Reliability of the attraction method for measuring lumbar spine backward bending

The distraction method is one method used to measure forward bending of the spine. Although this technique, which requires the use of a tape measure held over the spine and the location of anatomical landmarks, appears to be highly practical, previous studies have not examined its use for measuring backward bending. The purpose of our study was to determine the reliability of a similar technique, the attraction method, for measuring backward bending of the lumbar spine and to examine whether subjects with low back pain (LBP) could perform similar motion as subjects without LBP. Two groups composed of 100 subjects each, one with "significant" limiting low back pain (SLBP) and the other without "significant" limiting low back pain (NSLBP), were evaluated twice by a physical therapist to assess intrarater reliability. To assess interrater reliability, 11 subjects from the NSLBP Group were evaluated by a second therapist. For the total sample of 200 subjects, the intraclass correlation coefficient (ICC) for intrarater reliability was .95; for the SLBP Group, the ICC was .93; and for the NSLBP Group, the ICC was .90. For the sample of 11 NSLBP Group subjects examined for interrater reliability, the ICC was .94. Using a Kolmogorov-Smirnov test, we found the distribution for backward bending of the two groups to be significantly different. The attraction method, thus, appears to be a reliable method for measuring backward bending of the lumbar spine.     

A validity study of four empathy instruments

The construct validity of four empathy instruments were evaluated through examining group differences and correlations between tests. Subjects were 18 registered nurses (RNs) and 32 nursing assistants (NAs). Instruments used were the Empathy Test (Layton, 1979), the Carkhuff (1969a, 1969b) Empathic Understanding in Interpersonal Processes Scale, the empathy subtest of the Barrett-Lennard (1962) Relationship Inventory, and LaMonica's (1981) Empathy Construct Rating Scale (ECRS). The first hypothesis, that RNs would score significantly higher than NAs on all empathy measures, was confirmed (p less than .0003 to p less than .027). The second hypothesis, that the various empathy measures would be positively related, was partially confirmed. The Carkhuff scale was significantly correlated with the ECRS (r = .25, p less than .05). The ECRS and the Barrett-Lennard also were correlated (r = .78, p less than .001). Results are interpreted using Barrett-Lennard's (1981) theory of empathy.     

Reliability and concurrent validity of two instruments for measuring cervical range of motion: effects of age and gender

This study set out to determine the reliability and concurrent validity of two instruments for measuring cervical range of motion and, using these instruments, to establish age and gender effects on cervical mobility. 84 asymptomatic subjects were investigated for age and gender effects on cervical range of motion using the CROM and single inclinometer. Thirty of these subjects also took part in the reliability study. Intraclass correlation coefficients (ICC) for inter- and intra-examiner reliability of the CROM were 0.88 and 0.96 (flexion/extension), 0.84 and 0.96 (lateral flexion) and 0.92 and 0.92 (rotation) respectively. Corresponding values for the inclinometer were 0.84 and 0.94; 0.82 and 0.92; and 0.81 and 0.89. Reliability of the CROM and single inclinometer was thus supported. Concurrent validity of the two instruments was supported for flexion/extension (0.80) and lateral flexion (0.79) but not for rotation (-0.18). Using both measuring devices, cervical mobility decreased with age in all planes of motion (p < 0.0001) but was not significantly affected by gender. Based on our findings, reassessment of normative values of cervical range of motion is indicated taking age, but not gender, into account.     

Examination of four different instruments for measuring blood lactate concentration

Information on the performance of different instruments used to measure blood lactate concentration is incomplete. We therefore examined instruments from Yellow Springs Instruments (YSI 23L and YSI 1500) and three cheaper and simpler instruments: Dr. Lange's LP8+, Lactate Pro from Arkray in the KDK corporation and Accusport from Boehringer Mannheim. First, a number of blood samples were analysed by standard enzymatic photofluorometry (our reference method) and, in addition, by one or more of the instruments mentioned above. Second, measurements using two or more identical instruments were compared. Third, since Lactate Pro and Accusport are small (approximately 100 g, pocket-size), battery-driven, instruments that could be used for outdoor testing, the performance of these instruments was examined at simulated altitudes (O2 pressure of <10 kPa) and at temperatures below -20 degrees C, while screening the instruments as much as possible from the cold. Most of the different instruments showed systematically too high or too low values (10-25% deviation). The observed differences between instruments may affect the "blood lactate threshold" by 2-5%. We found different readings between "equal" YSI 1500 instruments, while we could see no difference when comparing the other instruments of the same type. Lactate Pro gave reliable results at both -21+/-1 degrees C and at simulated altitude. Accusport gave reliable results in the cold, but 1.85+/-0.08 mmol L(-1) (mean+/-SD) too high readings at the simulated altitude. Of the three simpler instruments examined, the Lactate Pro was at least as good as the YSI instruments and superior to the other two.     

Examination of four different instruments for measuring blood lactate concentration

Low serum haptoglobin values are often found in children. Nine different parameters were studied in 125 healthy children aged 9–10 years to get indirect information on erythrocyte turnover and its possible relation to the low mean plasma haptoglobin level in childhood.

The mean LD activity was higher than in adults. The mean carboxyhaemoglobin per cent saturation (COHb %) and the mean serum haptoglobin concentrations were lower than in adults. No significant correlation was found between serum haptoglobin and serum iron, serum bilirubin and COHb %. Significant correlation at low r-values was found between serum iron, serum bilirubin and COHb %. The low serum haptoglobin levels often seen in children seemed not to be caused by an increase in erythrocyte turnover.     

Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics

OBJECTIVE: To report instrument validity of CMS 70P, a new ultrasonography-based system for spatial kinematic analysis of the spine and its application in studying the reproducibility of cervical motion findings in healthy subjects. BACKGROUND: Reproducibility of cervical motion has been investigated using various instruments and consisting in most cases of short test-retest time intervals of between minutes to days. METHODS: Performance of the instrument was validated against a digital inclinometer, at ranges of motion compatible with actual cervical motion. To study reproducibility, 25 healthy individuals, 22 women and 3 men aged 26-48 were tested twice within an average time interval of 3.3 weeks. Performed in the seated position and at a self-determined pace, cervical motion was defined in terms of head motion relative to a sternal (reference) system, in all six primary motions: flexion, extension, right rotation, left rotation, right lateral flexion and left lateral flexion. RESULTS: The system exhibited excellent agreement with the digital inclinometer, establishing its instrument validity for testing cervical motion. No significant differences were indicated between the test and retest for both the net maximal displacements and average velocities. The correlation coefficients for the single plane motions (e.g. flexion+extension) were higher than those derived for the primary motions, and ranged between 0.78 (sagittal plane) and 0.88 (frontal plane). The magnitude of the standard error of the measurement reflected the same trend with the lowest value recorded for the frontal plane. The self-selected velocity at which these motions were performed was similar in the frontal and saggital planes but was significantly higher for the transverse plane (rotations). CONCLUSIONS: This study indicates that spanned over time intervals that are measured in weeks, cervical motion findings derived from the CMS 70P are well reproducible. Findings also imply the need for a more stringent control of subject positioning and stabilization. RELEVANCE: Reduction of range of motion and average is typically observed in various pathologies of the cervical spine and is regarded, together with pain, as a major impairment. Therefore, valid assessment of cervical motion which is essential for follow-up and treatment outcome strongly depends on reproducibility of the findings. This study indicates that acceptable reproducibility is maintained over periods of time which are clinically meaningful using the system described herewith.     

Reliability of assisted indentation in measuring lumbar spinal stiffness

The reliability of manual methods to assess spinal stiffness is modest at best. In response, instrumentation has been developed which may be reliable, but is often difficult to use in clinical settings. The purpose of this study was to determine the intra-rater reliability of assisted indentation (AI), a smaller, less automated technique of measuring spinal stiffness in vivo. Twenty-three asymptomatic subjects were included in the study. The AI device was placed over the 4th lumbar spinous process in each prone, resting subject. Ten indentations were performed at approximately 2-min intervals while load and displacement data were collected simultaneously. From these data, two outcome variables were calculated: Global Stiffness (GS; slope of the force-displacement data) and Mean Maximal Stiffness (MMS; peak force/peak displacement). Intra-class correlation coefficient values for 10 consecutive measures of GS and MMS were 0.93 and 0.91, respectively. A repeated measures analysis of variance (ANOVA) did not demonstrate significant differences between any indentation trials from the same subject. Measurement of spinal stiffness using AI demonstrated excellent intra-rater reliability. These data, in addition to specific features of AI (small, transportable, relatively low cost, ease of operation) suggest that AI may be of benefit within clinical environments.     

Intertester reliability and validity of motion assessments during lumbar spine accessory motion testing

BACKGROUND AND PURPOSE: Posterior-anterior (PA) assessment of the lumbar spine correlates with radiographic signs of instability and can guide treatment choices, yet studies of the validity of lumbar PA assessments have not been conducted in vivo. The purposes of this study were to determine the intertester reliability of the PA examination in assessing intersegmental lumbar spine motion and to evaluate the validity of this procedure in vivo with dynamic magnetic resonance imaging (MRI). SUBJECTS: Twenty-nine subjects with central lumbar pain participated in this study. METHODS: Two physical therapists independently identified each subject's most and least mobile lumbar segments using the PA procedure. Midsagittal lumbar images were obtained simultaneously during one examiner's assessment. Lumbar segmental mobility was quantified from magnetic resonance images as the change in the intervertebral angle between the resting position and the end range of the PA force application. For each vertebral level tested, maximal sagittal-plane segmental motion was determined. RESULTS: The intertester reliability for identifying the least mobile segment was good (agreement=82.8%, kappa=.71, 95% confidence interval [CI]=.48 to .94), but it was poor for identifying the most mobile segment (kappa=.29, 95% CI=-.13 to .71), despite good agreement (79.3%). The level of agreement between the PA assessments and intervertebral motion measured by MRI was poor (kappa=.04, 95% CI=-.16 to .24, and kappa=.00, 95% CI=-.09 to .08, for the least and most mobile segments, respectively). DISCUSSION AND CONCLUSION: Despite good intertester reliability for identifying the least mobile segment, PA assessments of lumbar segmental mobility did not agree with sagittal-plane motion measured by dynamic MRI. This finding calls into question the validity of the PA procedure for assessing intervertebral lumbar spine motion.     

Reliability and validity of the AutoCAD software method in lumbar lordosis measurement

OBJECTIVE: The aim of this study was to determine the reliability and validity of the AutoCAD software method in lumbar lordosis measurement. METHODS: Fifty healthy volunteers with a mean age of 23 ± 1.80 years were enrolled. A lumbar lateral radiograph was taken on all participants, and the lordosis was measured according to the Cobb method. Afterward, the lumbar lordosis degree was measured via AutoCAD software and flexible ruler methods. The current study is accomplished in 2 parts: intratester and intertester evaluations of reliability as well as the validity of the flexible ruler and software methods. RESULTS: Based on the intraclass correlation coefficient, AutoCAD's reliability and validity in measuring lumbar lordosis were 0.984 and 0.962, respectively. CONCLUSIONS: AutoCAD showed to be a reliable and valid method to measure lordosis. It is suggested that this method may replace those that are costly and involve health risks, such as radiography, in evaluating lumbar lordosis.     

Reliability and validity of an ultrasound-based imaging method for measuring interspinous process distance in the lumbar spine using two different index points

[Purpose] This study assessed the reliability and validity of an ultrasound-based imaging method for measuring the interspinous process distance in the lumbar spine using two different index points. [Subjects and Methods] Ten healthy males were recruited. Five physical therapy students participated in this study as examiners. The L2–L3 interspinous distance was measured from the caudal end of the L2 spinous process to the cranial end of the L3 spinous process (E-E measurement) and from the top of the L2 spinous process to the top of the L3 spinous process (T-T measurement). Intraclass correlation coefficients were calculated to estimate the relative reliability. Validity was assessed using a model resembling the living human body. [Results] The reliability study showed no difference in intra-rater reliability between the two measurements. However, the E-E measurement showed higher inter-rater reliability than the T-T measurement (Intraclass correlation coefficients: 0.914 vs. 0.725). Moreover, the E-E measurement method had good validity (Intraclass correlation coefficients: 0.999 and 95% confidence interval for minimal detectable change: 0.29 mm). [Conclusion] These results demonstrate the high reliability and validity of ultrasound-based imaging in the quantitative assessment of lumbar interspinous process distance. Of the two methods, the E-E measurement method is recommended.Key words: Ultrasound imaging, Interspinous process distance, Reliability     

国内外护理人文关怀测评工具的分析及思考

<正>护理人文关怀具有多重本质,可被视为一种态度、能力、属性和特征,或是一系列相互关联的复杂行为[1]。如何准确地测评护理人员人文关怀的品质,是护理界关心的一个问题,不少学者研制了相应的测评工具,在挖掘护理人文关怀本质的同时,也为测评提供了依据。为此,本研究对护理人文关怀测评工具进行综述,探讨不同测评工具的优劣,为研发更科学的测评工具提供参考。     

Carpal tunnel syndrome. Testing the sensitivity and validity of four "localized discomfort" instruments.

A convenience sample of 52 participants was used to examine the construct validity and sensitivity of four "localized discomfort" instruments and the severity of clients with carpal tunnel syndrome, using the "known group" method. Three groups known to have severe, mild, or no carpal tunnel syndrome based on either nerve conduction studies or an inability to complete a physical challenge (exercise) were used. The participants rated the amount of localized discomfort for one hand, wrist, and arm on four different instruments. Following a physical challenge, strenuous enough to result in an increase in localized discomfort, the four instruments were readministered. The difference in the pre- and posttest scores was compared for both sensitivity and validity. The ease of administration of the four instruments was also assessed. All four instruments were found to demonstrate sensitivity. Two of the four instruments, the Unipolar Borg Scale and the first Visual Analog Scale, were found to be most valid and easiest to administer. Occupational health nurses could use these two valid and sensitive tools as early markers for future injury. The tools also could be used to measure the progress of an intervention or therapy following an injury and gauge readiness for return to work.     

Reliability and validity of motivation for sexual health

The Health Self-Determinism Index-Sexual (HSDI-S) is a modification of the HSDI (a measure of motivation of health). Psychometric evaluation was needed to determine the usefulness of the HSDI-S as a measure of motivation of sexual health. The purpose of this study was to assess the reliability and validity of the HSDI-S. Three unique samples of HSDI-S scores were evaluated using principal component and maximum likelihood factor analyses with a Varimax rotation. Items that loaded on each of the factors were similar across all three samples. Factor analyses revealed two dimensions of the HSDI-S: self-directed and partner-directed motivation, which is discussed within the context of relationships. The ranges of internal consistency reliability coefficients across the samples were satisfactory for the HSDI-S (.74-.82) and for the two dimensions (.66-.77). Reliability and construct validity of the HSDI-S across three diverse samples was supported.     

Reliability of measuring pelvic floor elevation with a diagnostic ultrasonic imaging device

[Purpose] The purpose of this study was to investigate the reliability of measuring the amount of pelvic floor elevation during pelvic and abdominal muscle contraction with a diagnostic ultrasonic imaging device. [Subjects] The study group comprised 11 healthy women without urinary incontinence or previous birth experience. [Methods] We measured the displacement elevation of the bladder base during contraction of the abdominal and pelvic floor muscles was measured using a diagnostic ultrasonic imaging device. The exercise was a four-part operation undertaken with the subjects in the lateral position. The reliability analysis included use of the interclass correlation coefficient (ICC) was used to assess the reliability. [Results] ICC (1.1) values for the pelvic floor elevation measurement with a diagnostic ultrasonic imaging device were 0.98 [contraction of the transversus abdominis (TrA) muscle], 0.99 [contraction of pelvic floor muscles (PFMs)], 0.98 (co-contraction of the TrA and PFMs), and 0.98 (resistance of the TrA and PFMs). This study proved the reliability of the method because the coefficient of reliability was 0.97 or more for all of the measurements, even for those during exercise. [Conclusion] The diagnostic ultrasonic imaging device measures pelvic floor elevation with high reliability.Key words: Bladder base, Pelvic floor muscles (PFMs), Stress urinary incontinence     

手持式压力测痛仪的信度及效度检验

目的检验手持式压力测痛仪在压痛阈测量中的信度和效度。 方法研究分为两个阶段。第一阶段：3名施测者分别使用手持式压力测痛仪对37名健康正常受测者全身共12个部位进行压痛阈测量。第二阶段：1名施测者使用手持式压力测痛仪对10名肌筋膜痛综合征患者进行压痛阈测量,并采用目测类比评分法（VAS）进行评估。分别计算组内相关系数和Spearman相关系数以评估信度和效度。 结果重测信度及施测者间信度均较高（ICC&rt;0.95）,重测信度优于施测者间信度;根据同一施测者3次重复测量结果的均值所计算的施测者间信度高于单次测量的施测者间信度;肌筋膜痛患者激痛点与正常对照点的压痛阈差异具有统计学意义,激痛点压痛阈值与VAS评分呈显著的负相关。 结论手持式压力测痛仪测量正常健康人压痛阈时具有较高信度,其可作为量化评价激痛点疼痛敏感性的有效工具。