Teaching Physiotherapy Students Physical Examination Skills by Using Photogrammetry: A Randomized Control Trial of 3- Versus 2-Dimensional Images.

INTRODUCTION: Education research explains how healthcare professional training could be more efficient and effective by integrating simulation technology. Despite its relevance in training medical students, the evidence of its effectiveness in the manual skill training of physiotherapy students remains limited. The aim of this study was to compare the effectiveness of 3-dimensional (3D) images of real objects produced by photogrammetry and traditional 2-dimensional (2D) images when introducing manual therapy skills to undergraduate physiotherapy students via an online course. METHODS: In a randomized controlled trial, a group of first-year physiotherapy bachelor honor degree students participated in a 2-hour online course on 3 manual assessment skills: cervical compression, distraction, and flexion-rotation tests. They demonstrated 2 sets of learning materials, including either 3D images of real rotating objects using close-range photogrammetry (experimental group) or traditional 2D images (control group). After their respective training, an Objective Structured Clinical Evaluation procedure was conducted to demonstrate their knowledge about the techniques. A standardized 9-item practical performance test was used as the primary outcome measure for the analyses. RESULTS: Seventy-seven students participated in the study. The average Objective Structured Clinical Evaluation score for the experimental group (n = 40) was 41.3/50 (±3.9) and the control group (n = 37) was 39.1/50 (±4.5, P = 0.02). CONCLUSIONS: For learning 3 cervical spine assessment skills, this study shows that photogrammetry creates 3D images of real rotating objects that are more effective than 2D images for first-year physiotherapy students.

Interrater and intrarater reliability of common clinical standing balance tests for people with hip osteoarthritis.

BACKGROUND: Hip osteoarthritis (OA) is a common musculoskeletal condition affecting older individuals. Clinical balance tests are frequently used to assess standing balance in these people. There is insufficient information regarding the reliability of these tests. OBJECTIVE: The aim of this study was to estimate reliability and measurement error of 4 common clinical standing balance tests in people with hip OA. DESIGN: A prospective study was conducted with repeated measures between 2 independent raters within 1 session and within 1 rater over a 1-week interval. METHODS: Thirty people with hip OA were evaluated. Reliability was estimated for the Four-Square Step Test, Step Test, Functional Reach Test, and Timed Single-Leg Stance Test using intraclass correlation coefficients (ICC [2,1]). Measurement error was expressed as standard error of measurement and minimal detectable change. RESULTS: The Four-Square Step Test, Step Test, and Timed Single-Leg Stance Test were sufficiently reliable between raters (ICC=.85-.94, lower 1-sided 95% confidence interval [95% CI]=.71-.89), whereas the Step Test (standing on study limb) and Timed Single-Leg Stance Test (standing on nonstudy limb) were sufficiently reliable within a rater over a 1-week interval (ICC=.91, lower 1-sided 95% CI=.80-.83). The Step Test (standing on study limb) and Timed Single-Leg Stance Test (standing on nonstudy limb) achieved optimal levels of reliability (ICC >.90, lower 1-sided 95% CI >.70), with acceptable measurement error (<10%) for clinical outcome measures. The Functional Reach Test was not sufficiently reliable. A ceiling effect was detected for the Timed Single-Leg Stance Test. LIMITATIONS: Reliability was assessed only between 2 raters during a single session and within 1 rater over a 1-week interval, which limits generalizability. CONCLUSIONS: The Step Test (standing on study limb) is recommended as a highly reliable test with acceptable measurement error for assessing standing balance in people with hip OA.

Clinimetric properties of observer-assessed impairment tests used to evaluate hip and groin impairments: a systematic review.

OBJECTIVE: To recommend the most suitable observer-assessed impairment tests in people with hip and/or groin pathologies by conducting a systematic review of the clinimetric properties of these tests. METHODS: Electronic searches were performed in the Cochrane, PubMed, CINAHL, Embase, SPORTDiscus, and PsycINFO databases up to August 2011. Two reviewers independently rated the measurement properties of clinical tests of impairments, defined by the International Classification of Functioning, Disability and Health as problems in body structure or body function, using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN). "Best evidence synthesis" was made using COSMIN outcomes and the quality of findings was assessed using a purpose criteria system. RESULTS: Fifteen of 2,588 publications were eligible for inclusion. Impairments evaluated were range of motion (ROM; 9 studies), muscle strength (6 studies), tenderness (3 studies), leg length discrepancy (2 studies), balance (2 studies), and muscle length (2 studies) in people with hip osteoarthritis (OA), hip fractures, and mixed hip/groin pathologies. Measurement properties evaluated included reliability, measurement error, construct validity, and criterion validity. Responsiveness and interpretability were not assessed. Intrarater reliability of ROM tests (intraclass correlation coefficient [ICC] 0.82-0.97) and strength tests (ICC 0.84-0.98) for hip OA and of strength tests (ICC 0.66-0.86) and balance tests (ICC 0.73-0.94) for hip fractures was demonstrated. CONCLUSION: This systematic review highlighted a paucity of literature evaluating the clinimetric properties of impairment tests for people with hip and/or groin pathology. A large number of inconclusive findings were found and as such, many clinical impairment tests should be used with caution in people with hip and/or groin pathologies until further clinimetric evidence becomes available.