Using Fitts Law’ to detect intentional misrepresentation

In paralympic classification, tests of impaired coordination (e.g., reciprocal tapping tasks) are effort dependent and therefore susceptible to intentional misrepresentation of abilities (IM)-deliberate exaggeration of impairment severity. The authors investigated whether reciprocal tapping tasks performed submaximally could be differentiated from tapping tasks performed with maximal voluntary effort, based on conformity with Fitts' law. Ten nondisabled participants performed 14 tapping tasks with their dominant hand on 3 separate occasions. Seven tasks were performed with MVE and the other 7 at speeds that were at least 20% slower. Results revealed that evaluating conformity with Fitts' law is a potentially valid method for objectively detecting IM during reciprocal tapping. Evaluation of sensitivity and specificity of the method is now warranted

Classifying motor coordination impairment in Para swimmers with brain injury

© 2018 Sports Medicine Australia Objectives: The International Paralympic Committee has mandated that International Sport Federations develop sport-specific classification systems that are evidence-based. This study examined the predictive and convergent validity of instrumented tapping tasks to classify motor coordination impairments in Para swimming. Design: Cross-sectional. Methods: Thirty non-disabled participants and twenty-one Para swimmers with brain injury completed several instrumented tapping tasks as an assessment of upper and lower limb motor coordination. Para swimmers also completed a maximal freestyle swim to obtain a performance measure. The predictive and convergent validity of instrumented tapping tasks was examined by establishing differences in test measures between participants with and without brain injury and defining the strength of association between test measures and maximal freestyle swim speed in Para swimmers, respectively. Results: Random forest successfully classified 96% of participants with and without brain injury using test measures derived from instrumented tapping tasks. Most test measures had moderate to high correlations (r = 0.54 to 0.72; p < 0.01) with maximal freestyle swim speed and collectively explained up to 72% of the variance in maximal freestyle swim performance in Para swimmers with brain injury. Conclusions: The results of this study evidence the predictive and convergent validity of instrumented tapping tasks to classify motor coordination impairments in Para swimmers with brain injury. These tests can be included in revised Para swimming classification to improve the objectivity and transparency in determining athlete eligibility and sport class for these Para athletes

Using a Delphi process to determine optimal care for patients with pancreatic cancer

Aim Overall 5-year survival for pancreatic cancer is ~5%. Optimising the care that pancreatic cancer patients receive may be one way of improving outcomes. The objective of this study was to establish components of care which Australian health professionals believe important to optimally manage patients with pancreatic cancer. Methods Using a Delphi process, a multi-disciplinary panel of 250 health professionals were invited to provide a list of factors they considered important for optimal care of pancreatic cancer patients. They were then asked to score and then rescore (from one (no importance/disagree) to 10 (very important/agree) the factors. The mean and coefficient of variation scores were calculated and categorised into three levels of importance. Results Overall 63 (66% of those sent the final questionnaire; 25% of those initially invited) health professionals from 9 disciplines completed the final scoring of 55 statements/factors encompassing themes of presentation/staging, surgery and biliary obstruction, multi-disciplinary team details and oncology. Mean scores ranged from 3.7 to 9.7 with the highest related to communication and patient assessment. There was substantial intra- and inter- disciplinary variation in views about MDT membership and roles. Conclusion Overall the opinions of Australian health professionals reflect international guideline recommended care; however they identified a number of additional factors focusing on where patients should be treated, the importance of clear communication and the need for multi-disciplinary care which were not included in current clinical practice guidelines. Differences in priorities between specialty groups were also identified

Maximal and sub-maximal movement times for a reciprocal tapping task, and associated Fitts' law data.

Spreadsheet which provides the mean maximal and sub-maximal movement times (in seconds) to perform a reciprocal tapping task across seven indexes of difficulty (IDs). This task was performed by 10 non-disabled participants, and the spreadsheet provides details of their age and gender. For details about how the IDs were calculated please see the associated publication.&nbsp;In addition to the movement time data, the spreadsheet also gives the calculations of the two main Fitts' law parameters that were measured: R2 (linearity) and the difference between the fastest and slowest movement time for the four equivalent IDs (ID 3.6). The equivalent IDs had the same difficulty (ID = 3.6), but different combinations of target width and amplitude (details of these are provided within the publication).&nbsp

Developing tests of impaired coordination for Paralympic classification: normative values and test–retest reliability

Current methods of assessing coordination in Paralympic classification are non-instrumented and are based on ordinal scales of measurement and therefore impede the development of evidence-based methods of classification. This paper describes an instrumented battery of tests that measure impaired coordination in a way that will permit evidence-based classification. Test–retest reliability and normative values for each of the tests are reported. Twenty participants visited the laboratory on two occasions, each time completing 11 tests: three running-specific, lower-limb reciprocal tapping tests (yielding five outcome measures); four throwing-specific, upper-limb discrete tapping tests (yielding four outcome measures); and four wheelchair-specific, upper-limb reciprocal tapping tests yielding seven outcome measures. Reliability was evaluated using Intra-class Correlation Coefficients (ICCs), Standard Error of Measurement, Limits of Agreement and Paired t-tests. ICCs for fourteen of the 16 outcome measures were excellent (ICC ≥ 0.80), although systematic bias was evident in two of these—a unilateral, running-specific lower-limb tests on the non-dominant side, and a unilateral wheelchair-specific upper limb test on the dominant side. ICCs for two tests—a bilateral wheelchair-specific upper limb test (0.74), and a unilateral wheelchair-specific upper limb test on the non-dominant side (0.54)—were good and fair respectively. Results indicate that 12 of the measures evaluated have measurement properties that will facilitate the development of evidence-based methods of Paralympic classification in athletics. Positional adjustment and increased familiarization may improve reliability in the other four. Studies evaluating reliability of this test battery in people with coordination impairments are warranted

How much do range of movement and coordination affect paralympic sprint performance?

Introduction: Development of evidence-based methods of paralympic classification requires research quantifying the relative strength of association between ratio-scaled measures of impairment and sports performance. To date, no such research has been conducted. The purpose of this study was to quantify the extent to which range of movement (ROM) and coordination affect running performance in runners with and without brain impairment. Methods: Participants were 41 male runners, 13 with brain impairments (RBI) and 28 nondisabled (NDR). All participants completed a maximal 60-m sprint as well as a novel battery of five lower limb ROM tests and three lower limb coordination tests. Results: In the coordination tests, RBI showed significantly slower mean movement times compared to NDR on all measures (e.g., 0.54 s ± 0.12 s vs 0.34 s ± 0.05 s). Runners with brain impairments had significantly lower range of movement on five of ten measures (e.g., 25.9° ± 5.4° vs 37.0° ± 6.0°) and had significantly slower acceleration (0–15 m) (3.2 s ± 0.3 s vs 2.8 s ± 0.2 s) and top speed (30–60 m) (4.3 s ± 0.6 s vs 3.8 s ± 0.3 s). Five ROM measures significantly correlated with sprint performance in RBI and did not significantly correlate with sprint performance in NDR, satisfying convergent and divergent validity criteria. These individual tests explained 38% to 58% of the variance in sprint performance in RBI. Conclusion: This is the first study to quantify the extent to which eligible impairments affect performance in a paralympic sport. Five of the ROM measures significantly affected sprint performance in RBI and were deemed valid for the purposes of classifying impairments in classes T35–T38. This study is an important methodological step toward development of evidence-based methods of classifying impairments in classes T35–T38 and provides practical methodological guidance to researchers in this field

How Much Do Range of Movement and Coordination Affect Paralympic Sprint Performance?

Introduction: Development of evidence-based methods of paralympic classification requires research quantifying the relative strength of association between ratio-scaled measures of impairment and sports performance. To date, no such research has been conducted. The purpose of this study was to quantify the extent to which range of movement (ROM) and coordination affect running performance in runners with and without brain impairment. Methods: Participants were 41 male runners, 13 with brain impairments (RBI) and 28 nondisabled (NDR). All participants completed a maximal 60-m sprint as well as a novel battery of five lower limb ROM tests and three lower limb coordination tests. Results: In the coordination tests, RBI showed significantly slower mean movement times compared to NDR on all measures (e.g., 0.54 s ± 0.12 s vs 0.34 s ± 0.05 s). Runners with brain impairments had significantly lower range of movement on five of ten measures (e.g., 25.9° ± 5.4° vs 37.0° ± 6.0°) and had significantly slower acceleration (0–15 m) (3.2 s ± 0.3 s vs 2.8 s ± 0.2 s) and top speed (30–60 m) (4.3 s ± 0.6 s vs 3.8 s ± 0.3 s). Five ROM measures significantly correlated with sprint performance in RBI and did not significantly correlate with sprint performance in NDR, satisfying convergent and divergent validity criteria. These individual tests explained 38% to 58% of the variance in sprint performance in RBI. Conclusion: This is the first study to quantify the extent to which eligible impairments affect performance in a paralympic sport. Five of the ROM measures significantly affected sprint performance in RBI and were deemed valid for the purposes of classifying impairments in classes T35–T38. This study is an important methodological step toward development of evidence-based methods of classifying impairments in classes T35–T38 and provides practical methodological guidance to researchers in this field