Reproducibility of the Balance Evaluation Systems Test (BESTest) and the Mini-BESTest in school-aged children

This study evaluated the intra-rater, inter-rater and test-retest reproducibility of the Full-BESTest and Mini-BESTest when assessing postural control in children. Thirty-four children aged 7–17 years participated in intra-rater and inter-rater evaluation, and 22 children repeated assessment six weeks later for evaluation of test-retest reliability. Postural control was assessed using the Full Balance Evaluation Systems Test (Full-BESTest) and the short-form Mini-BESTest. Intra-rater, inter-rater and test-retest reproducibility were examined using video assessment. Test-retest reproducibility was also assessed in real-time. Reproducibility was examined by agreement and reliability statistics. Agreement was calculated using percentage of agreement, Limits of Agreement and Smallest Detectable Change. Reliability was calculated using Intra-class Correlation Coefficients. Results showed that the reliability of Total Scores was excellent for the Full-BESTest for all conditions (all ICCs > 0.82), whereas the Mini-BESTest ranged from fair to excellent (ICC = 0.56–0.86). Percentage of Domain Scores with good-excellent reliability (ICCs > 0.60) was slightly higher for the Full-BESTest (66%) compared to the Mini-BESTest (59%). Smallest Detectable Change scores were good to excellent for the Full-BESTest (2%–6%) and for the Mini-BESTest (5%–10%) relative to total test scores. Both the Full-BESTest and Mini-BESTest can discriminate postural control abilities within and between days in school-aged children. The Full-BESTest has slightly better reproducibility and a broader range of items, which could be the most useful version for treatment planning. We propose minor modifications to improve reproducibility for children, and indicate the modified version by the title Kids-BESTest. Future psychometric research is recommended for specific paediatric clinical populations.     

A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

Greater use of 3D conformal, Intensity Modulated Radiotherapy (IMRT) and external beam partial breast irradiation following local excision (LE) for breast cancer has necessitated a review of the effectiveness of immobilisation methods to stabilise breast tissue.To identify the suitability of currently available breast (rather than thorax) immobilisation techniques an appraisal of the literature was undertaken. The aim was to identify and evaluate the benefit of additional or novel immobilisation approaches (beyond the standard supine, single arm abducted and angled breast board technique adopted in most radiotherapy departments). A database search was supplemented with an individual search of key radiotherapy peer-reviewed journals, author searching, and searching of the grey literature. A total of 27 articles met the inclusion criteria.The review identified good reproducibility of the thorax using the standard supine arm-pole technique. Reproducibility with the prone technique appears inferior to supine methods (based on data from existing randomised controlled trials). Assessing the effectiveness of additional breast support devices (such as rings or thermoplastic material) is hampered by small sample sizes and a lack of randomised data for comparison.Attention to breast immobilisation is recommended, as well as agreement on how breast stability should be measured using volumetric imaging.     

Reproducibility,and sensitivity to motor unit loss in amyotrophic lateral sclerosis,of a novel MUNE method: MScanFit MUNE

ObjectiveTo examine inter- and intra-rater reproducibility and sensitivity to motor unit loss of a novel motor unit number estimation (MUNE) method, MScanFit MUNE (MScan), compared to two traditional MUNE methods; Multiple point stimulation MUNE (MPS) and Motor Unit Number Index (MUNIX).MethodsTwenty-two ALS patients and 20 sex- and age-matched healthy controls were included. MPS, MUNIX, and MScan were performed twice each by two blinded physicians. Reproducibility of MUNE values was assessed by coefficient of variation (CV) and intra class correlation coefficient (ICC). Ability to detect motor unit loss was assessed by ROC curves and area under the curve (AUC). The times taken for each of the methods were recorded.ResultsMScan was more reproducible than MPS and MUNIX both between and within operators. The mean CV for MScan (12.3%) was significantly lower than for MPS (24.7%) or MUNIX (21.5%). All methods had ICC > 0.94. MScan and Munix were significantly quicker to perform than MPS (6.3 m vs. 13.2 m). MScan (AUC = 0.930) and MPS (AUC = 0.899) were significantly better at discriminating between patients and healthy controls than MUNIX (AUC = 0.831).ConclusionsMScan was more consistent than MPS or MUNIX and better at distinguishing ALS patients from healthy subjects.SignificanceMScan may improve detection and assessment of motor unit loss.     

肺癌体素内不相干运动参数值测量的短期可重复性及影响因素

目的 评估肺癌短期重复扫描体素内不相干运动（IVIM）参数值测量的短期可重复性及影响因素。方法 对38例肺癌患者进行2次自由呼吸IVIM成像（间隔0.5~1.0 h）。由2名测量者基于IVIM图像独立测量慢扩散参数（D）、快扩散系数（D^*）及灌注分数（f）均值。采用配对样本t检验或Wilcoxon检验比较重复测量和重复扫描的误差。以组内相关系数（ICC）评价各参数值同一测量者和不同测量者的一致性和可重复性。采用变异系数（WCV）比较肺癌类型（周围型、中央型）、病变大小（≥ 2 cm、<2 cm）及位置（上、中、下肺野）对各参数值可重复性的影响。结果 所有参数2次测量的系统误差差异均无统计学意义（P均>0.05）。D^*和f值的WCVs（19.88%~36.83%）明显高于D值（2.97%~4.62%）。D值在中央型肺癌及最大径< 2 cm病灶的WCVs较高,并自上肺野到下肺野WCV依次增加;f在中央型肺癌和最大径≥ 2 cm的WCVs较大;D^*受肺癌类型、大小和位置的影响显著。结论 在肺癌的重复扫描中,D值可重复性好,而D^*、f值的可重复性较差;肺癌类型、大小和位置是影响IVIM参数值的因素。     

Reliability of two pragmatic tools for assessing text neck

Background

There is a hypothesis that the growing use of mobile phones in an inappropriate posture to text and read (text neck) could be a reason for the increasing prevalence of neck pain in the past decade. Before testing if there is an association between text neck and neck pain, it is necessary to develop reliable pragmatic tools appropriate to epidemiological studies.

Validity and Reliability of Outcome Measures Assessing Dexterity,Coordination, and Upper Limb Strength in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay

Objective

To document in adults affected by autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) the intra- and interrater reliability, standard error of measurement, agreement, minimal detectable change, and construct validity of the 9-Hole Peg Test (NHPT), the Standardized Finger-to-Nose Test (SFNT), and grip strength.

QTc离散度测定的重复性

为评价QT间期离散度（QTcd）测定的重复性，研究了同一观测者不同时间及两个观测者同一时间测定的46例急性心肌梗塞者的QTCd测定值的变化。结果发现同一观测者不同时间测定的QTcd的绝对误差为6ms，相对误差为20.1％，二者的相关系数r＝0．71，P＜o.01；两个观测者同一时间测定的QTcd的绝对误差为8ms，相对误差为23．9％，二者的相关系数r＝0．65，P＜0．01。提示，QTcd测定的重复性较差。