Posts Tagged validity
[Abstract] An investigation into the validity and reliability of mHealth devices for counting steps in chronic stroke survivors
Posted by Kostas Pantremenos in Gait Rehabilitation - Foot Drop, REHABILITATION on February 24, 2020
Abstract
Objective:
To investigate the validity and test–retest reliability of mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra) to estimate the number of steps in individuals after chronic stroke and to compare whether the measurement of the number of steps is affected by their location on the body (paretic and non-paretic side).
Main measures:
The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra), and compared against criterion-standard measure during the Two-Minute Walk Test using habitual speed.
Results:
Our sample was 54.5% men, mean age of 62.5 years (SD 14.9) with a chronicity after stroke of 66.8 months (SD 55.9). There was a statistically significant association between the actual number of steps and those estimated by the Google Fit, STEPZ Iphone and Android applications, Pacer iphone and Android, and Fitbit Ultra (0.30 ⩽ r ⩾ 0.80). The Pacer iphone application demonstrated the highest reliability coefficient (ICC(2,1) = 0.80; P < 0.001). There were no statistically significant differences in device measurements that depended on body location.
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[Abstract] An investigation into the validity and reliability of mHealth devices for counting steps in chronic stroke survivors
Posted by Kostas Pantremenos in Assistive Technology, Gait Rehabilitation - Foot Drop, REHABILITATION on December 22, 2019
Abstract
Objective:
To investigate the validity and test–retest reliability of mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra) to estimate the number of steps in individuals after chronic stroke and to compare whether the measurement of the number of steps is affected by their location on the body (paretic and non-paretic side).
Main measures:
The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra), and compared against criterion-standard measure during the Two-Minute Walk Test using habitual speed.
Results:
Our sample was 54.5% men, mean age of 62.5 years (SD 14.9) with a chronicity after stroke of 66.8 months (SD 55.9). There was a statistically significant association between the actual number of steps and those estimated by the Google Fit, STEPZ Iphone and Android applications, Pacer iphone and Android, and Fitbit Ultra (0.30 ⩽ r ⩾ 0.80). The Pacer iphone application demonstrated the highest reliability coefficient (ICC(2,1) = 0.80; P < 0.001). There were no statistically significant differences in device measurements that depended on body location.
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[Abstract] Development of the modified simple test for evaluating hand function (modified STEF): Construct, reliability, validity, and responsiveness
Posted by Kostas Pantremenos in Paretic Hand on September 15, 2019
Abstract
Study Design
Clinimetric evaluation study.
Introduction
Despite the availability of numerous performance tests to measure finger dexterity, there is no international consensus on hand function evaluation.
Purpose of the Study
To evaluate the reliability, validity, and responsiveness of the modified version of the simple test for evaluating hand function (STEF), which is widely used in Japan.
Methods
The intrarater (n = 40) and inter-rater (n = 32) reliability of the modified STEF was evaluated by calculating the intraclass correlation coefficient (ICC), models (1,1) and (2,1), respectively, in healthy individuals. The criterion validity of the modified STEF (n = 50) was evaluated by calculating the Pearson correlation coefficient relative to the STEF, the Purdue pegboard test (PPT), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The standardized response mean of the scores was calculated to determine responsiveness (n = 35). The modified STEF was used prospectively to measure the change in hand function in a cohort of patients with hand trauma injuries and inflammatory diseases (n = 30), as well as in a cohort of patients with cervical spondylosis (n = 20), from preoperative baseline to 1 and 3 months postoperatively.
Results
ICC1.1 and ICC2.1 values were ≥0.80, indicative of high intrarater and inter-rater reliability. All correlation coefficients were significant (P < .05): STEF (r = 0.89), PPT (r = 0.69), and DASH (r = −0.34). The standardized response mean indicated greater responsiveness of the modified STEF (0.89) than the STEF (0.71) and PPT (0.68) but a lower responsiveness than the DASH (1.11).
Discussion
It must be mentioned that modified STEF and DASH cannot be compared without caution. The two types of tools should complement each other when measuring someone’s activity and participation level.
Conclusions
The modified STEF is a reliable measurement tool, with a moderate positive correlation with the PPT and a greater responsiveness than the STEF and PPT.
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[Abstract] Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool
Posted by Kostas Pantremenos in REHABILITATION on March 10, 2018
Abstract
Purpose: To assess the inter-rater reliability and concurrent validity of the Communication Evaluation in Rehabilitation Tool, which aims to externally assess physiotherapists competency in using Self-Determination Theory-based communication strategies in practice.
Materials and methods: Audio recordings of initial consultations between 24 physiotherapists and 24 patients with chronic low back pain in four hospitals in Ireland were obtained as part of a larger randomised controlled trial. Three raters, all of whom had Ph.Ds in psychology and expertise in motivation and physical activity, independently listened to the 24 audio recordings and completed the 18-item Communication Evaluation in Rehabilitation Tool. Inter-rater reliability between all three raters was assessed using intraclass correlation coefficients. Concurrent validity was assessed using Pearson’s r correlations with a reference standard, the Health Care Climate Questionnaire.
Results: The total score for the Communication Evaluation in Rehabilitation Tool is an average of all 18 items. Total scores demonstrated good inter-rater reliability (Intraclass Correlation Coefficient (ICC) = 0.8) and concurrent validity with the Health Care Climate Questionnaire total score (range: r = 0.7–0.88). Item-level scores of the Communication Evaluation in Rehabilitation Tool identified five items that need improvement.
Conclusion: Results provide preliminary evidence to support future use and testing of the Communication Evaluation in Rehabilitation Tool.
- Implications for Rehabilitation
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Promoting patient autonomy is a learned skill and while interventions exist to train clinicians in these skills there are no tools to assess how well clinicians use these skills when interacting with a patient. The lack of robust assessment has severe implications regarding both the fidelity of clinician training packages and resulting outcomes for promoting patient autonomy.
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This study has developed a novel measurement tool Communication Evaluation in Rehabilitation Tool and a comprehensive user manual to assess how well health care providers use autonomy-supportive communication strategies in real world-clinical settings.
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This tool has demonstrated good inter-rater reliability and concurrent validity in its initial testing phase.
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The Communication Evaluation in Rehabilitation Tool can be used in future studies to assess autonomy-supportive communication and undergo further measurement property testing as per our recommendations.
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[ARTICLE] Development and validation of a novel questionnaire for self-determination of the range of motion of wrist and elbow – Full Text
Posted by Kostas Pantremenos in Paretic Hand on August 3, 2016
Abstract
Background
The aim of this study was to develop and validate a novel self-administered questionnaire for assessing the patient’s own range of motion (ROM) of the wrist and the elbow.
Methods
In a prospective clinical study from January 2015 to June 2015, 101 consecutive patients were evaluated with a novel, self-administered, diagram-based, wrist motion assessment score (W-MAS) and elbow motion assessment score (E-MAS). The questionnaire was statistically evaluated for test-retest reliability, patient-physician agreement, comparison with healthy population, and influence of covariates (age, gender, affected side and involvement in workers’ compensation cases).
Results
Assessment of patient-physician agreement demonstrated almost perfect agreement (k > 0.80) with regard to six out of eight items. There was substantial agreement with regard to two items: elbow extension (k = 0.76) and pronation (k = 0.75). The assessment of the test-retest reliability revealed at least substantial agreement (k = 0.70). The questionnaire revealed a high discriminative power when comparing the healthy population with the study group (p = 0.007 or lower for every item). Age, gender, affected side and involvement in workers’ compensation cases did not in general significantly influence the patient-physician agreement for the questionnaire.
Conclusion
The W-MAS and E-MAS are valid and reliable self-administered questionnaires that provide a high level of patient-physician agreement for the assessments of wrist and elbow ROM.
Level of evidence: Diagnostic study, Level II
Background
Assessing the patient’s outcome and satisfaction is important in modern orthopedic practice [1, 2, 3]. Using questionnaires to evaluate patients with wrist and elbow disorders is widespread and has been shown to be valid and reproducible [4, 5, 6, 7, 8, 9]. Self-reported outcome measures allow outcomes to be assessed from the patient’s perspective and do not require time in clinic or medical staff for data collection.
Common self-administered questionnaires for the determination of hand- and upper limp specific results of the wrist (e.g. patient-rated wrist evaluation, PRWE [8]) and of the elbow (e.g. The American Shoulder and Elbow Surgeons-Elbow, ASES-E [1]) enable the patient to assess the functional impairment of the joint, but they do not formally assess the range of motion, and patients have to attend clinic for this to be measured [10]. Therefore important data regarding the ROM would be lost in patients who are unable or unwilling to come to the outpatient clinic at the regular follow-up or for clinical research.
To our knowledge no validated self-assessment questionnaire for the ROM of the wrist or the elbow exists, which compares the agreement of the patient’s outcome with the examination by a physician.
Therefore, the aim of the current study was to develop a self-administered, diagram-based wrist motion assessment score (W-MAS) and elbow motion assessment score (E-MAS) to enable the patients to assess their own ROM of the wrist and the elbow. We further evaluated validity and reliability of this novel questionnaire with respect to the accuracy of self-determination of the wrist and elbow ROM.
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[ΒΟΟΚ] Chapter 19, The Future Usage and Challenges of Brain Stimulation – PDF
Posted by Kostas Pantremenos in Cognitive Rehabilitation, tDCS/rTMS on February 12, 2015
INTRODUCTION
The current book starts with an overview of the past, by providing a brief history of how transcranial electrical stimulation has been used to enhance cognition and improve health. The rest of the book discusses current knowledge in the field, and provides an excellent overview of different lines of research, such as those in animals, healthy humans, and patients. The aim of this last chapter is to discuss further directions for research in the field of transcranial electrical stimulation (tES).
Over the different chapters it becomes clear that research using tES has demonstrated improvements in different cognitive and non-cognitive functions, ranging from perception and motor movement to attention, working memory, language, and mathematical abilities. These results show that such improvements are not limited to typical populations but can also affect young adults and the elderly, and neurological and psychiatric patients. These results are indeed promising, but suffer from some limitations that have been discussed in various of these chapters, as well as elsewhere (Pascual-Leone, Horvath, & Robertson, 2012; Rothwell, 2012). Some of these limitations include low sample size, artificial tasks with reduced ecological validity, lack of consistency in the montage that led to the enhancement effects, and need for replication. I will not extend the discussion on these points, as they are rather trivial and are not limited to the current field. Instead I will discuss what I perceive as the directions in which the field of tES should, and hopefully will, go. It was difficult deciding which sections to include in this respect, and I have chosen to limit our discussion to 10 sections. I will conclude the chapter with a brief discussion of the challenges that the field is facing.
TBI Rehabilitation 