Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing

Background In clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM). Methods Two raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements. Findings Intra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886–0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71–0.87) and the IMC methods (ICCs 0.61–0.993) and (almost) perfect in the TM methods (ICCs 0.923–0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9–3.3° for the DI methods and 0.5–1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5–1.3cm for the TM methods and 0.6–2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41–0.81). Interpretation Measurement repetitions of either one or multiple trained raters can be considered reliable in all three devices

Semimembranosus muscle displacement is associated with movement of the superficial fascia: an in vivo ultrasound investigation

The deep fascia enveloping the skeletal muscle has been shown to contribute to the mechanics of the locomotor system. However, less is known about the role of the superficial fascia (SF). This study aimed to describe the potential interaction between the Hamstring muscles and the SF. Local movement of the dorsal thigh's soft tissue was imposed making use of myofascial force transmission effects across the knee joint: In eleven healthy individuals (26.8 ± 4.3 years, six males), an isokinetic dynamometer moved the ankle into maximal passive dorsal extension (knee extended). Due to the morphological continuity between the gastrocnemius and the Hamstrings, stretching the calf led to soft tissue displacements in the dorsal thigh. Ultrasound recordings were made to dynamically visualize (a) the semimembranosus muscle and (b) the superficial fascia. Differences in and associations between horizontal movement amplitudes of the two structures, quantified via cross‐correlation analyses, were calculated by means of the Mann–Whitney U test and Kendal's tau test, respectively. Mean horizontal movement was significantly higher in the muscle (5.70 mm) than in the SF (0.72 mm, p < 0.001, r = 0.82). However, a strong correlation between the tissue displacements in both locations was detected (p < 0.001, r = 0.91). Direct mechanical relationship may exist between the SF and the skeletal muscle. Deep pathologies or altered muscle stiffness could thus have long‐term consequences for rather superficial structures and vice versa

The relationship between acute exercise-induced changes in extramuscular connective tissue thickness and delayed onset muscle soreness in healthy participants: A randomized controlled crossover trial

Background The extramuscular connective tissue (ECT) has been shown to play a significant role in mechanical force transmission between musculoskeletal structures. Due to this and owing to its tight connection with the underlying muscle, the ECT may be vulnerable to excessive loading. The present study aimed to investigate the effect of eccentric elbow flexor exercise on the morphology of the biceps brachii ECT. In view of the high nociceptive capacity of the ECT, an additional objective was to elucidate the potential relationship between ECT damage and the occurrence of delayed onset muscle soreness (DOMS). Methods Eleven healthy participants (♂ = 7; 24 ± 2 years) performed fatiguing dumbbell elbow flexor eccentric exercise (EE) for one arm and concentric exercise (CE) for the other arm in random order and with random arm allocation. Before, immediately after and 24–96 h post-exercise, maximal voluntary isometric contraction torque of the elbow flexors (dynamometer), pressure pain (algometer), palpation pain (100 mm visual analog scale), biceps brachii ECT thickness and ECT/muscle mobility during passive movement (both high-resolution ultrasound) were examined. Results Palpation pain, suggestive of DOMS, was greater after EE than CE, and maximal voluntary isometric contraction torque decreased greater after EE than CE (p \u3c .05). Relative to CE, EE increased ECT thickness at 48 (+ 17%), 72 (+ 14%) and 96 (+ 15%) hours post-exercise (p \u3c .05). At 96 h post-EE, the increase in ECT thickness correlated with palpation pain (r = .68; p \u3c .05). ECT mobility was not different between conditions, but compared to CE, muscle displacement increased at 24 (+ 31%), 72 (+ 31%) and 96 (+ 41%) hours post-EE (p \u3c .05). Conclusion Collectively, these results suggest an involvement of the ECT changes in delayed onset muscle soreness

Semimembranosus muscle displacement is associated with movement of the superficial fascia: An in vivo ultrasound investigation

The deep fascia enveloping the skeletal muscle has been shown to contribute to the mechanics of the locomotor system. However, less is known about the role of the superficial fascia (SF). This study aimed to describe the potential interaction between the Hamstring muscles and the SF. Local movement of the dorsal thigh's soft tissue was imposed making use of myofascial force transmission effects across the knee joint: In eleven healthy individuals (26.8 ± 4.3 years, six males), an isokinetic dynamometer moved the ankle into maximal passive dorsal extension (knee extended). Due to the morphological continuity between the gastrocnemius and the Hamstrings, stretching the calf led to soft tissue displacements in the dorsal thigh. Ultrasound recordings were made to dynamically visualize (a) the semimembranosus muscle and (b) the superficial fascia. Differences in and associations between horizontal movement amplitudes of the two structures, quantified via cross‐correlation analyses, were calculated by means of the Mann–Whitney U test and Kendal's tau test, respectively. Mean horizontal movement was significantly higher in the muscle (5.70 mm) than in the SF (0.72 mm, p < 0.001, r = 0.82). However, a strong correlation between the tissue displacements in both locations was detected (p < 0.001, r = 0.91). Direct mechanical relationship may exist between the SF and the skeletal muscle. Deep pathologies or altered muscle stiffness could thus have long‐term consequences for rather superficial structures and vice versa

Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing.

BackgroundIn clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM).MethodsTwo raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements.FindingsIntra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886-0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71-0.87) and the IMC methods (ICCs 0.61-0.993) and (almost) perfect in the TM methods (ICCs 0.923-0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9-3.3° for the DI methods and 0.5-1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5-1.3cm for the TM methods and 0.6-2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41-0.81).InterpretationMeasurement repetitions of either one or multiple trained raters can be considered reliable in all three devices