Reliability of the Expanded Cutting Alignment Scoring Tool (E-CAST) to Assess Trunk and Limb Alignment During a 45-Degree Side-Step Cut

BackgroundCurrent clinical screening tools assessing risky movements during cutting maneuvers do not adequately address sagittal plane foot and ankle evaluations. The Cutting Alignment Scoring Tool (CAST) is reliable in evaluating frontal plane trunk and lower extremity alignment during a 45-degree side-step cut. The Expanded Cutting Alignment Scoring Tool (E-CAST) includes two new sagittal plane variables, knee flexion and ankle plantarflexion angle.Hypothesis/PurposeTo assess the inter-and intra-rater reliability of the E-CAST to evaluate trunk and lower extremity alignment during a 45-degree side-step cut.Study DesignRepeated MeasuresMethodsParticipants included 25 healthy females (13.8 ± 1.4 years) regularly participating in cutting or pivoting sports. Participants were recorded performing a side-step cut in frontal and sagittal planes. One trial was randomly selected for analysis. Two physical therapists independently scored each video using the E-CAST on two separate occasions, with randomization and a two-week wash-out between rounds. Observed movement variables were awarded a score of “1”, with higher scores representing poorer technique. Intraclass correlation coefficients (ICC) and 95% confident intervals (95% CI) were calculated for the total score, and a kappa coefficient (k) was calculated for each variable.ResultsThe cumulative intra-rater reliability was good (ICC=0.78, 95% CI 0.59-0.96) and the cumulative inter-rater reliability was moderate (ICC=0.71, 95% CI 0.50-0.91). Intra-rater kappa coefficients ranged from moderate to excellent for all variables (k= 0.50-0.84) and inter-rater kappa coefficients ranged from slight to excellent for all variables (k=0.20-0.90).ConclusionThe addition of two sagittal plane variables resulted in lower inter-rater ICC compared to the CAST (ICC= 0.81, 95% CI 0.64-0.91). The E-CAST is a reliable tool to evaluate trunk and LE alignment during a 45-degree side-step cut, with good intra-rater and moderate inter-rater reliability.Level of EvidenceLevel 2, Diagnosis     

Reliability and Validity of the Functional Movement Screen™ with a Modified Scoring System for Young Adults with Low Back Pain

BackgroundLow back pain (LBP) is one of the most common complaints in individuals who seek medical care and is a leading cause of movement impairments. The Functional Movement Screen (FMS™) was developed to evaluate neuromuscular impairments during movement. However, the reliability and validity of the FMS™ have not yet been established for the LBP population because of a limitation of its original scoring system.PurposeThe purposes of this study were to determine the reliability and validity of the FMS™ with a modified scoring system in young adults with and without LBP. The FMS™ scores were modified by assigning a zero score only when there was an increase in LBP during the FMS™, not simply for the presence of pain, as in the original FMS™ scoring system.Study DesignReliability and validity study.MethodsTwenty-two participants with LBP (8 males and 14 females, 26.7 ± 4.68 years old) and 22 age- and gender-matched participants without LBP (26.64 ± 4.20 years old) completed the study. Each participant performed the FMS™ once while being scored simultaneously and independently by two investigators. In addition, each participant’s FMS™ performance was video-recorded and then was scored by another two investigators separately. The video-recorded performance also was scored twice six weeks apart by the same investigator to determine intra-rater reliability.ResultsThe results showed excellent inter-rater and intra-rater reliability of the FMS™ composite score with intraclass correlation coefficients ranging from 0.93 to 0.99 for both groups. In addition, the LBP group scored significantly lower than the group without LBP (p = 0.008).ConclusionsThe results indicate that the FMS™ is able to distinguish between individuals with and without LBP, and that it could be a useful test for clinicians to quantify movement quality and to assess movement restrictions in individuals with LBP.Levels of Evidence2b.     

Reliability and validity of a Thai version of the edmonton symptom assessment scale (ESAS-Thai)

Context

The Edmonton Symptom Assessment Scale (ESAS), created by the Edmonton Group in 1991, is an instrument assessing symptom control that is commonly used in palliative care. It asks patients to rate nine items on 11-point numeric rating scales.

Objectives

The aim of this study was to translate the ESAS to Thai and validate its final version with transcultural adaptation for Thai palliative care patients. The original ESAS was translated into Thai following the process of cross-cultural adaptation of self-report measures’ standard guidelines, including forward translation, synthesis of the translation, back translation, cross-cultural adaptation, and pretesting.

Methods

This cross-sectional study was first undertaken with 44 patients with advanced cancer in an inpatient setting, which led to the final version. The reliability and validity of the final version was then examined in a sample of 37 cancer patients in the outpatient department at Ramathibodi Hospital. Face validity was evaluated through patient interviews, using guide questions. The internal consistency was calculated using Cronbach's alpha.

Results

In total, 91.8% of patients declared that the ESAS-Thai questionnaire was generally clear. It yielded a Cronbach's alpha of 0.75 in the inpatient setting. After modifying the words “appetite” and “well-being,” 37 cancer patients, whose mean (standard deviation) age was 52.2 (10.8) years and who were cared for by the Departments of Medicine, Surgery, Gynecology, and Otolaryngology, self-administered the questionnaire in the outpatient department. The Cronbach's alpha in the validation sample was 0.89.

Conclusion

After the translation and cross-cultural adaptation, the Thai version of the ESAS achieved good levels of face validity and internal consistency. It is now available as a patient-administered instrument to evaluate symptoms among palliative care patients in Thailand.     

Reliability testing of the patellofemoral joint reaction force (PFJRF) measurement in taped and untaped patellofemoral conditions during single leg squatting: a pilot study

Introduction

Measuring patellofemoral joint reaction forces (PFJRF) may provide reliable evidence for patellar taping to correct probable malalignment in subjects with anterior knee pain, or patellofemoral pain syndrome (PFPS). The aim of the present study was to examine the reliability of PFJRF measurements in different patellofemoral conditions during squatting in healthy subjects.

Methods

Using a motion analysis system and one forceplate, PFJRF of eight healthy subjects was assessed during single leg squatting. Data was collected from superficial markers taped to selected landmarks. This procedure was performed on the right knees, before (BT), during (WT) and shortly after patellar taping (SAT). The PFJRF was calculated using a biomechanical model of the patellofemoral joint.

Results

The results revealed that, there were no significant differences between the PFJRF mean values for three conditions of BT (2100.55 ± 455.25), WT (2026.20 ± 516.45) and SAT (2055.35 ± 669.30) (p > 0.05). The CV (coefficient of variation), ICC (intra class correlation coefficient), LSD (least significant difference) and SEM (standard error of measurement) values revealed the high reliability of PFJRF measurements during single leg squatting (p < 0.05).

Conclusion

The high reliability of PFJRF measurements reveals that the future studies could rely on these measurements during single leg squatting.