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Whetstone KS, Matsel KA, Patton AS, Gehres SE, Schwartzkopf-Phifer K. Reliability and Validity of Visual Estimation in Determining Thorax Rotation Mobility using the Quadruped Lumbar-Locked Position. Int J Sports Phys Ther 2024; 19:581-590. [PMID: 38707852 PMCID: PMC11065767 DOI: 10.26603/001c.116154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/29/2024] [Indexed: 05/07/2024] Open
Abstract
Background Thoracic rotation mobility is crucial for athletes in rotational sports such as baseball, golf, and swimming to maintain the proper biomechanics associated with the sport. Accurate differentiation between normal mobility and active and passive physiological deficits in the thoracic region is critical for identifying the need for intervention to the thorax. Purpose To establish the reliability and discriminant validity of visual estimation of thorax rotation range of motion across clinicians of differing experience levels in determining normal mobility and active or passive physiological deficits when utilizing the quadruped lumbar-locked position. Study Design Cross-sectional. Methods Thirty-eight subjects (21 female, 17 male) with a mean age of 27 years ± 6.67 were assessed with the quadruped lumbar-locked thorax rotation test by three examiners with various clinical experience in real-time and again one week later. Bilateral active and passive lumbar-locked thorax rotation mobility was assessed by all raters and categorized as "Unrestricted" (≥50°) or "Restricted" (<50°) while a research assistant simultaneously measured the motion with a digital inclinometer. All raters were blinded to the results. All results were analyzed for intra-rater reliability and agreement. Results Test-retest intra-rater reliability ranged from 0.55-0.72 and percent absolute agreement ranged from 0.82-0.89. Inter-rater reliability ranged from 0.45-0.59 while percent absolute agreement between raters ranged from 0.74-0.84. There was a significant difference in range of motion between "Unrestricted" and "Restricted" categories for both active (Unrestricted=54.6-58.9; Restricted=40.4-44.4; p<0.001) and passive motion (Unrestricted=61.3-63.5; Restricted=39.2-39.7; p<0.001). The only interaction effect was for passive left rotation [Rater A Restricted x ® =34.3(30.4-38.2); Rater C Restricted (x ) ®=43.8(41.3-46.4); p=.000]. Conclusion The quadruped lumbar-locked thorax rotation test demonstrates moderate to substantial test-retest intra-rater and inter-rater reliability regardless of clinical experience. The quadruped lumbar-locked thorax rotation test can accurately discriminate between individuals with active and passive physiological deficits regardless of rater experience using visual estimation. Level of Evidence 3b.
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Ichikawa K, Otsuka T, Abduh HAM, Kuruma H. Assessing validity of thoracic spine rotation range of motion measurement methods: comparison of magnetic resonance imaging and clinical measurements. J Phys Ther Sci 2024; 36:95-101. [PMID: 38434995 PMCID: PMC10904216 DOI: 10.1589/jpts.36.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/25/2023] [Indexed: 03/05/2024] Open
Abstract
[Purpose] This work was designed to establish criteria for assessing common clinical measurement methods for thoracic spinal rotation angles by comparing their results with magnetic resonance imaging measurements. [Participants and Methods] Twenty-six healthy participants underwent thoracic rotation angle assessments using an electronic goniometer in three positions: lumbar-locked, seated, and half-kneeling. We compared these results with measurements obtained by magnetic resonance imaging. [Results] A moderate but significant positive correlation was observed between the thoracic rotation angle measured by magnetic resonance imaging and the lumbar-locked rotation test. The respective 95% confidence intervals of these correlation coefficients were 0.09 and 0.72. Bland-Altman analysis revealed a fixed error in the lumbar-locked rotation test, suggesting that the test tended to overestimate thoracic rotation compared with magnetic resonance imaging, but proportional errors could not be definitively identified. [Conclusions] Thoracic spine rotation angles measured using magnetic resonance imaging aligned closely with previously reported results. Notably, although measurements obtained by the lumbar-locked rotation test correlated with magnetic resonance imaging results, they exhibited fixation errors. Functional tests (seated and half-kneeling) showed limited correlations with magnetic resonance imaging results. The influence of adjacent joints on clinical measurements should be considered.
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Affiliation(s)
- Kazuna Ichikawa
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Takuya Otsuka
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | | | - Hironobu Kuruma
- Department of Physical Therapy, Tokyo Metropolitan
University: 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
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de Sousa Almeida AP, Matsui EKK, da Silva FN, de Oliveira Vasconcelos FB, de Oliveira MR. Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults. Eval Health Prof 2024; 47:133-138. [PMID: 38065535 DOI: 10.1177/01632787231220612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.
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Kilic RT, Yildirimalp S, Sayaca C. The impact of protrusion size on pain, range of motion, functional capacity, and multifidus muscle cross-sectional area in lumbar disc herniation. Medicine (Baltimore) 2023; 102:e35367. [PMID: 37986396 PMCID: PMC10666988 DOI: 10.1097/md.0000000000035367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE To investigate the effect of protrusion amount on pain, lumbar mobility, physical dysfunction, and the cross-sectional area of the multifidus muscle in patients with lumbar disc herniation. METHODS 54 male patients aged 20 to 50 years were included in this study in 2 groups. The control group (n = 18) consisted of patients with disc herniation without nerve root compression, and the study group (n = 36) consisted of patients with lumbar disc herniation and nerve root compression in 3 subgroups according to the amount of protrusion. The multifidus muscle cross-sectional area and the amount of protrusion were measured using Magnetic Resonance Imaging. Pain intensity was measured using the Visual Pain Scale, physical dysfunction was measured using the Oswestry Disability Index, flexion-extension was measured with TiltMeter, and trunk rotation was measured with smartphone applications called iPhone Compass. RESULTS There were no differences in pain levels (P > .05), mean trunk rotation movements of the affected and unaffected sides (P = .001, P = .001, P = .983, and P = .954, respectively), Oswestry Disability Index results (P = .967), or cross-sectional area sizes of the multifidus muscle (P = .866, P = .552, P = .787, respectively). There was a difference between the groups in terms of the mean trunk flexion and extension movement values (P = .001). The regression analysis indicated that there was no significant correlation between the binary variables, and the models exhibited a low explanatory rate for the dependent variable. CONCLUSION A relationship has been identified between lumbar disc herniation and low back pain, lumbar movement limitation, and physical functionality. Nevertheless, subsequent to the regression analysis, it became evident that the binary variables did not exhibit a noteworthy relationship, leading to a decrease in the explanatory capacity of the models for the dependent variable. In forthcoming studies, it is advisable to contemplate the augmentation of the subject pool or the incorporation of multiple independent variables into the regression analysis as potential strategies to enhance the model capability in elucidating variations in the dependent variable.
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Affiliation(s)
- Rabia Tugba Kilic
- Rabia Tugba KILIC, Faculty of Health Sciences, Department of Physiotherapy, Ankara Yildirim Beyazit University, Turkey
| | - Sedef Yildirimalp
- Sedef YILDIRIMALP, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Uskudar University, Turkey
| | - Cetin Sayaca
- Cetin SAYACA, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Uludag University, Turkey
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Pottorf O, Vapne D, Ghigiarelli J, Haase K. Reliability and Concurrent Validity of a Markerless, Single Camera, Portable 3D Motion Capture System for Assessment of Glenohumeral Mobility. Int J Sports Phys Ther 2023; 18:1176-1185. [PMID: 37795320 PMCID: PMC10547068 DOI: 10.26603/001c.88003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Recent technological advancements have enabled medical, sport, and fitness professionals to utilize digital tools that assist with conducting movement examinations and screenings. One such advancement has been the implementation of a single camera, markerless, and portable 3D motion capture system designed to obtain ROM measurements for multiple body parts simultaneously. However, the reliability and validity of a markerless 3D motion capture system that uses a single camera has not been established. Purpose The purpose of this study was to investigate the reliability and concurrent validity of this 3D motion capture system compared to a goniometer in assessing ROM of the glenohumeral joint. Study Design Quasi-experimental reliability, convenience sampling. Methods/materials Forty healthy volunteers (mean ± SD, age 27.4 ± 12.4 years, height 173.4 ± 11.1 cm, weight 72.1 ± 16.2 kg) participated in this study. Intrarater reliability was analyzed by ICC(2,k) with a 95% CI using two repeated trials for each shoulder movement (flexion, abduction, external rotation, internal rotation) that were recorded simultaneously via two methods: a standard goniometer and a 3D motion capture system. Concurrent validity was analyzed using Pearson Correlation Coefficient (r). Results The intrarater reliability between the two instruments for glenohumeral motions yielded an overall ICC of 0.82 (95% CI: 0.74-0.88) indicating good reliability for both instruments.The 3D motion capture system demonstrated strong correlations with goniometry for shoulder flexion (r = 0.67), abduction (r = 0.63), and external rotation (r = 0.76), and very strong correlation for shoulder internal rotation (r = 0.84). Conclusion Results from this study indicated that a markerless, single camera, portable 3D motion capture system can be a reliable and valid tool to assess glenohumeral joint ROM in comparison to a standard goniometer. Level of Evidence 3.
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Affiliation(s)
- Ofra Pottorf
- Allied Health and Kinesiology Hofstra University
| | | | | | - Kaitlyn Haase
- Allied Health and Kinesiology Hofstra University
- PT Solutions Physical Therapy
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van Baalen GB, Vanwanseele B, Venter RR. Reliability and Validity of a Smartphone Device and Clinical Tools for Thoracic Spine Mobility Assessments. SENSORS (BASEL, SWITZERLAND) 2023; 23:7622. [PMID: 37688076 PMCID: PMC10490560 DOI: 10.3390/s23177622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
Quantifying thoracic spine mobility with reliable and valid tools is a challenge for clinicians in practice. The aim of this study is to determine the reliability and validity of a smartphone device, bubble inclinometer and universal goniometer to quantify the static kyphotic curve and active range of motion of the thoracic spine. A total of 17 participants (mean age = 23.7 ± 2.3 years) underwent repeated measurements with three raters, on three separate days performing the lumbar-locked trunk rotation, standing full extension, standing full flexion, standing relaxed curve and seated trunk rotation assessments. Mostly "Good" to "Excellent" intra-rater (ICC ranging from 0.624 to 0.981) and inter-reliability (ICC ranging from 0.671 to 0.968) was achieved with the smartphone and clinical tools. "Excellent" validity (ICC ranging from 0.903 to 0.947) with the smartphone was achieved during lumbar-locked trunk rotation and standing relaxed curve assessment. "Good" validity (ICC ranging from 0.836 to 0.867) of the smartphone was achieved during the seated trunk rotation. The Samsung s9+ smartphone with the iSetSquare mobile application is a reliable and valid tool to use for clinical assessments assessing thoracic spine mobility.
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Affiliation(s)
- Gabriela Bella van Baalen
- Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch 7600, South Africa; (G.B.v.B.); (R.R.V.)
| | | | - Ranel Rachel Venter
- Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch 7600, South Africa; (G.B.v.B.); (R.R.V.)
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Bellosta-López P, Simonsen MB, Palsson TS, Djurtoft C, Hirata RP, Christensen SWM. Validity of an inertial measurement unit for the assessment of range and quality of movement during head and thoracic spine movements. Musculoskelet Sci Pract 2023; 66:102826. [PMID: 37433251 DOI: 10.1016/j.msksp.2023.102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/12/2023] [Accepted: 07/06/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Patients with spinal pain often exhibit movement limitations and altered motor control, which can be challenging to measure accurately in clinical practice. Inertial measurement sensors present a promising new opportunity to develop valid, low-cost, and easy-to-use methods for assessing and monitoring spinal motion in a clinical setting. AIM This study aimed to investigate the agreement of an inertial sensor and a 3D camera system for assessing the range of motion (ROM) and quality of movement (QOM) in head and trunk single-plane movements. METHODS Thirty-three healthy, pain-free volunteers were included. Each participant performed movements of the head (cervical flexion, extension, and lateral flexion) and trunk (trunk flexion, extension, rotation, and lateral flexion), which were simultaneously recorded by a 3D camera system and an inertial measurement unit (MOTI, Aalborg, Denmark). Agreement and consistency were analyzed for ROM and QOM by determining intraclass correlation coefficients (ICC), mean bias, and with Bland-Altman plots. RESULTS The agreement between systems was excellent for all movements (ICC between 0.91 and 1.00) for ROM and good to excellent for the QOM (ICC between 0.84 and 0.95). The mean bias for all movements (0.1-0.8°) was below the minimum acceptable difference between devices. The Bland-Altman plot indicated that MOTI systematically measured a slightly greater ROM and QOM than the 3D camera system for all neck and trunk movements. CONCLUSION This study showed that MOTI is a feasible and potentially applicable option to assess ROM and QOM for head and trunk movements in experimental and clinical settings.
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Affiliation(s)
- Pablo Bellosta-López
- Universidad San Jorge. Campus Universitario, Autov. A23 km 299, 50830, Villanueva de Gállego, Zaragoza, Spain.
| | - Morten Bilde Simonsen
- Department of Materials and Production, Faculty of Engineering and Science, Aalborg University, Aalborg, Denmark
| | - Thorvaldur Skuli Palsson
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Chris Djurtoft
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Center for General Practice at Aalborg University, Aalborg, Denmark
| | - Rogerio Pessoto Hirata
- ExerciseTech Research Group, Department of Health Science and Technology Aalborg University, Denmark
| | - Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
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Park HY, Hwang UJ, Kwon OY. Correlation between trunk rotation and lateral flexion range of motion, peak cough flow, and chest expansion in stroke patients. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1970. [PMID: 35962597 DOI: 10.1002/pri.1970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/28/2022] [Accepted: 07/21/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Stroke patients have problems with voluntary movement and trunk control. Moreover, the respiratory function in stroke patients is affected by neurological impairment, which increases the incidence of respiratory complications. OBJECTIVES To determine the correlation between trunk rotation range of motion (TRROM) and trunk lateral flexion range of motion (TLFROM), peak cough flow (PCF), and chest expansion in stroke patients. METHODS This was an observational study involving 21 patients with a clinical diagnosis of stroke from October 2021 to January 2022. TRROM and TLFROM were assessed using smartphone applications (Compass and Clinometer), respectively, PCF was assessed using a peak flow meter, and chest expansion was assessed using a tape measure. Pearson's correlation was used to analyze the relationships between the variables. RESULTS Statistically significant correlations were found between TRROM and TLFROM (r = 0.91, p < 0.01) and between upper chest expansion and PCF (r = 0.59, p < 0.01). There were significant correlations between lower chest expansion and TRROM (r = 0.50, p < 0.05) and between lower chest expansion and TLFROM (r = 0.51, p < 0.05). CONCLUSION This study demonstrates the relationship between upper chest expansion and PCF. Upper chest expansion exercises should be considered to improve the PCF in stroke patients. In addition, a very strong positive correlation between TRROM and TLFROM was demonstrated. TRROM and TLFROM exercises should be considered to improve the lower chest expansion in stroke patients.
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Affiliation(s)
- Hee-Yong Park
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Korea
| | - Ui-Jae Hwang
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea.,Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea.,Kinetic Ergocise Based on Movement Analysis Laboratory, Wonju, Korea
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Santos-Paz JA, Sánchez-Picot Á, Rojo A, Martín-Pintado-Zugasti A, Otero A, Garcia-Carmona R. A novel virtual reality application for autonomous assessment of cervical range of motion: development and reliability study. PeerJ 2022; 10:e14031. [PMID: 36124134 PMCID: PMC9482359 DOI: 10.7717/peerj.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/17/2022] [Indexed: 01/19/2023] Open
Abstract
Background Neck pain, one of the most common musculoskeletal diseases, affects 222 million people worldwide. The cervical range of motion (CROM) is a tool used to assess the neck's state across three movement axes: flexo-extension, rotation, and lateral flexion. People with neck pain often have a reduced CROM, and they feel pain at the end-range and/or accompany neck movements with compensatory trunk movements. Virtual reality (VR) setups can track the movement of the head and other body parts in order to create the sensation of immersion in the virtual environment. Using this tracking position information, a CROM assessment can be performed using a VR setup that may be carried out autonomously from the user's home. The objectives of this study were to develop a VR experience that could be used to perform a CROM assessment, and to evaluate the intra-rater and inter-rater reliability of the CROM measures guided by this VR experience. To the best of our knowledge, a study of this type has not been carried out before. Materials & Methods A total of 30 asymptomatic adults were assessed using a VR device (HTC Vive Pro Eye™). Two raters provided support with the VR setup, and the participants were guided by the VR experience as they performed the movements. Each rater tested each subject twice, in random order. In addition to a head-mounted display (HMD), a tracker located on the subject's back was used to measure trunk compensatory movements. The CROM was estimated using only the HMD position and this measurement was corrected using the tracker data. The mean and standard deviation were calculated to characterize the CROM. To evaluate the reliability, the interclass correlation coefficients (ICC) were calculated for intra-rater and inter-rater analysis. The standard error of measurement and minimum detectable change were also calculated. The usability of the VR system was measured using the Spanish version of the System Usability Scale. Results The mean CROM values in each axis of movement were compatible with those described in the literature. ICC values ranged between 0.86 and 0.96 in the intra-rater analysis and between 0.83 and 0.97 in the inter-rater analysis; these values were between good and excellent. When applying the correction of the trunk movements, both the intra-rater and inter-rater ICC values slightly worsened except in the case of the lateral flexion movement, where they slightly improved. The usability score of the CROM assessment/VR system was 86 points, which is an excellent usability score. Conclusion The reliability of the measurements and the usability of the system indicate that a VR setup can be used to assess CROM. The reliability of the VR setup can be affected by slippage of the HMD or tracker. Both slippage errors are additive, i.e., only when the sum of these two errors is less than the compensatory movement do the measurements improve when considering the tracker data.
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Affiliation(s)
- Jose Angel Santos-Paz
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Álvaro Sánchez-Picot
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Ana Rojo
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | | | - Abraham Otero
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | - Rodrigo Garcia-Carmona
- Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
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Huang T, Zhao Z, Wang L, Zhang C, Zhao R, Xiong C, Zhong W, Luo X. Rapid measurement of thoracolumbar kyphosis with the integrated inclinometer of a smartphone: a validity and reliability study. Sci Rep 2022; 12:8745. [PMID: 35610284 PMCID: PMC9130239 DOI: 10.1038/s41598-022-12690-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to evaluate the accuracy, reliability, and time requirements of two methods for measuring thoracolumbar kyphosis: a conventional method using a picture archiving and communication system (PACS) and this new method using the integrated inclinometer of a smartphone. The thoracolumbar kyphotic angles of one hundred consecutive patients were measured by a PACS and this novel smartphone method. The measured angles were analysed by multiple statistical methods, and the two measurement tools were compared in terms of accuracy, reliability, and time requirements. The mean result of thoracolumbar kyphosis measured by the PACS was 21.43 ± 12.96°, and the mean value measured by the smartphone was 21.03 ± 13.01°. A Bland–Altman plot for these two methods showed a mean difference of 0.4°, with the limits of agreement being -2.4° and 3.2°. One-way ANOVA showed no significant difference (F = 0.080, P = 0.999) among measurements by different observers and different methods. The intraclass correlation coefficients (ICCs) of the mean values of four repeated measurements of thoracolumbar kyphosis between these two methods were 0.997 (0.995–0.998), revealing that the two methods were highly correlated. The ICC results showed that the concordance between these two methods was very good for all measurements of thoracolumbar kyphosis, and the inter- and intra-observer reliability of the novel smartphone method were very good. The PACS method (36.95 ± 0.98 s) took significantly longer than the smartphone method (17.68 ± 0.97 s) when compared by an independent-samples t test (P = 0.000). This new method using the integrated inclinometer of a smartphone has satisfactory validity and reliability compared to the PACS method. Additionally, the new method took significantly less time than the PACS method. Measuring with a smartphone is more convenient than using a PACS, which is always rooted in a full-sized computer. In summary, this new method using the integrated inclinometer of a smartphone is rapid, convenient, accurate and reliable when measuring thoracolumbar kyphosis in osteoporotic vertebral compression fracture (OVCF) patients.
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Affiliation(s)
- Tianji Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Zenghui Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Lin Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Chao Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Runhan Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Chuang Xiong
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
| | - Weiyang Zhong
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
| | - Xiaoji Luo
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
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Esteban-González P, Sánchez-Romero EA, Villafañe JH. Analysis of the Active Measurement Systems of the Thoracic Range of Movements of the Spine: A Systematic Review and a Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2022; 22:3042. [PMID: 35459026 PMCID: PMC9026805 DOI: 10.3390/s22083042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
(1) Objective: to analyze current active noninvasive measurement systems of the thoracic range of movements of the spine. (2) Methods: A systematic review and meta-analysis were performed that included observational or clinical trial studies published in English or Spanish, whose subjects were healthy human males or females ≥18 years of age with reported measurements of thoracic range of motion measured with an active system in either flexion, extension, lateral bending, or axial rotation. All studies that passed the screening had a low risk of bias and good methodological results, according to the PEDro and MINORS scales. The mean values and 95% confidence interval of the reported measures were calculated for different types of device groups. To calculate the differences between the type of device measures, studies were pooled for different types of device groups using Review Manager software. (3) Results: 48 studies were included in the review; all had scores higher than 7.5 over 10 on the PEDro and MINORs methodological rating scales, collecting a total of 2365 healthy subjects, 1053 males and 1312 females; they were 39.24 ± 20.64 years old and had 24.44 ± 3.81 kg/m2 body mass indexes on average. We summarized and analyzed a total of 11,892 measurements: 1298 of flexoextension, 1394 of flexion, 1021 of extension, 491 of side-to-side lateral flexion, 637 of right lateral flexion, 607 of left lateral flexion, 2170 of side-to-side rotation, 2152 of right rotation and 2122 of left rotation. (4) Conclusions: All collected and analyzed measurements of physiological movements of the dorsal spine had very disparate results from each other, the cause of the reason for such analysis is that the measurement protocols of the different types of measurement tools used in these measurements are different and cause measurement biases. To solve this, it is proposed to establish a standardized measurement protocol for all tools.
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Affiliation(s)
- Pablo Esteban-González
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Vil-laviciosa de Odón, Madrid, Spain
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Vil-laviciosa de Odón, Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Madrid, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 La Orotava, Canary Islands, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Eu-ropea de Canarias, 38300 La Orotava, Canary Islands, Spain
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Miyachi Y, Ito M, Furuta K, Ban R, Hanamura S, Kamiya M. Reliability and validity of lower limb joint range of motion measurements using a smartphone. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:7-18. [PMID: 35392008 PMCID: PMC8971043 DOI: 10.18999/nagjms.84.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the reliability and validity of using a smartphone to measure the multi-joint range of motion of the lower limbs. We measured the straight leg raise angle, ankle dorsiflexion angle, and hip internal rotation angle in each of the 40 lower extremities of 20 healthy adults. Measurements were compared between a conventional method using a goniometer and a smartphone application method. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each smartphone measurement, and Bland-Altman analysis was used to examine measurement errors. The criterion-related validity of the two methods was also examined. Intra-rater reliability (ICC 0.668-0.939) was substantial to almost perfect, with no systematic errors found for all items, and the standard errors of measurement were acceptable. Inter-rater reliability (ICC 0.701-0.936) was also substantial to almost perfect, but the straight leg raise angle and hip internal rotation angle showed fixation errors. For these two measurements, with more than one examiner, the limit of agreement of error needs to be considered. No systematic errors were found in the ankle dorsiflexion angle, and the standard error of measurement was within the acceptable range. A moderate to strong correlation (r = 0.626-0.915) was found between the conventional and smartphone methods, demonstrating good criterion-related validity. However, in the ankle dorsiflexion angle measurements, the reliability and validity were shown to be lower than the other two items. This suggested the necessity of changing the measurement conditions in order to use the ankle dorsiflexion angle in clinical practice.
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Affiliation(s)
- Yousuke Miyachi
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
,Department of Rehabilitation, Asahi Hospital, Kasugai, Japan
| | - Morihiro Ito
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
,Department of Biomedical Sciences, College of Life and Health Science, Chubu University, Kasugai, Japan
| | - Kunihiro Furuta
- Department of Rehabilitation, Sikatsu Orthopedic Hospital, Kitanagoya, Japan
| | - Rua Ban
- Department of Rehabilitation, Asahi Hospital, Kasugai, Japan
| | | | - Mitsuhiro Kamiya
- Department of Orthopedic Surgery, Asahi Hospital, Kasugai, Japan
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Pottorf OA, Lee DJ, Czujko PN. Reliability and Concurrent Validity of Mobile Health Technology for Patient Self-Monitoring in Physical Rehabilitation. JSES Int 2022; 6:506-511. [PMID: 35572423 PMCID: PMC9091929 DOI: 10.1016/j.jseint.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Forearm pronation and supination are important for everyday functional tasks and some recreational activities. Healthcare providers use reliable and valid tools during the physical rehabilitation process to measure joint range of motion (ROM), assess functional mobility, guide decisions for skilled interventions, and progress a plan of care. Since the onset of the COVID-19 pandemic, both healthcare providers and patients benefited from mobile health technologies that have emerged, which can be used by patients in the home to monitor ROM and assist the healthcare provider in guiding the rehabilitation process when utilizing telehealth. Purpose The goal of this study was to investigate the reliability and concurrent validity of a smartphone application for obtaining goniometric measurements of forearm pronation and supination. Methods This study consisted of 83 participants that were recruited on a voluntary basis from an academic institution. An iPhone with the application Clinometer and a standard goniometer (SG) were utilized to obtain goniometric measurements of forearm pronation and supination. The intraclass correlation coefficient (ICC) was used to analyze intrarater reliability, and the Pearson correlation coefficient was used to analyze concurrent validity. Scatterplots with regression lines were created to visually display the results. Results The smartphone demonstrated strong correlations for both pronation and supination (r = 0.71, P < .001; r = 0.73, P < .001). This study demonstrated overall good-excellent intrarater reliability and good concurrent validity for the smartphone application with a higher test-retest reliability in the measurement of forearm pronation compared to supination. Conclusions This study concludes that the reliability and concurrent validity of the smartphone was consistent with the SG for assessing forearm pronation and supination. It may be of value to further investigate interrater reliability between patient and healthcare practitioner, and report on the ease of use to assess ROM with a smartphone.
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Takeda Y, Furukawa K. Clinical reliability and usability of smartphone goniometers for hip range of motion measurement. J Phys Ther Sci 2022; 34:433-439. [PMID: 35698549 PMCID: PMC9170486 DOI: 10.1589/jpts.34.433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/06/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yugo Takeda
- Iwaki Yumoto Hospital: 6 Daiyama, Joban-Yumoto-cho, Iwaki City, Fukushima 972-8321, Japan
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Nuhmani S, Khan MH, Kachanathu SJ, Bari MA, Abualait TS, Muaidi QI. Reliability and validity of smartphone applications to measure the spinal range of motion: A systematic review. Expert Rev Med Devices 2021; 18:893-901. [PMID: 34334079 DOI: 10.1080/17434440.2021.1962290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: The objective of this study is to conduct a systematic review on the reliability and validity of various smartphone applications for spinal range of motion (ROM) measurements.Methods: Eleven studies were selected following an electronic search of PubMed, CINAHAL, Medline, Embase and SPORTDiscus. Quality appraisals of selected studies were conducted using a standardized appraisal tool.Results: Most studies demonstrated a good intra- and inter-rater reliability, as well as validity in more than 50% of joint movements. At the same time, relative reliability/validity outcomes (e.g. interclass correlation co-efficient) were stronger than absolute reliability/validity outcomes (e.g. mean differences, limits of agreement). Spinal rotation movement showed less reliability and validity when compared to other spinal movements.ConclusionsːResult of the study supports the use of smartphone applications for ROM measurements of spinal joints. However, we cannot advocate the most appropriate application for spinal ROM measurement or suggest which application is superior to all others. As clinicians have multiple options in selecting applications, it is recommended they use applications that have proven reliable and valid for that particular joint. Data from this study provides clinicians with evidence-based research on smartphone devices for measuring spinal joint ROM in clinical settings.
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Affiliation(s)
- Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, KSA
| | - Moazzam Hussain Khan
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Shaji J Kachanathu
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, KSA
| | - Mohd Arshad Bari
- Department of Physical Education, Aligarh Muslim University, Aligarh, India
| | - Turki S Abualait
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, KSA
| | - Qassim I Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, KSA
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Shaw MP, Satchell LP, Thompson S, Harper ET, Balsalobre-Fernández C, Peart DJ. Smartphone and Tablet Software Apps to Collect Data in Sport and Exercise Settings: Cross-sectional International Survey. JMIR Mhealth Uhealth 2021; 9:e21763. [PMID: 33983122 PMCID: PMC8160809 DOI: 10.2196/21763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/01/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Advances in smartphone technology have facilitated an increase in the number of commercially available smartphone and tablet apps that enable the collection of physiological and biomechanical variables typically monitored in sport and exercise settings. Currently, it is not fully understood whether individuals collect data using mobile devices and tablets, independent of additional hardware, in their practice. OBJECTIVE This study aims to explore the use of smartphone and tablet software apps to collect data by individuals working in various sport and exercise settings, such as sports coaching, strength and conditioning, and personal training. METHODS A total of 335 practitioners completed an electronic questionnaire that surveyed their current training practices, with a focus on 2 areas: type of data collection and perceptions of reliability and validity regarding app use. An 18-item questionnaire, using a 5-point Likert scale, evaluated the perception of app use. RESULTS A total of 204 respondents reported using apps to directly collect data, with most of them (196/335, 58.5%) collecting biomechanical data, and 41.2% (138/335) respondents reported using at least one evidence-based app. A binomial general linear model determined that evidence accessibility (β=.35, 95% CI 0.04-0.67; P=.03) was significantly related to evidence-based app use. Age (β=-.03, 95% CI -0.06 to 0.00; P=.03) had a significant negative effect on evidence-based app use. CONCLUSIONS This study demonstrates that practitioners show a greater preference for using smartphones and tablet devices to collect biomechanical data such as sprint velocity and jump performance variables. When it is easier to access information on the quality of apps, practitioners are more likely to use evidence-based apps. App developers should seek independent research to validate their apps. In addition, app developers should seek to provide clear signposting to the scientific support of their software in alternative ways.
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Affiliation(s)
- Matthew Peter Shaw
- Sports, Physical Activity and Food, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Liam Paul Satchell
- Department of Psychology, University of Winchester, Winchester, United Kingdom
| | - Steve Thompson
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | | | | | - Daniel James Peart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, United Kingdom
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St-Pierre MO, Boivin K, Fontaine N, Saadé N, Sobczak S. Influence of Standardized Procedures on the Reliability of Hip Clinical Assessment. J Manipulative Physiol Ther 2021; 44:137-145. [PMID: 33431277 DOI: 10.1016/j.jmpt.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 03/29/2020] [Accepted: 09/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study evaluated a standardized and personalized approach to verify the effects of conditions on intrarater and interrater reliability, standard error of measurement, and minimal detectable difference for provocative tests and range-of-motion (ROM) tests used in hip pain assessment: flexion-adduction-internal rotation (FADIR), flexion-abduction-external rotation-extension (FABER), and hip internal rotation with 90° of hip flexion (hip IR). METHODS Nineteen participants (mean [± SD] age = 24 ± 2 years; 10 women and 9 men) without lower limb or back pain were recruited. Three raters evaluated each participant during 2 testing sessions, 1 day apart. Raters performed the 3 tests in 4 conditions: classic (C), controlled pressure duration (CPD), subject-specific position (SSP), and mixed (M = CPD + SSP). RESULTS For intrarater reliability, the CPD condition showed the highest intraclass correlation coefficients (ICCs; mean and 95% confidence interval [CI]) for hip IRROM (0.83; 95% CI, 0.53-0.94) and FADIRROM (0.75; 95% CI, 0.60-0.89). The SSP condition showed the highest ICCs for FABERheight (0.71; 95% CI, 0.42-0.87) and FABERROM (0.62; 95% CI, 0.27-0.83). Concerning interrater reliability, the classic condition presented the highest ICCs for FABER variables (height: 0.54; 95% CI, 0.28-0.76; ROM: 0.58; 95% CI, 0.32-0.79) and hip IR ROM (0.72; 95% CI, 0.51-0.87). The CPD condition showed the highest ICC for FADIRROM (0.57; 95% CI, 0.32-0.78). CONCLUSION In the conditions of this study, CPD showed the highest ICCs for hip IRROM and FADIRROM, and SSP showed the highest ICCs for FABERheight and FABERROM.
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Affiliation(s)
| | - Karine Boivin
- Human Kinetics Department, University of Quebec, Trois-Rivieres, Quebec, Canada
| | - Naomi Fontaine
- Human Kinetics Department, University of Quebec, Trois-Rivieres, Quebec, Canada
| | - Nour Saadé
- Human Kinetics Department, University of Quebec, Trois-Rivieres, Quebec, Canada
| | - Stéphane Sobczak
- Anatomy Department, University of Quebec, Trois-Rivieres, Quebec, Canada
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Cunningham G, Wright D, Nnadi C. Smartphone application technique for localising magnetically controlled growth rod actuators: the Oxford Magnetic Counter App Technique (TOMCAT). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:2025-2028. [PMID: 32382879 DOI: 10.1007/s00586-020-06440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/02/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study is to report a novel smartphone app technique to localise a magnetically controlled growing rod (MCGR) actuator, along with determining this novel technique accuracy compared to current tactile localisation techniques through an experimental study. METHODS Five spinal surgery fellows recorded attempts localising the MCGR magnetic actuator using a novel smartphone app technique, MAGEC Wand and magnetic disc. Three attempts per technique were performed and repeated in both the average and overweight patient models. RESULTS In total, 90 separate localisation attempts were recorded. The smartphone app produced less localisation error than both the MAGEC Wand and magnetic disc. Mean difference was - 0.71 cm (95% CI - 1.24 to - 0.18 cm p = 0.06) and - 0.58 cm (95% CI - 1.11 to - 0.04 cm p = 0.031), respectively. Mean localisation error for the smartphone app, MAGEC Wand and magnetic disc, was 0.9 cm, 1.61 cm, 1.47 cm, respectively, for both average and overweight models combined. CONCLUSIONS This novel smartphone app localisation technique is accurate. Current MAGEC Wand and magnetic disc techniques produced more localisation error than the reported tolerance of the external remote control lengthening unit in this experiment.
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Affiliation(s)
- Gregory Cunningham
- Division of Spinal Surgery, Department of Orthopaedic and Spinal Surgery, University of Oxford Hospital NHS Foundation Trust, Oxford, England, UK.
| | - Dan Wright
- Division of Spinal Surgery, Department of Orthopaedic and Spinal Surgery, University of Oxford Hospital NHS Foundation Trust, Oxford, England, UK
| | - Colin Nnadi
- Division of Spinal Surgery, University of Oxford Hospital NHS Foundation Trust, Oxford, England, UK
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Cunha AB, Babik I, Harbourne R, Cochran NJ, Stankus J, Szucs K, Lobo MA. Assessing the Validity and Reliability of a New Video Goniometer App for Measuring Joint Angles in Adults and Children. Arch Phys Med Rehabil 2020; 101:275-282. [DOI: 10.1016/j.apmr.2019.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 01/14/2023]
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Ruiz J, Feigenbaum L, Best TM. The Thoracic Spine in the Overhead Athlete. Curr Sports Med Rep 2020; 19:11-16. [PMID: 31913918 DOI: 10.1249/jsr.0000000000000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Overhead athletes are susceptible to many injuries, particularly in the shoulder and lumbar spine. Due to the heterogeneity of these two regional injuries, it is difficult to pinpoint the exact origin. A potential contributing factor that should be thoroughly evaluated is the thoracic spine. It can be challenging to quantify exactly how much thoracic spine mobility or lack thereof plays a role toward injury. Despite this, when examining mechanics of an overhead athlete, if neuromuscular control of the thorax is impaired, adjacent motion segments often take the brunt of the required movements. This article addresses the need to incorporate the thoracic spine when analyzing the entire kinetic chain. Clinical pearls regarding thoracic neuromuscular control and rehabilitation were explored, as well as a review of recent literature. Further investigation of thoracic spine therapeutic interventions should be considered when treating overhead athletes.
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Affiliation(s)
- Jeffrey Ruiz
- Department of Physical Therapy and Athletics, Miller School of Medicine, University of Miami, Coral Gables, FL
| | - Luis Feigenbaum
- Department of Physical Therapy and Athletics, Miller School of Medicine, University of Miami, Coral Gables, FL
| | - Thomas M Best
- Division of Sports Medicine, Department of Orthopedics, Miller School of Medicine, University of Miami Sports Medicine Institute, Coral Gables, FL
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Examining the link between thoracic rotation and scapular dyskinesis and shoulder pain amongst college swimmers. Phys Ther Sport 2019; 40:78-84. [PMID: 31499399 DOI: 10.1016/j.ptsp.2019.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES In National Collegiate Athletic Association Division I swimmers, we examined the differences in thoracic spine rotation in swimmers with and without scapular dyskinesis and the relationship between thoracic spine rotation and shoulder pain/dysfunction according to the Kerlan-Jobe Orthopaedic Clinic (KJOC) score. DESIGN Cross-sectional. SETTING Laboratory-based. PARTICIPANTS 34 NCAA Division I swimmers (13 males, 21 females). MAIN OUTCOME MEASURES Self-reported upper extremity function and pain assessed with the KJOC questionnaire, thoracic spine range of motion, presence of scapular dyskinesis. RESULTS Dyskinesis was present in 15 of 34 (44%) subjects. Thoracic rotation averaged 136.7° and KJOC averaged 87.7 with no differences between swimmers with or without dyskinesis. We observed no correlation between KJOC-identified shoulder pain/dysfunction and thoracic rotation. CONCLUSIONS In our cohort of NCAA Division 1 swimmers, no differences were found between swimmers with or without scapular dyskinesis and extent of thoracic rotation. We found no correlation between thoracic rotation and the amount of self-reported pain and dysfunction experienced in the upper extremity. The presence of scapular dyskinesis in nearly half of our subjects indicates that swimmers need to be assessed for this abnormality. If observed, rehabilitation should address the dyskinesis and improve thoracic rotation in an attempt to alleviate further upper extremity pain and dysfunction.
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Guillén-Rogel P, Franco-Escudero C, Marín PJ. Test-retest reliability of a smartphone app for measuring core stability for two dynamic exercises. PeerJ 2019; 7:e7485. [PMID: 31413933 PMCID: PMC6690332 DOI: 10.7717/peerj.7485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/16/2019] [Indexed: 01/12/2023] Open
Abstract
Background Recently, there has been growing interest in using smartphone applications to assess gait speed and quantify isometric core stability exercise intensity. The purpose of this study was to investigate the between-session reliability and minimal detectable change of a smartphone app for two dynamic exercise tests of the lumbopelvic complex. Methods Thirty-three healthy young and active students (age: 22.3 ± 5.9 years, body weight: 66.9 ± 11.3 kg, height: 167.8 ± 10.3 cm) participated in this study. Intraclass correlation coefficient (ICC), coefficient of variation (%CV), and Bland–Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD) were calculated for clinical applicability. Results The ICCs ranged from 0.73 to 0.96, with low variation (0.9% to 4.8%) between days of assessments. The Bland–Altman plots and one-sample t-tests (p > 0.05) indicated that no dynamic exercise tests changed systematically. Our analyses showed that SEM 0.6 to 1.5 mm/s-2) and MDD (2.1 to 3.5 mm/s-2). Conclusion The OCTOcore app is a reliable tool to assess core stability for two dynamic exercises. A minimal change of 3.5 mm/s-2 is needed to be confident that the change is not a measurement error between two sessions.
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Affiliation(s)
- Paloma Guillén-Rogel
- Laboratory of Physiology, European University Miguel de Cervantes, Valladolid, Spain
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Keogh JWL, Cox A, Anderson S, Liew B, Olsen A, Schram B, Furness J. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One 2019; 14:e0215806. [PMID: 31067247 PMCID: PMC6505893 DOI: 10.1371/journal.pone.0215806] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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Affiliation(s)
- Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Cluster for Health improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- * E-mail:
| | - Alistair Cox
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Sarah Anderson
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ben Schram
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
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Abstract
Mobile health apps are growing constantly in number and popularity. Some mobile apps are used for clinical assessment, and consequently need to be verified and validated appropriately, along with the mobile platform, to ensure their safe and effective operation. We review the current literature on available smartphone goniometric apps validated for joint angle measurement and their main psychometric characteristics. A literature search of Medline and Scopus databases was performed to select papers on smartphone commercial apps validated for joint angle measurement and relevant to Physical Medicine and Rehabilitation. A platform search verified whether the selected apps were still available for download. The literature search identified 126 papers in Medline and 113 in Scopus, 49 of which were selected. They dealt with the validation of 23 apps, eight of which were no longer available and therefore excluded from the review. Psychometric characteristics of the selected apps were robust, but heterogeneity of the studies did not enable comparisons between apps to identify the most valid one. The increase in the number of apps and validation studies highlights the growing interest in this new approach for measuring body angles. Given the precarious commercial availability of some apps, when research is the goal, it is advisable to select apps with the longest durability. A need continues to exist for validation studies on available apps focused on goniometric measurement in gait or during performance of therapeutic exercises in neurological and orthopedic disorders.
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Lee JB, Kim IS, Lee JJ, Park JH, Cho CB, Yang SH, Sung JH, Hong JT. Validity of a Smartphone Application (Sagittalmeter Pro) for the Measurement of Sagittal Balance Parameters. World Neurosurg 2018; 126:e8-e15. [PMID: 30557655 DOI: 10.1016/j.wneu.2018.11.242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The study was aimed to compare the validity, reproducibility, precision, and efficiency of a picture archiving and communication system (PACS) and a smartphone application, which is an educative app to easily measure sagittal balance parameters (SagittalMeter Pro), for measuring spinopelvic sagittal parameters. METHODS Three spine surgeons measured lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) on standing posteroanterior radiographs of 30 patients using PACS and SagittalMeter Pro. Measurements were repeated a week after the original measurements. Intraobserver and interobserver variabilities and reliabilities of each parameter (LL, PI, SS, and PT) were calculated for both techniques. Comparisons were performed using the paired t-test. Results are expressed as mean ± standard deviation and P values of < 0.05 were considered significant. RESULTS PACS to SagittalMeter Pro differences between the mean absolute values of LL, PI, SS, PT were 0.50°, 0.82°, 0.81°, 0.34°, respectively, and intraobserver and interobserver variabilities were similar. Excellent intraobserver and interobserver reliabilities were obtained for PACS and SagittalMeter Pro as demonstrated by values >0.86 and >0.84, respectively. Measurement times for PACS and SagittalMeter Pro were 36.63 ± 7.55 and 14.57 ± 1.96 seconds, respectively, and this difference was significant (P = 0.001). CONCLUSIONS The study shows PACS and SagittalMeter Pro are equivalent in terms of their abilities to measure spinopelvic sagittal parameters, and that the time required to obtain measurements was significantly less for SagittalMeter Pro. We believe that SagittalMeter Pro may be helpful when planning spinal surgery.
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Affiliation(s)
- Jong Beom Lee
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
| | - Il Sup Kim
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea.
| | - Jung Jae Lee
- Department of Neurosurgery, Gangneung Asan Hospital, Asan Medical Center, Gangneung, South Korea
| | - Jong-Hyeok Park
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
| | - Chul Bum Cho
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
| | - Seung Ho Yang
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
| | - Jae Hoon Sung
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
| | - Jae Taek Hong
- Department of Neurosurgery, St. Vincent`s Hospital, Catholic University of Korea, Suwon, South Korea
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Satpute K, Nalband S, Hall T. The C0-C2 axial rotation test: normal values, intra- and inter-rater reliability and correlation with the flexion rotation test in normal subjects. J Man Manip Ther 2018; 27:92-98. [PMID: 30935342 DOI: 10.1080/10669817.2018.1533195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Impairment in upper cervical spine mobility is associated with cervicogenic headache severity and disability. Measures of such mobility include the flexion-rotation test (FRT), which requires full cervical flexion and may be influenced by lower cervical spine dysfunction. The C0-C2 axial rotation test also evaluates upper cervical mobility but normal values and reliability have not been reported. Our objective is to determine normal values, and intra-rater and inter-rater reliability of the C0-C2 axial rotation test. METHODS Two therapists independently evaluated the FRT and C0-C2 axial rotation test with an iPhone compass application on 32 asymptomatic subjects with mean age 40.53 (SD 11.64) years on two occasions. Measurement procedures were standardized; and order of testing randomized. RESULTS For the FRT and C0-C2 axial rotation test reliability was high (ICC > 0.88). For rater one, Mean range to the left during the FRT and C0-C2 axial rotation test was 45.0° (6.04) and 14.43° (2.94), respectively, while range to the right was 44.6° (6.57) and 15.44° (2.68). For the FRT and C0-C2 axial rotation test the standard error of measurement was at most 2°, while the minimum detectable change was at most 4°. A strong positive correlation exists between the FRT and C0-C2 axial rotation test (r = 0.84, P < 0.01). DISCUSSION The range recorded during the C0-C2 axial rotation test and FRT have high levels of reliability when evaluated using an iPhone. The strong correlation between the FRT and C0-C2 axial rotation test indicate that both may be measuring similar constructs, but each test needs to be referenced to normal values.
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Affiliation(s)
- Kiran Satpute
- a Department of Kinesiotherapy and Physical Diagnosis, Department of Musculoskeletal Physiotherapy , Smt. Kashibai Navale College of Physiotherapy , Pune , India
| | - Sadaf Nalband
- b Smt. Kashibai Navale College of Physiotherapy , Pune , India
| | - Toby Hall
- c School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia.,d Faculty of Health & Medical Sciences , The University Of Western Australia , Perth , Australia
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Pan F, Firouzabadi A, Reitmaier S, Zander T, Schmidt H. The shape and mobility of the thoracic spine in asymptomatic adults - A systematic review of in vivo studies. J Biomech 2018; 78:21-35. [PMID: 30100219 DOI: 10.1016/j.jbiomech.2018.07.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 12/29/2022]
Abstract
A comprehensive knowledge of the thoracic shape and kinematics is essential for effective risk prevention, diagnose and proper management of thoracic disorders and assessment of treatment or rehabilitation strategies as well as for in silico and in vitro models for realistic applications of boundary conditions. After an extensive search of the existing literature, this study summarizes 45 studies on in vivo thoracic kyphosis and kinematics and creates a systematic and detailed database. The thoracic kyphosis over T1-12 determined using non-radiological devices (34°) was relatively less than measured using radiological devices (40°) during standing. The majority of kinematical measurements are based on non-radiological devices. The thoracic range of motion (RoM) was greatest during axial rotation (40°), followed by lateral bending (26°), and flexion (21°) when determined using non-radiological devices during standing. The smallest RoM was identified during extension (13°). The lower thoracic level (T8-12) contributed more to the RoM than the upper (T1-4) and middle (T4-8) levels during flexion and lateral bending. During axial rotation and extension, the middle level (T4-8) contributed the most. Coupled motion was evident, mostly during lateral bending and axial rotation. With aging, the thoracic kyphosis increased by about 3° per decade, whereas the RoM decreased by about 5° per decade for all load directions. These changes with aging mainly occurred in the lower region (T6-12). The influence of sex on thoracic kyphosis and the RoM has been described as partly contradictory. Obesity was found to decrease the thoracic RoM. Studies comparing standing, sitting and lying reported the effect of posture as significant.
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Affiliation(s)
- Fumin Pan
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Ali Firouzabadi
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Sandra Reitmaier
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
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