Intratester Reliability for Quantification of Forces With Accessory and Physiologic Movements Stratified Between First, Second, and Third Year Physical Therapy Students Using Computerized Instrumented Shoulder Models

Document Type

Article

Publication Date

2013

Publication Title

Journal of Orthopaedic & Sports Physical Therapy

ISSN

1938-1344

Abstract

Purpose/Hypothesis: The purpose of the study was to determine the intratester reliability for quantification of forces of accessory and physio-logical movements between first-, second-, and third-year physical therapy students using computerized instrumented shoulder models. We hypothesized the results would demonstrate good reliability among each year of experience.

Number Of Subjects: Fourteen first-year, 19 second-year, and 12 third-year physical therapy students.

Materials/Methods: Each subject performed 2 trials of movements on a shoulder model, instrumented with transducers calibrated to measure forces applied, in randomized order: anterior glide (AG), posterior glide (PG), internal rotation (IR), and external rotation (ER). The examiner demonstrated each of the techniques before the subjects performed their initial testing. Subjects were permitted a 10-second practice trial before performing the 10-second test trial of Maitland’s grade IV (IV) and grade II (II) mobilizations; subjects returned within 48 to 72 hours to repeat tests. Transducer signals were captured at 30 Hz and exported to MAT-LAB Version 2009a, where the mean of the last 7 seconds was calculated.

Results: Test-retest reliability was assessed using intraclass correlation coefficients (ICCs) of the means using SPSS Version 17. Calculated ICCs were stratified for each year of the student’s experience. The values for the test movements of the first-year students are as follows: PG II = 0.35, PG IV = 0.57, AG II = 0.79, AG IV = 0.82, ER II = 0.80, ER IV = 0.88, IR II = 0.62, and IR IV = 0.79. The ICC values for the second-year stu-dents are as follows: PG II = 0.64, PG IV = 0.84, AG II = 0.59, AG IV = 0.63, ER II = 0.81, ER IV = 0.86, IR II = 0.60, and IR IV = 0.87. The ICC values for the third-year students are as follows: PG II = 0.23, PG IV = 0.65, AG II = 0.11, AG IV = 0.29, ER II = 0.86, ER IV = 0.86, IR II = 0.75, IR IV = 0.91.

Conclusion: Portney and Watkins describe ICCs greater than 0.75 rep-resent good reliability and less than 0.75 reflect moderate to poor reli-ability. The results supported part of the hypothesis, showing all physi-cal therapy students demonstrated good intratester reliability during ER II and IV and IR IV. First-year physical therapy students demonstrated good reliability for AG II and IV as well. Second-year physical therapy students also demonstrated good reliability with PG IV. Third-year phys-ical therapy students demonstrated good reliability with IR II. All other movements demonstrated moderate to poor reliability between the dif-ferent classes stratified by years of experience.

Clinical relevance: Physical therapists perform joint mobilizations on patients on a daily basis, but there is no evidence to quantify the forces that are used when these mobilizations are performed. The computerized shoulder model captured the forces during mobilizations applied by first-, second-, and third-year physical therapy students. The calculated results demonstrated that physical therapy students are consistent in some mobilizations, but inconsistent in others

Comments

©2013 Journal of Orthopaedic & Sports Physical Therapy d/b/a Movement Science Media

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