Validity and intra-rater reliability of an Android phone application to measure cervical range-of-motion

Concurrent validity and intra-rater reliability using a customized Android phone application to measure cervical-spine range-of-motion (ROM) has not been previously validated against a gold-standard three-dimensional motion analysis (3DMA) system

Anthropometric indices as screening tools for cardiovascular risk factors in Singaporean women

Previous studies have suggested the need to revise the World Health Organization (WHO) cut-off values for the various indices of obesity and fat distribution in Singapore. The purpose of this study was to delineate cut-off points of body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), and waist-stature ratio (WSR) as screening tools for cardiovascular risk factors in Singaporean women. Anthropometric indices were measured in a cross sectional survey of 566 subjects (60% Chinese individuals, 28% Malay individuals and 12% Indian individuals). Cardiovascular risk factors were determined by measuring blood pressure, serum lipids, and fasting blood glucose levels. Receiver Operating Characteristic (ROC) curves were constructed to determine cut-off points. Forward logistic regression and area under curves (AUC) were used to determine the best anthropometric index. For at least one cardiovascular risk factor (hypertension, dyslipidaemia and diabetes mellitus), the cut-off points for BMI, WHR, WC and WSR were around 23.6kg/m 2 , 0.80, 77.8cm and 0.48 for Singaporean females. The AUC of WSR was the highest for all three risk factors in females (0.79 for hypertension, 0.70 for dyslipidaemia, 0.88 for diabetes mellitus). Regression analyses revealed that WSR was independently associated with all risk factors. For Singaporean female adults, the cut-off points were lower than the criteria suggested by the WHO, but were in agreement with those reported for Asians. BMI, WHR, WC and WSR may be used as screening tools for cardiovascular risk factors, of which WSR may be the best anthropometric index

The reliability of a maximal isometric hip strength and simultaneous surface EMG screening protocol in elite, junior rugby league athletes

Objectives Firstly to describe the reliability of assessing maximal isometric strength of the hip abductor and adductor musculature using a hand held dynamometry (HHD) protocol with simultaneous wireless surface electromyographic (sEMG) evaluation of the gluteus medius (GM) and adductor longus (AL). Secondly, to describe the correlation between isometric strength recorded with the HHD protocol and a laboratory standard isokinetic device. Design Reliability and correlational study. Methods A sample of 24 elite, male, junior, rugby league athletes, age 16–20 years participated in repeated HHD and isometric Kin-Com (KC) strength testing with simultaneous sEMG assessment, on average (range) 6 (5–7) days apart by a single assessor. Strength tests included; unilateral hip abduction (ABD) and adduction (ADD) and bilateral ADD assessed with squeeze (SQ) tests in 0 and 45° of hip flexion. Results HHD demonstrated good to excellent inter-session reliability for all outcome measures (ICC\ua0=\ua00.76–0.91) and good to excellent association with the laboratory reference KC (ICC\ua0=\ua00.80–0.88). Whilst intra-session, inter-trial reliability of EMG activation and co-activation outcome measures ranged from moderate to excellent (ICC\ua0=\ua00.70–0.94), inter-session reliability was poor (all ICC\ua

Efficacy of a multimodal physiotherapy treatment program for hip osteoarthritis: a randomised placebo-controlled trial protocol

<p>Abstract</p> <p>Background</p> <p>Hip osteoarthritis (OA) is a common condition leading to pain, disability and reduced quality of life. There is currently limited evidence to support the use of conservative, non-pharmacological treatments for hip OA. Exercise and manual therapy have both shown promise and are typically used together by physiotherapists to manage painful hip OA. The aim of this randomised controlled trial is to compare the efficacy of a physiotherapy treatment program with placebo treatment in reducing pain and improving physical function.</p> <p>Methods</p> <p>The trial will be conducted at the University of Melbourne Centre for Health, Exercise and Sports Medicine. 128 participants with hip pain greater or equal to 40/100 on visual analogue scale (VAS) and evidence of OA on x-ray will be recruited. Treatment will be provided by eight community physiotherapists in the Melbourne metropolitan region. The active physiotherapy treatment will comprise a semi-structured program of manual therapy and exercise plus education and advice. The placebo treatment will consist of sham ultrasound and the application of non-therapeutic gel. The participants and the study assessor will be blinded to the treatment allocation. Primary outcomes will be pain measured by VAS and physical function recorded on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) immediately after the 12 week intervention. Participants will also be followed up at 36 weeks post baseline.</p> <p>Conclusions</p> <p>The trial design has important strengths of reproducibility and reflecting contemporary physiotherapy practice. The findings from this randomised trial will provide evidence for the efficacy of a physiotherapy program for painful hip OA.</p> <p>Trial Registration</p> <p>Australian New Zealand Clinical Trials Registry reference: ACTRN12610000439044</p

Morphology of knee extension torque-time curves following anterior cruciate ligament injury and reconstruction

Background: Mechanical instability, neurosensory deficits, and/or modified coactivation strategies following anterior cruciate ligament injury and surgery might compromise the ability of the knee extensors to exert a precise force during isokinetic knee extension with maximal effort. The purpose of this study was to examine the effects of an anterior cruciate ligament deficiency and reconstruction on knee extensor torque-time curve smoothness and to elucidate its association with hamstring (antagonist) activation and physical performance. Methods: Thirteen subjects who had a unilateral deficiency of the anterior cruciate ligament, twenty-five matched subjects with a unilateral reconstructed anterior cruciate ligament, and thirty-three control subjects performed knee extension and flexion repetitions bilaterally with maximal effort at 180[degrees]/sec on a Cybex dynamometer. For the subjects with a deficient or a reconstructed anterior cruciate ligament, hamstring activation was measured electromyographically. Physical performance was measured by requiring subjects to perform single-limb timed hopping on the involved limb. Results: In the subjects with a reconstructed or a deficient anterior cruciate ligament, wavelet-derived mean instantaneous frequency of the extensor torque-time curves was significantly (p < 0.001) higher in the involved limb than in the noninvolved limb and the limbs of the control subjects. Furthermore, for the subjects with a reconstructed or deficient anterior cruciate ligament, the mean instantaneous frequency of the extensor torque-time curves was positively associated with the level of hamstring antagonist activity (r = 0.580, p < 0.001) and with hopping performance (b = -0.943, p = 0.019), whereas isokinetic peak torque was not (b = -0.001, p = 0.797). Conclusions: For individuals who have a deficient or a reconstructed anterior cruciate ligament, an increased frequency content of the knee extensor torque is not, as previously and commonly assumed, a deleterious manifestation of the neuromuscular system. Rather, our results suggest that torque smoothness reduces as hamstring activation increases-a positive neuromuscular adaptation that enhances joint stability and, hence, optimizes physical performance. Wavelet-derived measures of extensor torque smoothness may provide valuable clinical information regarding joint function that conventional isokinetic torque measures cannot

Reliability and concurrent validity of a smartphone, bubble inclinometer and motion analysis system for measurement of hip joint range of motion

Objectives: Traditional methods of assessing joint range of motion (ROM) involve specialized tools that may not be widely available to clinicians. This study assesses the reliability and validity of a custom Smartphone application for assessing hip joint range of motion. Design:Intra-tester reliability with concurrent validity. Methods: Passive hip joint range of motion was recorded for seven different movements in 20 males on two separate occasions. Data from a Smartphone, bubble inclinometer and a three dimensional motion analysis (3DMA) system were collected simultaneously. Intraclass correlation coefficients (ICCs), coefficients of variation (CV) and standard error of measurement (SEM) were used to assess reliability. To assess validity of the Smartphone application and the bubble inclinometer against the three dimensional motion analysis system, intraclass correlation coefficients and fixed and proportional biases were used. Results: The Smartphone demonstrated good to excellent reliability (ICCs > 0.75) for four out of the seven movements, and moderate to good reliability for the remaining three movements (ICC = 0.63–0.68). Additionally, the Smartphone application displayed comparable reliability to the bubble inclinometer. The Smartphone application displayed excellent validity when compared to the three dimensional motion analysis system for all movements (ICCs > 0.88) except one, which displayed moderate to good validity (ICC = 0.71). Conclusions: Smartphones are portable and widely available tools that are mostly reliable and valid for assessing passive hip range of motion, with potential for large-scale use when a bubble inclinometer is not available. However, caution must be taken in its implementation as some movement axes demonstrated only moderate reliability

Validity of the Microsoft Kinect for providing lateral trunk lean feedback during gait retraining

Gait retraining programs are prescribed to assist in the rehabilitation process of many clinical conditions. Using lateral trunk lean modification as the model, the aim of this study was to assess the concurrent validity of kinematic data recorded using a marker-based 3D motion analysis (3DMA) system and a low-cost alternative, the Microsoft Kinect™ (Kinect), during a gait retraining session. Twenty healthy adults were trained to modify their gait to obtain a lateral trunk lean angle of 10°. Real-time biofeedback of the lateral trunk lean angle was provided on a computer screen in front of the subject using data extracted from the Kinect skeletal tracking algorithm. Marker coordinate data were concurrently recorded using the 3DMA system, and the similarity and equivalency of the trunk lean angle data from each system were compared. The lateral trunk lean angle data obtained from the Kinect system without any form of calibration resulted in errors of a high (>2°) magnitude (mean error = 3.2 ± 2.2°). Performing global and individualized calibration significantly (P < 0.001) improved this error to 1.7 ± 1.5° and 0.8 ± 0.8° respectively. With the addition of a simple calibration the anatomical position coordinates of the Kinect can be used to create a real-time biofeedback system for gait retraining. Given that this system is low-cost, portable and does not require any sensors to be attached to the body, it could provide numerous advantages when compared to laboratory-based gait retraining systems

Evaluation of the Wii Balance Board for Walking Aids Prediction: Proof-of-Concept Study in Total Knee Arthroplasty

<div><p>Background and Objectives</p><p>To provide proof-of-concept for the validity of the Wii Balance Board (WBB) measures to predict the type of walking aids required by inpatients with a recent (≤4days) total knee arthroplasty (TKA).</p><p>Methods</p><p>A cross-sectional sample of 89 inpatients (mean age, 67.0±8years) with TKA was analyzed. A multivariable proportional odds prediction model was constructed using 8 pre-specified predictors – namely, age, sex, body mass index, knee pain, knee range-of-motion, active knee lag, and WBB-derived standing balance. The type of walking aids prescribed on day 4 post-surgery was the outcome of interest – an ordinal variable with 4 categories (walking stick, narrow- and broad-base quadstick, and walking frame).</p><p>Results</p><p>Women, increasing body mass index, and poorer standing balance were independently associated with greater odds for requiring walking aids with a larger base-of-support. The concordance-index of the prediction model was 0.74. The model comprising only WBB-derived standing balance had nearly half (44%) the explanatory power of the full model. Adding WBB-derived standing balance to conventional demographic and knee variables resulted in a continuous net reclassification index of 0.60 (95%CI,0.19-1.01), predominantly due to better identification of patients who required walking aids with a large base-of-support (sensitivity gain).</p><p>Conclusions</p><p>The WBB was able to provide quantitative measures of standing balance which could assist healthcare professionals in prescribing the appropriate type of walking aids for patients. Further investigation is needed to assess whether using the WBB could lead to meaningful changes in clinical outcomes such as falls.</p></div