The purpose of this study was a serial assessment of gross motor development of infants at risk is an established procedure in neonatal follow-up clinics. Assessments based on home video recordings could be a relevant addition. In 48 infants (1.5-19 months), the concurrent validity of 2 applications was examined using the Alberta Infant Motor Scale: (1) a home video made by parents and (2) simultaneous observation on-site by a pediatric physical therapist. Parents’ experiences were explored using a questionnaire.
BACKGROUND AND PURPOSE: The MyotonPRO is a portable device that measures muscle tone and biomechanical muscle properties objectively. MyotonPRO has already proven to be effective in measuring muscle properties in healthy and diseased populations. However, to the best of our knowledge, it has never been tested in individuals suffering from paratonia, a form of hypertonia frequently accompanying dementia. The aims of the present study were to (1) compare muscle tone, elasticity, and stiffness between 3 different subpopulations of young and old healthy adults and individuals with paratonia, and (2) investigate the intra- and interrater reproducibility of MyotonPRO measurements of the biceps brachii (BB) muscle in each subpopulation.METHODS: MyotonPRO measurements of muscle tone, elasticity, and dynamic stiffness were carried out by 2 investigators on 2 different days over the BB muscles of 54 participants (18 healthy young adults, 20 healthy older adults, and 16 older individuals with paratonia). Muscle properties were compared between subpopulations using ANOVA/Welch and post hoc tests. Reliability (intraclass correlation coefficient) and agreement parameters (standard error of measurement and the minimal detectable change) were calculated.RESULTS: Statistically significant differences between subpopulations were found in all parameters, except for stiffness between healthy elderly and individuals with paratonia. In the healthy subpopulations, (a) intrarater reliability was very high and intrarater agreement was good between 2 consecutive series, (b) between days intrarater reliability was low to high and intrarater agreement was variable, (c) interrater reliability was high to very high and interrater agreement was good. In individuals with paratonia, (a) intrarater reliability was moderate to high and agreement was variable between series, (b) between days intrarater reliability was poor to moderate and agreement was poor, (c) interrater reliability ranged from low to high with poor agreement.CONCLUSIONS: MyotonPRO measurements of the BB muscle showed good reproducibility in both healthy subpopulations, particularly for measurements performed within the same day. In individuals with paratonia, reliability and agreement were substantially lower. MyotonPRO can be used in clinical assessment and research. However, in individuals with paratonia, careful interpretation of results is required. Research in a larger sample of persons with paratonia at different stages of disease severity is recommended.
BACKGROUND: Intensive care unit (ICU) stays often lead to reduced physical functioning. Change in physical functioning in patients in the ICU is inadequately assessed through available instruments. The de Morton Mobility Index (DEMMI), developed to assess mobility in elderly hospitalized patients, is promising for use in patients who are critically ill.OBJECTIVE: The aim of this study was to evaluate the clinimetric properties of the DEMMI for patients in the ICU.DESIGN: A prospective, observational reliability and validity study was conducted.METHODS: To evaluate interrater and intrarater reliability (intraclass correlation coefficients), patients admitted to the ICU were assessed with the DEMMI during and after ICU stay. Validity was evaluated by correlating the DEMMI with the Barthel Index (BI), the Katz Index of Independence in Activities of Daily Living (Katz ADL), and manual muscle testing (MMT). Feasibility was evaluated based on the percentage of participants in which the DEMMI could be assessed, the floor and ceiling effects, and the number of adverse events.RESULTS: One hundred fifteen participants were included (Acute Physiology and Chronic Health Evaluation II [APACHE II] mean score=15.2 and Sepsis-related Organ Failure Assessment [SOFA] mean score=7). Interrater reliability was .93 in the ICU and .97 on the wards, whereas intrarater reliability during the ICU stay was .68. Validity (Spearman rho coefficient) during the ICU stay was .56, -.45, and .57 for the BI, Katz ADL, and MMT, respectively. The DEMMI showed low floor and ceiling effects (2.6%) during and after ICU discharge. There were no major adverse events.LIMITATIONS: Rapid changes in participants' health status may have led to underestimation of intrarater reliability.CONCLUSION: The DEMMI was found to be clinically feasible, reliable, and valid for measuring mobility in an ICU population. Therefore, the DEMMI should be considered a preferred instrument for measuring mobility in patients during and after their ICU stay.
