Inter rater reliability of the Modified Tardieu Scale in the assessment of spasticity in adults with cerebral palsy

Spasticity is one of the symptoms that contributes to functional limitation in adults with cerebral palsy and characterized by a velocity dependent increase in tonic reflex due to the hyperexcitability of the stretch reflex. Modified Tardieu Scale [MTS] is a valid clinical tool for assessment of spasticity. The purpose of this study was to investigate Inter-rater reliability of the Modified Tardieu Scale [MTS] for hip adductors, knee extensors and ankle plantar flexors muscles in adult subjects with cerebral palsy. In an analytical cross sectional study, 30 participants 11 men' 21 women, age range 20 to 40 years, mean age [26.57 +/- 4.8] with spastic cerebral palsy from Ra'ad Rehabilitation Goodwill Complexes in Tehran city in a convenient sampling took part in this study. Spasticity was measured by two physiotherapist for hip adductors, knee extensors and ankle plantar flexors with MTS during same session with ten minutes interval between assessment of two raters. ICC values for R2-Ri as an indicator of spasticity in hip adductors, knee extensor and plantar flexors were 0.97, 0.88 and 0.81 respectively. Also ICC Values for quality of muscle reaction was 0.89 in hip adductors, 0.96 in knee extensors and 0.92 in ankle plantar flexors. MTS has a high reliability in spasticity assessment of adductors, knee extensors and ankle plantar flexors muscles, Probably MTS can be used as a reliable clinical tool to measure spasticity of lower extremity muscles in adult subjects with cerebral palsy

[Repeatability assessment of quantified measurement method in hand drawing skills]

Because of high incidence of hand injuries and the need for a quantitative method that provides measures of patient improvement in treatment period a precise and easy-to-apply quantitative procedure is necessary. As a first step in validating of such a method, the intersession repeatability of quantified measures was assessed in this study. Measurement of hand drawing skills by drawing circle shape in two speeds [preferred and maximum] and spiral shape just in a preferred voluntary speed with two repetitions for each subject was assessed in 15 subjects. Digital data was recorded by a Tablet PC using special software with average sampling rate of 120 Hz. The quantified variables computed for circle and spiral drawing tests with preferred speed were reliable [0.55 < ICC < 0.85], so they can be used for drawing quantifications. Results of drawing circles with maximum speed were not reliable [ICC < 0.5]. Repeatability analysis revealed that measures based on drawing circles with maximum speed are not repeatable and cannot be used for process monitoring. This may be due to large variation in providing maximum drawing speed during test time. On the other hand, spiral and circle drawing parameters with preferred speed had a better repeatability and can be used for quantification of hand drawings in researches

Comparison of the test-retest reliability of hip strength measurements using dynamometer fixed by hand versus fixed to a stable frame in female athletes

Assessment of hip strength needs a reliable method. Hand-held dynamometers are appropriate alternatives for manual muscle testing and isokinetics. Stabilizing the dynamometer with hand will increase error in measurements. The purpose of this study was to compare the test-retest reliability of hand-held dynamometer fixed by hand and fixed to a new stable frame for measuring hip extension, abduction and external rotation strength in healthy female athletes. Normalized average and peak values of torque of three successive trials for each muscle group were calculated in two sessions one week apart in ten healthy female athletes. Strength was measured with hand-held dynamometer fixed by hand and fixed to the stable frame in each session. Intra-class correlation coefficients [ICC], coefficients of variation [CV] and standard error of measurement [SEM] were calculated to determine the reliability. For hip extension, abduction, and external rotation strength measured by hand fixation. The ICC ranged from -1.22 to 0.6, the CV ranged from 8% to 33% and the SEM ranged from 0.007 to 0.04. For strength measurements with stable frame, the ICC ranged from .93 to .96, and CV ranged from 5.26% to 7.94%. The range of the SEM was from .004 to .08. Measurements of hip muscles strength with a dynamometer fixed to a stable frame showed higher reliability than fixation by hand in young female athletes. These findings support the error within hand fixation of dynamometers and the necessity for providing better fixation