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Jeffrey B. Driban, Nicole Cattano, Easwaran Balasubramanian, Michael R. Sitler, Mamta Amin, Joseph Glutting and Mary F. Barbe

Context: To better understand why a knee develops osteoarthritis after joint trauma we need to assess the local biochemical changes. Unfortunately, it is challenging to obtain synovial fluid from a knee with no effusion. Objective: To describe the authors' protocol for aspirating synovial fluid from noneffused knees. Second, they demonstrate the validity of this method by evaluating the relationships between normalized and raw biomarker concentrations among knees with effusion (undergoing a traditional aspiration) and without effusion (requiring a saline-assisted aspiration). Design: Validation study based on secondary analyses from 2 cohort studies. Setting: Outpatient orthopedic clinic and basic-science laboratory. Participants: Participants had moderate to severe radiographic knee osteoarthritis (n = 15 with and 11 without effusion) and no osteoarthritis or effusion (n = 4). Interventions: The same orthopedic surgeon performed all synovial-fluid joint aspirations, including saline-assisted aspirations. Main Outcome Measures: The authors used multiplex enzyme-linked immunosorbent assays to determine 7 synovial-fluid biomarker concentrations. They then calculated correlations between raw and normalized (to total synovial-fluid protein content) biomarker concentrations. Results: The authors excluded 1 sample collected with a saline-assisted aspiration because it contained blood. Normalized biomarker concentrations had positive associations with raw biomarker concentrations (r = .77-99), with the exception of interleukin-13 and interleukin-1Β among knees that underwent a saline-assisted aspiration. Excluding interleukin-1Β, associations between normalized and raw biomarker concentrations were consistent between knees that had a saline-assisted or traditional aspiration. Conclusions:Saline-assisted aspiration is a valid technique for assessing the local biochemical changes in knees without effusion.

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Sofiya Alhassan, John R. Sirard, Laura B. F. Kurdziel, Samantha Merrigan, Cory Greever and Rebecca M. C. Spencer


The purpose of this study was to cross-validate previously developed Actiwatch (AW; Ekblom et al. 2012) and AcitGraph (AG; Sirard et al. 2005; AG-P, Pate et al. 2006) cut-point equations to categorize free-living physical activity (PA) of preschoolers using direct observation (DO) as the criterion measure. A secondary aim was to compare output from the AW and the AG from previously developed equations.


Participants’ (n = 33; age = 4.4 ± 0.8 yrs; females, n=12) PA was directly observed for three 10-min periods during the preschool-day while wearing the AW (nondominant wrist) and AG (waist). Device specific cut-points were used to reduce the AW-E (Ekblom et al. 2012) and AG (AG-S, Sirard et al. 2005; AG-P, Pate et al. 2006) data into intensity categories. Spearman correlations (rsp) and agreement statistics were used to assess associations between the DO intensity categories and device data. Mixed model regression was used to identify differences in times spent in activity intensity categories.


There was a significant correlation between AW and AG output across all data (rsp = 0.41, p < .0001) and both were associated with the DO intensity categories (AW: rsp = 0.47, AG: rsp = 0.47; p < .001). At the individual level, all devices demonstrated relatively low sensitivity but higher specificity. At the group level, AW-E and AG-P provided similar estimates of time spent in moderate-to-vigorous PA (MVPA, AW-E: 4.7 ± 4.1, AG-P: 4.4 ± 3.3), compared with DO (5.1 ± 3.5). Conclusion: The AW-E and AG-P estimated times spent in MVPA were similar to DO, but the weak agreement statistics indicate that neither device cut-point equations provided accurate estimates at the individual level.

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Gregg Afman, Richard M. Garside, Neal Dinan, Nicholas Gant, James A. Betts and Clyde Williams

Current recommendations for nutritional interventions in basketball are largely extrapolated from laboratory-based studies that are not sport-specific. We therefore adapted and validated a basketball simulation test relative to competitive basketball games using well-trained basketball players (n = 10), then employed this test to evaluate the effects of two common preexercise nutritional interventions on basketball-specific physical and skilled performance. Specifically, in a randomized and counterbalanced order, participants ingested solutions providing either 75 g carbohydrate (sucrose) 45 min before exercise (Study A; n = 10) or 2 × 0.2 g·kg−1 sodium bicarbonate (NaHCO3) 90 and 20 min before exercise (Study B; n = 7), each relative to appropriate placebos (H2O and 2 × 0.14 g·kg−1 NaCl, respectively). Heart rate, sweat rate, pedometer count, and perceived exertion did not systematically differ between the 60-min basketball simulation test and competitive basketball, with a strong positive correlation in heart rate response (r = .9, p < .001). Preexercise carbohydrate ingestion resulted in marked hypoglycemia (< 3.5 mmol·l−1) throughout the first quarter, coincident with impaired sprinting (+0.08 ± 0.05 second; p = .01) and layup shooting performance (8.5/11 versus 10.3/11 baskets; p < .01). However, ingestion of either carbohydrate or sodium bicarbonate before exercise offset fatigue such that sprinting performance was maintained into the final quarter relative to placebo (Study A: –0.07 ± 0.04 second; p < .01 and Study B: -0.08 ± 0.05 second; p = .02), although neither translated into improved skilled (layup shooting) performance. This basketball simulation test provides a valid reflection of physiological demands in competitive basketball and is sufficiently sensitive to detect meaningful changes in physical and skilled performance. While there are benefits of preexercise carbohydrate or sodium bicarbonate ingestion, these should be balanced against potential negative side effects.

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Maria Hagströmer, Barbara E. Ainsworth, Lydia Kwak and Heather R. Bowles


The quality of methodological papers assessing physical activity instruments depends upon the rigor of a study’s design.


We present a checklist to assess key criteria for instrument validation studies.


A Medline/PubMed search was performed to identify guidelines for evaluating the methodological quality of instrument validation studies. Based upon the literature, a pilot version of a checklist was developed consisting of 21 items with 3 subscales: 1) quality of the reported data (9 items: assess whether the reported information is sufficient to make an unbiased assessment of the findings); 2) external validity of the results (3 items: assess the extent to which the findings are generalizable); 3) internal validity of the study (9 items: assess the rigor of the study design). The checklist was tested for interrater reliability and feasibility with 6 raters.


Raters viewed the checklist as helpful for reviewing studies. They suggested minor wording changes for 8 items to clarify intent. One item was divided into 2 items for a total of 22 items.


Checklists may be useful to assess the quality of studies designed to validate physical activity instruments. Future research should test checklist internal consistency, test-retest reliability, and criterion validity.

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Sarah Danthony, Nicolas Mascret and François Cury

during PE tests has not been specifically studied, and no measure of test anxiety in PE has been available. The aim of the present research is to develop and validate a scale to specifically assess test anxiety in PE. Assessing Test Anxiety Perception of examinations and other assessment situations as

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Dany Lafontaine and Mario Lamontagne

Many human activities, particularly sporting skills, occur over large distances. But technical limitations have forced biomechanists to conduct studies only on portions of such skills. In this paper we present the design and validation of a mobile data collection system composed of a camera cart that allows the tracking of athletes along a larger portion of their movements. A key feature of this system is that it requires only a small field of view to record and analyze joint motions. The validation of this method was conducted with three approaches. For all approaches, intermarker distances obtained from real measures were compared to those obtained from digitized video data. In all three experiments, the results proved to be within the accepted error range of 5%. The net differences between measured values and digitized values ranged from 0.8 to 3 mm, while the relative errors ranged from 0.2 to 6%. This first experimentation using a mobile camera array to collect and reconstruct biomechanical data has proven to be valid and worth pursuing for recording and analyzing ice hockey skating.

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Faisal Awad Barwais, Thomas F. Cuddihy, Tracy Washington, L. Michaud Tomson and Eric Brymer


Low levels of physical activity and high levels of sedentary behavior (SB) are major public health concerns. This study was designed to develop and validate the 7-day Sedentary (S) and Light Intensity Physical Activity (LIPA) Log (7-day SLIPA Log), a self-report measure of specific daily behaviors.


To develop the log, 62 specific SB and LIPA behaviors were chosen from the Compendium of Physical Activities. Face-to-face interviews were conducted with 32 sedentary volunteers to identify domains and behaviors of SB and LIPA. To validate the log, a further 22 sedentary adults were recruited to wear the GT3x for 7 consecutive days and nights.


Pearson correlations (r) between the 7-day SLIPA Log and GT3x were significant for sedentary (r = .86, P < .001), for LIPA (r = .80, P < .001). Lying and sitting postures were positively correlated with GT3x output (r = .60 and r = .64, P < .001, respectively). No significant correlation was found for standing posture (r = .14, P = .53).The kappa values between the 7-day SLIPA Log and GT3x variables ranged from 0.09 to 0.61, indicating poor to good agreement.


The 7-day SLIPA Log is a valid self-report measure of SB and LIPA in specific behavioral domains.

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Anne-Claire M. Verheul, Angelique N. Prins, Han C.G. Kemper, Alwine F.M. Kardinaal and Marie-Agnes J. van Erp-Baart

The purpose of this study is to validate a physical activity questionnaire (PAQ) developed to classify adolescent girls and young adult women according to their level of weight-bearing activities. Twenty-six girls age 11-15 years and 29 women age 20-25 years reported average weekly times spent in several physical activities that were classified according to their weight-bearing levels. The relative validity of the PAQ was determined by comparing findings with a 3-day recording using a Caltrac accelerometer (3DCal) and a 3-day activity diary (3DAD). In the girls, no significant correlations were found between PAQ scores and either 3DCal or 3DAD. In the women, however, significant associations were observed between PAQ and both of these measures (r = .58 and .77, respectively). The validity of PAQ in women is supported by this study, but not in girls.

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David Xiaoqian Sun, Gordon Schmidt and Sock Miang Teo-Koh

This is a validation study of the RT3 accelerometer for measuring physical activities of children in simulated free-living conditions. Twenty-five children age 12–14 years completed indoor testing, and 18 of them completed outdoor testing. Activity counts from the RT3 accelerometer estimated activity energy expenditure (AEE) and the Cosmed K4b2 analyzer measured oxygen uptake. Correlations were found between activity counts and metabolic cost (r = .95, p < .001), metabolic cost and RT3 estimated AEE (r = .96, p < .001) in the indoor test, activity counts and RT3 estimated AEE (r = .97, p < .001) in the outdoor test, and activity counts and metabolic cost when all activities were combined (r = .77, p < .001). Results indicate that the RT3 accelerometer might be used to provide acceptable estimates of free-living physical activity in children.

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Dusa Marn-Vukadinovic and Helena Jamnik


Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions.


To validate the Slovenian translation of Medical Outcome Survey (MOS) Short Form Health Survey (SF-36) and to assess relations among various knee measurements, activity tested with Oxford Knee Score (OKS) and health-related quality of life as estimated with SF-36 domains.


Descriptive validation study.


Isokinetic laboratory in outpatient rehabilitation unit.


101 subjects after unilateral sport knee injury.


All subjects completed the SF-36 and OKS, and isokinetic knee-muscle strength output at 60°/s was determined in 78 participants. Within a 3-d period, 43 subjects completed the SF-36 and OKS questionnaires again.

Main Outcome Measures:

Reliability testing included internal consistency and test–retest reliability. Correlations between SF-36 subscales and OKS were calculated to assess construct validity, and correlation between SF-36 subscales and muscle strength was calculated to assess concurrent validity.


Chronbach α was above .78 for all SF-36 subscales. ICCs ranged from .80 to .93. The correlation between OKS and the physical-functioning subscale, showing convergent construct validity, was higher (r = .83, P < .01) than between OKS and mental health (r = .50, P < .01), showing divergent construct validity. Knee-extensor weakness negatively correlated with physical-functioning (r = −.59, P < .01) and social-functioning (r = −.43, P < .01) subscales.


The Slovenian translation of the SF-36 is a reliable and valuable tool. The relationships between knee-muscle strength and activity and between knee-muscle strength and SF-36 subscales in patients after sport knee injury were established.