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Norman S. Hannibal III, Sharon Ann Plowman, Marilyn A. Looney and Jason Brandenburg

Background:

Strength, muscular endurance, and flexibility are important components of healthy back function. This study determined the reliability and evaluated the validity of selected low back field tests (FITNESSGRAM ® Trunk Extension [FG-TE] and Box 90° Dynamic Trunk Extension [B-90° DTE]) when compared to laboratory tests (Parallel Roman Chair Dynamic Trunk Extension [PRC-DTE], Parallel Roman Chair Static Trunk Extension [PRC-STE], and Dynamometer Static Back Lift [DSBL]).

Methods:

Forty males age 15.1 ± 1.2 yr and 32 females age 15.5 ± 1.2 yr participated.

Results:

Intraclass test-retest reliability coefficients (one-way ANOVA model for a single measure) ranged from .940 to .996. Validity coefficients determined by Pearson product moment correlation coefficients for males and females, respectively, were as follows: B-90° DTE vs. PRC-DTE = .82, .62 (p < .05); B-90° DTE vs. PRC-STE = .55, .38 (p < .05); B-90° DTE vs. DSBL = −.29, −.23; FG-TE vs. PRC-DTE = .23, −.11; FG-TE vs. PRC-STE = −.15, .33; and FG-TE vs. DSBL = −.04, −.36.

Conclusions:

B-90° DTE was shown to be a valid field test when compared to PRC-DTE, but only for the males. Further research on the PRC-DTE and PRC-STE items for adolescents is recommended.

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Fiona C. Bull, Tahlia S. Maslin and Timothy Armstrong

Purpose:

Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison.

Methods:

Male and female adults were recruited from diverse sociocultural, educational and economic backgrounds in 9 countries (total n = 2657). GPAQ and the International Physical Activity Questionnaire (IPAQ) were administered on at least 2 occasions. Eight countries assessed criterion validity using an objective measure (pedometer or accelerometer) over 7 days.

Results:

Reliability coefficients were of moderate to substantial strength (Kappa 0.67 to 0.73; Spearman's rho 0.67 to 0.81). Results on concurrent validity between IPAQ and GPAQ also showed a moderate to strong positive relationship (range 0.45 to 0.65). Results on criterion validity were in the poor-fair (range 0.06 to 0.35). There were some observed differences between sex, education, BMI and urban/rural and between countries.

Conclusions:

Overall GPAQ provides reproducible data and showed a moderate-strong positive correlation with IPAQ, a previously validated and accepted measure of physical activity. Validation of GPAQ produced poor results although the magnitude was similar to the range reported in other studies. Overall, these results indicate that GPAQ is a suitable and acceptable instrument for monitoring physical activity in population health surveillance systems, although further replication of this work in other countries is warranted.

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Carlo Castagna, Ferdinando Iellamo, Franco Maria Impellizzeri and Vincenzo Manzi

The aim of this study was to examine the reliability and validity of a popular field test for aerobic fitness used in soccer (45-15) in Italy. Alternating progressive 45-s runs with 15 s passive recovery until exhaustion, the test considers peak speed (PS) as a reflection of maximal aerobic speed (MAS). The validity and reliability of the 45-15 was assessed in 18 young male soccer players (age 16.7 ± 1.8 y, body mass 70 ± 7.45 kg, height 177 ± 0.5 cm, 55.62 ± 5.56 mL · kg−1 · min−1) submitted to laboratory testing for aerobic fitness and repeatedly to the 45-15. Results showed that 45-15 PS was significantly related to VO2max (r = .80, P < .001, 95%CI .47–.93) and MAS (r = .78, P = .001, 95%CI .43–.93). No significant bias between MAS 45-15 PS (P = .11) was found during the measurement-consistency study. Receiver-operating-characteristic (ROC) analysis showed that 45-15 PS was sensitive in detecting VO2max changes in subjects as revealed by area under the curve (.97; 95%CI .73–1). Players with peak 45-15 speed equal to or above 16.5 km/h (ie, ROC cutoff) may be considered to have good aerobic fitness. In light of this study’s findings, the 45-15 test may be considered a reliable and valid test to evaluate meaningful information to direct generic aerobic training in soccer.

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Keith P. Gennuso, Charles E. Matthews and Lisa H. Colbert

Background:

The purpose of this study was to examine the reliability and validity of 2 currently available physical activity surveys for assessing time spent in sedentary behavior (SB) in older adults.

Methods:

Fifty-eight adults (≥65 years) completed the Yale Physical Activity Survey for Older Adults (YPAS) and Community Health Activities Model Program for Seniors (CHAMPS) before and after a 10-day period during which they wore an ActiGraph accelerometer (ACC). Intraclass correlation coefficients (ICC) examined test-retest reliability. Overall percent agreement and a kappa statistic examined YPAS validity. Lin’s concordance correlation, Pearson correlation, and Bland-Altman analysis examined CHAMPS validity.

Results:

Both surveys had moderate test-retest reliability (ICC: YPAS = 0.59 (P < .001), CHAMPS = 0.64 (P < .001)) and significantly underestimated SB time. Agreement between YPAS and ACC was low (κ = −0.0003); however, there was a linear increase (P < .01) in ACC-derived SB time across YPAS response categories. There was poor agreement between ACC-derived SB and CHAMPS (Lin’s r = .005; 95% CI, −0.010 to 0.020), and no linear trend across CHAMPS quartiles (P = .53).

Conclusions:

Neither of the surveys should be used as the sole measure of SB in a study; though the YPAS has the ability to rank individuals, providing it with some merit for use in correlational SB research.

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Nicola Relph and Lee Herrington

Context: Clinicians require portable, valid, and cost-effective methods to monitor knee joint-position-sense (JPS) ability. Objective: To examine the criterion-related validity of image-capture JPS measures against an isokinetic-dynamometer (IKD) procedure. Design: Random crossover design providing a comparison of knee JPS measures from image capture and IKD procedures. Participants: 10 healthy participants, 5 female, age 28.0 ± 13.29 y, mass 60.3 ± 9.02 kg, height 1.65 ± 0.07 m, and 5 male, 29.6 ± 10.74 y, mass 73.6 ± 5.86 kg, height 1.75 ± 0.07 m. Main Outcome Measures: The dependent variables were absolute error scores (AES) provided by 2 knee directions (flexion and extension). The independent variables were the method (image capture and IKD). Results: There was no significant difference between clinical and IKD AED into knee-extension data (P = .263, r = 0.55). There was a significant difference between clinical and IKD AES into knee-flexion data (P = .016, r =.70). Conclusions: Analysis of photographic images to assess JPS measurements using knee flexion is valid against IKD techniques. However, photo-analysis measurements provided a lower error score using knee-extension data and thus may provide an optimal environment to produce maximal knee JPS acuity. Therefore, clinicians do not need expensive equipment to collect representative JPS ability.

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James Onate, Nelson Cortes, Cailee Welch and Bonnie Van Lunen

Context:

A clinical assessment tool that would allow for efficient large-group screening is needed to identify individuals potentially at risk for anterior cruciate ligament (ACL) injury.

Objective:

To assess the criterion validity of a jumplanding assessment tool compared with 3-dimensional (3D) motion analysis and evaluate interrater reliability across an expert vs novice rater using the Landing Error Scoring System (LESS).

Design:

Validity protocol.

Setting:

Controlled, laboratory.

Participants:

Nineteen female (age 19.58 ± .84 y, height 1.67 ± .05 m, mass 63.66 ± 10.11 kg) college soccer athletes volunteered.

Main Outcome Measurement:

Interrater reliability between expert rater (5 y LESS experience) vs novice rater (no LESS experience). LESS scores across 13 items and total score. 3D lower extremity kinematics were reduced to dichotomous values to match LESS items.

Interventions:

Participants performed drop-box landings from a 30-cm height with standard video-camera and 3D kinematic assessment.

Results:

Intrarater item reliability, assessed by kappa correlation, between novice and experienced LESS raters ranged from moderate to excellent (κ = .459–.875). Overall LESS score, assessed by intraclass correlation coefficient, was excellent (ICC2,1 = .835, P < .001). Statistically significant phi correlation (P < .05) was found between rater and 3D scores for knee-valgus range of motion; however, percent agreement between expert rater and 3D scores revealed excellent agreement (range of 84–100%) for ankle flexion at initial contact, knee-flexion range of motion, trunk flexion at maximum knee flexion, and foot position at initial contact for both external and internal rotation of tibia. Moderate agreement was found between rater and 3D scores for trunk flexion at initial contact, stance width less than shoulder width, knee valgus at initial contact, and knee-valgus range of motion.

Conclusions:

Our findings support moderate to excellent validity and excellent expert vs novice interrater reliability of the LESS to accurately assess 3D kinematic motion patterns. Future research should evaluate the efficacy of the LESS to assess individuals at risk for ACL injury.

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Sinem Suner-Keklik, Gamze Cobanoglu-Seven, Nihan Kafa, Mustafa Ugurlu and Nevin Atalay Guzel

Context: Proprioception is the basic element of the spontaneous control of movement, balance and joint stability. Therefore, it is necessary for the execution of walking and daily and sport activities. Loss of proprioception of the knee, which may cause a new injury, is important to evaluate the position sense of the joint during the rehabilitation period. However, the evaluation methods that are used are very expensive, complicated and nonportable, or the measuring method is difficult to implement. Objective: We demonstrated the validity and reliability of knee proprioception measurements performed in the open kinetic chain position and closed kinetic chain position with a dual inclinometer. Design: We assessed the validity and intratester reliability of a digital inclinometer for measuring the knee joint position sense in different positions. Setting: Clinical laboratory. Participants: We enrolled 22 participants (age = 21.8 ± 0.95 y, height = 172 ± 9.1 cm, weight = 64.9 ± 14 kg) into the study. Intervention: The same investigator used an inclinometer to take knee proprioception measurements in open and closed kinetic chain positions. Main Outcome Measures: The relative angular error was calculated by taking the arithmetic average of the difference between the target angle and reproduced angle and was the main outcome measure. Results: We found that the dynamometer-inclinometer had a moderate ICC value (ICC = 0.594, SEM = 1.60, P = .005), whereas inclinometer t1 vs inclinometer t2 (ICC = 0.778, SEM = 0.62, P < 0.001) and closed kinetic chain position t1 and closed kinetic chain position t2 (ICC = 0.888, SEM = 0.63, P < 0.001) had high ICC values. Conclusion: Knee proprioception measurements performed with a dual inclinometer were reliable in the closed kinetic chain position in healthy, sedentary individuals and were valid and reliable in the open kinetic chain position.

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William Temes, Amy Temes Clifton, Valerie Hilton, Leslie Girard, Neisha Strait and Andrew Karduna

Context: The supraspinatus is the most commonly affected muscle with rotator-cuff pathology and necessary for stability of the humeral head in the glenoid fossa. Rehabilitative ultrasound imaging (RUSI) of skeletal muscles provides a safe and clinically accessible measure of intact human muscle function at rest or during contracted states. The ability to perform accurate assessment of supraspinatus function has not been studied and may be of value in assessment and treatment. Objectives: To determine the validity and reliability of measures obtained using RUSI for assessing supraspinatus muscle at rest and contracted conditions. Design: Reliability and validity Setting: Outpatient physical therapy clinic. Subjects: 15 asymptomatic subjects age 30-49 y. Main Outcome Measures: The supraspinatus muscle was measured at rest and contracted with a 0.9-kg weight with the arm positioned in 45° of abduction in the plane of the scapula. Repeated ultrasound images of the supraspinatus were collected by 3 physical therapists on 2 separate days. Main Outcome Measures: Reliability was assessed with the intraclass correlation coefficient (ICC) and standard error of measurement (SEM). Validity was tested by comparing mean difference between active and passive states for all 3 rates on both days. Results: All ICC values were found to be at .9 or above. In addition, for all days and raters, the active condition was significantly thicker than the passive condition (P < .001). Conclusions: Thickness measures of the supraspinatus using RUSI, during passive and active conditions, demonstrate high interrater and intrarater reliability and can easily distinguish between active and passive states. These findings suggest that RUSI may provide an appropriate quantitative measure for changes in the thickness of supraspinatus that are important for determining improvement or deterioration in muscle function.

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Martin Buchheit, Matt Spencer and Said Ahmaidi

Purpose:

Two studies involving 122 handball players were conducted to assess the reliability, usefulness, and validity of a repeated shuttle-sprint and jump ability (RSSJA) test. The test consisted of 6 × (2 × 12.5-m) sprints departing on 25 s, with a countermovement jump performed during recovery between sprints.

Methods:

For the reliability and usefulness study, 14 well-trained male handball players performed the RSSJA test 7 d apart. Reliability of the test variables was assessed by the typical error of measurement, expressed as a coefficient of variation (CV). The minimal changes likely to be “real” in sprint time and jump power were also calculated. For the validity study, players of seven teams (national to international levels, women and men) performed the RSSJA test.

Results:

CV values for best and mean sprint time were 1.0% (90% CL, 0.7 to 1.6) and 1.0% (90% CL, 0.7 to 1.4). CV values for best and mean jump peak power were 1.7% (90% CL, 1.2 to 2.7) and 1.5% (90% CL, 1.1 to 2.5). The percent sprint and jump decrements were less reliable, with CVs of 22.3% (90% CL, 15.7 to 38.3) and 34.8% (90% CL, 24.2 to 61.8). Minimal changes likely to be “real” for mean sprint time and jumping peak power were -2.6% and 4.8%. Qualitative analysis revealed that the majority of between-team differences were rated as “almost certain” (ie, 100% probability that the true differences were meaningful) for mean sprint and jump performances.

Conclusion:

The RSSJA test is reliable and valid to assess repeated explosive effort sequences in team sports such as handball. Test results are likely to be representative of gender and competition level; thus the test could be used to discriminate across playing standards and monitor fitness levels.

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Patrick B. Wilson

Gastrointestinal (GI) symptoms may affect up to 90% of competitors during endurance races. Studies have typically assessed GI symptoms retrospectively or only over an acute timeframe, and information on the validity and reliability of the questionnaires employed is lacking. This investigation aimed to estimate the frequency of GI distress experienced by runners over 30 days and to establish the validity and reliability of a retrospective GI symptom questionnaire. Runners (70 men, 75 women) recorded GI symptoms with a prospective journal for 30 days. Retrospective GI symptom data were then collected after the 30-day period on two occasions within one week. GI symptoms were rated on a 0–10 scale. Descriptive statistics for GI symptoms are reported as medians (interquartile ranges) because of nonnormal distributions. Men and women experienced at least one GI symptom on 84.0% (59.8–95.1%) and 78.3% (50.0–95.2%) of runs, respectively. Moderate-to-severe GI symptoms (score of ≥5) were experienced on 13.8% (6.7–37.3%) and 21.7% (5.3–41.2%) of runs for men and women. Spearman’s rho correlations between journal ratings and retrospective questionnaire ratings ranged from 0.47 to 0.82 (all p < .001), although they were highest when journal ratings were quantified as mean 30-day values (all rho ≥ 0.59). Reliability of the retrospective questionnaire ratings was high (rho = 0.78–0.92; p < .001). In comparison with tracking GI symptoms with a daily journal, retrospective questionnaires seem to offer a convenient and reasonably valid and reliable method of quantifying GI symptoms over 30 days.