Activity trackers are not valid for step count registration when walking with crutches

BackgroundThe use of activity trackers has been proposed in rehabilitation where resuming physical activity is deemed crucial, e.g. after total knee arthroplasty (TKA). As patients initially often walk with crutches, it is of importance that clinicians can rely on the information provided by activity trackers.Research questionTo determine concurrent validity of 2 activity trackers for step count, positioned on different locations on the body during gait with crutches.MethodsThirty healthy participants performed normal gait and gait with one crutch and two crutches over a distance of 400 m while wearing a Garmin Vivofit 3 and Nokia Go on both wrists and both sides at the waist (only Nokia Go). The gold standard was manual step count. Inter-device reliability (within brand) was assessed by calculating Intraclass Correlation Coëfficients (ICC) and concurrent validity was determined by performing paired sample t-tests, ICC and Bland-Altman Plots with % bias and 95% CI Limits of Agreement (LoA).ResultsDuring normal gait, both the Nokia and Garmin showed good to excellent inter-device reliability (ICC > 0.75). Both devices showed concurrent validity compared to manual step count, with slightly better results for the Garmin compared to the Nokia at the wrist (% bias = respectively 0.0% and -1.4% with 95% CI LoA: respectively -1.7%;1.7% and -8.6%;5.8%; ICC: respectively 0.995 and 0.859). During gait with crutches, however, overall 95% CI of LoA were beyond clinically acceptable differences and ICC values with the gold standard were poor. Therefore, notwithstanding a sometimes reported small average % bias, validity of the activity trackers for step count during gait with crutches was not established, independent of tracker position.SignificanceActivity trackers showed no concurrent validity when monitoring step count during gait with crutches. This should be taken into account when implementing this technology in e.g. post-operative goal setting in patients with TKA.     

Improved test-retest reliability of 50-ms paired-click auditory gating using magnetoencephalography source modeling

Used to study filtering abnormalities in schizophrenia, the paired-click paradigm suffers from poor test-retest reliability of the gating ratio, calculated from the P50 component of the ERP recorded at Cz approximately 50 ms following each of two stimuli. This study sought to improve reliability by assessing 50-ms gating at primary auditory cortices (PAC), the main generators of the P50 Cz component. MEG source modeling was used, taking advantage of the tangentially oriented PAC sources. Ten healthy subjects underwent three sessions, during which Cz-based and PAC-derived gating was measured. Unlike Cz P50, gating ratios at bilateral PACs achieved an intraclass coefficient of .8 or greater. Variability of gating within the same subject was also significantly smaller for bilateral PACs than for Cz P50. Paired-click gating ratio reliability can be improved by examining the individual PACs rather than composite scalp-recorded activity.     

Durability improvement of polymer chamber of pulsatile extracorporeal life support system in terms of mechanical change

Twin Pulse Life Support, T-PLS™ has received the CE mark (2003) and Korea Food and Drug Administration (KFDA) approval (2004) for short-term application as an Extracorporeal Life Support system (ECLS). T-PLS’s original intention was to apply for not only short-term but also long-term application such as Extracorporeal ventricular assist device (VAD). Hence, a long-term durability test was conducted. The 1-year reliability of the systems tested in this study did not meet the STS/ASAIO standard of 80% reliability with 60% confidence for a 1-year mission life. However, without the disposable units, which are only designed to operate for 6 h, the 1-year reliability exceeded the STS/ASAIO standard of 80% reliability with 60% confidence. In this study, by using the existing analysis methods and analyzing the root cause of the failure used by a numerical analysis. As eliminating or mitigating of the root cause of the failure, we improved the durability of blood chamber and evaluated the performance of the modified system via the hemolysis test.     

Reliability of cardiovascular reactivity to stress: internal consistency

Research on the reliability of cardiovascular reactivity has focused on temporal stability and intertask consistency with only modest results. The present study evaluated the internal consistency reliability of cardiovascular reactivity in three large samples of adolescents and young adults (N=326, 136, and 142). Impedance cardiographic and blood pressure measures were recorded at rest and during standard laboratory stress tasks (math, video game, cold pressor). The reliability of cardiovascular reactivity within tasks, as assessed by Cronbach's alpha coefficient of internal consistency, ranged from alpha=.83 to .96 for 4-min to 5-min math tasks, and alpha=.65 to .94 for 3-min video game and cold pressor tasks. Although highly reliable within tasks, cardiovascular reactivity was less reliable across tasks, even within a single testing session. Possible reasons for the discrepancy between internal consistency and intertask consistency are discussed.     

Validating the Medical Data Interpretation Test in a Dutch population

Objective

To validate the Dutch translation of the Medical Data Interpretation Test.

Methods

A test–retest design with a 2-week interval was used.

Results

The intraclass correlation coefficient (ICC = .82), the limits-of-agreement interval (LOA = −8.96 to 2.48) and the test–retest reliability (Pearson's r = 86) suggest that the Dutch translation has good reproducibility. Construct validity was tested by two hypotheses, both of which were confirmed. University participants had higher test scores than non-university participants (p = .02), and males did not score differently than females (p = .61).

Conclusion

The results suggest that the Dutch version of the Medical Data Interpretation Test is an adequate scale to assess ability to interpret medical data.

Practice implications

Assessing patients’ numeracy skills before a counseling session will enable the counselor to adjust subsequent communication accordingly and, as such, improve the session's effectiveness.     

Development and psychometric properties of the Self-Efficacy Scale for transfers for caregivers of children requiring transfer assistance

OBJECTIVE: To test the psychometric properties of a newly developed measure of caregiver self-efficacy, the Caregiver Self-Efficacy Scale for Transfers (CSEST), a 14-item questionnaire that measures the perceived self-efficacy of adult caregivers of dependent children and focuses on their perceived abilities and the challenges of assisting a child with restricted transfer ability. DESIGN: Reliability and validity study using survey data. SETTING: Community-based survey study. PARTICIPANTS: Adult caregivers (eg, mother, father, grandparent) of dependent minors who require transfer assistance. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Using the Rasch measurement model, the CSEST was tested for reliability and separation, validity (hierarchical and content), and factor structure. RESULTS: The CSEST yields data with sufficient reliability (reliability indices of .96 and .94 for respondents and items, respectively) as well as sufficient separation of levels of self-efficacy (item separation index, 4.13; person separation index, 5.23). The CSEST has a stable hierarchical structure with adequate content validity (standardized chi2 fit statistics <2.0) and point biserial correlations greater than .67. Factor analysis confirmed 2 insubstantial subscales; the 14-item CSEST accounted for greater than 85% of the total variance. CONCLUSIONS: The CSEST yields reliable data and valid inferences of self-efficacy from adult caregivers of children requiring transfer assistance. The CSEST may identify areas of need and/or difficulty with transfers for parents caring for dependent children.     

脑卒中高危筛查意向量表的编制与信效度检验研究

背景 我国正在大力开展社区脑卒中高危筛查项目,居民的参与意向是影响项目成效的重要因素。但是目前缺乏可靠的社区居民脑卒中高危筛查意向量表。 目的 编制脑卒中高危筛查意向量表并评价其信效度,为评估居民脑卒中高危筛查意向提供可靠的工具。 方法 基于计划行为理论,通过文献回顾、实地走访和头脑风暴,形成量表条目池。2021年7—8月,遴选5名脑卒中相关研究或精通量表编制的专家,进行2轮专家评价,形成初始版脑卒中高危筛查意向量表（包含3个维度,28个条目）。2021年8—9月,采用便利抽样法,选取湖北省襄阳市、武汉市、荆门市,广东省广州市、惠州市、深圳市的社区居民为研究对象,对初始版脑卒中高危筛查意向量表进行信效度检验。 结果 共发放问卷535份,有效问卷524份,有效回收率为98%。最终形成4个维度25个条目的量表,分为积极态度、消极态度、主观规范、知觉行为控制。总量表Cronbach's α系数为0.904,重测信度的组内相关系数（ICC）为0.810。各条目内容效度（I-CVI）为0.8~1.0,量表的全体一致内容效度（S-CVI/UA）为0.93,平均内容效度（S-CVI/Ave）为0.99。探索性因子分析显示,因子累积方差贡献率为61.945%,各条目因子载荷量为0.482~0.828。验证性因子显示拟合优度χ2=361.040,df=267,χ2/df=1.352,近似误差均方根（RMSEA）=0.038,拟合优度指数（GFI）=0.897,比较拟合指数（CFI）=0.958,调整拟合优度指数（AGFI）=0.875,增值拟合指数（IFI）=0.959,非规准适配指数（TLI）=0.953,规范拟合指数（NFI）=0.859。 结论 脑卒中高危筛查意向量表具有较好的信效度,可作为测量居民脑卒中高危筛查意向的工具。     

脑卒中影响量表的测试研究

目的探讨应用汉化的脑卒中影响量表（SIS）的可行性。方法使用汉化的SIS量表对130例中老年首发脑卒中患者发病后1个月时的生存质量进行评定，并对其中的105例患者在发病后进行为期3个月的随访评定。根据结果对该量表的信度、效度、反应度和可行性进行全面分析。结果SIS量表8个分量表和总量表中表示内部一致性的克朗巴赫α系数（Cronbach’s α）均〉0．8，重测结果的组内相关系数ICC（intraclasscorrelation coefficients，IOC）值均〉0．7（P〈0．05）。各分量表的Pearson相关系数均〉0．5（P〈0．05）。因子分析法提取的8个因子总共解释总体变量的80％。情绪、ADL／IADL、移动能力、参与4个方面及总分方面的变化差异有显著性（P〈0．05）。结论汉化SIS量表具有良好的信度、效度、反应度和可行性，可应用于临床和社区护士对中老年脑卒中患者的生存质量和护理效果的评定。