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Robert H. Wellmon, Dawn T. Gulick, Mark L. Paterson and Colleen N. Gulick

Context:

Smartphones are being used in a variety of practice settings to measure joint range of motion (ROM). A number of factors can affect the validity of the measurements generated. However, there are no studies examining smartphone-based goniometer applications focusing on measurement variability and error arising from the electromechanical properties of the device being used.

Objective:

To examine the concurrent validity and interrater reliability of 2 goniometric mobile applications (Goniometer Records, Goniometer Pro), an inclinometer, and a universal goniometer (UG).

Design:

Nonexperimental, descriptive validation study.

Setting:

University laboratory.

Participants:

3 physical therapists having an average of 25 y of experience.

Main Outcome Measures:

Three standardized angles (acute, right, obtuse) were constructed to replicate the movement of a hinge joint in the human body. Angular changes were measured and compared across 3 raters who used 3 different devices (UG, inclinometer, and 2 goniometric apps installed on 3 different smartphones: Apple iPhone 5, LG Android, and Samsung SIII Android). Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to examine interrater reliability and concurrent validity.

Results:

Interrater reliability for each of the smartphone apps, inclinometer and UG were excellent (ICC = .995–1.000). Concurrent validity was also good (ICC = .998–.999). Based on the Bland-Altman plots, the means of the differences between the devices were low (range = –0.4° to 1.2°).

Conclusions:

This study identifies the error inherent in measurement that is independent of patient factors and due to the smartphone, the installed apps, and examiner skill. Less than 2° of measurement variability was attributable to those factors alone. The data suggest that 3 smartphones with the 2 installed apps are a viable substitute for using a UG or an inclinometer when measuring angular changes that typically occur when examining ROM and demonstrate the capacity of multiple examiners to accurately use smartphone-based goniometers.

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Scott Cheatham, Morey J. Kolber and Michael P. Ernst

Context:

Pulse oximetry has become mobile with the use of smartphone and Bluetooth wireless technology. This technology offers many benefits but has not been extensively studied. There is a need to further validate its clinimetric properties for health professionals to provide proper guidance to patients.

Objective:

This investigation assessed the concurrent validity of the iSpO2 pulse oximeter against a traditional pulse oximeter in measuring short-term resting blood oxygen saturation (SpO2) and pulse rate.

Design:

Observational study of reliability.

Setting:

University kinesiology laboratory.

Participants:

Thirty healthy, recre-ationally active adults (18 men, 12 women; mean age = 25.7 ± 5.46 years, mean height = 170.3cm ± 9.51, mean body mass = 76.4 kg ± 19.33).

Intervention:

Resting measurement of SpO2 and pulse rate using the iSpO2 pulse oximeter with the iPad Mini and a traditional pulse oximeter with Bluetooth.

Main Outcome Measure:

Resting SpO2 and pulse rate were concurrently measured over 5 min.

Results:

The concurrent validity between the iSpO2 and traditional pulse oximeter was moderate for measuring SpO2, intraclass correlation coeffcient (ICC)(3, 1) = .73, SEM = 0.70%, and good for pulse rate, ICC(3, 1) = .97, SEM = 1.74 beats per minute (bpm). The minimal detectable change at the 95% confidence interval for both instruments suggests that there may be 1.94% disagreement for SpO2 and 4.82 bpm disagreement between pulse oximetry methods. The 95% limits of agreement (LoA) for measuring SpO2 suggests that the iSpO2 and traditional pulse oximeters may vary -0.28 ± 1.98%, or approximately 2%. The 95% LoA for measuring pulse rate suggests that the iSpO2 and traditional pulse oximeter may vary 1.74 ± 4.98 bpm, potentially upward of 6 bpm. On the basis of the results of the LoA, it appears that there may be a slight systematic bias between the two devices, with the traditional pulse oximeter producing higher pulse rates than the iSpO2.

Conclusion:

The findings suggest that both instruments may be beneficial for indirect short-term measurements of resting SpO2 and pulse rate.

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Robert J. de Vos, Marinus P. Heijboer, Harrie Weinans, Jan A.N. Verhaar and Hans T.M. van Schie

Context:

Chronic midportion Achilles tendinopathy is a common and hard-to-treat disorder characterized by degenerative changes of the tendon matrix. Ultrasonographic tissue characterization (UTC) was successfully used to quantify structural human Achilles tendon changes. This novel and reliable technique could be used in follow-up studies to relate tendon structure to symptoms.

Objective:

To quantify structural tendon changes and assess clinical change in patients with tendinopathy.

Design:

Prospective observational study.

Setting:

Orthopedic department in a university medical center.

Patients:

23 patients with chronic midportion Achilles tendinopathy.

Intervention:

The patients performed a 16-wk home-based eccentric exercise program. An experienced researcher performed the ultrasonographic data collection with the UTC procedure. These data were assessed by a blinded observer. The severity of symptoms was established with the validated Victorian Institute of Sport Assessment–Achilles (VISA-A) questionnaire.

Main Outcome Measures:

UTC was performed to quantify tendon structure through measuring the proportion of 4 echo types. Echo types I and II represent more or less organized tendon bundles, and echo types III and IV represent disintegrated tendon structure. On the VISA-A, the total possible score is divided by 100 for a percentage score, with a perfect score of 100. Follow-up was at 2, 8, 16, and 24 wk.

Results:

The mean percentage of echo types I and II changed by 0.3% after 24 wk (P = .92, 95% CI −5.8 to 5.3). The mean VISA-A score increased slightly but significantly by 11.3 points after 24 wk (P = .01, 95% CI 2.6–20.0). An increased VISA-A score was not correlated with an increased percentage of echo types I and II (P = .94, r = −.02), and the baseline percentage of echo types I and II did not correlate with an increased VISA-A score (P = .74, r = .07).

Conclusions:

There is no short-term increase in organized tendon structure after eccentric exercises. Tendon structure is not related to symptom severity and cannot be used as a predictor of clinical outcome.

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Mark A. Sutherlin

Collegiate Swimmers Shoulder Functional Performance Status on National Collegiate Athletic Association Swimmers: Baseline Kerlan-Jobe Orthopedic Clinic Scores Development and Validation of a Swimmer’s Functional Pain Scale Study Participants 18 NCAA Division II female swimmers 99 NCAA swimmers 58 USA

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Reed D. Gurchiek, Hasthika S. Rupasinghe Arachchige Don, Lasanthi C. R. Pelawa Watagoda, Ryan S. McGinnis, Herman van Werkhoven, Alan R. Needle, Jeffrey M. McBride and Alan T. Arnholt

to train and validate the regression models. Since regression models are improved with more observations and the photocells failed to register the 40-m time for some of the sprints, only the 10-, 20-, and 30-m split times were used in this study. Of the 84 sprint trials, the photocell system false

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Elshan Najafov, Şeyda Özal, Ahmet Yiğit Kaptan, Coşkun Ulucaköy, Ulunay Kanatlı, Baybars Ataoğlu and Selda Başar

examination findings (range of motion and muscle strength assessment) constitute the remaining 65 points. Originally, Constant and Murley did not give a standard test protocol in their first article and the CMS did not undergo validation. 11 Multiple modifications were made after its development. 12 The

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Christopher J. Burcal, Sunghoon Chung, Madison L. Johnston and Adam B. Rosen

properties of PROs. The Foot and Ankle Ability Measure (FAAM) assesses function during activities of daily living (FAAM-ADL) and sports (FAAM-Sport). 5 It is a common PRO that can be used during the initial evaluation of a patient as well as a metric to assess treatment success. The FAAM has been validated

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Sarah P. Shultz, Jinsup Song, Andrew P. Kraszewski, Jocelyn F. Hafer, Smita Rao, Sherry Backus, Rajshree M. Hillstrom and Howard J. Hillstrom

extract the parameters associated most strongly with foot type. A third canonical regression analysis was performed on the pooled extracted structure, function, and flexibility variables to find a combined model. Cross-validation is a standard statistical method that is used to validate a model with data

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Saurabh Sharma and M. Ejaz Hussain

Disability Index (SPADI): translation, cultural adaptation, and validation in patients with rotator cuff tear . J Orthop Traumatol . 2016 ; 17 ( 4 ): 315 – 326 . PubMed ID: 27623841 doi:10.1007/s10195-016-0425-8 10.1007/s10195-016-0425-8 27623841 12. Membrilla-Mesa MD , Cuesta-Vargas AI , Pozuelo

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Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro and Frederico Ribeiro Neto

Measurement (Functional Independence Measure [FIM] and Spinal Cord Independence Measure) The functional independence was assessed using the FIM and the SCIM: total score (FIM total and SCIM total) and mobility subitem (FIM mobility and SCIM mobility). The FIM scale validation for the Brazilian population has