Test-retest reliability of stability outcome measures during treadmill walking in patients with balance problems and healthy controls

BackgroundImprovement of balance control is an important rehabilitation goal for patients with motor and sensory impairments. To quantify balance control during walking, various stability outcome measures have described differences between healthy controls and patient groups with balance problems. To be useful for the evaluation of interventions or monitoring of individual patients, stability outcome measures need to be reliable.Research questionWhat is the test-retest reliability of six stability outcome measures during gait?MethodsPatients with balance problems (n = 45) and healthy controls (n = 20) performed two times a two-minute walk test (2MWT). The intraclass correlation coefficient (ICC) and Bland-Altman analysis (coefficient of repeatability; CR) were used to evaluate the test-retest reliability of six stability outcome measures: dynamic stability margin (DSM), margin of stability (MoS), distance between the extrapolated centre of mass (XCoM) and centre of pressure (CoP) in anterior-posterior (XCoM-CoP_AP) and medial-lateral (XCoM-CoP_ML) direction, and inclination angle between centre of mass (CoM) and CoP in anterior-posterior (CoM-CoP_AP-angle) and medial-lateral (CoM-CoP_ML-angle) direction. A two way mixed ANOVA was performed to reveal measurement- and group-effects.ResultsThe ICCs of all stability outcome measures ranged between 0.51 and 0.97. Significant differences between the measurements were found for the DSM (p = 0.017), XCoM-CoP_AP (p = 0.008) and CoM-CoP_AP-angle (p = 0.001). Significant differences between controls and patients were found for all stability outcome measures (p < 0.01) except for the MoS (p = 0.32). For the XCoM-CoP distances and CoM-CoP angles, the CRs were smaller than the difference between patients and controls.SignificanceBased on the ICCs, the reliability of all stability outcome measures was moderate to excellent. Since the XCoM-CoP_ML and CoM-CoP_ML-angle showed no differences between the measurements and smaller CRs than the differences between patients and controls, the XCoM-CoP_ML and CoM-CoP_ML-angle seem the most promising stability outcome measures to evaluate interventions and monitor individual patients.     

Test–retest reliability and variability of knee adduction moment peak,impulse and loading rate during walking

BackgroundPrevious studies have reported good test-retest reliability for peak knee adduction moment (KAM) during walking. However, reliability of other KAM measurements has not been established.Research questionWhat is the test-retest reliability of peak KAM, KAM impulse, and KAM loading rate measurements during walking in knee-healthy individuals?MethodsData from 32 knee-healthy participants were analysed in this test-retest reliability study. Various KAM measurements were reported for two sessions with kinematic and kinetic data obtained from a motion capture system synchronised with force plates, with a median of 1 week between sessions.ResultsFor all KAM measures, intra-class correlation coefficients were above 0.90 and their lower bound 95 % confidence limits exceeded 0.81. However, absolute measurement variability differed across measures, with normalized SEM (8 %–15 %), normalized MDC₉₅ (20 %–40 %), intra-session MAD (10 %–18 %), and inter-session MAD (12 %–22 %) varying over a 2-fold range. Overall and first peak KAM, KAM impulse over 50 % stance, and KAM loading rate (15 frame window) showed ≤10 % and ≤15 % intra- and inter-session MAD, respectively.SignificanceThis study provided previously undefined test-retest reliability estimates for various KAM measures during walking. Researchers and clinicians should not assume that the various aspects of the KAM curve share similar reliability.     

Reliability of 3D dental and skeletal landmarks on CBCT images

Objectives:To quantify reliability of three-dimensional skeletal landmarks and a comprehensive set of dental landmarks in cone-beam computed tomography (CBCT) and to determine the shapes of envelope of error.Materials and Methods:Three judges located 31 skeletal landmarks and 60 dental landmarks on the pre- and posttreatment CBCT images of 22 patients. Landmark error was determined by calculating the distance of deviation of landmark locations around their average. Standard deviation and mean radial spherical error were calculated. Scatterplots were constructed to characterize envelope of error.Results:The midline landmarks of the cranial base were highly reliable. Bilateral skeletal landmarks tended to have larger error than midline landmarks. Among the nonconventional landmarks, fronto-zygomatic suture, condyle, and mental foramen showed relatively high reliability. However, foramen spinosum and temporal fossa showed larger errors. Gonion was the least reliable landmark. Most dental landmarks were located more reliably than skeletal landmarks. The highest reliability was found at incisal edges. Mesiobuccal cusp of first molars also showed high reliability.Conclusions:There were differences in the size and shape of the distributions of errors of different landmarks. Most landmarks showed elongated envelopes. Bilateral structures tended to show greater errors than midline structures. Most dental landmarks were more reliable than skeletal landmarks.     

Perceptions of self,significant others,and teacher–child relationships in indiscriminately friendly children

ObjectiveDespite increasing research on indiscriminate friendliness in children, almost no research exists on social-cognitive deficits that are supposed to underlie indiscriminately friendly behavior. In this study, we compared indiscriminately friendly children with controls regarding their perceptions of self, reliability trust in significant others, and perceptions of the teacher–child relationship.MethodChildren's perceptions were compared in two samples: a sample of 33 likely cases for disinhibited reactive attachment disorder (RAD) from special education for children with emotional and behavioral disorders (75.76% boys, M_age = 8.52, 96.9% Caucasian, 33.3% and 45.5% of their mothers completed primary or secondary education, respectively) was matched on sex, age, and socio-economic status with a sample of 33 controls from general education. Children participated individually in several interviews assessing global and social self-concept, reliability trust in significant others, teacher–child relationship perceptions, and vocabulary. Parents and teachers completed a screening questionnaire for RAD and the Strengths and Difficulties Questionnaire.ResultsLikely disinhibited RAD-cases showed more indiscriminate friendliness and more problem behavior in general according to their parents and teachers than controls. Furthermore, likely RAD-cases reported a more positive global self-concept, more reliability trust in significant others, and more dependency in the teacher–child relationship than controls.ConclusionsThe results are in line with clinical observations of indiscriminately friendly children and findings in clinical samples of maltreated or attachment disrupted children but contrast hypotheses from developmental attachment research. Further research is needed to explain the more positive perceptions of indiscriminately friendly children.     

Validity and reliability of the Mastication Observation and Evaluation (MOE) instrument

The Mastication Observation and Evaluation (MOE) instrument was developed to allow objective assessment of a child's mastication process. It contains 14 items and was developed over three Delphi rounds. The present study concerns the further development of the MOE using the COSMIN (Consensus based Standard for the Selection of Measurement Instruments) and investigated the instrument's internal consistency, inter-observer reliability, construct validity and floor and ceiling effects. Consumption of three bites of bread and biscuit was evaluated using the MOE. Data of 59 healthy children (6–48 mths) and 38 children (bread) and 37 children (biscuit) with cerebral palsy (24–72 mths) were used.Four items were excluded before analysis due to zero variance. Principal Components Analysis showed one factor with 8 items. Internal consistency was >0.70 (Chronbach's alpha) for both food consistencies and for both groups of children. Inter-observer reliability varied from 0.51 to 0.98 (weighted Gwet's agreement coefficient). The total MOE scores for both groups showed normal distribution for the population. There were no floor or ceiling effects.The revised MOE now contains 8 items that (a) have a consistent concept for mastication and can be scored on a 4-point scale with sufficient reliability and (b) are sensitive to stages of chewing development in young children. The removed items are retained as part of a criterion referenced list within the MOE.     

职业院校教师心理素质量表的编制和信效度检验

目的 编制职业院校教师心理素质量表,并检验其信效度。方法 通过对630例职业院校教师的调研和访谈,编制了职业院校教师心理素质量表,间隔两周后对其中的87例教师重新施测,考察问卷的重测信度、同质性信度;选用大学优秀教师心理素质量表（DTPA）、中学教师心理素质量表（MTCA）作为效标问卷,对其中64例进行效标效度检验。结果 探索性因子分析形成6个因子,分别为表达与交流性、创新性、操作演示性、稳定性、聪慧性、职业认同感。量表重测信度为0.654,6个因子的Cronbach＇sα系数均大于0.7;总的分半信度系数为0.871,90.6%的条目的 CVR在0.6以上。效标效度检验除操作演示性与两个量表的相关没有达到显著性水平外,其他均具有统计学意义（P〈0.05）。结论该量表具有较好的信度效度,可以作为职业院校教师心理素质的测量工具。     

1 year test–retest reliability of ImPACT in professional ice hockey players

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery is widely used to assess neurocognitive outcomes following sports-related concussion. The purpose of this study was to examine the 1 year test–retest reliability of ImPACT in a multilingual sample of professional hockey players. A total of 305 professional hockey players were tested 1 year apart using ImPACT. Reliable change confidence intervals were calculated and test–retest reliability was measured using Pearson and Intraclass correlation coefficients. Results indicated that the 1-year test–retest reliabilities for the Visual Motor and Reaction Time Composites ranged from low to high (.52 to .81). In contrast, 1-year test–retest reliabilities for the Verbal and Visual Memory Composites were low (.22 to .58). The 1-year test–retest results provided mixed support for the use of Visual Motor and Reaction Time Composites in select samples; in contrast, the Verbal and Visual Memory Composites may not be sensitive to clinical change.     

Validation of the FSA as screening tool for children with ADHD

The validity of the Face Stimulus Assessment (FSA) (Betts, 2003) as a tool for screening children with attention-deficit/hyperactivity disorder (ADHD) was investigated. The study subjects were 193 children from first to sixth graders in an elementary school located in Busan city, South Korea. Study analysis using the FSA drawings and Korean-ADHD rating scale (K-ARS) revealed the following results. First, in order to examine the reliability of the FSA assessment items, reliability was verified based on internal consistency while inter- and intra-rater consistencies were calculated. The reliability coefficient of assessment items for each FSA drawing was Cronbach's α = .778, .835 and .831 for the FSA drawing #1, #2 and #3, respectively. Inter-rater consistency of three persons was r = .801–1.00 while intra-rater consistency was r = .830–1.00. Second, in order to investigate the validity of the FSA as a screening tool for children with ADHD, cross tabulation and discriminant analyses were conducted to examine differences in the characteristics of the responses to the FSA drawings between normal children and children with ADHD. According to the analysis results, the common items that showed differences in the FSA drawing #1, #2 and #3 included color fit, logic, realism, developmental level, details of objects and environment, line quality, perseveration, form, and emotional tone. In other words, compared to normal children, Children with ADHD showed a higher tendency to be unable to use colors properly, were illogical and drew a simple face in the lower level of development. In many cases, the subjects drew a face with insufficient detail in the object and the environment and used shaky or wavering lines with repetitive coloring. In regard to the drawing theme, children with ADHD were more inclined to draw something other than a portrait and something that expressed negative emotions such as sorrow, fright, grotesqueness, fear, and anxiety. Among the aforementioned items of FSA assessment, line quality had the highest explanatory power. Discriminant power, which is the ability to predict normal children and children with ADHD based on the assessment items of the FSA drawings, was in the range of 79–81.3%. The drawing #3 showed the highest value of 81.3%.     

护理人员传染病突发事件防控能力问卷编制及信效度检验

目的 编制护理人员传染病突发事件防控能力问卷并检验其信效度。方法 以前期课题组汉化的感染预防协会能力框架为理论基础,通过文献回顾、德尔菲专家函询和预调查形成问卷初稿。采用方便抽样法,2022年6月选取湖北省某三级甲等综合医院303名护理人员作为调查对象,对问卷进行项目分析、探索性因子分析和信度检验;2022年7月另取湖北省3所三级甲等综合医院561名护理人员作为调查对象,对问卷进行验证性因子分析。结果 最终形成的护理人员传染病突发事件防控能力问卷包括临床实践能力、学习与教育能力、领导与管理能力、质量改进与研究能力、职业道德素养5个维度,共35个条目。探索性因子分析提取5个公因子,累计方差贡献率为74.587%;验证性因子分析结果显示,模型拟合良好,问卷因子结构稳定。问卷总体内容效度和各条目内容效度均为1.00。问卷总的Cronbach’s α系数为0.975,分半信度为0.874,重测信度为0.877。结论 护理人员传染病突发事件防控能力问卷信效度良好,可作为评价护理人员传染病突发事件防控能力的工具。     

Measuring anxiety in late life: A psychometric examination of the Geriatric Anxiety Inventory and Geriatric Anxiety Scale

We examined the psychometric properties, internal scale reliability and validity, of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and Geriatric Anxiety Scale (GAS). We also determined the extent to which memory ability influenced the psychometric properties of these measures. Older adult participants (N = 110; M age = 75 years) completed self-report, clinician-rated and diagnostic psychiatric measures and a neuropsychiatric battery. GAI and GAS scores had good internal consistency, adequate reliability, and strong convergent validity. GAI scores had better discriminant validity than GAS scores relative to a health rating. Both measures had strong associations with depression scores. Psychometric properties were decreased in participants with average delayed memory recall compared with those with superior recall. Both measures had good psychometric support, particularly in those with strong memory abilities. Psychometric performance characteristics indicate that the GAI and GAS may be good alternatives to anxiety measures not designed specifically for older adults.