Inter-tester reliability and agreement of the Cumulated Ambulation Score in acute stroke: The InTRO-CAS-stroke study.

TITLE: Inter-Tester Reliability and Agreement of the Cumulated Ambulation Score in Stroke patients: The InTRO-CAS-stroke study OBJECTIVE: To examine the inter-tester reliability of the total Cumulated Ambulation Score (CAS) and the three activities of the CAS, and to define limits for the smallest change in basic mobility that indicates a real change in patients with stroke. METHODS: An intertester reliability study. SETTING: Participants: 60 participants from a specialized stroke unit with a mean age of 69.10 ± 13.23 years. The CAS describes a patient's independency in three activities - (1) getting in and out of bed, (2) sit to stand from a chair, and (3) walking ability and was assessed by two independent physiotherapists at median day 3 poststroke. Each activity was assessed on a three-point ordinal scale from 0 (not able to) to 2 (independent). The cumulated score for each activity provides a total CAS from 0 to 6, with 6 indicating independent basic mobility. Relative and absolute reliability was evaluated using weighted kappa, the standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS: The weighted kappa for the total CAS score was 0.816 and ranged from 0.733 to 0.904 for the 3 CAS activities. The SEM and the MDC of the total CAS was 0.37 and 1.03 respectively. CONCLUSIONS: The intertester reliability of the CAS is almost perfect, and a change of 1 CAS point for the total CAS indicates a real change in basic mobility, at group level and for an individual patient with stroke CLINICALTRIALS. GOV IDENTIFIER: NCT05601089.

Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training: A Case Study in Women's Elite Soccer.

The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL injury went through neuromuscular screening as measured by EMG preactivity of vastus lateralis and semitendinosus during a standardized sidecutting maneuver. Subsequently, the player experienced a noncontact ACL injury. The player was screened again following postreconstruction rehabilitation, then underwent 6-week kettlebell training, and was subsequently screened again at 6-week follow-up. Prior to and after postreconstruction rehabilitation the player demonstrated a neuromuscular profile during sidecutting known to increase the risk for noncontact ACL injury, that is, reduced EMG preactivity for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high-risk neuromuscular profile changed to low-risk in response to 6 weeks of kettlebell training. Thus, short-term kettlebell exercise with documented high levels of medial hamstring activation was found to transfer into high medial hamstring preactivation during a sidecutting maneuver.