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The validity and reliability of preoperative radiographic canal diameter measurements of the femur.

ABSTRACT: BACKGROUND: The femoral canal is frequently measured preoperatively in cases where an intramedullary device is planned for operative fixation of a fracture. To our knowledge, a formal assessment of validity and reliability of preoperative canal measurements has not been previously performed. QUESTIONS/PURPOSES: This study aims to determine the validity and reliability of preoperative canal measurements of the femur made on plain radiographs using comparison with curved planar reformation software as the gold standard. METHODS: Fifty-six patients were identified based on availability of anterior-posterior (AP) and lateral radiographs of the femur and computed tomography (CT) of the lower extremity. Four "raters" measured the canal diameter at its narrowest point and the distance from the lesser trochanter to the isthmus on the AP, lateral radiograph, and CT. The width of the femoral nail on AP radiographs was also measured to determine magnification error. Curved planar reformation (CPR) was used to provide the most accurate calculation of the canal diameter. RESULTS: Compared to the isthmus position determined by CPR, the measurement was most accurate on an AP and the diameter of the canal was most accurate using coronal CT, followed by AP radiographs. The measured canal diameter of the fractured femur on APs was compared to that of the used implant and varied by 1 mm. DISCUSSION/CONCLUSION: The AP plain radiographic measurement was found to be more accurate for determination of the canal diameter compared to the lateral radiograph. These findings confirm the utility of preoperative canal measurements in predicting the feasibility of placing a specific size intramedullary implant.

SUBMITTER: Walsh KP

PROVIDER: S-EPMC3757481 | biostudies-other | 2013 Jul

REPOSITORIES: biostudies-other

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The validity and reliability of preoperative radiographic canal diameter measurements of the femur.

Walsh Kenneth P KP Fowler John R JR Chen Oliver O Gaughan John P JP Ali Sayed S Rehman Mahin M Rehman Saqib S

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20130621 2

<h4>Background</h4>The femoral canal is frequently measured preoperatively in cases where an intramedullary device is planned for operative fixation of a fracture. To our knowledge, a formal assessment of validity and reliability of preoperative canal measurements has not been previously performed.<h4>Questions/purposes</h4>This study aims to determine the validity and reliability of preoperative canal measurements of the femur made on plain radiographs using comparison with curved planar reform ...[more]

PMID: 24426861

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Project description:The cervical range of motion device (CROM) has been shown to provide reliable forward head position (FHP) measurement when the upper cervical angle (UCA) is controlled. However, measurement without UCA standardization is reflective of habitual patterns. Criterion validity has not been reported. The purposes of this study were to establish: (1) criterion validity of CROM FHP and UCA compared to Optotrak data, (2) relative reliability and minimal detectable change (MDC95) in patients with and without cervical pain, and (3) to compare UCA and FHP in patients with and without pain in habitual postures.(1) Within-subjects single session concurrent criterion validity design. Simultaneous CROM and OP measurement was conducted in habitual sitting posture in 16 healthy young adults. (2) Reliability and MDC95 of UCA and FHP were calculated from three trials. (3) Values for adults over 35 years with cervical pain and age-matched healthy controls were compared.(1) Forward head position distances were moderately correlated and UCA angles were highly correlated. The mean (standard deviation) differences can be expected to vary between 1·48 cm (1·74) for FHP and -1·7 (2·46)° for UCA. (2) Reliability for CROM FHP measurements were good to excellent (no pain) and moderate (pain). Cervical range of motion FHP MDC95 was moderately low (no pain), and moderate (pain). Reliability for CROM UCA measurements was excellent and MDC95 low for both groups. There was no difference in FHP distances between the pain and no pain groups, UCA was significantly more extended in the pain group (P<0·05).Cervical range of motion FHP measurements were only moderately correlated with Optotrak data, and limits of agreement (LOA) and MDC95 were relatively large. There was also no difference in CROM FHP distance between older symptomatic and asymptomatic individuals. Cervical range of motion FHP measurement is therefore not recommended as a clinical outcome measure. Cervical range of motion UCA measurements showed good criterion validity, excellent test-retest reliability, and achievable MDC95 in asymptomatic and symptomatic participants. Differences of more than 6° are required to exceed error. Cervical range of motion UCA shows promise as a useful reliable and valid measurement, particularly as patients with cervical pain exhibited significantly more extended angles.

Project description:BackgroundA patient's physical function plays a leading role in the treatment prescription for patients with cancer. Objective assessments of physical function may be more predictive for treatment tolerability and survival than frequently used subjective measures, such as the Eastern Cooperative Oncology Group/World Health Organization (ECOG/WHO) performance score. The use of smartphones to measure physical activity and fitness may provide an excellent opportunity to objectively estimate a patient's physical function against low costs and little time. We investigated feasibility, validity and reliability of smartphone measurements of step count and physical fitness in patients with cancer.MethodsIn total, 72 patients participated. They wore a smartphone for 14 days to measure the mean number of steps per day, concomitant with an accelerometer during the first 7 days. Patients performed a six-minute walk test (6MWT) twice outdoors via a smartphone application and once in a test environment in the hospital. Feasibility was evaluated by the proportion of patients who completed the study as well as smartphone assessments of step count and physical fitness. Validity was assessed with the intraclass correlation coefficient (ICC) between the accelerometer and the first week of the smartphone for step count, and between the 6MWT in the hospital and via the application for physical fitness. Test-retest reliability was assessed with the ICC between step count levels of the first and second week of smartphone assessments, and between the first and second six-minute walk test in the home environment.ResultsThe completeness of smartphone measurements was approximately 90% for step count and 64% for physical fitness assessments. Validity was excellent for step count (ICC = 0.97, p < 0.001) and fair for fitness (ICC = 0.47, p < 0.001). We found excellent test-retest reliability for step count (ICC = 0.91, p < 0.001) and physical fitness (ICC = 0.88, p < 0.001).ConclusionsThis study showed that objective smartphone measurements of step count in clinical practice are feasible, valid and reliable. These findings indicate that the use of smartphones to objectively assess physical activity in clinical cancer practice is promising and may be used to select patients for treatment and study participation, to monitor patients during treatment and to guide treatment decisions.

Project description:BACKGROUND:Muscle strength measurements using hand-held dynamometry (HHD) can be affected by the inadequate strength of the tester and lack of stabilization of the participants and the device. A portable HHD anchoring system was designed that enabled the measurement of isometric knee extensor muscle strength in a supine position. This can be used with individuals who are unable to assume the sitting position required for the measurement of knee extensor strength in conventional isokinetic dynamometry (IKD). The aim of this study was to evaluate the reliability and validity of knee extensor strength measurements using this device. METHODS:The maximal knee extensor isometric strength of the dominant leg in healthy adults aged 20 to 40?years was tested. Three trials of three contractions were assessed by two raters using the portable dynamometer anchoring system whilst the participant was in the supine position. After the three measurement trials, peak knee extensor torque was evaluated using IKD. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) for intra- and inter-rater reliability were obtained. RESULTS:Thirty-nine participants (19 male and 20 female, aged 30.08?±?4.16 y), completed the three measurement trials. The ICC for intra-rater reliability was 0.98 for the maximum measurements of knee extensor strength (95% confidence interval [CI]: 0.96-0.98) and 0.98 (95% CI: 0.96-0.99) for inter-rater reliability. The mean difference (%) between the maximum knee extensor strength measurements of each trial was 1.02% (LOA range: -?11.13 to 13.16%) for intra-rater and?-?1.44% (LOA range: -?13.98 to 11.08%) for inter-rater measurements. The Pearson correlation coefficient of the maximum voluntary peak torque measurements with the portable dynamometer anchoring system and IKD was 0.927. CONCLUSIONS:The portable dynamometer anchoring system is a reliable and valid tool for measuring isometric knee extensor strength in a supine position. Future clinical feasibility studies are needed to determine if this equipment can be applied to people with severe illness or disabilities. TRIAL REGISTRATION:KCT0003041 .

Project description:The advantages of intraoral model scanning have yielded recent developments. However, few studies have explored the orthodontic clinical use of this technique particularly among young patients. This study aimed to evaluate the reliability, reproducibility and validity of the orthodontic measurements: tooth width, arch length and arch length discrepancy in each digital model obtained by model scanner and intraoral scanner, relative to a plaster model. Arch length measured using two methods: curved arch length (CAL) measured automatically by digital program and sum of sectional liner arch length (SLAL) measured sum of anterior and posterior liner arch lengths. Arch length discrepancy calculated each arch length measurement methods: curved arch length discrepancy (CALD) and sum of sectional liner arch length discrepancy (SLALD). Forty young patients were eligible for the study. A plaster model (P), model-scanned digital model (MSD) and intraoral scanned digital model (ISD) were acquired from each patient. The reliability of the measurements was evaluated using Pearson's correlation coefficient, while the reproducibility was evaluated using the intraclass correlation coefficient. The validity was assessed by a paired t-test. All measurements measured in P, MSD and ISD exhibited good reliability and reproducibility. Most orthodontic measurements despite of CAL in MSD exhibited high validity. Only the SLAL and SLALD in ISD group differed significantly, despite the good validity of the tooth width, CAL and CALD. The measurements based on the digital program appeared high reliability, reproducibility and accurate than conventional measurement. However, SLAL and SLALD in ISD group appeared shorter because of distortion during intraoral scanning. However, this could be compensated by using digital programed curved arch. Although the validity of SLAL and SLALD in the ISD group differed statistically, the difference is not considered clinically significant. Although MSD and ISD are acceptable for a clinical space analysis, clinicians should be aware of digital model-induced errors.

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The validity and reliability of preoperative radiographic canal diameter measurements of the femur.

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The validity and reliability of preoperative radiographic canal diameter measurements of the femur.

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