Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy : an intra- and interrater reliability and validity study

Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC) were calculated. To measure reliability of MMT linear Cohen`s Kappa was computed for single muscle groups and ICC for total score. Additionally, correlations between MMT8 and HHD were evaluated with Spearman Correlation Coefficients. Fifty people with myositis (56±14 years, 76% female) were included in the study. Intra-and interrater reliability of HHD yielded excellent ICCs (0.75-0.97) for all muscle groups, except for interrater reliability of ankle extension (0.61). The corresponding SEMs% ranged from 8 to 28% and the SDCs% from 23 to 65%. MMT8 total score revealed excellent intra-and interrater reliability (ICC>0.9). Intrarater reliability of single muscle groups was substantial for shoulder and hip abduction, elbow and neck flexion, and hip extension (0.64-0.69); moderate for wrist (0.53) and knee extension (0.49) and fair for ankle extension (0.35). Interrater reliability was moderate for neck flexion (0.54) and hip abduction (0.44); fair for shoulder abduction, elbow flexion, wrist and ankle extension (0.20-0.33); and slight for knee extension (0.08). Correlations between the two tests were low for wrist, knee, ankle, and hip extension; moderate for elbow flexion, neck flexion and hip abduction; and good for shoulder abduction. In conclusion, the MMT8 total score is a reliable assessment to consider general muscle weakness in people with myositis but not for single muscle groups. In contrast, our results confirm that HHD can be recommended to evaluate strength of single muscle groups

Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study

Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC) were calculated. To measure reliability of MMT linear Cohen`s Kappa was computed for single muscle groups and ICC for total score. Additionally, correlations between MMT8 and HHD were evaluated with Spearman Correlation Coefficients. Fifty people with myositis (56±14 years, 76% female) were included in the study. Intra-and interrater reliability of HHD yielded excellent ICCs (0.75-0.97) for all muscle groups, except for interrater reliability of ankle extension (0.61). The corresponding SEMs% ranged from 8 to 28% and the SDCs% from 23 to 65%. MMT8 total score revealed excellent intra-and interrater reliability (ICC>0.9). Intrarater reliability of single muscle groups was substantial for shoulder and hip abduction, elbow and neck flexion, and hip extension (0.64-0.69); moderate for wrist (0.53) and knee extension (0.49) and fair for ankle extension (0.35). Interrater reliability was moderate for neck flexion (0.54) and hip abduction (0.44); fair for shoulder abduction, elbow flexion, wrist and ankle extension (0.20-0.33); and slight for knee extension (0.08). Correlations between the two tests were low for wrist, knee, ankle, and hip extension; moderate for elbow flexion, neck flexion and hip abduction; and good for shoulder abduction. In conclusion, the MMT8 total score is a reliable assessment to consider general muscle weakness in people with myositis but not for single muscle groups. In contrast, our results confirm that HHD can be recommended to evaluate strength of single muscle groups

Personalarbeit in der Industrie 4.0: Einführung einer digitalen Personalakte in der Zimmer Group

Die vorliegende Thesis thematisiert die aufkommenden Herausforderungen, welche sich für die Personalarbeit im Zuge der Einführung von Industrie 4.0 ergeben werden. Neue Technologien werden definiert und in Gartner’s Hype Cycle eingeordnet, um sie auf ihre Realisierbarkeit in der Praxis hin zu untersuchen. Zudem werden Grenzen der Einsatzmöglichkeiten dieser Technologien ausgewertet. Anschließend erläutert der Praxisteil die aktuelle Situation hinsichtlich des Standes der Industrie 4.0 und der Digitalisierung in der Personalabteilung der Zimmer Group. Des Weiteren werden die Projektphasen, welche sich auf die Einführung einer digitalen Personalakte beziehen, aufgeführt sowie analysiert, ob die Einführung einer digitalen Personalakte eine sinnvolle Investition für die Zimmer Group darstellt. In welcher Weise neue Technologien zukünftig in der Personalabteilung gewinnbringend eingesetzt werden können, wird abschießend dargestellt.This thesis is about the occurring challenges for the Human Resource Department which will come up with the introduction of “Industrie 4.0”. New technologies will be defined and classified on Gartner’s hype cycle, to show if using them in daily operation will be realistic in the near future. Moreover, the limitations of adopting these technologies will be evaluated. In the practical part of this thesis the current situation concerning “Industrie 4.0” and digitalization in the Human Resource department of Zimmer Group will be described. The project of implementing a software for digitalized personnel files is described and it will be analyzed if it can be an appropriate investment for Zimmer Group. Finally, assumptions about how new technologies can be used in the future to create an innovative Human Resource Management will be made

Muscle strength measured by hand-held dynamometry (in Newton) and MMT8 (MMT-Scale).

<p>The association between results from MMT8 and HHD are not consistent.</p

Kendall 10-point scale.

<p>Kendall 10-point scale.</p

MMT8 single muscle groups at M1, M2, M3 plus intra- and interrater Kappa values (N = 46).

<p>MMT8 single muscle groups at M1, M2, M3 plus intra- and interrater Kappa values (N = 46).</p

Sample selection.

<p>From 76 people with myositis fulfilling all inclusion criteria 50 agreed to participate. After the first measurement four participants dropped out.</p

Measuring knee extension using a belt to stabilize the dynamometer.

<p>Standard body position of the patient and the device are shown with knees and hips flexed to 90°.</p

Correlations (Spearman`s rho) between peak force (averaged and normalized) and MMT8 (N = 50).

<p>Correlations (Spearman`s rho) between peak force (averaged and normalized) and MMT8 (N = 50).</p

Ceiling effects of MMT8.

<p>All but one muscle group (hip extension) showed ceiling effects of 22 to 82%. Abbreviations: A_EXT: ankle extension, E_FLEX: elbow flexion, W_EXT: wrist extension, K_EXT: knee extension, N_FLEX: neck flexion, S_ABD: shoulder abduction, H_ABD: hip abduction, H_EXT: hip extension.</p