Surface electromyographic measurements on land prior to and after 90 min of submersion (swimming) are highly reliable

The purpose of this study was to investigate the reliability of surface electromyography (sEMG) measurements after submersion (swimming) for 90 min. Isometric maximal voluntary contractions (MVC) on land and in water were collected from eight muscles on the right side of the body in 12 healthy participants (6 women and 6 men). Repeated measures analyses of variance (general linear model ANOVA) showed no significant differences in the peak amplitude MVC scores between land pre and post measurements for all muscles, p > .05. The mean of the Intraclass correlation coefficient (1, 1) for land pre and land post was .985 with (95% Cl = .978–.990), for land pre and water pre .976 (95% Cl = .964–.984) and for land pre and post, water pre and post .981 (95% Cl = .974–.987). Measuring sEMG on land before and after a prolonged submersion is highly reliable without additional waterproofing when using electrodes with 57 mm diameter.     

Intra- and inter-rater reliability of electrical impedance myography using adhesive electrodes in healthy volunteers

In spite of the growing use of the electrical impedance myography (EIM) measures for clinical assessment and follow-up of diseased muscle tissue, reliability studies are scarce. We evaluate the reliability of the (EIM) technique using four adhesive electrodes over the muscle of interest.Intra- and inter-rater reliability was studied within the same session and between sessions. Thirty-one healthy and volunteer subjects aged between 20 and 26 years were recruited. Phase angle, reactance and resistance were assessed for each EIM measurement. Intraclass correlation coefficient (ICC) was used to determine the relative reliability. Absolute reliability was expressed as the standard error of measurement and the minimum detectable change.Relative reliability within the same session and between sessions for the EIM technique was excellent (ICCs > 0.9) concerning both intra- and inter-rater reliability, except for the component reactance. The absolute reliability was very high for the three EIM components.EIM measures using four adhesive electrodes over the area of interest is a reliable technique to assess muscle tissue status. This study confirms that these measurement results barely vary depending on the examiner and the moment. The present study also confirms phase angle as the least affected EIM component by examiner and evaluation moment.     

Reliability of Contractile Properties of the Knee Extensor Muscles in Individuals with Post-Polio Syndrome

Objective

To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS) and 18 age-matched healthy individuals.

Methods

Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with the use of a fixed dynamometer. Reliability was determined for fatigue resistance, rate of torque development (MRTD), and early and late relaxation time (RT50 and RT25), using the intraclass correlation coefficient (ICC) and standard error of measurement (SEM, expressed as % of the mean).

Results

In both groups, reliability for fatigue resistance was good, with high ICCs (>0.90) and small SEM values (PPS: 7.1%, healthy individuals: 7.0%). Reliability for contractile speed indices varied, with the best values found for RT50 (ICCs>0.82, SEM values <2.8%). We found no systematic differences between test and retest occasions, except for RT50 in healthy subjects (p = 0.016).

Conclusions

In PPS and healthy individuals, the reliability of fatigue resistance, as obtained from electrically evoked contractions is high. The reliability of contractile speed is only moderate, except for RT50 in PPS, demonstrating high reliability.

Significance

This was the first study to examine the reliability of electrically evoked contractile properties in individuals with PPS. Our results demonstrate its potential to study mechanisms underlying muscle fatigue in PPS and to evaluate changes in contractile properties over time in response to interventions or from natural course.     

Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry

This study aimed to evaluate the validity and test–retest reliability of trunk muscle strength testing performed with a latest-generation isokinetic dynamometer. Eccentric, isometric, and concentric peak torque of the trunk flexor and extensor muscles was measured in 15 healthy subjects. Muscle cross sectional area (CSA) and surface electromyographic (EMG) activity were respectively correlated to peak torque and submaximal isometric torque for erector spinae and rectus abdominis muscles. Reliability of peak torque measurements was determined during test and retest sessions. Significant correlations were consistently observed between muscle CSA and peak torque for all contraction types (r = 0.74−0.85; P < 0.001) and between EMG activity and submaximal isometric torque (r ⩾ 0.99; P < 0.05), for both extensor and flexor muscles. Intraclass correlation coefficients were comprised between 0.87 and 0.95, and standard errors of measurement were lower than 9% for all contraction modes. The mean difference in peak torque between test and retest ranged from −3.7% to 3.7% with no significant mean directional bias. Overall, our findings establish the validity of torque measurements using the tested trunk module. Also considering the excellent test–retest reliability of peak torque measurements, we conclude that this latest-generation isokinetic dynamometer could be used with confidence to evaluate trunk muscle function for clinical or athletic purposes.     

Intrarater reliability and agreement of linear encoder derived heel-rise endurance test outcome measures in healthy adults

A linear encoder measuring vertical displacement during the heel-rise endurance test (HRET) enables the assessment of work and maximum height in addition to the traditional repetitions measure. We aimed to compare the test-retest reliability and agreement of these three outcome measures. Thirty-eight healthy participants (20 females, 18 males) performed the HRET on two occasions separated by a minimum of seven days. Reliability was assessed by the intraclass correlation coefficient (ICC) and agreement by a range of measures including the standard error of measurement (SEM), coefficient of variation (CV), and 95% limits of agreement (LoA). Reliability for repetitions (ICC = 0.77 (0.66, 0.85)) was equivalent to work (ICC = 0.84 (95% CI 0.76, 0.89)) and maximum height (ICC = 0.85 (0.77, 0.90)). Agreement for repetitions (SEM = 6.7 (5.8, 7.9); CV = 13.9% (11.9, 16.8%); LoA = −1.9 ± 37.2%) was equivalent to work (SEM = 419 J (361, 499 J); CV = 13.1% (11.2, 15.8%); LoA = 0.1 ± 34.8%) with maximum height superior (SEM = 0.8 cm (0.6, 1.0 cm); CV = 6.6% (5.7, 7.9%); LoA = 1.3 ± 17.1%). Work and maximum height demonstrated acceptable reliability and agreement that was at least equivalent to the traditional repetitions measure.     

Reliability of bulky DNA adducts measurement by the nuclease P1 32P-post-labelling technique.

The aim was to assess the reliability of bulky DNA adducts measurement by means of the 32P-post-labelling assay. The research design consisted of an intramethod reliability study. Buffy coats from 41 subjects were used to obtain two aliquots of 1-5 microg DNA for each subject; bulky DNA adducts were measured using the nuclease P1 32P-post-labelling technique. The reliability of the measurement was assessed by means of the intraclass correlation coefficient (ICC), the distribution of the differences between the two measurements and the limits of agreement. The estimated ICC was 0.977, with a 95% confidence interval between 0.921 and 0.977. The limits of agreement were +/- 0.44 (DNA adducts per 10(8) nucleotides). Only three subjects had differences lying out of such limits. Bulky DNA adduct levels measured by the 32P-post-labelling technique showed good reliability. Only one measurement is needed to use DNA adducts as a biomarker of exposure and, possibly, cancer risk. Besides, as a validation analysis, 32P-post-labelling measurements can be repeated in only 20-30% of samples.     

The Reliability and Sensitivity of the National Institutes of Health Stroke Scale for Spontaneous Intracerebral Hemorrhage in an Uncontrolled Setting

Background and Purpose

The National Institutes of Health Stroke Scale (NIHSS) is commonly used to measure neurologic function and guide treatment after spontaneous intracerebral hemorrhage (ICH) in routine stroke clinics. We evaluated its reliability and sensitivity to detect change with consecutive and unique rater combinations in a real-world setting.

Methods

Conservative measures of interrater reliability (unweighted Kappa (κ), Intraclass Correlation Coefficient (ICC_1,1) and sensitivity to detect change (Minimal Detectable Difference (MDD)) were estimated. Sixty-one repeated ratings were completed within 1 week after ICH by physicians and nurses with no investigator intervention.

Results

Reliability (consistency) of the NIHSS total score was good for both physicians vs. nurses and nurses vs. nurses (ICC=0.78, 95%CI: 0.58-0.89 and ICC=0.75, 95%CI: 0.55-0.87 respectively) in this scenario. Reliability (agreement) of items 1C and 9 were excellent (κ>=0.61) for both rater comparisons, however, reliability was poor to fair on most remaining items (κ:0.01-0.60), with item 11 being completely unreliable in this scenario (κ<0.01). The MDD₉₅ of the total NIHSS score was ±10 and ±11 points for physician vs. nurse and nurse vs. nurse comparisons.

Conclusions

The reliability of the NIHSS is good overall for ICH even in an uncontrolled setting. However, on repeated measurements changes in total NIHSS score of at least >=10 points need to be observed for clinicians to be confident that real changes had occurred within 1 week after ICH.     

Core and peripheral site measurement of body temperature in short wool sheep

Understanding circadian rhythms of body temperature is important for the interpretation of single body temperature measurements and the assessment of the physiological state of an animal. The ability to measure body temperature at peripheral locations may also be important in the development of minimally invasive tools for remote temperature measurement in livestock. This study aimed to investigate how well body temperature measured at peripheral sites reflected a commonly used core measurement (vaginal temperature) and the circadian rhythmicity of the body temperature of sheep with a view to practical application in extensive sheep production systems. Eleven crossbred ewes were implanted with peripheral temperature sensing microchips (LifeChip®) which were positioned transversely in the sternocleidomastoid (neck) muscle and subcutaneously under the tail. iButton® temperature loggers were placed intravaginally to record core body temperature measurements (Tv). The body temperature measurements observed at the peripheral sites in the neck (Tn) and tail (Tt) differed significantly to those measured at the core site, Tv (P < 0.05), with Tn lower than Tv and Tt lower than both Tv and Tn. Similarities in circadian rhythm patterns were observed across the day between Tv, Tn and Tt in repeated measures analysis, with a short period of difference between Tv and Tn (from 1400 to 1600 h) and a long period of difference between Tv and Tt (from 1000 to 2100 h) (P < 0.05).These results suggest that neck muscle temperature measurements may have utility in detecting circadian rhythm patterns in core temperature in sheep, but may not accurately reflect absolute core temperatures. Peripheral measures may require adjustment or correction to more accurately reflect absolute core temperature with respect to determining accurate clinical thresholds relative to the expected normal temperature for the time of day observed. Further investigation into the utility and application of peripheral measurement of body temperature is warranted.     

Reliability of bulky DNA adducts measurement by the nuclease P1 32P-post-labelling technique

The aim was to assess the reliability of bulky DNA adducts measurement by means of the ³²P-post-labelling assay. The research design consisted of an intramethod reliability study. Buffy coats from 41 subjects were used to obtain two aliquots of 1–5 μg DNA for each subject; bulky DNA adducts were measured using the nuclease P1 ³²P-post-labelling technique. The reliability of the measurement was assessed by means of the intraclass correlation coefficient (ICC), the distribution of the differences between the two measurements and the limits of agreement. The estimated ICC was 0.977, with a 95% confidence interval between 0.921 and 0.977. The limits of agreement were ±0.44 (DNA adducts per 10⁸ nucleotides). Only three subjects had differences lying out of such limits. Bulky DNA adduct levels measured by the ³²P-post-labelling technique showed good reliability. Only one measurement is needed to use DNA adducts as a biomarker of exposure and, possibly, cancer risk. Besides, as a validation analysis, ³²P-post-labelling measurements can be repeated in only 20–30% of samples.     

Within-day and between-days reliability of quadriceps isometric muscle fatigue using mechanomyography on healthy subjects

This study aimed to examine within-day and between-days intratester reliability of mechanomyography (MMG) in assessing muscle fatigue. An accelerometer was used to detect the MMG signal from rectus femoris. Thirty one healthy subjects (15 males) with no prior knee problems initially performed three maximum voluntary contractions (MVCs) using an ISOCOM dynamometer. After 10 min rest, subjects performed a fatiguing protocol in which they performed three isometric knee extensions at 75% MVC for 40 s. The fatiguing protocol was repeated on two other days, two to four days apart for between-days reliability. MMG activity was determined by overall root mean squared amplitude (RMS), mean power frequency (MPF) and median frequency (MF) during a 40 s contraction. RMS, MPF and MF linear regression slopes were also analysed. Intraclass Correlation Coefficients (ICC); ICC1,1 and ICC1,2 were used to assess within-day reliability and between-days reliability respectively. Standard error of measurement (SEM) and smallest detectable difference (SDD) described the within-subjects variability. MMG fatigue measures using linear regression slopes showed low reliability and large between-days error (ICC1,2 = 0.43–0.46; SDD = 306.0–324.8% for MPF and MF slopes respectively). Overall MPF and MF, on the other hand, were reliable with high ICCs and lower SDDs compared to linear slopes (ICC1,2 = 0.79–0.83; SDD = 21.9–22.8% for MPF and MF respectively). ICC1,2 for overall MMG RMS and linear RMS slopes were 0.81 and 0.66 respectively; however, the SDDs were high (56.4% and 268.8% respectively). The poor between-days reliability found in this study suggests caution in using MMG RMS, MPF and MF and their corresponding slopes in assessing muscle fatigue.     

Reliability and agreement of a dynamic quadriceps incremental test for the assessment of neuromuscular function

The quadriceps-intermittent-fatigue (QIF) test assesses knee extensors strength, endurance and performance fatigability in isometric condition. We aimed to assess reliability and agreement for this test in dynamic conditions and with the use of transcranial magnetic stimulation. On two separate sessions, 20 young adults (25 ± 4 yr, 10 women) performed stages of 100 knee extensors concentric contractions at 120°/s (60° range-of-motion) with 10% increments of the initial maximal concentric torque until exhaustion. Performance fatigability across the test was quantified as maximal isometric and concentric torque loss, and its mechanisms were investigated through the responses to transcranial magnetic and electrical stimulations. Reliability and agreement were assessed using ANOVAs, coefficients of variation (CVs) and intra-class correlation coefficients (ICCs) with 95% CI. Good inter-session reliability and high agreement were found for number of contractions [489 ± 75 vs. 503 ± 95; P = 0.20; ICC = 0.85 (0.66; 0.94); CV = 5% (3; 7)] and total work [11,285 ± 4,932 vs. 11,792 ± 5838 Nm.s; P = 0.20; ICC = 0.95 (0.87; 0.98); CV = 8% (5; 11)]. Poor reliability but high agreement were observed for isometric [–33 ± 6 vs. −31 ± 7%; P = 0.13; ICC = 0.47 (0.05; 0.75); CV = 6% (4;8)] and concentric [−20 ± 11% vs. −19 ± 9%; P = 0.82; ICC = 0.26 (−0.22; 0.63); CV = 9% (6; 12)] torque loss. The dynamic QIF test represents a promising tool for neuromuscular evaluation in isokinetic mode.     

Reliability of a modified motor unit number index (MUNIX) technique

IntroductionThe purpose of this study was to examine the relative and absolute between-day reliability of the motor unit number index (MUNIX).MethodsYoung, healthy adults (n = 19) attended two testing sessions separated by 4-weeks where their maximal pinch-grip strength, MUNIX, and motor unit size index (MUSIX) were assessed in the abductor pollicis brevis muscle. Reliability was assessed by intraclass correlation coefficients (ICC), coefficient of variation (CV) and limits of agreement (LOA).ResultsNo mean differences were observed for MUNIX or MUSIX. The CV for the MUNIX and MUSIX measures were between 13.5% and 17.5%. The ICC for both measures were moderate to moderately-high (0.73–0.76), The LOA for both indicated a homoscedastic relationship.DiscussionOur findings indicate moderate to moderately-high reliability for both MUNIX and MUSIX. Future work is needed to ensure both measures are reliable in other muscles and cohorts, and further investigations are required to examine the validity of MUNIX.     

Measurement of Waist and Hip Circumference with a Body Surface Scanner: Feasibility,Validity, Reliability,and Correlations with Markers of the Metabolic Syndrome

Objective

Body surface scanners (BS), which visualize a 3D image of the human body, facilitate the computation of numerous body measures, including height, waist circumference (WC) and hip circumference (HC). However, limited information is available regarding validity and reliability of these automated measurements (AM) and their correlation with parameters of the Metabolic Syndrome (MetS) compared to traditional manual measurements (MM).

Methods

As part of a cross-sectional feasibility study, AM of WC, HC and height were assessed twice in 60 participants using a 3D BS (Vitus^smartXXL). Additionally, MM were taken by trained personnel according to WHO guidelines. Participants underwent an interview, bioelectrical impedance analysis, and blood pressure measurement. Blood samples were taken to determine HbA1c, HDL-cholesterol, triglycerides, and uric acid. Validity was assessed based on the agreement between AM and MM, using Bland-Altman-plots, correlation analysis, and paired t-tests. Reliability was assessed using intraclass correlation coefficients (ICC) based on two repeated AM. Further, we calculated age-adjusted Pearson correlation for AM and MM with fat mass, systolic blood pressure, HbA1c, HDL-cholesterol, triglycerides, and uric acid.

Results

Body measures were higher in AM compared to MM but both measurements were strongly correlated (WC, men, difference = 1.5cm, r = 0.97; women, d = 4.7cm, r = 0.96; HC, men, d = 2.3cm, r = 0.97; women, d = 3.0cm; r = 0.98). Reliability was high for all AM (nearly all ICC>0.98). Correlations of WC, HC, and the waist-to-hip ratio (WHR) with parameters of MetS were similar between AM and MM; for example the correlation of WC assessed by AM with HDL-cholesterol was r = 0.35 in men, and r = -0.48 in women, respectively whereas correlation of WC measured manually with HDL cholesterol was r = -0.41 in men, and r = -0.49 in women, respectively.

Conclusions

Although AM of WC, HC, and WHR are higher when compared to MM based on WHO guidelines, our data indicate good validity, excellent reliability, and similar correlations to parameters of the MetS.     

Validity of hand-to-foot measurement of bioimpedance: standing compared with lying position

Objective: To assess the reliability of the standing measurement of hand‐to‐foot bioimpedance compared with measurements made in the lying position. Research Methods and Procedures: In 205 volunteers 6 to 89 years of age, 111 males and 94 females from six ethnic groups, effects of posture, time, and age on hand‐to‐foot resistance were studied over a range of body size. The effect of time in a position on resistance was also recorded in a small subset (n = 10), and repeat measurements over 3 days at the same time of the day were recorded in another subset (n = 12). Results: Lying impedance was consistently higher than standing, with the relationship (resistance lying/resistance standing) for the children (5 to 14 years) being 1.031, progressing to a ratio of 1.016 in those >60 years. The time spent static in either position did change resistance measurements—a decrease of up to 9 Ω (mean 5 Ω, 1.0%) over 10 minutes of standing and an increase of up to 7 Ω (mean 3 Ω, 0.7%) with lying. Discussion: In the field, measurements of hand‐to‐foot bioimpedance can be made in the standing position, and, with appropriate adjustment, previously validated recumbent equations can be used. Given that errors in the measurement of height and weight also affect the reliability of the derivation of body fat from bioelectrical conductance, the errors that may arise from a more practical standing measurement rather than lying are minimal.     

Internal consistency and test–retest reliability of an instrumented functional reaching task using wireless electromyographic sensors

The purpose of this study was to establish the internal consistency and test–retest reliability of the electromyographic and accelerometric data sampled from the prime movers of the dominant arm during an antigravity, within-arm’s length stand-reaching task without trunk restraint. Ten healthy young adults participated in two experimental sessions, approximately 7–10 days apart. During each session, subjects performed 15 trials of both a flexion- and an abduction-reaching task. Surface EMG and acceleration using wireless sensors were sampled from the anterior and middle deltoid. Reliability was established using Cronbach’s alpha, intraclass correlation coefficients (ICC 2, k) and standard error of measurements (SEM) for electromyographic reaction time, burst duration and normalized amplitude along with peak acceleration. Results indicated high degrees of inter-trial and test–retest reliability for flexion (Cronbach’s α range = 0.92–0.99; ICC range = 0.82–0.92) as well as abduction (Cronbach’s α range = 0.94–0.99; ICC range = 0.81–0.94) reaching. The SEM associated with response variables for flexion and abduction ranged from 1.55–3.26% and 3.33–3.95% of means, respectively. Findings from this study revealed that electromyographic and accelerometric data collected from prime movers of the arm during the relatively functional stand-reaching task were highly reproducible. Given its high reliability and portability, the proposed test could have applications in clinical and laboratory settings to quantify upper limb function.     

Reliability and variability of bioimpedance measures in normal adults: effects of age, gender, and body mass

This study aimed to analyze the reliability and evaluate the causes of variability of bioimpedance parameters. Direct measures were analyzed because they are not affected by inappropriate prediction models. Resistance (R), reactance (Xc), and phase angle (PA) were determined at three fixed frequencies (5, 50, and 100 kHz) in 653 normal Germans (244 males and 409 females), aged 20-90 years, using a phase-sensitive whole-body tetrapolar bioimpedance analyzer (BIA 2000-M, Data Input, Germany). From these values, six bioimpedance ratios were calculated (R(5)/R(50), R(5)/R(100), Xc(5)/Xc(50), Xc(5)/Xc(100), PA(5)/PA(50), and PA(5)/PA(100)). Reliability of duplicate measurements, as determined by technical error, is high. ANOVA for repeated measurements yields a significant frequency main effect (within-subjects factor) and significant effects of age and gender (between-subject factors) on variation of resistance, reactance, and phase angle. Multiple regression analyses indicate independent effects of age, gender, and body mass index on variability of resistance, reactance, and phase angle at the three frequencies. Gender primarily influences variation in resistance (smaller values in males), whereas age mainly affects variations in reactance and phase angle (smaller values in older adults). Obesity is associated with smaller resistance (at all frequencies) and smaller reactance (high frequencies), but larger phase-angle values (low frequency). The study shows that variability of direct bioimpedance measures depends on age, gender, and body mass characteristics of the study population. The potential benefit for using both low and high frequencies in R measures is to differentiate between extra- and intracellular fluid spaces, which may be altered during human growth and aging.     

Reliability of high-density surface electromyography for assessing characteristics of the thoracic erector spinae during static and dynamic tasks

PurposeTo establish intra- and inter-session reliability of high-density surface electromyography (HDEMG)-derived parameters from the thoracic erector spinae (ES) during static and dynamic goal-directed voluntary movements of the trunk, and during functional reaching tasks.MethodsTwenty participants performed: 1) static trunk extension, 2) dynamic trunk forward and lateral flexion, and 3) multidirectional functional reaching tasks on two occasions separated by 7.5 ± 1.2 days. Muscle activity was recorded bilaterally from the thoracic ES. Root mean square (RMS), coordinates of the barycentre, mean frequency (MNF), and entropy were derived from the HDEMG signals. Reliability was determined with intraclass correlation coefficient (ICC), coefficient of variation, and standard error of measurement.ResultsGood-to-excellent intra-session reliability was found for all parameters and tasks (ICC: 0.79-0.99), whereas inter-session reliability varied across tasks. Static tasks demonstrated higher reliability in most parameters compared to functional and dynamic tasks. Absolute RMS and MNF showed the highest overall reliability across tasks (ICC: 0.66-0.98), while reliability of the barycentre was influenced by the direction of the movements.ConclusionRMS and MNF derived from HDEMG show consistent inter-session reliability in goal-directed voluntary movements of the trunk and reaching tasks, whereas the measures of the barycentre and entropy demonstrate task-dependent reliability.     

Between-day reliability of a hand-held dynamometer and surface electromyography recordings during isometric submaximal contractions in different shoulder positions

Functional shoulder assessments require the use of objective and reliable standardized outcome measures. Therefore, the aim of this study was to examine the between-day reliability of a hand-held dynamometer when measuring muscle strength during flexion, abduction, and internal and external rotation as well as surface electromyography (EMG) when measuring muscle activity from m. trapezius superior and deltoideus anterior. Twenty-four healthy subjects participated and performed four isometric contractions measured with a hand-held dynamometer and EMG. Both relative and absolute reliability were calculated based on the mean of the last three of the four repetitions. EMG amplitude was assessed calculating both absolute and normalized root-mean-square (RMS) values. The reliability of the hand-held dynamometer was high (LOA = 3.2–7.6% and ICC = 0.89–0.98). The absolute reliability for EMG showed similar results for absolute RMS values (LOA = 20.0–68.4%) and normalized RMS values (LOA = 42.4–66.5%). However, the results concerning the relative reliability showed higher ICC for absolute RMS values (ICC = 0.82–0.92) compared with normalized values (ICC = 0.57–0.72).The outcome measurements of this study with healthy subjects were found reliable and, therefore, have the potential to detect changes in muscle strength and muscle activity.     

Issues of cost and efficiency in the design of reliability studies

Reliability of continuous and dichotomous responses is usually assessed by means of the intraclass correlation coefficient (ICC). We derive the optimal allocation of the number of subjects k and the number of repeated measurements n that minimize the variance of the estimated ICC. Cost constraints are discussed for the case of normally distributed responses. Tables showing optimal choices of k and n are given, along with guidelines for the design of reliability studies in light of our results and those reported by others.     

Reliability of ultrasound measurement for isolated control of the transversus abdominis muscle during abdominal hollowing: A secondary analysis

Ultrasonography (US) measurements of the transversus abdominis muscle (TrA) during abdominal hollowing (AH) are conducted at the maximum AH, which would be unable to evaluate isolated control of the TrA to the internal or external oblique muscles (outer muscles). The present study aimed to establish a reliable method to evaluate the skills of isolated control of the TrA to the outer muscles using US. The datasets of two follow-ups were analyzed with 1-week interval of a wait-and-see control group comprising 20 participants with LBP in a randomized controlled trial. The primary measures were; % change in the thickness of the TrA at 1 cm lateral to the muscle–fascia junction of the TrA, and changes in horizontal distance of the superior edge of the TrA fascia. The measurement time points were immediately before AH during resting and when outer muscle thickness above 1 cm lateral to the muscle–fascia junction of the TrA increased by 10%. Consequently, five repetitions were required to obtain a stable mean value and good reliability (intraclass correlation coefficient [ICC]_(1,5) = 0.65–0.68 for the % change, and 0.84–0.88 for the change in horizontal distance; ICC_(2,5) = 0.82 for the % change, and 0.93 for the change in horizontal distance).