be detected by the instrument beyond measurement error for individuals and groups in community‐dwelling adults with knee OA. [ABSTRACT FROM AUTHOR]

Background and Objectives: Multiple sclerosis (MS) is a disease that manifests with varied neurological symptoms, including muscle weakness, especially in the lower extremities. Strength exercises play an important role in the rehabilitation and functional maintenance of these patients. The individualized prescription of strength exercises is recommended to be based on the maximum force determined by the one-repetition maximum (1RM), although to save time and because it requires less equipment, it is often determined by the maximum voluntary isometric contraction (MVIC). The purpose of this work was to study, in patients with MS (pwMS), the reliability of MVIC and the correlation between the MVIC and 1RM of the knee extensors and to predict the MVIC-based 1RM. Materials and Methods: A total of 328 pwMS participated. The study of the reliability of MVIC included all pwMS, for which MVIC was determined twice in one session. Their 1RM was also evaluated. The sample was randomized by MS type, sex, and neurological disability score into a training group and a testing group for the analysis of the correlation and prediction of MVIC-based 1RM. Results: MVIC repeatability (ICC, 2.1 = 0.973) was determined, along with a minimum detectable change of 13.2 kg. The correlation between MVIC and 1RM was R2 = 0.804, with a standard error estimate of 12.2 kg. The absolute percentage error of 1RM prediction based on MVIC in the test group was 12.7%, independent of MS type and with no correlation with neurological disability score. Conclusions: In patients with MS, MVIC presents very good intrasubject repeatability, and the difference between two measurements of the same subject must differ by 17% to be considered a true change in MVIC. There is a high correlation between MVIC and 1RM, which allows estimation of 1RM once MVIC is known, with an estimation error of about 12%, regardless of sex or type of MS, and regardless of the degree of neurological disability. [ABSTRACT FROM AUTHOR]

Introduction The most common work-related musculoskeletal disorder worldwide is neck pain, especially among individuals who extensively use computers in a seated position. One biomedical cause of this neck pain is the prolonged activity of the muscles around the neck. Electromyography (EMG) has been used to evaluate the frequency and intensity of muscle activity. "Relative rest time (RRT)" is an index derived indicating the proportion of time below a certain threshold to the total task time. This study aimed to investigate the measurement errors and minimum detectable change (MDC) of RRT of the pericervical muscles during prolonged typing tasks in individuals with neck symptoms and to examine the differences in measurement errors at 3 µV and 6 µV thresholds. Methods This test-retest reliability study was conducted twice with a one-week interval to examine measurement errors of the RRT using surface EMG. The number of participants was set to 30 subjects who had neck symptoms with a Neck Disability Index of 16% or higher. The primary outcome measure was RRT of the following: the pericervical muscles of the right side during a 60-minute typing task; the splenius capitis muscle, upper trapezius (UT) muscle, middle trapezius muscle, sternocleidomastoid muscle, serratus anterior muscle, longissimus muscle, and pectoralis major muscle. RRT was calculated as the percentage of time that muscle activity was below the threshold for more than 0.250 seconds continuously during a 60-minute typing task. The standard error of measurement (SEM) and MDC were calculated with the two thresholds of 3 µV and 6 µV. The SEMs of the two thresholds were compared using a paired method. Results Ultimately, the data of 26 participants were analyzed. The SEM (MDC) values of the RRT at the 3 µV and 6 µV thresholds were 19.22 (53.27) and 9.52 (26.39) for the splenius capitis muscle, 3.24 (8.97) and 0.38 (1.05) for the sternocleidomastoid muscle, 15.47 (42.88) and 18.79 (52.08) for the UT muscle, 21.28 (58.99) and 2.28 (6.32) for the middle trapezius muscle, 13.67 (37.90) and 11.64 (32.27) for the serratus anterior muscle, 16.81 (46.60) and 3.32 (9.20) for the longissimus muscle, and 8.97 (24.87) and 4.24 (11.74) for the pectoralis major muscle, respectively. The SEMs of the RRT with the 6 µV threshold were statistically significantly lower than those with the 3 µV threshold in all pericervical muscles, except for the UT muscle. Conclusion This study identified the SEM and MDC of the RRT for the pericervical muscles during prolonged typing tasks in individuals with neck symptoms. Except for the UT muscle, the SEMs of the RRT with the 6 µV threshold were statistically smaller than those with the 3 µV threshold. Therefore, when using the RRT in intervention studies that aim to reduce muscle activity during typing in those with neck symptoms, the 6 µV threshold measurement would be recommended for the RRT of the pericervical muscles except for the UT muscle., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee of Saitama Prefectural University issued approval 22502. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: This study was supported by the Saitama Prefectural University under Grant A22006., (Copyright © 2024, Kikkawa et al.)

PURPOSE: This study aimed to investigate the internal consistency, inter-rater, and test-retest reliability of the balance subtest of the Bruininks-Oseretsky test of motor proficiency-second edition (BOT-2) and to estimate the minimum detectable change (MDC) and minimum clinically important difference (MCID) of the balance subtest of the BOT-2 in children with cerebral palsy (CP). METHODS: In total, 20 children with CP participated in the present study. Internal consistency, test-retest, and inter-rater reliability were computed to establish reliability of the balance subtest of the BOT-2. The MDC95 was estimated from the standard error of measurement (SEM) to determine a real change for an individual child with CP. The anchor- and distribution-based MCID were calculated to determine the smallest change that might be important to clinicians. For concurrent validity, the correlation between the balance subtest of the BOT-2 and the pediatric balance scale (PBS) were calculated using Spearman's correlation. RESULTS: Internal consistency was good (Cronbach's alpha coefficient = 0.89). The BOT-2 had excellent test-retest (ICC = 0.99, p < 0.001) and inter-rater reliability (ICC = 0.99, p < 0.001). The balance subtest of the BOT-2 had an SEM of 0.70, MDC95 of 9.61, and MCIDs of 2.54 (anchor-based) and 1.38 (distribution-based). Additionally, there was a moderate positive correlation between the balance subtest of the BOT-2 and the PBS (Spearman's rho = 0.629, p = 0.003). CONCLUSIONS: Our experimental results indicate that the balance subtest of the BOT-2 had good internal consistency, along with excellent test-retest and inter-rater reliability. The change in scores of an individual child with CP should attain 9.61 points on the balance subtest of the BOT-2 to indicate a clinically important change. The MDC95 and MCID values could be helpful in understanding therapeutic effects and evaluating balancing ability using the balance subtest of the BOT-2 in children with CP. [ABSTRACT FROM AUTHOR]

Background: Evaluation over time is important in assessing the reduction of the syndesmosis after suture-button fixation for ankle malleolar fractures. The purposes of this study were to evaluate time-dependent change in the syndesmotic reduction immediately after suture-button fixation for ankle malleolus fractures and 1 year after surgery using computed tomography, and to investigate the reliability of the measurement values to evaluate the reduction of syndesmosis. Methods: We assessed 28 patients who underwent suture-button fixation for ankle fractures. Syndesmotic reduction was assessed within 2 weeks of the fracture surgery and 1 year after surgery using axial computer tomographic images. Side-to-side differences in the anterior, central, and posterior tibiofibular distances, anteroposterior fibular translation, fibular rotation, and syndesmosis area were measured. Results: The mean anterior tibiofibular distance and anteroposterior fibular translation were 1.8 mm and 1.5 mm, respectively, after syndesmotic fixation. They decreased to 1.2 mm and 0.6 mm, respectively, at 1 year after surgery (P =.03 and P =.01, respectively). The other measurement values did not change over time. The minimum detectable change in the distance of measurements was 1 mm or less. Conclusion: The anterior tibiofibular distance and anteroposterior fibular translation had decreased 1 year after fixation in ankle malleolar fractures with syndesmotic suture button. Even if the fibula is posteriorly malreduced by the time computed tomography is performed immediately after surgery, the fibula may return to a good position 1 year after surgery. Level of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Background: The Unilateral Seated Shot-Put Test (USSPT) consists of pushing an overweight ball as far as possible to assess upper extremity power unilaterally and bilateral symmetry. Literature however reports various body positions and upper limb pushing patterns to perform USSPT, demanding to provide additional guideline to achieve overweight ball push. This study therefore aimed at assessing the reliability and agreement of USSPT outcome measures when pushing an overweight ball in a horizontal direction. Methods: Twenty-seven healthy male athletes performed two sessions, one week apart, of three unilateral pushes per upper limb using a 3-kg medicine ball, for which the distances were measured. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change at a 95 % confidence level (MDC95 %) and coefficient of variation (CV) were assessed for the pushing distances based on one, two or three trials per side to produce two outcome measures: the pushing distance per limb and USSPT Limb Symmetry Index (LSI) when dividing pushing distance of the dominant side by that of the non-dominant side. Results: The most reliable pushing distance per limb was obtained when averaging three pushing distances, normalized by body mass with the exponent 0.35. The mean USSPT LSI was 1.09 ± 0.10 for the first session and 1.08 ± 0.10 for the second session, highlighting good reliability and agreement (ICC = 0.82; SEM = 0.045; MDC95 % = 0.124; CV = 5.02 %). Conclusions: When the overweight ball is pushed in a horizontal direction, averaging the distances of three trials for both the dominant and non-dominant limbs is advised to provide the most reliable USSPT distance per limb and USSPT LSI. [ABSTRACT FROM AUTHOR]

Introduction/aim: The use of outcome measures is recommended for chronic inflammatory demyelinating polyneuropathy (CIDP). Implications of minimal important differences (MID) to ascertain responder status are unknown. The reliability of patient-reported treatment-response in relation to clinically relevant change is also unknown.Methods: We retrospectively studied 72 subjects with "definite" or "probable" CIDP evaluated at pre-specified time-intervals pre- and post-treatment. We derived MID and the minimum detectable change with 95% confidence intervals (MDC95 ) for four scales. Scale sensitivities were determined with applicable MID-defined cutoffs (aMIDc), to detect subjects with self-identifying treatment response through a single question.Results: The use of MID was not valid for the Medical Research Council Sum Score, as MDC95  > MID. The aMIDc for the Overall Neuropathy Limitation Score (ONLS) was 1 (sensitivity: 84.7%). The aMIDc for the centile Inflammatory Rasch-built Overall Disability Scale (cI-RODS) was 8 (sensitivity: 62.3%). The aMIDc for grip strength was 4 kg (sensitivity: 79.1%). MID-defined amelioration of any one scale among ONLS, cI-RODS, or grip strength, significantly improved sensitivity to detect treatment-responders compared with the ONLS alone (McNemar test: P = .008, odds ratio: 3.36 [95% confidence interval: 1.44-7.86]). Patient-reported improvement was highly reliable in relation to MID-defined amelioration on any one scale.Discussion: In subjects with CIDP, MID-defined amelioration of any one of three commonly used outcome measures offers optimum relevance and sensitivity to detect self-identifying treatment-responders. Patient reliability to single-question ascertainment of response is high in relation to MID-defined clinical relevance. These findings support use of multiple outcome measures in CIDP monitoring and justify enhanced patient involvement in the process. [ABSTRACT FROM AUTHOR]

Background and Objectives: Multiple sclerosis (MS) is a disease that manifests with varied neurological symptoms, including muscle weakness, especially in the lower extremities. Strength exercises play an important role in the rehabilitation and functional maintenance of these patients. The individualized prescription of strength exercises is recommended to be based on the maximum force determined by the one-repetition maximum (1RM), although to save time and because it requires less equipment, it is often determined by the maximum voluntary isometric contraction (MVIC). The purpose of this work was to study, in patients with MS (pwMS), the reliability of MVIC and the correlation between the MVIC and 1RM of the knee extensors and to predict the MVIC-based 1RM. Materials and Methods: A total of 328 pwMS participated. The study of the reliability of MVIC included all pwMS, for which MVIC was determined twice in one session. Their 1RM was also evaluated. The sample was randomized by MS type, sex, and neurological disability score into a training group and a testing group for the analysis of the correlation and prediction of MVIC-based 1RM. Results: MVIC repeatability (ICC, 2.1 = 0.973) was determined, along with a minimum detectable change of 13.2 kg. The correlation between MVIC and 1RM was R2 = 0.804, with a standard error estimate of 12.2 kg. The absolute percentage error of 1RM prediction based on MVIC in the test group was 12.7%, independent of MS type and with no correlation with neurological disability score. Conclusions: In patients with MS, MVIC presents very good intrasubject repeatability, and the difference between two measurements of the same subject must differ by 17% to be considered a true change in MVIC. There is a high correlation between MVIC and 1RM, which allows estimation of 1RM once MVIC is known, with an estimation error of about 12%, regardless of sex or type of MS, and regardless of the degree of neurological disability.

Increasing soil organic carbon (SOC) content is crucial for soil quality and climate change mitigation. SOC monitoring is indispensable to the corresponding policies and should provide results at farm scale to allow for incentives. In Switzerland, farmers perform mandatory analyses of the SOC content of the 0–20 cm topsoil of every field, based on a composite sample, at least every 10 years. The corresponding results are stored in a database in canton of Geneva. These data may be relevant for topsoil SOC monitoring, in particular for carbon sequestration policies, provided that they show appropriate quality, which is analyzed in this study. The minimum detectable change (MDC) of past results calculated based on the observed SOC changes was 0.013% g g–1 at canton scale (2,700 fields). Based on extended sampling of three representative fields, different sampling strategies were simulated to determine the best future sampling guidelines for farmers. Collecting 20 aliquots with a gouge on the field diagonals was considered the best sampling compromise with field MDC of ∼0.1% g g–1 and a sampling duration of 20 min. Compared to this procedure, former farmers’ sampling was not biased in average but showed a variance of 0.22% g g–1 due to smaller number of aliquots and varying sampling depths. Based on the best sampling results and assumptions on farm-scale SOC variance or SOC differences, the MDCs at farm scale ranged from 0.21 to 0.12% g g–1 (5 fields) and 0.09 to 0.05% g g–1 (30 fields), respectively. These MDCs are small compared to published monitoring networks MDCs and allow determining SOC change rates at farm scale, thus offering perspectives for inexpensive and efficient monitoring in the frame of soil quality or climate mitigation incentives. For the latter, however, additional information with equivalent soil mass and deeper-layer carbon content would be necessary.

Current regulatory guidelines for pesticide risk assessment recommend that nonsignificant results should be complemented by the minimum detectable difference (MDD), a statistical indicator that is used to decide whether the experiment could have detected biologically relevant effects. We review the statistical theory of the MDD and perform simulations to understand its properties and error rates. Most importantly, we compare the skill of the MDD in distinguishing between true and false negatives (i.e., type II errors) with 2 alternatives: the minimum detectable effect (MDE), an indicator based on a post hoc power analysis common in medical studies; and confidence intervals (CIs). Our results demonstrate that MDD and MDE only differ in that the power of the MDD depends on the sample size. Moreover, although both MDD and MDE have some skill in distinguishing between false negatives and true absence of an effect, they do not perform as well as using CI upper bounds to establish trust in a nonsignificant result. The reason is that, unlike the CI, neither MDD nor MDE consider the estimated effect size in their calculation. We also show that MDD and MDE are no better than CIs in identifying larger effects among the false negatives. We conclude that, although MDDs are useful, CIs are preferable for deciding whether to treat a nonsignificant test result as a true negative, or for determining an upper bound for an unknown true effect. Environ Toxicol Chem 2020;39:2109–2123. © 2020 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: The aim of this study was to clarify the absolute reliability of muscle strength and physical performance measures in older people. Findings: Only the five-times chair stand test was found to have a significant systematic error. The minimum detectable changes to the measurement value of grip strength, 5-m walking time, and the timed up and go test were all < 10%, whereas that of knee extension strength was 12%. Message: Changes beyond the minimum detectable change are necessary to detect true changes in muscle strength and physical performance tests over time in community-dwelling older people. Purpose: The purpose of this study was to clarify the absolute reliability of muscle strength and physical performance measures in older people. Methods: The participants were 718 community-dwelling older people who were living independently. Muscle strength and physical performance tests were administered twice for all participants by the same rater. Grip and knee extension strength during isometric contractions were used as muscle strength tests, and the five-times chair stand test (FCST), 5-m walking time at comfortable pace, and the timed up and go test (TUG) as physical performance tests. Bland–Altman analysis was performed to determine the systematic errors for each muscle strength and physical performance test, and the amount of errors was estimated using the minimum detectable change (MDC). Further, %MDC was calculated by dividing the MDC with the mean of two measurement values for each test. Results: No systematic errors were found in any of the muscle strength or physical performance tests, except for the FCST, for which MDC and %MDC could not be calculated. The %MDC of grip strength, 5-m walking time, and the TUG were estimated at < 10%, whereas that of knee extension strength was 12%. Age and gender were not found to affect any systematic errors or MDC and %MDC. Conclusion: Grip strength, 5-m walking time, and the TUG, which all have excellent reliability, were suggested to be appropriate indexes as outcome measures of muscle strength and physical performance in community-dwelling older people. [ABSTRACT FROM AUTHOR]

Background Context: The minimal clinically important difference (MCID) is the smallest change in an outcomes instrument deemed relevant to a patient. MCID values proposed in spine research are limited by poor discriminative abilities to accurately classify patients as "improved" or "not improved." Furthermore, the MCID should not compare relative effectiveness between two groups of patients, though it is frequently used for this. The minimum detectable measurement difference (MDMD) is an alternative to the MCID in outcomes research. The MDMD must be greater than the MCID for the latter to be of value and the MDMD can compare change between groups.Purpose: The purpose of this study was to determine the MDMD for the Scoliosis Research Society-22r (SRS-22r) in adolescent idiopathic scoliosis (AIS) patients treated with surgery.Study Design: Retrospective cohort study from multi-center registry.Patient Sample: Patients treated surgically for AIS.Outcome Measures: Self-reported SRS-22r.Methods: An observational cohort of surgically treated AIS patients was queried for patients with complete baseline, 1-year, and 2-year SRS-22r data. The MDMD was calculated for SRS-22r domain and subscores. Effect size (ES) and standardized response mean were calculated to measure responsiveness of the SRS-22r to change. MDMD values were compared with MCID values. Research grants were received from DePuy Synthes Spine, EOS imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet to Setting Scoliosis Straight Foundation.Results: One thousand two hundred and eighty-one AIS patients (1,034 female, 247 male, mean age 14.6 years) were analyzed. MDMD values were between 0.23 and 0.31. SRS-Pain MDMD was 0.3, greater than the MCID of 0.2. SRS-Activity MDMD was 0.24, greater than the MCID of 0.08. SRS-self-image MDMD was 0.3, less than the MCID of 0.98. Sixty-four percent of those with baseline SRS-self-image>4.0 improved MDMD or more, whereas only 14% improved beyond the MCID. ES and standardized response mean were highest for subscore and self-image.Conclusions: The MDMD can compare the relevance of change in SRS-22r scores between groups of AIS patients. SRS-pain and SRS-activity MDMD values are greater than the MCID and should serve as the threshold for clinically relevant improvement. MDMD may help evaluate change in patients with baseline self-image>4.0. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: The quantitative assessment of volumetric CT for discriminating small changes in nodule size has been under-examined. This phantom study examined the effect of imaging protocol, nodule size, and measurement method on volume-based change discrimination across low and high object to background contrast tasks.Materials and Methods: Eight spherical objects ranging in diameter from 5.0 mm to 5.75 mm and 8.0 mm to 8.75 mm with 0.25 mm increments were scanned within an anthropomorphic phantom with either foam-background (high-contrast task, ∼1000 HU object to background difference)) or gelatin-background (low-contrast task, ∼50 to 100 HU difference). Ten repeat acquisitions were collected for each protocol with varying exposures, reconstructed slice thicknesses and reconstruction kernels. Volume measurements were obtained using a matched-filter approach (MF) and a publicly available 3D segmentation-based tool (SB). Discrimination of nodule sizes was assessed using the area under the ROC curve (AUC).Results: Using a low-dose (1.3 mGy), thin-slice (≤1.5 mm) protocol, changes of 0.25 mm in diameter were detected with AU = 1.0 for all baseline sizes for the high-contrast task regardless of measurement method. For the more challenging low-contrast task and same protocol, MF detected changes of 0.25 mm from baseline sizes ≥5.25 mm and volume changes ≥9.4% with AUC≥0.81 whereas corresponding results for SB were poor (AUC within 0.49-0.60). Performance for SB was improved, but still inconsistent, when exposure was increased to 4.4 mGy.Conclusion: The reliable discrimination of small changes in pulmonary nodule size with low-dose, thin-slice CT protocols suitable for lung cancer screening was dependent on the inter-related effects of nodule to background contrast and measurement method. [ABSTRACT FROM AUTHOR]

Background: Tissue dielectric constant (TDC) measurements are increasingly being used as a tool to help characterize lymphedema features, detect its presence, and assess treatment related changes. Although the underlying physics of this technology has been well described in the literature, there has been little systematic study of in vivo reliability aspects. A central unanswered question is the minimal detectable change (MDC) that, with a given level of confidence, may be ascribed to this technology. Our goal was to address this issue using test-retest measurements from which intraclass correlations coefficients (ICC) and MDC could be estimated. Methods and Results: Forty volunteers (20 females) aged 19–61 years with body mass indices of 14.7–47 kg/m2 and body fat percentages of 12.0%–48.9% were evaluated. Two measurers (M1 and M2) used two different TDC measuring devices (multiprobe and compact) to measure TDC in triplicate sequentially and bilaterally at three locations; anterior forearm, hand palmar mid-thenar eminence, and dorsum mid-web. These measurements were made by each measurer twice constituting test-retest values (T1 and T2). From these measurements ICC2,1 and MDC at 95% confidence were determined for each site and probe for absolute TDC values and for inter-side ratios. MDC values for absolute TDC ranged from 2 to 9 TDC units, and for inter-side ratios ranged from 5.3% to 8.0% depending on site and probe. ICC2,1 values ranged from 0.765 to 0.982. Conclusions: The MDC values herein documented may be used to provide guidance to aid interpretation of measured TDC changes or differences in a clinical environment. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective analysis.Objective: The aim of this study was to elucidate the psychometric properties of the original Japanese Orthopaedic Association (JOA) score, including the minimum detectable change (MDC), minimum clinically important difference (MCID), and patient-accepted symptom state (PASS).Summary Of Background Data: Despite the worldwide popularity of modified JOA score (mJOA), the original JOA score is still commonly used in East Asian countries, including Japan. However, unlike mJOA score, the psychometric properties of JOA score remain poorly understood.Methods: We retrospectively reviewed a consecutive series of laminoplasty for degenerative cervical myelopathy patients in a single academic institution. Pre- and postoperative JOA scores were collected, and the recovery rate was calculated. Anchor-based methods were used to determine the cut-off values by a receiver operating characteristic (ROC) curve analysis. The patients were also asked to answer an anchor question analyzing their postoperative health transition used for the MDC and another question assessing the patient satisfaction used for the MCID and PASS.Results: A total of 101 patients were included in the analysis. The mean preoperative JOA score was 10.3 [standard deviation (SD): 2.4), and the mean postoperative JOA score was 13.4 (SD: 2.5). The mean recovery rate was 44%. A total of 68% of the patients admitted that their health condition was at least "somewhat better" than their preoperative condition, and 66% were at least "somewhat satisfied" with the treatment results. On the basis of ROC curve analyses, the MDC and MCID for JOA score in degenerative cervical myelopathy patients were calculated to be 2.5. The PASS was estimated to be 14.5, and the MCID for JOA recovery rate was 52.8%.Conclusion: The MDC, MCID, and PASS for JOA score for degenerative cervical myelopathy patients were reported by anchor-based ROC curve analyses.Level Of Evidence: 4. [ABSTRACT FROM AUTHOR]

Three-dimensional gait analysis is the gold standard for gait-assessment in patients with stroke. This technique is commonly used to assess the effect of treatment on gait parameters. In clinical practice, three gait analyses are usually carried out (baseline, after treatment and follow-up), the objectives were to define the reproducibility and the Minimum Detectable Change (MDC) for gait parameters in stance and swing measured using 3D-gait analysis, and to assess changes in MDC across three repeated 3D-gait analyses. Three gait analyses (V1, V2 and V3) were performed at 7-day intervals in twenty-six patients with chronic stroke. Kinematic data (in the sagittal plane, during swing and stance) and spatiotemporal data were evaluated for the paretic limb. Reliability was tested using repeated measures ANOVA with a Tukey post hoc test, and the MDC values were calculated for each parameter. Only the range of hip motion during swing changed significantly between V1 and V2, but no other kinematic parameters changed. No significant differences were observed for the spatiotemporal parameters. MDC values were always higher during the V1vsV2 comparison for both kinematic and spatiotemporal parameters. This is the first study to evaluate the MDC for kinematic and spatiotemporal parameters during stance and swing. Reliability of kinematic and spatiotemporal data across sessions was very good over the three sessions. MDC values were the lowest between V2 and V3 for most parameters. Use of the MDC will allow clinicians to more accurately determine the effect of treatments. [ABSTRACT FROM AUTHOR]

Background: Gait limitation is one of the most common disabilities in people with multiple sclerosis (MS). Several studies have used gait parameters to determine the effects of different therapies. However, few studies have determined their reproducibility, also the therapeutic effects could be overestimated.Research Question: To examine the reproducibility in gait measurements during short and long distances.Methods: In this cross-sectional study we recruited a group of MS patients and compare it to a control group. The participants performed the following tests in a fixed order: a 25-foot walk at a comfortable speed, at a fast speed and during a dual task, a timed up-and-go test (TUG) and a six- minute walk test (6MWT). Two measurements were conducted a week apart. Systematic error was evaluated by the Student t-test, reliability by the intra-class correlation coefficients (ICC) and agreement by the minimum detectable change (MDC95).Results: A total of 58 people with MS and 19 healthy people were included. The absence of systematic error was only found for the fast speed condition. The reliability of the gait parameters had moderate to high ICC values (ICC > 0.7) except for the dual task cost (DTC) which was 0.45. The MDC95 was higher in people with MS compared to healthy people, and it was higher in people with MS for gait speeds in all conditions (> 34%). For the TUG and 6MWT, the MDC95 were 51.5% and 31.7% respectively. For people with MS the smallest MDC95 was found for the stance time for all conditions (6.8%), whereas the highest was found for the dual task cost (158.7%).Significance: The MDC95 values were higher than the cut-off point based on the minimally important clinical difference (MICD) proposed in previous studies. Thus, the MDC95 should be used as a cut-off rather than MICD values. [ABSTRACT FROM AUTHOR]

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Background Context: Health-related quality-of-life outcomes have been collected with the Medical Outcomes Study (MOS) Short Form 36 (SF-36) survey. Boston University School of Public Health has developed algorithms for the conversion of SF-36 to Veterans RAND 12-Item Health Survey (VR-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores.Purpose: The purpose of the present study is to investigate the conversion of the SF-36 to VR-12 PCS and MCS scores.Study Design: Preoperative and postoperative SF-36 were collected from patients who underwent lumbar or cervical surgery from a single surgeon between August 1998 and January 2013.Methods: Short Form 36 PCS and MCS scores were calculated following their original instructions. The SF-36 answers were then converted to VR-12 PCS and MCS scores following the algorithm provided by the Boston University School of Public Health. The mean score, preoperative to postoperative change, and proportions of patients who reach the minimum detectable change were compared between SF-36 and VR-12.Results: A total of 1,968 patients (1,559 lumbar and 409 cervical) had completed preoperative and postoperative SF-36. The values of the SF-36 and VR-12 mean scores were extremely similar, with score differences ranging from 0.77 to 1.82. The preoperative to postoperative improvement was highly significant (p<.001) for both SF-36 and VR-12 scores. The mean change scores were similar, with a difference of up to 0.93 for PCS and up to 0.37 for MCS. Minimum detectable change (MDC) values were almost identical for SF-36 and VR-12, with a difference of 0.12 for PCS and up to 0.41 for MCS. The proportions of patients whose change in score reached MDC were also nearly identical for SF-36 and VR-12. About 90% of the patients above SF-36 MDC were also above VR-12 MDC.Conclusions: The converted VR-12 scores, similar to the SF-36 scores, detect a significant postoperative improvement in PCS and MCS scores. The calculated MDC values and the proportions of patients whose score improvement reach MDC are similar for both SF-36 and VR-12. [ABSTRACT FROM AUTHOR]

PURPOSE: We compared a goniometer method in a non-weight-bearing position with a tape measure method in a weight-bearing position to determine which was more reliable for assessing dorsiflexion range of motion (ROM) in children with cerebral palsy (CP). METHODS: Ankle dorsiflexion ROM was measured using goniometer and tape measure methods in non-weight- and weight-bearing positions, respectively. RESULTS: In the test-retest reliability of ankle dorsiflexion ROM using a universal goniometer, the intraclass correlation coefficient (ICC) varied from 0.75 to 0.96 and the overall ICC score was 0.91 ( p < 0.001). In the test-retest reliability of ankle dorsiflexion ROM using a tape measure, ICC varied from 0.98 to 0.99 and the overall ICC score was 0.99 ( p < 0.001). Ankle dorsiflexion ROM using a universal goniometer had a standard error of measurement (SEM) of 2.86 and a minimum detectable change (MDC) of 7.94. Ankle dorsiflexion ROM using a tape measure had an SEM of 1.01 and a MDC of 2.80. CONCLUSIONS: The tape measure method in a weight-bearing position was more reliable than using a universal goniometer in a non-weight-bearing position in children with CP. [ABSTRACT FROM AUTHOR]

Previous studies evaluated 3D human jaw movements using kinematic analysis systems during mouth opening, but information on the reliability of such measurements is still scarce. The purpose of this study was to analyze within- and between-session reliabilities, inter-rater reliability, standard error of measurement (SEM), minimum detectable change (MDC) and consistency of agreement across raters and sessions of 3D kinematic variables during maximum mouth opening (MMO). Thirty-six asymptomatic subjects from both genders were evaluated on two different days, five to seven days apart. Subjects performed three MMO movements while kinematic data were collected. Intraclass correlation coefficient (ICC), SEM and MDC were calculated for all variables, and Bland-Altman plots were constructed. Jaw radius and width were the most reproducible variables (ICC > 0.81) and demonstrated minor error. Incisor displacement during MMO and angular movements in the sagittal plane presented good reliability (ICC from 0.61 to 0.8) and small errors and, consequently, could be used in future studies with the same methodology and population. The variables with smaller amplitudes (condylar translations during mouth opening and closing and mandibular movements on the frontal and transversal planes) were less reliable (ICC < 0.61) and presented larger SEM and MDC. Although ICC, SEM and MDC showed less between-session reproducibility than within-session and inter-rater, the limits of agreement were larger in inter-rater comparisons. In future studies care must be taken with variables collected on different days and with mandibular movements in the frontal and transversal planes. [ABSTRACT FROM AUTHOR]

The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable. [ABSTRACT FROM AUTHOR]

ResumenEl análisis de la velocidad de carrera mediante sensores láser permite la obtención de datos en tiempo real siendo ventajosos frente a otros sistemas. El objetivo de este estudio fue valorar la validez y fiabilidad del sensor láser del sistema BioLaserSportÒ para el cálculo de velocidades medias y máximas mediante estadísticos relativos y absolutos. Los participantes fueron 17 varones (20.85 ± 1.54 años). Se utilizó un sensor láser tipo 1 (LDM301, Jenoptik, Germany) que registró posiciones de los deportistas a 2000 Hz. Los datos se trataron con la rutina DSL-30 creada con DasyLab v.10.0. Para la validación se utilizó un sistema de fotogrametría-2D con una cámara de alta velocidad (Exilim High Speed EX-F1, Casio) y SkillSpector v.1.3.2. (Video4coach, Grubbemollevej). Además, se utilizaron foto-células de doble haz (Polifemo Light, Microgate, Italy) y un cronómetro Racetime2 (Microgate, Italy). Se registraron, durante dos días, tres series de 30 m de carrera a máxima velocidad. El sensor láser proporcionó, con relación a la fotogrametría, diferencias en las velocidades medias y máximas de -0.11 m·s-1 y 0.14 m·s-1, respectivamente, con unos coeficientes de correlación superiores a 0.86, y mayores de 0.92 con las foto-células para las velocidades medias. Este mostró una excelente fiabilidad test-retest para las velocidades medias con un coeficiente de correlación intraclase (ICC) entre 0.7-0.9 y un error estándar de la media (SEM y SEM%), intrasesión e intersesión, menor de 0.05 m·s-1 y 0.12 m·s-1, respectivamente, y menores de 0.75% y de 2%, respectivamente. Para las velocidades máximas, los valores fueron menores de 0.10 m·s-1 y 0.17 m·s-1, respectivamente, y en ambos casos menores a 1.36% y 1,89%. El láser fue capaz de identificar mínimos cambios detectables (MDC y MDC%) intrasesión, para ambas variables, menores a 0.14 m·s-1 y 0.29 m·s-1, respectivamente (< 2.09% y < 3.76%) e intersesión, menores de 0.34 m·s-1 y 0.47 m·s-1 (< 5.56% y < 5.25%), respectivamente. En consecuencia, es un instrumento útil para el análisis de la evolución de la velocidad intrasujeto y entre sujetos en la carrera de velocidad entre 0-30 m, proporcionando resultados en tiempo real, pero se han de considerar los SEM, SEM%, MDC y MDC% para valorar la mejora del rendimiento.AbstractSpeed running analysis using laser sensors allows to obtain data in real-time showing an advantage compared with other systems. The objective of this study was to assess the validity and reliability of the laser sensor of the BioLaserSport® system for the calculation of mean and maximum velocities using relative and absolute statistics tools. The participants were 17 men (20.85 ± 1.54 years). A laser sensor type 1 (LDM301, Jenoptik, Germany) was used to record positions of the subjects to 2000 Hz. The data were analyzed using DSL-30 routine created with DasyLab v.10.0. A Photogrammetry-2D system with a high-speed camera (Exilim High Speed EX-F1, Casio) and SkillSpector v.1.3.2. (Video4coach, Grubbemollevej) and a reference system 4 x 2 m2 was used. Furthermore, a double photocell (Polifemo Light, Microgate, Italy) with an electronic stopwatch (Microgate, Italy) Racetime2 was used. Three series of 30 m sprint were recorded during two days. The results indicated that the laser sensor provided differences in mean and maximum velocities of -0.11 m·s-1 and 0.14 m·s-1, respectively. The correlation coefficients were higher than 0.86 in relation to photogrammetry and higher than 0.92 in relation to photo-cells. The laser system showed an excellent test-retest reliability for mean velocities with a coefficient of correlation intraclass (ICC) between 0.7-0.9. The standard error of the mean (SEM and SEM%), intra-session e inter-session, were lower than, 0.05 m·s-1 and 0.12 m·s-1, respectively, and in both cases less than 0.75% and 2%, respectively . In relation to maximum velocities, the values were lower than 0.10 m·s-1 and 0.17 m·s-1, respectively, and in both cases less than 1.36% and 1,89%. The minimum detectable change (MDC and MDC%) intra-session, for both variables, was lower than 0.14 m·s-1 and 0.29 m·s-1, respectively, (< 2.09% y < 3.76%). In relation to inter-session, the values were lower than 0.34 m·s-1 and 0.47 m·s-1 (< 5.56% y < 5.25%), respectively. Therefore, the laser system was a useful tool to analyze the evolution of the intra-subject and inter-subject velocity in a 30 m sprint running. Moreover, it provides results in real time, although assessing performance improvements must be considered the SEM, SEM%, MDC and MDC% values.

The objectives of this work were (i) to determine Gait Profile Score (GPS) for hemiparetic stroke patients, (ii) to evaluate its reliability within and between sessions, and (iii) to establish its minimal detectable change (MDC). Seventeen hemiparetic patients (mean age 54.9±10.5years; 9 men and 8 women; 6 hemiparetic on the left side and 11 on the right side; mean time after stroke 6.1±3.5months) participated in 2 gait assessment sessions within an interval of 2-7 days. Intra-session reliability was obtained from the intraclass correlation coefficient (ICC) between the three strides of each session. Inter-session reliability was estimated by the ICC from the averages of that three strides. GPS value of non paretic lower limb (NPLL) (13.9±2.4°) was greater than that of paretic lower limb (PLL) (12.0±2.8°) and overall GPS (GPS_O) was 13.7±2.5°. The Gait Variable Scores (GVS), GPS and GPS_O exhibited intra-session ICC values between 0.70 and 0.99, suggesting high intra-day stability. Most of GVS exhibited excellent inter-session reliability (ICC between 0.81 and 0.93). Only hip rotation, hip abduction of PLL exhibited moderate reliability with ICC/MDC values of 0.57/10.0° and 0.71/3.1°, respectively. ICC/MDC values of GPS were 0.92/2.3° and 0.93/1.9° for PLL and NPLL, respectively. GPS_O exhibited excellent test-retest reliability (ICC=0.95) and MDC of 1.7°. Given its reliability, the GPS has proven to be a suitable tool for therapeutic assessment of hemiparetic patients after stroke. [ABSTRACT FROM AUTHOR]

Abstract Background Due to the specific anatomy of the subtalar joint with its oblique axis, isometric pronator and supinator strength is not well documented. The purpose of this study was to determine intra‐ and between‐session reliability of pronator and supinator strength and lower leg muscle activity measurements during maximum voluntary isometric contractions (MVIC). Methods Pronator and supinator peak torques (PT), with and without supplementary visual muscle strength biofeedback (FB), and muscular activities of peroneus longus (PL) and tibialis anterior (TA) were assessed twice 3 days apart by the same examiner in 21 healthy young male adults (mean age: 27.6 years; SD = 3.9). Limits of agreement (LoA) and minimum detectable change (MDC) were evaluated. Results By applying FB, reliability of both pronator and supinator PT was improved: LoA were reduced from 32% to 26% and from 20% to 18% and MDC from 20% to 15% and from 16% to 12% in supinator and pronator PT, respectively. Learning effects in pronator and supinator PT (p

Background: The incidence of diabetes mellitus is increasing worldwide, resulting in a global epidemic. The most common type, the type 2 diabetes mellitus, constitutes of 90-95 % of the cases and is characterized by the action of and/or impaired insulin secretion. Regular exercise is a recommended strategy in several studies and guidelines for type 2 diabetes control and complications associated with it. Therefore, we evaluated and compared the effects of aerobic and strength exercise programs on the glycemic control in patients with type 2 diabetes. Methods: The selected patients were divided into groups which performed moderate strength training (ST) and aerobic training (AT). The study lasted 20 weeks and was divided into two 10 week phases with anthropometric (body mass index, waist, abdomen and hips circumferences, waist/hip ratio) and biochemical (glycemic and lipid profile) assessments at baseline, 10 weeks and 20 weeks. For intra and inter analyses a mixed ANOVA model was used. Individual changes were calculated using the minimum detectable change, based on a 90 % confidence interval. Results: Eleven patients (five men and six women) completed the 20 weeks of training; five from the ST group and six from the AT. No significant changes were observed in any anthropometric variable in either group. Statistically significant differences were found in mean hemoglobin A1c in both groups between baseline (AT: 8.6 ± 2.5; ST: 9.2 ± 1.9) and 10 weeks (AT: 7.2 ± 1.7; ST: 7.9 ± 1.2) (p = 0.03), and baseline (AT: 8.6 ± 2.5; ST: 9.2 ± 1.9) and 20 weeks (AT: 7.5 ± 1.7; ST: 7.4 ± 0.9) (p = 0.01). For the minimal detectable changes, 40 % of the ST and 33 % of AT achieved these changes for hemoglobin A1c. Conclusion: Both aerobic and strength exercises can help the metabolic control in patients with type 2 diabetes, even without significant changes in anthropometry over the 20 weeks of training. However, this period was sufficient to cause changes in hemoglobin A1c values and the estimated average glucose, which are important parameters in controlling diabetes, thus signaling an important consequence of adhering to an exercise routine for type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

The King-Devick test appears to be a promising tool in screening for concussions. However, limited evidence exists on the baseline associations between the K-D test and age and baseline screening tools used after concussion. Additionally, there are no published reference values for the K-D test in high school football players. The K-D test, the Balance Error Scoring System, and the Limits of Stability ( LOS) test were administered to 157 high school football players. Additionally, a subsample of 62 participants completed the test twice to examine the reliability of K-D test. There was no relationship between the K-D test and the BESS, or the reaction time and directional control of LOS test. Students aged between 16 and 18 years demonstrated faster K-D test performance compared to students between 13 and 15 years of age. However, there was no association between K-D test and history of concussion. The reliability of the K-D test was ( ICC2,1 = 0.89), and the minimal detectable change was 6.10 s. Normative reference values for high school football players are presented in this study. [ABSTRACT FROM AUTHOR]

Reduced stepping speed is associated with balance deficits and falls in older adults. We evaluated psychometric properties of a test of rapid stepping, the Thirty-Rapid-Step test (30-RST) in 37 community-dwelling older adults. Participants performed the 30-RST, dynamic (step execution time, five-times-sit-to-stand test, gait speed, maximum step length and four-square-step test) and static (single-leg-stance-time and postural sway) performance-based tests. Relationships between 30-RST and performance-based tests were evaluated with Spearman's rho. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), 95% limits of agreement and minimum detectable change at the 95% confidence level (MDC95) were computed for the 30-RST. Relationships between 30-RST and dynamic measures were moderate to very good (r = −0.35–0.73,p < 0.05); however, relationships between 30-RST and static balance were weak (r = 0.04–0.19,p > 0.05). The ICC2,1was 0.85 for 30-RST indicating excellent test–retest reliability. SEM expressed as a percent of mean 30-RST was 8.2%, indicating low measurement error. The MDC95was 9.4 s, and MDC95expressed as a percent of mean 30-RST was moderately low at 22.6%. The 30-RST is a valid measure of dynamic balance and mobility with excellent relative and absolute reliability, and may be a useful measure in geriatric clinical settings and studies investigating balance in healthy community-dwelling older adults. [ABSTRACT FROM PUBLISHER]

Background: Measuring subtalar joint (STJ) motion is accompanied by complications due to the oblique STJ axis which results in triplanar pronation and supination.Objective: We developed a pronator and supinator testing apparatus whose axis was aligned with Inman's STJ axis. The purpose of this study was to assess day-to-day reliability of active STJ range of motion (ROM) measurements and to compare the results with those of a rearfoot goniometer.Methods: Active pronation, supination and total STJ ROM measurements were administered to 12 men (mean age: 23.8 years) and 12 women (mean age: 22.3 years) at two separate test sessions. Intraclass correlations (ICC), limits of agreement (LoA) and minimum detectable change (MDC) were calculated.Results: Except for pronation ROM in men, the STJ goniometer revealed substantial (ICC > 0.8) reliability in all conditions. Relative MDCs and LoAs were below 15% and 10%, respectively. Significantly higher total ROM (P< 0.05) was found for women compared to men when using the STJ goniometer. The rearfoot goniometer showed high reliability (ICCs > 0.7) but underestimated STJ ROM in average of 37%.Conclusions: Both goniometric methods showed high day-to-day reliability. However, when using the rearfoot goniometer, researchers have to consider whether the level of underestimation of STJ motion is acceptable in the context of the planned investigation. [ABSTRACT FROM AUTHOR]

Background: Due to the specific anatomy of the subtalar joint with its oblique axis, isometric pronator and supinator strength is not well documented. The purpose of this study was to determine intra- and between-session reliability of pronator and supinator strength and lower leg muscle activity measurements during maximum voluntary isometric contractions (MVIC). Methods: Pronator and supinator peak torques (PT), with and without supplementary visual muscle strength biofeedback (FB), and muscular activities of peroneus longus (PL) and tibialis anterior (TA) were assessed twice 3 days apart by the same examiner in 21 healthy young male adults (mean age: 27.6 years; SD = 3.9). Limits of agreement (LoA) and minimum detectable change (MDC) were evaluated. Results: By applying FB, reliability of both pronator and supinator PT was improved: LoA were reduced from 32% to 26% and from 20% to 18% and MDC from 20% to 15% and from 16% to 12% in supinator and pronator PT, respectively. Learning effects in pronator and supinator PT (p < 0.05), which were present without FB, were eliminated using FB. Except for TA during pronation, muscle activities showed low reliability indicated by LoA of 51% to 79%. Conclusions: Using supplementary biofeedback, isometric subtalar pronator and supinator strength testing is reliable in healthy subjects. LoA of 18% and 26% have to be exceeded for pronator and supinator PT, respectively, to detect relevant effects in repeated measures. [ABSTRACT FROM AUTHOR]

Assessing assay variability for field samples in environmental research is challenging, since a quantitative assay is typically constrained by a lower limit of detection. The purpose of this paper is to compare three parametric models for assessing assay variability using duplicate data subject to heavy left-censoring. Efron information criterion (EIC) and Bayesian information criterion (BIC) are used to aid in model selections. Distributional parameter estimates are obtained using maximum likelihood estimation for bivariate lognormal, bivariate zero-inflated lognormal, and bivariate 3-component mixture models. We illustrate a practical application using duplicate pesticide data from the Community Participatory Approach to Measuring Farmworker Pesticide Exposure (PACE3) study. Furthermore, a simulation study is conducted to empirically evaluate the performance of the three models. The results from PACE3 indicate that the bivariate zero-inflated lognormal model is fairly competitive based on EIC or BIC. Further, total variability for the lognormal component can be decomposed into between-subject and within-subject variance based on this model. Assay variability estimates such as within-subject coefficient variation, minimum detectable change, and probability of $$k$$ -fold difference can be easily derived under the bivariate zero-inflated lognormal model. Additionally, the assay variability is rather large for the PACE3 data. Therefore, apparent longitudinal change in pesticide exposure should be examined cautiously in the context of substantial assay variability. Supplementary materials accompanying this paper appear online. [ABSTRACT FROM AUTHOR]

Abstract: Tensiomyography (TMG) is a technique utilised to measure mechanical and contractile properties of skeletal muscle. Aim of this study was to assess long-term stability of TMG across a variety of muscle conditions. Gastrocnemius Medialis of 21 healthy males was measured using TMG in rested conditions, after a warm-up, after a maximal voluntary contraction and after a fatigue protocol. Participants were re-tested on a second occasion 4weeks apart. Among the parameters examined, Contraction Time, Sustain Time and Delay time exhibited a good level of absolute reliability (CV=3.8–9.4%) and poor to excellent level of relative reliability (ICC=0.56–0.92). On the other hand, relative reliability was good to excellent for muscle Displacement (ICC=0.86–0.96), whereas its level of absolute reliability was questionable (CV=8.0–14.8%). Minimum detectable change was less than 20% in most conditions for the aforementioned parameters. Half-relaxation Time yielded overall insufficient reliability. In general, the level of reliability tended to increase after the maximal voluntary contraction and the fatigue protocol were administered, probably because of more controlled conditions preceding the measurement. Information about the long-term stability of TMG across different muscle conditions is essential when intervention studies are undertaken with an exercising population, particularly athletes. [Copyright &y& Elsevier]

Abstract: Stroke is a significant cause of deficits in balance, mobility and disability. Although tests of stepping speed are associated with balance performance after stroke, relationships between clinical tests of stepping distance and balance performance have not been investigated in people with stroke. A validated test of stepping distance and balance in older adults (the maximum step length [MSL] test), and two clinical measures associated with balance in people with stroke (the five-times-sit-to-stand test [FTSST] and gait speed) were evaluated in nineteen independent community-dwelling people with chronic stroke. There were strong relationships between MSL and performance on the clinical balance measures (Pearson''s r 0.69 to −0.88), suggesting that MSL is a valid measure of balance after stroke. Test–retest reliability coefficients were excellent for the MSL tests (ICC both limbs; 0.98). Standard error of measurement expressed as a percentage of mean MSL was computed as 5.6% (hemiparetic leg) and 5.4% (unaffected leg), indicative of low levels of measurement error and excellent absolute reliability of the MSL test in people with stroke. Minimum detectable change expressed as a percentage of mean MSL was low (14.9% to 15.4%), suggesting that MSL may be sensitive to detecting change in physical performance in people with stroke. Advantages of the MSL test are that it is easy to administer, requiring minimal training, equipment, time or space. These advantages, together with the validity of the MSL test, its excellent test–retest and absolute reliability, and its low minimum change percent value suggest that MSL may be a useful measure of balance capabilities in people with stroke. [Copyright &y& Elsevier]

Objectives: The influence of self-selected unsupported seated posture on cervical range of motion (ROM) has not been widely studied. Cervical ROM in habitual (HAB) compared to erect (ER) seated posture in adults 50 or older with cervical pain was investigated. Methods: Individuals 50 or older with chronic neck pain participated in this within-subject observational study. ROM and posture (sagittal distances from the nose to the occiput, C7, and thoracic width and relative to a projected laser plumb line) were measured with the CROM device in the two postures. Test- retest reliability, standard error of measurement (SEM) and minimum detectable change at the 95% confidence level (MDC95) were calculated. Results: Total planar ROM values were significantly different between HAB and ER postures. Extension, total rotation and lateral flexion, and R lateral flexion ROM were greater, while flexion decreased significantly in the ER posture. SEM% ranged from 4.0 to 9.5% and MDC95 values were lower in ER (5.8- 11.6") compared to HAB (6.6-17.7°). MDC95% was moderately low for both postures (11.2-26.2%). Discussion: ROM was significantly different between HAB and ER postures. The directions most likely to detect real change in neck mobility were rotation in both postures, and extension as well as total flexion/ extension in ER. Flexion and lateral flexion should be regarded cautiously as measures of improvement. Erect posture maximizes available cervical ROM in individuals over 50 with chronic neck pain compared to habitual postures. [ABSTRACT FROM AUTHOR]

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Background and aims: The five-times- sit-to-stand test (FTSST) is a physical performance test commonly-used in clinical geriatric studies. The relationship between FTSST times and dynamic balance has not been widely investigated in older adults. The main objective of this study was to evaluate the validity of the FTSST as a measure of dynamic balance in older adults. A second objective was to quantify relative and absolute reliability, as well as minimum detectable change (MDC) of the FTSST in older adults. Methods: Twenty-nine females (mean age, 73.6 years) performed two trials of the FTSST, timed up and go (TUG), and functional reach (FR) tests. Validity of the FTSST as a measure of dynamic balance was evaluated by quantifying strength of relationships between the FTSST and two measures of dynamic balance, TUG and FR, using Pearson's correlation coefficient. Measures of relative [intraclass correlation coefficient (ICC)] and absolute [standard error of measurement (SEM)] reliability, as well as the MDC at the 95% confidence level (MDC95) were computed for the FTSST. Results: The Pearson's correlation coefficient between FTSST and TUG (r=0.64, p<0.001) indicates that FTSST is a valid measure of dynamic balance and functional mobility in older adults. The ICC21 of 0.95 is indicative of excellent relative reliability of the FTSST. SEM was 0.9 seconds and MDC95 was 2.5 seconds for the FTSST. SEM (6.3% of mean FTSST) and MDC (17.5% of mean FTSST) percent values were low. Conclusions: The FTSST is a valid measure of dynamic balance and functional mobility in older adults. The high ICC and low SEM and SEM% suggest excellent relative and absolute reliability and reproducibility of the FTSST in older adults. Change in FTSST performance should exceed 2.5 seconds to be considered real change beyond measurement error. [ABSTRACT FROM AUTHOR]

Despite its widespread use in performance assessment, the reliability of vertical jump in an ageing population has not been addressed properly. The aim of the present study was to assess intra- and inter-day reliability of countermovement jump in healthy middle-aged (55–65 years) and older (66–75 years) men and women. Eighty-two participants were recruited and asked to perform countermovement jumps on two different occasions interspersed by 4 weeks. The middle-aged groups exhibited excellent absolute reliability for flight height, jump height, peak force, peak power, peak force/body mass, and peak power/body mass, with coefficients of variation ranging from 2.9% to 7.2% in men and from 3.6% to 6.9% in women and moderate-to-high intraclass correlations (0.75 to 0.97 in men; 0.77 to 0.95 in women). The older groups displayed good coefficients of variation (4.2% to 10.8% in men and 3.4% to 9.5% in women), but the intraclass correlations were low-to-high (0.43 to 0.84 in men; 0.42 to 0.93 in women). Overall, intra-session reliability was higher than inter-session reliability. Peak power was by far the most consistent variable, whereas flight and jump height had the most marked variability. The minimum detectable change varied from 10.5% to 33%, depending on the variable examined, suggesting important implications for intervention studies. [ABSTRACT FROM AUTHOR]

The lack of standardized criteria for measuring therapeutic response is a major obstacle to the development of new therapeutic agents for chronic graft-versus-host disease (cGVHD). National Institutes of Health (NIH) consensus criteria for evaluating therapeutic response were published in 2006. We report the results of 4 consecutive pilot trials evaluating the feasibility and estimating the interrater reliability and minimum detectable change of these response criteria. Hematology-oncology clinicians with limited experience in applying the NIH cGVHD response criteria (n = 34) participated in a 2.5-hour training session on response evaluation in cGVHD. Feasibility and interrater reliability between subspecialty cGVHD experts and this panel of clinician raters were examined in a sample of 25 children and adults with cGVHD. The minimum detectable change was calculated using the standard error of measurement. Clinicians’ impressions of the brief training session, the photo atlas, and the response criteria documentation tools were generally favorable. Performing and documenting the full set of response evaluations required a median of 21 minutes (range: 12-60 minutes) per rater. The Schirmer tear test required the greatest time of any single test (median: 9 minutes). Overall, interrater agreement for skin and oral manifestations was modest; however, in the third and fourth trials, the agreement between clinicians and experts for all dimensions except movable sclerosis approached satisfactory values. In the final 2 trials, the threshold for defining change exceeding measurement error was 19% to 22% body surface area (BSA) for erythema, 18% to 26% BSA for movable sclerosis, 17% to 21% BSA for nonmovable sclerosis, and 2.1 to 2.6 points on the 15-point NIH Oral cGHVD scale. Agreement between clinician-expert pairs was moderate to substantial for the measures of functional capacity and for the gastrointestinal and global cGVHD rating scales. These results suggest that the NIH response criteria are feasible for use, and these reliability estimates are encouraging, because they were observed following a single 2.5-hour training session given at multiple transplant centers, with no opportunity for iterative training and calibration. Research is needed to evaluate inter- and intrarater reliability in larger samples, and to evaluate these response criteria as predictors of outcomes in clinical trials. [ABSTRACT FROM AUTHOR]

Background and aims: Gait speed is a commonly-used assessment and outcomes measure in geriatric clinical and research settings. Although relative reliability of usual gait speed has been well studied in community-dwelling older adults, less emphasis has been placed on a measure of absolute reliability (the standard error of measurement [SEM]), and on an associated clinically relevant index of real change in gait speed, minimum detectable change (MDC). The purpose of this study was to quantify measurement error and MDC for usual gait speed over 4 meters in community-dwelling older adults ambulating at intermediate and fast speeds. Methods: Community-dwelling older adults ambulating at intermediate gait speed (IGS), (n=15, mean age 74.2 yrs) and fast gait speed (FGS), (n=15, mean age 72.1) were included in this study. Participants performed two trials of gait speed over a distance of 4 meters. SEM and MDC at the 95% confidence level (MDC95) were computed for the IGS and FGS groups. Results: Mean gait speed was 85.4 cm/s (IGS) and 129.9 cm/s (FGS). Measurement error (<5% of mean gait speed) and minimum detectable change (<13% of mean gait speed) were low in both groups. MDC95 was computed as 10.8 cm/s and 14.4 cm/s for the IGS and FGS groups, respectively. Conclusions: To be considered real change beyond the bounds of measurement error, change in 4-meter gait speed should exceed 10.8 cm/s (for intermediate speed ambulators) or 14.4 cm/s (for fast speed ambulators). Low measurement error in assessing 4-meter gait speed in community-dwelling older adults suggests that gait speed assessed over short distances has excellent reproducibility across trials. Low minimum change values suggest that 4-meter gait speed may be responsive and sensitive to change. [ABSTRACT FROM AUTHOR]

Abstract: Although plantar pressure measurement systems are being used increasingly during gait analyses to investigate foot orthotics, there is limited information describing test–retest reliability of such measurements. Objectives of this study were to (1) examine the test–retest reliability of lateral heel pressure (LHP) and centre of pressure (COP) during walking with and without lateral heel wedges, and (2) evaluate the effects of 4° and 8° lateral heel wedges on the magnitude of LHP, the pathway of the COP and the peak external knee adduction moment (KAM) in subjects with and without knee osteoarthritis (OA). Twenty-six subjects, 12 patients with knee OA and 14 healthy subjects, were evaluated during three lateral heel wedge conditions (control, 4° and 8°) with standardized footwear. Three-dimensional analyses of gait with optical motion capture, floor-mounted force plate and in-shoe plantar pressure were completed on two occasions. Intraclass correlation coefficients (ICC2, 1) for LHP were excellent (0.79–0.83) while ICCs for COP in the medial–lateral and anterior–posterior directions were more variable (0.66–0.86). Reliability was slightly diminished when using heel wedges. Standard errors of measurement suggested considerable day-to-day variability in an individual''s measures. Lateral heel wedges significantly (p <0.001) increased LHP, shifted COP anteriorly and laterally, and decreased the KAM. No significant differences were observed between subjects with and without OA. Although the day-to-day variability appears too large to confidently evaluate changes in individual patients, and decreases in reliability with increases in wedge size indicate caution, these results suggest in-shoe measurement of LHP and COP are appropriate for use in studies evaluating biomechanical effects of foot orthoses for knee OA. [Copyright &y& Elsevier]

Abstract: Purpose: Report the test-retest reliability, construct validity, minimum clinically important difference (MCID), and minimal detectable change (MDC) for the Neck Disability Index (NDI). Study design/setting: Cohort study of patients presenting to outpatient physical therapy clinics. Patient sample: Ninety-one subjects with a primary complaint of neck pain, with or without concomitant upper extremity (UE) symptoms, who were participants in a randomized clinical trial. Outcome Measures: NDI and the 15-point Global Rating of Change (GRC) self-report measures. Methods: All subjects completed the NDI at baseline and at a 3-week follow-up. Additionally, subjects completed the GRC scale, which was used to dichotomize patients into improved or stable groups. Changes in the NDI were used to assess test-retest reliability, construct validity, MCID, and MDC. Results: Test-retest reliability was moderate for the NDI (intraclass correlation coefficient, 0.64; 95% confidence interval, 0.19–0.84). For the NDI, the MCID was 7.5 points and the MDC was 10.2 points. Conclusions: The NDI appears to demonstrate adequate responsiveness based on statistical reference criteria when used in a sample that approximates the high percentage of patients with neck pain and concomitant UE referred symptoms. Because the MCID is within the bounds of measurement error, a 10-point change (the MDC) should be used as the MCID. [Copyright &y& Elsevier]

Soil profile data are the basis for estimating soil organic carbon (SOC) storage and any changes in SOC storage, which are of great significance in terms of global climate change. Estimates based on various profile data have been made for SOC storage in China. Modeling studies have given contrasting results on changes in SOC storage in Chinese croplands. A certain number of measured soil profile data are needed to validate the modeled results. In the present study, we examined the relationships between sample size, population variance and detection limit using the central limit theorem and the statistical properties of the normal distribution. Based on the profile dataset from the Second National Soil Survey in China, we calculated that to derive a reliable estimate of the overall mean SOC density for all the soils of China, a sample size of 4,000 soil profiles is needed. In this case, a reliable estimate is defined as having a 95% confidence interval and allowing a ±5% detection limit of SOC. The necessary sample size for cropland soils is 1,250. Our results indicate that approximately 100 samples only are needed to validate a modeled SOC loss of 20–30% in cropland soils in China. By aggregating the soil profiles in the dataset into soil orders and calculating the variance of each soil order, we show that the sample sizes in the dataset are insufficient to give reliable estimates on the carbon densities of most soil orders; thus, we conclude that there is considerable uncertainty in the SOC distribution maps resulting from the Second National Soil Survey. [ABSTRACT FROM AUTHOR]