Improving the test-retest and inter-rater reliability for stretch reflex measurements using an isokinetic device in stroke patients with mild to moderate elbow spasticity

Minki Sin, Won Seok Kim, Kyujin Cho, Sungmin Cho, Nam Jong Paik

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The conventional tools to measure spasticity exhibited insufficient test-retest or inter-rater reliability. Therefore, the spasticity measurement using an isokinetic device has been proposed to improve these reliabilities of the angle of catch (AoC) measurements; however, this proposal has not been investigated in a standardized manner. In this study, the comparison of the AoC measurement was performed using two modes (isokinetic and manual motion) to investigate whether the standardized isokinetic motion could increase the reliabilities. Motion consistency was calculated using a newly developed index. To analyze the effect of the motion standardization, AoC were estimated using EMG data for both modes, and to compare the measurement reliability, AoC for isokinetic mode was estimated using both EMG and torque data. Although the test-retest reliability for manual motion was excellent, the use of isokinetic motion improved it to the level of extremely excellent. Intraclass correlation coefficient (ICC) for the inter-rater reliability of manual motion was 0.788, which was near the lower limit of the excellent. Isokinetic motion improved it to the ICC of 0.890 and 0.931 based on the EMG and torque, respectively. These improvements in reliabilities reduced the measurement errors, sample size, and need for the same rater in clinical trials.

Original languageEnglish
Pages (from-to)120-127
Number of pages8
JournalJournal of Electromyography and Kinesiology
Volume39
DOIs
StatePublished - Apr 2018

Fingerprint

Stretch Reflex
Elbow
Stroke
Equipment and Supplies
Torque
Reproducibility of Results
Sample Size
Clinical Trials

Keywords

  • Electromyography
  • Isokinetic
  • Muscle Sspasticity
  • Quantification
  • Reliability
  • Stretch reflex
  • Stroke
  • Torque

Cite this

@article{6838b6ecf3d34fea8f6f80f4f0cdbffe,
title = "Improving the test-retest and inter-rater reliability for stretch reflex measurements using an isokinetic device in stroke patients with mild to moderate elbow spasticity",
abstract = "The conventional tools to measure spasticity exhibited insufficient test-retest or inter-rater reliability. Therefore, the spasticity measurement using an isokinetic device has been proposed to improve these reliabilities of the angle of catch (AoC) measurements; however, this proposal has not been investigated in a standardized manner. In this study, the comparison of the AoC measurement was performed using two modes (isokinetic and manual motion) to investigate whether the standardized isokinetic motion could increase the reliabilities. Motion consistency was calculated using a newly developed index. To analyze the effect of the motion standardization, AoC were estimated using EMG data for both modes, and to compare the measurement reliability, AoC for isokinetic mode was estimated using both EMG and torque data. Although the test-retest reliability for manual motion was excellent, the use of isokinetic motion improved it to the level of extremely excellent. Intraclass correlation coefficient (ICC) for the inter-rater reliability of manual motion was 0.788, which was near the lower limit of the excellent. Isokinetic motion improved it to the ICC of 0.890 and 0.931 based on the EMG and torque, respectively. These improvements in reliabilities reduced the measurement errors, sample size, and need for the same rater in clinical trials.",
keywords = "Electromyography, Isokinetic, Muscle Sspasticity, Quantification, Reliability, Stretch reflex, Stroke, Torque",
author = "Minki Sin and Kim, {Won Seok} and Kyujin Cho and Sungmin Cho and Paik, {Nam Jong}",
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T1 - Improving the test-retest and inter-rater reliability for stretch reflex measurements using an isokinetic device in stroke patients with mild to moderate elbow spasticity

AU - Sin, Minki

AU - Kim, Won Seok

AU - Cho, Kyujin

AU - Cho, Sungmin

AU - Paik, Nam Jong

PY - 2018/4

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N2 - The conventional tools to measure spasticity exhibited insufficient test-retest or inter-rater reliability. Therefore, the spasticity measurement using an isokinetic device has been proposed to improve these reliabilities of the angle of catch (AoC) measurements; however, this proposal has not been investigated in a standardized manner. In this study, the comparison of the AoC measurement was performed using two modes (isokinetic and manual motion) to investigate whether the standardized isokinetic motion could increase the reliabilities. Motion consistency was calculated using a newly developed index. To analyze the effect of the motion standardization, AoC were estimated using EMG data for both modes, and to compare the measurement reliability, AoC for isokinetic mode was estimated using both EMG and torque data. Although the test-retest reliability for manual motion was excellent, the use of isokinetic motion improved it to the level of extremely excellent. Intraclass correlation coefficient (ICC) for the inter-rater reliability of manual motion was 0.788, which was near the lower limit of the excellent. Isokinetic motion improved it to the ICC of 0.890 and 0.931 based on the EMG and torque, respectively. These improvements in reliabilities reduced the measurement errors, sample size, and need for the same rater in clinical trials.

AB - The conventional tools to measure spasticity exhibited insufficient test-retest or inter-rater reliability. Therefore, the spasticity measurement using an isokinetic device has been proposed to improve these reliabilities of the angle of catch (AoC) measurements; however, this proposal has not been investigated in a standardized manner. In this study, the comparison of the AoC measurement was performed using two modes (isokinetic and manual motion) to investigate whether the standardized isokinetic motion could increase the reliabilities. Motion consistency was calculated using a newly developed index. To analyze the effect of the motion standardization, AoC were estimated using EMG data for both modes, and to compare the measurement reliability, AoC for isokinetic mode was estimated using both EMG and torque data. Although the test-retest reliability for manual motion was excellent, the use of isokinetic motion improved it to the level of extremely excellent. Intraclass correlation coefficient (ICC) for the inter-rater reliability of manual motion was 0.788, which was near the lower limit of the excellent. Isokinetic motion improved it to the ICC of 0.890 and 0.931 based on the EMG and torque, respectively. These improvements in reliabilities reduced the measurement errors, sample size, and need for the same rater in clinical trials.

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