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Inter- and intra-unit reliability of the COSMED K5: Implications for multicentric and longitudinal testing.

ABSTRACT: PURPOSE:To evaluate the intra-unit (RELINTRA) and inter-unit reliability (RELINTER) of two structurally identical units of the metabolic analyser K5 (COSMED, Rome, Italy) that allows to utilize either breath-by-breath (BBB) or dynamic mixing chamber (DMC) technology. METHODS:Identical flow- and gas-signals were transmitted to both K5s that always operated simultaneously either in BBB- or DMC-mode. To assess RELINTRA and RELINTER, a metabolic simulator was applied to simulate four graded levels of respiration. RELINTRA and RELINTER were expressed as typical error (TE%) and Intraclass Correlation Coefficient (ICC). To assess also inter-unit differences via natural respiratory signals, 12 male athletes performed one incremental bike step test each in BBB- and DMC-mode. Inter-unit differences within biological testing were expressed as percentages. RESULTS:In BBB, TE% of RELINTRA ranged 0.30-0.67 vs. RELINTER 0.16-1.39 and ICC ranged 0.57-1.00 vs. 0.09-1.00. In DMC, TE% of RELINTRA ranged 0.38-0.90 vs. RELINTER 0.03-0.86 and ICC ranged 0.22-1.00 vs. 0.52-1.00. Mean inter-unit differences ranged -2.30-2.20% (Cohen's ds (ds) 0.13-1.52) for BBB- and -0.55-0.61% (ds 0.00-0.65) for DMC-mode, respectively. Inter-unit differences for [Formula: see text] and RER were significant (p < 0.05) at each step. CONCLUSION:Two structurally identical K5-units demonstrated accurate RELINTRA with TE < 2.0% and similar RELINTER during metabolic simulation. During biological testing, inter-unit differences for [Formula: see text] and RER in BBB-mode were higher than 2% with partially large ES in BBB. Hence, the K5 should be allocated personally wherever possible. Otherwise, e.g. in multicenter studies, a decrease in total reliability needs to be considered especially when the BBB-mode is applied.

SUBMITTER: Winkert K

PROVIDER: S-EPMC7584194 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Inter- and intra-unit reliability of the COSMED K5: Implications for multicentric and longitudinal testing.

Winkert Kay K Kamnig Rupert R Kirsten Johannes J Steinacker Jürgen M JM Treff Gunnar G

PloS one 20201023 10

<h4>Purpose</h4>To evaluate the intra-unit (RELINTRA) and inter-unit reliability (RELINTER) of two structurally identical units of the metabolic analyser K5 (COSMED, Rome, Italy) that allows to utilize either breath-by-breath (BBB) or dynamic mixing chamber (DMC) technology.<h4>Methods</h4>Identical flow- and gas-signals were transmitted to both K5s that always operated simultaneously either in BBB- or DMC-mode. To assess RELINTRA and RELINTER, a metabolic simulator was applied to simulate four ...[more]

PMID: 33096546

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Project description:BackgroundMusculoskeletal disorders particularly in the back and lower extremities are common among marines. Here, movement-control tests are considered clinically useful for screening and follow-up evaluation. However, few studies have addressed the reliability of clinical tests, and no such published data exists for marines. The present aim was therefore to determine the inter- and intra-observer reliability of clinically convenient tests emphasizing movement control of the back and hip among marines. A secondary aim was to investigate the sensitivity and specificity of these clinical tests for discriminating musculoskeletal pain disorders in this group of military personnel.MethodsThis inter- and intra-observer reliability study used a test-retest approach with six standardized clinical tests focusing on movement control for back and hip. Thirty-three marines (age 28.7 yrs, SD 5.9) on active duty volunteered and were recruited. They followed an in-vivo observation test procedure that covered both low- and high-load (threshold) tasks relevant for marines on operational duty. Two independent observers simultaneously rated performance as "correct" or "incorrect" following a standardized assessment protocol. Re-testing followed 7-10 days thereafter. Reliability was analysed using kappa (κ) coefficients, while discriminative power of the best-fitting tests for back- and lower-extremity pain was assessed using a multiple-variable regression model.ResultsInter-observer reliability for the six tests was moderate to almost perfect with κ-coefficients ranging between 0.56-0.95. Three tests reached almost perfect inter-observer reliability with mean κ-coefficients > 0.81. However, intra-observer reliability was fair-to-moderate with mean κ-coefficients between 0.22-0.58. Three tests achieved moderate intra-observer reliability with κ-coefficients > 0.41. Combinations of one low- and one high-threshold test best discriminated prior back pain, but results were inconsistent for lower-extremity pain.ConclusionsOur results suggest that clinical tests of movement control of back and hip are reliable for use in screening protocols using several observers with marines. However, test-retest reproducibility was less accurate, which should be considered in follow-up evaluations. The results also indicate that combinations of low- and high-threshold tests have discriminative validity for prior back pain, but were inconclusive for lower-extremity pain.

Dataset Information

Inter- and intra-unit reliability of the COSMED K5: Implications for multicentric and longitudinal testing.

Publications

Inter- and intra-unit reliability of the COSMED K5: Implications for multicentric and longitudinal testing.

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