Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

BACKGROUND:

Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain.

OBJECTIVE:

The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle.

METHOD:

A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC_2,1) was used to assess the intra- and inter-rater reliability.

RESULTS:

With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC.

CONCLUSION:

The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices.     

RELIABILITY OF THREE MEASURES OF ANKLE DORSIFLEXION RANGE OF MOTION

Purpose/Background:

A variety of methods exist to measure ankle dorsiflexion range of motion (ROM). Few studies have examined the reliability of a novice rater. The purpose of this study was to determine the reliability of ankle ROM measurements using three different techniques in a novice rater.

Methods:

Twenty healthy subjects (mean±SD, age=24±3 years, height=173.2±8.1 cm, mass=72.6±15.2 kg) participated in this study. Ankle dorsiflexion ROM measures were obtained in a weight-bearing lunge position using a standard goniometer, digital inclinometer, and a tape measure using the distance-to-wall technique. All measures were obtained three times per side, with 10 minutes of rest between the first and second set of measures. Intrarater reliability was determined using an intraclass correlation coefficient (ICC_2,3) and associated 95% confidence intervals (CI). Standard error of measurement (SEM) and the minimal detectable change (MDC) for each measurement technique were also calculated.

Results:

The within-session intrarater reliability (ICC_2,3) estimates for each measure are as follows: tape measure (right 0.98, left 0.99), digital inclinometer (right 0.96; left 0.97), and goniometer (right 0.85; left 0.96). The SEM for the tape measure method ranged from 0.4–0.6 cm and the MDC was between 1.1–1.5 cm. The SEM for the inclinometer was between 1.3–1.4° and the MDC was 3.7–3.8°. The SEM for the goniometer ranged from 1.8–2.8° with an MDC of 5.0–7.7°.

Conclusions:

The results indicate that reliable measures of weight-bearing ankle dorsiflexion ROM can be obtained from a novice rater. All three techniques had good reliability and low measurement error, with the distance-to-wall technique using a tape measure and inclinometer methods resulting in higher reliability coefficients (ICC_2,3=0.96 to 0.99) and a lower SEM compared to the goniometer (ICC_2,3=0.85 to 0.96).

Level of Evidence:

2b     

THE RELIABILITY OF THE VAIL SPORT TEST? AS A MEASURE OF PHYSICAL PERFORMANCE FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Purpose/Background:

The decision to return an athlete to sports following anterior cruciate ligament reconstruction can be controversial. The purposes of this study are 1) to describe a functional test (Vail Sport Test™) that includes the evaluation of muscle strength, endurance, power, and movement quality in those patients attempting to return to sports following ACL reconstruction and 2) to assess the reliability of the Vail Sport Test™.

Methods:

A prospective cohort study design. A total of 30 (12 F, 18 M) subjects (18.1±5.3 yrs) volunteered for the study. All subjects were post-operative ACL reconstruction (5.2±1.9 months) and were in the process of returning to sports. Each subject completed the Vail Sport Test™ and was videotaped from the anterior and lateral view. The videotape was then viewed and graded at two different points in time (48 hours apart) by three licensed physical therapists. Intraclass correlations (ICCs) were calculated to determine intra- and inter-rater reliability.

Results:

Intra-rater reliability was excellent with a range of .95 to 1.0. Reliability values between graders were .97 (ICC₂,k) and 1.55 (SEM).

Conclusions:

The results of this study suggest that the Vail Sport Test™ has excellent reliability when the same graders scored the test using video on repeated occasions. In addition, the test was reliable between different graders.

Level of Evidence:

Level 2b     

EVALUATING CHANGE IN CLINICAL STATUS: RELIABILITY AND MEASURES OF AGREEMENT FOR THE ASSESSMENT OF GLENOHUMERAL RANGE OF MOTION

Objectives:

To evaluate intra-rater and inter-rater reliability and measurement error in glenohumeral range of motion (ROM) measurements using a standard goniometer.

Study design:

17 adult subjects with and without shoulder pathology were evaluated for active and passive range of motion. Fifteen shoulder motions were assessed by two raters to determine reliability. The intra-class correlation coefficients (ICC) were calculated and examined to determine if reliability of ICC ≥ 0.70 existed. The standard error of measurement (SEM) and the minimal clinical difference (MCD) were also calculated.

Results:

Thxe criterion reliability was achieved in both groups for intra-rater reliability of standing AROM abduction; supine AROM and PROM abduction, flexion, external rotation at 0° abduction; and for inter-rater reliability of supine AROM and PROM abduction, external rotation at 0° abduction. The SEM ranged from 4°-7° for intra-rater and 6°-9° for inter-rater agreement on movements that achieved the criterion reliability. The MCD ranged from 11°-16° for a single evaluator and 14°-24° for two evaluators.

Conclusions:

Assessment of AROM and PROM in supine achieves superior reliability. The use of either a single or multiple raters affects the number of movements that achieved clinically meaningful reliability. Some movements consistently did not achieve the criterion and may not be the best movements to monitor treatment outcome.     

Manual Ability Classification System (MACS): reliability between therapists and parents in Brazil

BACKGROUND:

The Manual Ability Classification System (MACS) has been widely used to describe the manual ability of children with cerebral palsy (CP); however its reliability has not been verified in Brazil.

OBJECTIVE:

To establish the inter- and intra-rater reliability of the Portuguese-Brazil version of the MACS by comparing the classifications given by therapists and parents of children with CP.

METHOD:

Data were obtained from 90 children with CP between the ages of 4 and 18 years, who were treated at the neurology and rehabilitation clinics of a Brazilian hospital. Therapists (an occupational therapist and a student) classified manual ability (MACS) through direct observation and information provided by parents. Therapists and parents used the Portuguese-Brazil version of the MACS. Intra- and inter-rater reliability was obtained using unweighted Kappa coefficient (k) and intra-class correlation coefficient (ICC). The Chi-square test was used to identify the predominance of disagreements in the classification of parents and therapists.

RESULTS:

An almost perfect agreement resulted among therapists [K=0.90 (95% CI 0.83-0.97); ICC=0.97 (95%CI 0.96-0.98)], as well as with intra-rater (therapists), with Kappa ranging between 0.83 and 0.95 and ICC between 0.96 and 0.99 for the evaluator with more and less experience in rehabilitation, respectively. The agreement between therapists and parents was fair [K=0.36 (95% CI 0.22-0.50); ICC=0.79 (95% CI 0.70-0.86)].

CONCLUSIONS:

The Portuguese version of the MACS is a reliable instrument to be used jointly by parents and therapists.     

RELIABILITY OF THE SITTING HAND PRESS-UP TEST FOR IDENTIFYING AND QUANTIFYING THE LEVEL OF SCAPULAR MEDIAL BORDER POSTERIOR DISPLACEMENT IN OVERHEAD ATHLETES

Background:

The lack of proper scapular kinematics can limit the function of the entire shoulder complex.^1,3 Many forms of scapular dyskinesis have been proposed along with tests to measure for the position and motion associated with those positional and movement faults (2,4-6). While scapular internal rotation has been listed among the forms of scapular dyskinesis there has not been a reliable test documented in the literature that examines this motion. The purpose of this study was to determine whether an innovative scapular medial border posterior displacement measurement device has adequate inter-rater and intra-rater reliability when used at rest and during the sitting hand press up test.

Methods:

16 male Division III baseball players free of upper limb injury for the previous 12 months participated in the study. Posterior scapular displacement measures were taken on each subject in a resting static posture and while performing a sitting hand press up test. Subjects were tested twice within 24 hours by two separate examiners. Intraclass correlation coefficients (ICC) were calculated to determine intra-rater and inter-rater reliability.

Results:

The intra-rater reliability for rater 1 was .97 (95% confidence interval [CI]= .91-.98), for the rest position and .95 (95% CI= .86-.98) for the sitting hand press-up position. Intra-rater reliability for rater 2 was .99 (95% CI= .97-.99) for the rest position and .98 (95% CI=. 95-.99) for the sitting hand press-up position. The ICCs for inter-rater reliability of the scapular medial border posterior displacement measurement in at the rest position and the sitting hand press-up position were .89 (95% CI= .81-.96) and .89 (95% CI= .80-.96) respectively.

Conclusions:

The findings of this study indicate that the measurement of medial border posterior displacement using this device demonstrates good to excellent inter-rater and intra-rater reliability.     

TEST-RETEST RELIABILITY OF TWO CLINICAL TESTS FOR THE ASSESSMENT OF HIP ABDUCTOR ENDURANCE IN HEALTHY FEMALES

Background

Substantial deficits in performance of hip abductor in patients with common lower extremity injuries are reported in literature. Therefore, assessing hip abductor endurance might be of major importance for clinicians and researchers.

Purposes

The purpose of this study was to examine the test-retest reliability of two hip abductor endurance tests in healthy females. Learning effect, systematic difference in the rate of perceived exertion and relationship between endurance performance and some clinical characteristics of participants were also investigated.

Design

Observational study, with a test-retest design.

Methods

Thirty-six healthy females, aged 18-30 years, were recruited. In two identical assessment sessions, the participants performed an isometric hip abductor strength test and two different hip abductor endurance tests

Results

Isometric and dynamic endurance tests demonstrated good test-retest reliability (intraclass correlation coefficients (ICC) = 0.73 and 0.78, respectively). The standard errors of measurement (SEM) and the minimal detectable changes (MDC) were, respectively, 19.8 and 54.9 seconds for isometric endurance test and 21.2 and 58.7 repetitions for dynamic endurance test. Moderate correlation between both endurance tests (r = 0.60, p = 0.0001) and weak correlation between dynamic endurance test and strength (r = 0.44, p = 0.008) were found.

Conclusions

The results of the present study demonstrate good test-retest reliability of two non-instrumented clinical tests of hip abductor endurance in healthy females.

Level of evidence

2b     

Validation and reliability of a modified sphygmomanometer for the assessment of handgrip strength in Parkinson′s disease

BACKGROUND:

Handgrip strength is currently considered a predictor of overall muscle strength and functional capacity. Therefore, it is important to find reliable and affordable instruments for this analysis, such as the modified sphygmomanometer test (MST).

OBJECTIVES:

To assess the concurrent criterion validity of the MST, to compare the MST with the Jamar dynamometer, and to analyze the reproducibility (i.e. reliability and agreement) of the MST in individuals with Parkinson''s disease (PD).

METHOD:

The authors recruited 50 subjects, 24 with PD (65.5±6.2 years of age) and 26 healthy elderly subjects (63.4±7.2 years of age). The handgrip strength was measured using the Jamar dynamometer and modified sphygmomanometer. The concurrent criterion validity was analyzed using Pearson''s correlation coefficient and a simple linear regression test. The reproducibility of the MST was evaluated with the coefficient of intra-class correlation (ICC_2,1), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland-Altman plot. For all of the analyses, α≤0.05 was considered a risk.

RESULTS:

There was a significant correlation of moderate magnitude (r≥0.45) between the MST and the Jamar dynamometer. The MST had excellent reliability (ICC_2,1≥0.7). The SEM and the MDC were adequate; however, the Bland-Altman plot indicated an unsatisfactory interrater agreement.

CONCLUSIONS:

The MST exhibited adequate validity and excellent reliability and is, therefore, suitable for monitoring the handgrip strength in PD. However, if the goal is to compare the measurements between examiners, the authors recommend that the data be interpreted with caution.     

Isometric muscle strength in children and adolescents using Handheld dynamometry: reliability and normative data for the Brazilian population

Objective

Isometric muscle strength measured by Handheld dynamometer indicates physical ability. There is no normative data for the Brazilian population. This study aims (a) to describe the development of isometric muscle strength in healthy children and adolescents 5–15 years of age; (b) to evaluate Handheld dynamometer inter and intra-rater reliability.

INTRA‐RATER AND INTER‐RATER RELIABILITY OF THE FIVE IMAGE‐BASED CRITERIA OF THE FOOT POSTURE INDEX‐6

Purpose/Background:

The Foot Posture Index‐6 (FPI‐6) is considered a simple quantification tool to assess static foot alignment. Palpation of the foot is required for assessment of one of the six criteria that comprise the FPI‐6; the remaining five criteria may be evaluated using still‐frame photographs. Using only the image‐based criteria may allow multiple clinicians to evaluate large groups of patients quickly. Reliability using only these five image‐based criteria has not been established. The purposes of the current study were to establish the inter‐ and intra‐rater reliability using five image‐based criteria from the Foot Posture Index‐6 (FPI‐6) as well as to examine the agreement between the raters in identifying foot type using the composite five FPI scores.

Methods:

Forty participants (23 females, 17 males; 23.67 ± 8.49 years; 64.59 ± 14.43 kg; 166.07 ± 11.79 cm) volunteered for this study. An investigator took three photos with a digital camera of the medial longitudinal arch, posterior ankle, and of the talonavicular joint approximately 45° from the posterior calcaneus for both right and left feet. Two investigators assessed the five image‐based criteria of the FPI‐6 for both feet of 40 participants on three occasions separated by a day. Inter‐and intra‐rater reliability were assessed with Intraclass Correlation Coefficients (ICC_3,2). The amount of agreement for classification of foot posture type between the two raters was assessed with Cohen''s kappa coefficient. Significance was set a priori at P < 0.05.

Results:

The inter‐rater reliability was poor to moderate for all three sessions (ICC_3,2 = 0.334‐0.634). For the foot posture classification, the amount of agreement between two raters was poor for left (κ= 0.12) and right (κ= 0.19) feet. The intra‐rater reliability was excellent for left (ICC_3,2=0.956) and right feet (ICC_3,2=0.959).

Conclusions:

Excellent intra‐rater and poor to moderate inter‐rater reliability was found using only the five image‐based criteria of the FPI‐6. However, the classification of foot posture did not improve the amount of agreement between raters. Therefore, caution is needed when interpreting FPI scores from five image‐based criteria.

Levels of Evidence:

3b     

Standardized voluntary force measurement in a lower extremity rehabilitation robot

Background

Isometric force measurements in the lower extremity are widely used in rehabilitation of subjects with neurological movement disorders (NMD) because walking ability has been shown to be related to muscle strength. Therefore muscle strength measurements can be used to monitor and control the effects of training programs. A new method to assess isometric muscle force was implemented in the driven gait orthosis (DGO) Lokomat. To evaluate the capabilities of this new measurement method, inter- and intra-rater reliability were assessed.

Methods

Reliability was assessed in subjects with and without NMD. Subjects were tested twice on the same day by two different therapists to test inter-rater reliability and on two separate days by the same therapist to test intra-rater reliability.

Results

Results showed fair to good reliability for the new measurement method to assess isometric muscle force of lower extremities. In subjects without NMD, intraclass correlation coefficients (ICC) for inter-rater reliability ranged from 0.72 to 0.97 and intra-rater reliability from 0.71 to 0.90. In subjects with NMD, ICC ranged from 0.66 to 0.97 for inter-rater and from 0.50 to 0.96 for intra-rater reliability.

Conclusion

Inter- and intra- rater reliability of an assessment method for measuring maximal voluntary isometric muscle force of lower extremities was demonstrated. We suggest that this method is a valuable tool for documentation and controlling of the rehabilitation process in patients using a DGO.     

Intra-rater reliability of an experienced physiotherapist in locating myofascial trigger points in upper trapezius muscle

Objectives:

Myofascial trigger points (MTrPs) are considered the principal clinical feature of myofascial pain syndrome (MPS). An MTrP consists of spot tenderness within a taut band of muscle fibers and its stimulation can produce both local and referred pain. The clinical diagnosis of MPS depends on correct history taking and a physical examination aimed at identifying the presence of MTrP. The purpose of this study was to investigate the intra-rater reliability of a palpation protocol used for locating an MTrP in the upper trapezius muscle.

Methods:

Twenty-four subjects with MTrP in the upper trapezius muscle were examined by an experienced physiotherapist. During each of eight experimental sessions, subjects were examined twice in randomized order using a palpation protocol. An anatomical landmark system was defined and the MTrP location established using X and Y values.

Results:

The intraclass correlation coefficient ICC_(1,1) values were 0.62 (95% CI: 0.30–0.81) for X and 0.81 (95% CI: 0.61–0.91) for Y. The Bland–Altman plots for X and Y showed a mean of difference of 0.04 and −0.2 mm, respectively. Limits of agreement for X ranged from −26.3 to 26.2 mm and for Y from −27 to 26.4 mm.

Discussion:

The ICC_(1,1) for the observed values revealed a moderate to high correlation and the Bland–Altman analysis showed means of difference very close to zero with narrow limits of agreement. An experienced physiotherapist can reliably identify MTrP locations in upper trapezius muscle using a palpation protocol.     

FUNCTIONAL MOVEMENT SCREENTM NORMATIVE VALUES IN A YOUNG,ACTIVE POPULATION

Background:

The Functional Movement Screen^TM (FMS^TM) is a screening instrument which evaluates selective fundamental movement patterns to determine potential injury risk. However, despite its global use, there are currently no normative values available for the FMS^TM.

Objectives:

To establish normative values for the FMS^TM in a population of active, healthy individuals. Secondary aims were to investigate whether performance differed between males and females, between those with and without a previous history of injury, and to establish real-time inter-rater reliability of the FMS^TM.

Methods:

Two hundred and nine (108 females and 101 males) physically active individuals, aged between 18 and 40 years, with no recent (<6 weeks) history of musculoskeletal injury were recruited. All participants performed the FMS^TM and were scored using the previously established standardized FMS^TM criteria. A representative sub-group participant sample (28%) determined inter rater reliability.

Results:

The mean composite FMS^TM score was 15.7 with a 95% confidence interval between 15.4 and 15.9 out of a possible total of 21. There was no statistically significant difference in scores between females and males (t₂₀₇ = .979, p = .329), or those who reported a previous injury and those who did not (t₂₀₇ = .688, p= .492). Inter-rater reliability (ICC_3,1) for the composite FMS^TM score was .971, demonstrating excellent reliability. Inter-rater reliability (Kappa) for individual test components of the FMS^TM demonstrated substantial to excellent agreement (0.70 — 1.0).

Discussion and Conclusion:

This cross-sectional study provides FMS^TM reference values for young, active individuals, which will assist in the interpretation of individual scores when screening athletes for musculoskeletal injury and performance factors.     

Hand‐held Dynamometer Positioning Impacts Discomfort During Quadriceps Strength Testing: A Validity and Reliability Study

Purpose/Background

A belt‐stabilized hand‐held dynamometer (HHD) offers the ability to quantify quadriceps muscle strength in a clinical environment, but a limitation is participant discomfort at the interface between the HHD and the tibia. The purpose of this study was to quantify the level of discomfort associated with a modified belt‐stabilized HHD configuration compared to a standard belt‐stabilized configuration and an isokinetic dynamometer. The secondary purpose of this study was to determine the validity and reliability of a modified configuration used to measure quadriceps strength compared to the “gold‐standard” isokinetic dynamometer.

Methods

Twenty healthy participants (5 males, 15 females; age=24.7±2.2 years, height=171.1±8.8 cm, mass=72.0±18.7 kg) performed maximal knee extension isometric contractions during each of three testing conditions: isokinetic dynamometer, standard configuration with HHD placement on the tibia, and an alternative configuration with the HHD interfaced with the leg of a table. Discomfort was quantified using a Visual Analog Scale (VAS). Differences in discomfort and torque (N•m) associated with the testing positions were determined using Friedman test or repeated measures analysis of variance. Validity was quantified using Pearson correlations and within‐session intrarater reliability was determined using an intraclass correlation coefficient (ICC2,1) and associated confidence intervals (95% CI).

Results

The isokinetic dynamometer configuration resulted in the least discomfort (p< .01) and the modified configuration was more comfortable than the standard configuration (p= .003). There was a significant correlation between measures from the isokinetic dynamometer and the standard configuration (r=.87) and modified configuration (r=.93). Within‐session intrarater reliability was good for both the standard configuration (ICC_2,1=0.93) and modified configuration (ICC_2,1=0.93) conditions.

Conclusions

The use of the modified belt‐stabilized HHD configuration, where the HHD was interfaced with the leg of a table, offers a more comfortable alternative compared to the standard belt‐stabilized configuration to obtain isometric quadriceps strength measures in a clinical environment. This configuration is also a valid and reliable alternative to the “gold standard” isokinetic dynamometer when testing isometric quadriceps strength at 90° of knee flexion.

Level of Evidence

Diagnostic, Level 3     

Reliability of measuring the passive range of shoulder horizontal adduction using a smartphone in the supine versus the side-lying position

[Purpose] The purpose of this study was to compare the reliability of the measurement of the passive range of motion (PROM) of shoulder horizontal adduction (SHA) measurements using a smartphone for the assessment posterior shoulder tightness (PST) between the side-lying and supine test positions. [Subjects and Methods] Forty-seven subjects (mean ± age, 24.9 ± 3.5 years) without shoulder pathology were included in this study. Intra-rater and inter-rater reliabilities were determined using intraclass correlation coefficients. The SHA PROM of each subject’s dominant shoulder was measured using a smartphone by two investigators in two positions: the standard supine position, and a side-lying position on the tested side. [Results] The intra-rater reliability of the supine measurements was fair to good (ICC_3,1 = 0.72–0.89), and for the side-lying measurements was excellent (ICC_3,1 = 0.95–0.97). The inter-rater reliability of the supine measurements was fair (ICC_2,2 = 0.79) and for the side-lying measurements was excellent (ICC_2,2 = 0.94). [Conclusion] These results suggest that for healthy subjects, measurements of SHA using smartphones in the side-lying position has superior intra-rater and inter-rater reliabilities compared to the standard supine position.Key words: Reliability, Horizontal adduction, Smartphone     

CROSS‐CULTURAL ADAPTATION AND VALIDATION OF THE KOREAN VERSION OF THE CUMBERLAND ANKLE INSTABILITY TOOL

Background

The Cumberland Ankle Instability Tool (CAIT) is a valid and reliable patient reported outcome used to assess the presence and severity of chronic ankle instability (CAI). The CAIT has been cross‐culturally adapted into other languages for use in non‐English speaking populations. However, there are no valid questionnaires to assess CAI in individuals who speak Korean.

Purpose

The purpose of this study was to translate, cross‐culturally adapt, and validate the CAIT, for use in a Korean‐speaking population with CAI.

Study Design

Cross‐cultural reliability study.

Methods

The CAIT was cross‐culturally adapted into Korean according to accepted guidelines and renamed the Cumberland Ankle Instability Tool‐Korean (CAIT‐K). Twenty‐three participants (12 males, 11 females) who were bilingual in English and Korean were recruited and completed the original and adapted versions to assess agreement between versions. An additional 168 national level Korean athletes (106 male, 62 females; age = 20.3 ± 1.1 yrs), who participated in ≥ 90 minutes of physical activity per week, completed the final version of the CAIT‐K twice within 14 days. Their completed questionnaires were assessed for internal consistency, test‐retest reliability, criterion validity, and construct validity.

Results

For bilingual participants, intra‐class correlation coefficients (ICC_2,1) between the CAIT and the CAIT‐K for test‐retest reliability were 0.95 (SEM=1.83) and 0.96 (SEM=1.50) in right and left limbs, respectively. The Cronbach''s alpha coefficients were 0.92 and 0.90 for the CAIT‐K in right and left limbs, respectively. For native Korean speakers, the CAIT‐K had high internal consistency (Cronbach''s α=0.89) and intra‐class correlation coefficient (ICC_2,1 = 0.94, SEM=1.72), correlation with the physical component score (rho=0.70, p = 0.001) of the Short‐Form Health Survey (SF‐36), and the Kaiser‐Meyer‐Olkin score was 0.87.

Conclusions

The original CAIT was translated, cross‐culturally adapted, and validated from English to Korean. The CAIT‐K appears to be valid and reliable and could be useful in assessing the Korean speaking population with CAI.     

Relationship among vaginal palpation,vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles

Background:

The proper evaluation of the pelvic floor muscles (PFM) is essential for choosing the correct treatment. Currently, there is no gold standard for the assessment of female PFM function.

Objective:

To determine the correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the female PFM.

Method:

This cross-sectional study evaluated 80 women between 18 and 35 years of age who were nulliparous and had no pelvic floor dysfunction. PFM function was assessed based on digital palpation, vaginal squeeze pressure, electromyographic activity, bilateral diameter of the bulbocavernosus muscles and the amount of bladder neck movement during voluntary PFM contraction using transperineal bi-dimensional ultrasound. The Pearson correlation was used for statistical analysis (p<0.05).

Results:

There was a strong positive correlation between PFM function and PFM contraction pressure (0.90). In addition, there was a moderate positive correlation between these two variables and PFM electromyographic activity (0.59 and 0.63, respectively) and movement of the bladder neck in relation to the pubic symphysis (0.51 and 0.60, respectively).

Conclusions:

This study showed that there was a correlation between vaginal palpation, vaginal squeeze pressure, and electromyographic and ultrasonographic variables of the PFM in nulliparous women. The strong correlation between digital palpation and PFM contraction pressure indicated that perineometry could easily be replaced by PFM digital palpation in the absence of equipment.     

Cross-cultural adaptation and measurement properties of the Brazilian Version of the Michigan Neuropathy Screening Instrument

Background

The Michigan Neuropathy Screening Instrument is an easy-to-use questionnaire aimed at screening and detecting diabetic polyneuropathy.

COMPARISON OF THE EFFECTS OF AN EIGHT‐WEEK PUSH‐UP PROGRAM USING STABLE VERSUS UNSTABLE SURFACES

Background and Purpose:

Recently, the trend among physical training and rehabilitation professionals is the use of resistance exercise on unstable equipment in order to increase the effort of the agonist and stabilizing muscles. It is unknown if performing exercises on unstable surfaces provides a greater training stimulus as compared to training on a stable training surface. Therefore, the purpose of this research was to compare the effect that push‐up training on stable and unstable surfaces had on strength performance in healthy young men.

Methods:

Thirty subjects with experience in resistance training participated in push‐up training two days per week for eight weeks on one of three different surfaces: the floor (Tp), the T‐Bow® (TBp) or the BOSU® (Bp).

Results:

Strength, as measured by one repetition maximum (1‐RM) and muscle endurance, as measured by number of pushups performed did not improve significantly (p>0.05) for any of the intervention groups.

Conclusions:

The addition of unstable surfaces in push‐up training does not provide greater improvement in muscular strength and endurance than push up training performed on a stable surface in young men.

Levels of Evidence:

3b