The reliability of card-based and tablet-based left/right judgment measurements

A Scoping Review on Mobile Health Technology for Assessment and Intervention of Upper Limb Motor Function in Children with Motor Impairments

Upper limb (UL) motor dysfunctions impact residual movement in hands/shoulders and limit participation in play, sports, and leisure activities. Clinical and laboratory assessments of UL movement can be time-intensive, subjective, and/or require specialized equipment and may not optimally capture a child's motor abilities. The restrictions to in-person research experienced during the COVID-19 pandemic have inspired investigators to design inclusive at-home studies with child participants and their families. Relying on the ubiquity of mobile devices, mobile health (mHealth) applications offer solutions for various clinical and research problems. This scoping review article aimed to aggregate and synthesize existing research that used health technology and mHealth approaches to evaluate and assess the hand function and UL movement in children with UL motor impairment. A scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) model was conducted in March 2023 yielding 25 articles (0.32% of 7891 studies). Assessment characteristics included game or task-based tests (13/25, 52%), primarily for neurological disorders (e.g., autism spectrum disorder [ASD], dystonia, dysgraphia) or children with cerebral palsy (CP). Although several mHealth studies were conducted in the clinical environment (10/25, 40%), studies conducted at home or in nonclinical settings (15/25, 60%) reported acceptable and highly satisfactory to the patients as minimizing the potential risks in participation. Moreover, the remaining barriers to clinical translation included object manipulation on a touch screen, offline data analysis, real-world usability, and age-appropriate application design for the wider population. However, the results emphasize the exploration of mHealth over traditional approaches, enabling user-centered study design, family-oriented methods, and large-scale sampling in future research.

Factors affecting upper limb functional recovery after mastectomy with immediate breast reconstruction: a prospective study

BACKGROUND

Little is known about the differences in postoperative shoulder function following two common approaches for immediate breast reconstruction (IBR): abdominal-based breast reconstruction and implant-based breast reconstruction (ABR and IMBR). It was hypothesized that postoperative upper limb function would differ between the ABR and IMBR due to incomplete detachment of the pectoral muscles.

PURPOSE

This study aimed to investigate the factors for shoulder function recovery post-IBR and compare recovery outcomes between ABR and IMBR.

METHODS

This single-center prospective follow-up study included 60 patients who underwent IBR for 4 months postoperatively. Patients were invited to complete functional measurements 1 and 4 months postoperatively. The primary outcome was improvement in upper limb disability based on the Q-DASH score. Secondary outcomes were functional shoulder recovery markers: shoulder flexibility, strength, movement accuracy, scapular alignment, body schema accuracy, and neuropathic pain. Repeated-measures analyzes of variance and linear regression were performed.

RESULTS

Within-group differences were found for most variables (p < .05) except for neuropathic pain (p = .929). However, there was no overall main group effect (p > .05). Multivariate regression analysis established significant models for ABR and IMBR (R2 = 0.430, p = .002 and R2 = 0.442, p < .001, respectively). However, the variables included in the model showed between-group differences.

CONCLUSION

Postoperative shoulder function was comparable between the two IBR approaches. However, different factors were associated with improved upper limb disability between ABR and IMBR. Acute rehabilitation focused on resolving muscle tightness and pain may help mitigate upper limb disabilities following IBR.Trial registration number: KCT 0006501.

A Case-Series of Dry Needling as an Immediate Sensory Integration Intervention

BACKGROUND

Chronic low back pain (CLBP) has been associated with altered cortical mapping in the primary somatosensory cortex. Various sensory discrimination treatments have been explored to positively influence CLBP by targeting cortical maps.

OBJECTIVES

To determine if dry needling (DN) applied to patients with CLBP would yield changes in two-point discrimination (TPD) and left-right judgment (LRJ) tasks for the low back. Secondary measurements of pain and limited range of motion (ROM) was also assessed.

METHODS

A sample of 15 patients with CLBP were treated with DN to their low back. Prior to and immediately after DN, TPD, LRJ tasks, low back pain, spinal ROM, and straight leg raise (SLR) were measured.

RESULTS

Following DN, there was a significant (p < 0.005) improvement in LRJ for low back images in all measures, except accuracy for the right side. TPD significantly improved at the L3 segment with a moderate effect size. A significant improvement was found for pain and trunk ROM after DN with a large effect in changing pain of 3.33 points and improving SLR by 9.0 degrees on average, which exceeds the minimal detectable change of 5.7 degrees.

CONCLUSIONS

This is the first study to explore if DN alters TPD and LRJ tasks in patients with CLBP. Results show an immediate significant positive change in TPD and LRJ tasks, as well as pain ratings and movement.

Imagery ability assessments: a cross-disciplinary systematic review and quality evaluation of psychometric properties

BACKGROUND

Over the last two centuries, researchers developed several assessments to evaluate the multidimensional construct of imagery. However, no comprehensive systematic review (SR) exists for imagery ability evaluation methods and an in-depth quality evaluation of their psychometric properties.

METHODS

We performed a comprehensive systematic search in six databases in the disciplines of sport, psychology, medicine, education: SPORTDiscus, PsycINFO, Cochrane Library, Scopus, Web of Science, and ERIC. Two reviewers independently identified and screened articles for selection. COSMIN checklist was used to evaluate the methodological quality of the studies. All included assessments were evaluated for quality using criteria for good measurement properties. The evidence synthesis was summarised by using the GRADE approach.

RESULTS

In total, 121 articles reporting 155 studies and describing 65 assessments were included. We categorised assessments based on their construct on: (1) motor imagery (n = 15), (2) mental imagery (n = 48) and (3) mental chronometry (n = 2). Methodological quality of studies was mainly doubtful or inadequate. The psychometric properties of most assessments were insufficient or indeterminate. The best rated assessments with sufficient psychometric properties were MIQ, MIQ-R, MIQ-3, and VMIQ-2 for evaluation of motor imagery ability. Regarding mental imagery evaluation, only SIAQ and VVIQ showed sufficient psychometric properties.

CONCLUSION

Various assessments exist to evaluate an individual's imagery ability within different dimensions or modalities of imagery in different disciplines. However, the psychometric properties of most assessments are insufficient or indeterminate. Several assessments should be revised and further validated. Moreover, most studies were only evaluated with students. Further cross-disciplinary validation studies are needed including older populations with a larger age range. Our findings allow clinicians, coaches, teachers, and researchers to select a suitable imagery ability assessment for their setting and goals based on information about the focus and quality of the assessments.

SYSTEMATIC REVIEWS REGISTER

PROSPERO CRD42017077004 .

Feasibility of motor imagery and effects of activating and relaxing practice on autonomic functions in healthy young adults: A randomised, controlled, assessor-blinded, pilot trial

Introduction

Motor imagery (MI) is the mental rehearsal of a motor task. Between real and imagined movements, a functional equivalence has been described regarding timing and brain activation. The primary study aim was to investigate the feasibility of MI training focusing on the autonomic function in healthy young people. Further aims were to evaluate participants’ MI abilities and compare preliminary effects of activating and relaxing MI on autonomic function and against controls.

Methods

A single-blinded randomised controlled pilot trial was performed. Participants were randomised to the activating MI (1), relaxing MI (2), or control (3) group. Following a MI familiarisation, they practiced home-based kinaesthetic MI for 17 minutes, 5 times/week for 2 weeks. Participants were called once for support. The primary outcome was the feasibility of a full-scale randomised controlled trial using predefined criteria. Secondary outcomes were participants’ MI ability using the Movement Imagery Questionnaire-Revised, mental chronometry tests, hand laterality judgement and semi-structured interviews, autonomic function.

Results

A total of 35 participants completed the study. The feasibility of a larger study was confirmed, despite 35% attrition related to the COVID-19 pandemic. Excellent MI capabilities were seen in participants, and significant correlations between MI ability measures. Interview results showed that participants accepted or liked both interventions. Seven major themes and insider recommendations for MI interventions emerged. No significant differences and negligible to medium effects were observed in MI ability or autonomic function between baseline and post-intervention measures or between groups.

Conclusions

Results showed that neither activating nor relaxing MI seems to change autonomic function in healthy individuals. Further adequately powered studies are required to answer open questions remaining from this study. Future studies should investigate effects of different MI types over a longer period, to rule out habituation and assess autonomic function at several time points and simultaneously with MI.

Reliability and validity of a mobile tablet for assessing left/right judgements

BACKGROUND

Left/right judgement (LRJ) of body parts is commonly used to assess the ability to perform implicit motor imagery and the integrity of brain-grounded maps of the body. Clinically, LRJ are often undertaken using a mobile tablet, but the concurrent validity and reliability of this approach has not yet been established.

OBJECTIVES

To evaluate the concurrent validity and test-retest reliability of a mobile tablet for assessing LRJ.

METHOD

Participants completed LRJ for 50 hand images (Experiment 1), and 40 back, foot, or neck images (Experiment 2) using a mobile tablet and desktop computer in random order. Participants in Experiment 2 performed a repeat test the following day to assess test-retest reliability. Accuracy and response time (RT) were recorded.

RESULTS

Twenty participants aged 55.3 (±6.7) years in Experiment 1, and 37 participants aged 38.2 (±12.3) years in Experiment 2, were recruited. Concurrent validity of the mobile tablet was good to excellent for hand judgements (ICC_3,1 = 0.836 for RT; ICC = 0.909 for accuracy), and was good for back, foot, and neck judgements (ICC = 0.781 for accuracy; ICC = 0.880 for RT). Test-retest reliability of the mobile tablet was good to excellent (ICC = 0.824 for accuracy; ICC = 0.903 for RT).

CONCLUSIONS

The mobile tablet demonstrated good to excellent concurrent validity with the desktop computer in two separate samples. The mobile tablet also demonstrated good to excellent test-retest reliability. The mobile tablet for LRJ is a valid alternative to the original desktop version.