Innovative Diagnostics Tools in Physiotherapy: from the Laboratory to the Clinical Setting

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 56601

Special Issue Editors


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Guest Editor

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Co-Guest Editor
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
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Special Issue Information

Proper diagnosis in physical therapy is a challenging step before the application of any clinical procedure. The evidence-based physical therapy paradigm has established the patterns of a well-grounded practice, and the diagnosis and monitoring of the status and the evaluation of the patients are also submitted to the highest standardized rules.

Currently, the broad spectrum of pathologies and syndromes requiring physical therapy attention has been increased. Nevertheless, an adequate support of proper and valuable diagnostic procedures is not always available.

Recently, technological and non-technological tools have been developed with promising approaches in health care and, specifically, in physiotherapy. Some examples include movement analyses throughout portable or non-portable devices, such as inertial measurement units, cameras, or smartphones; and the evaluation of normal tissue mechanical properties determined by elastography, ultrasound, or myotonometry. Examples of non-technological tools include the identification of clinical features (clinical prediction rules) for anticipating the results of defined treatments; specific questionnaires designed to address pathological features of chronic pain syndromes; or patient classification systems for a better definition of the most disabling syndromes, such as low back pain or fibromyalgia.

In summary, this Special Issue targets any innovative solution for a better detection, quantification, or control of any relevant biopsychosocial dimensions for physical therapy in clinical setting application.

Prof. Francisco Alburquerque-Sendín
Prof. César Fernández-de-las-Peñas
Guest Editors

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Keywords

  • innovative diagnostic tools
  • physical therapy diagnosis
  • diagnosis in clinical settings
  • biopsychosocial model evaluation tools

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Published Papers (15 papers)

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9 pages, 400 KiB  
Article
Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study
by Cecilia Estrada-Barranco, Roberto Cano-de-la-Cuerda, Vanesa Abuín-Porras and Francisco Molina-Rueda
Diagnostics 2021, 11(2), 365; https://doi.org/10.3390/diagnostics11020365 - 21 Feb 2021
Cited by 13 | Viewed by 3678
Abstract
(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke [...] Read more.
(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months). Full article
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21 pages, 1772 KiB  
Article
Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study
by Sandra Alcaraz-Clariana, Lourdes García-Luque, Juan Luis Garrido-Castro, César Fernández-de-las-Peñas, Cristina Carmona-Pérez, Daiana Priscila Rodrigues-de-Souza and Francisco Alburquerque-Sendín
Diagnostics 2021, 11(2), 352; https://doi.org/10.3390/diagnostics11020352 - 20 Feb 2021
Cited by 17 | Viewed by 3727
Abstract
Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify [...] Read more.
Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups. Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated. The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls. Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls. This study supports a tendency of the affectation of other spinal regions when only one is affected. Full article
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15 pages, 911 KiB  
Article
Reproducibility and Concurrent Validity of Manual Palpation with Rehabilitative Ultrasound Imaging for Assessing Deep Abdominal Muscle Activity: Analysis with Preferential Ratios
by Irene Valentín-Mazarracin, Miriam Nogaledo-Martín, Ibai López-de-Uralde-Villanueva, César Fernández-de-las-Peñas, María Stokes, José L. Arias-Buría, María J. Díaz-Arribas and Gustavo Plaza-Manzano
Diagnostics 2021, 11(2), 298; https://doi.org/10.3390/diagnostics11020298 - 13 Feb 2021
Cited by 5 | Viewed by 5059
Abstract
The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- [...] Read more.
The abdominal drawing-in maneuver (ADIM) is a clinical tool used for identifying preferential activity of deep abdominal muscles. However, concurrent validity and reproducibility of palpation during the ADIM has not been formally investigated. The aims of this study were (1) to assess intra- and interrater reliability of manual palpation during the ADIM, and (2) to determine the concurrent validity of manual palpation during the ADIM by calculating preferential activation ratio cut-off as assessed with ultrasound imaging (RUSI). Thirty-two subjects (n = 16 patients with nonspecific low back pain and 16 comparable healthy individuals) performed the ADIM in a supine hook-lying position. Two experienced assessors evaluated the presence or absence of preferential contraction of the deep abdominal muscles by palpation during the ADIM on 2 different days. Intrarater (test-retest) and interrater reliability of palpation were calculated using Cohen’s kappa coefficients. Muscle thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles at rest and during the ADIM were also measured. TrA-Contraction Ratio (TrA-CR), TrA-Preferential Activation Ratio (TrA-PAR), and Modified-TrA-PR (M-TrA-PAR) were calculated. The concurrent validity of manual palpation was determined using the correlation between manual palpation and imaging and by calculating ROC curve (operating characteristics curve), Youden index, and sensitivity and specificity. Intra- and interrater reliability of manual palpation during the ADIM was excellent (k: 0.82–1.00) and good to excellent (k: 0.71–1.00), respectively. Interrater reliability for muscle thickness ranged from good to excellent (ICC3,1 0.79–0.91). Manual palpation and TrA ratio showed low to moderate correlations (r: 0.36–0.60). When evaluating the diagnostic accuracy of manual palpation, the best predictive model (ROC value: 0.89; p < 0.001) for correct a preferential contraction of TrA was obtained when the M-TrA-PAR was ≥0.08 (sensitivity: 0.95–1.00; specificity: 0.62). Good to excellent intra- and interrater reliability of manual palpation was found during the ADIM in both patients and healthy groups. Manual palpation showed concurrent validity for identifying the preferential activity of the TrA muscle supporting its use in clinical practice. Full article
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13 pages, 3003 KiB  
Article
Quantification of the Therapist’s Gentle Pull for Pinch Strength Testing Based on FMA and MMT: An Experimental Study with Healthy Subjects
by Abdallah Alsayed, Raja Kamil, Veronica Rowe, Mazatulfazura S. F. Salim, Hafiz R. Ramli and Azizan As’arry
Diagnostics 2021, 11(2), 225; https://doi.org/10.3390/diagnostics11020225 - 2 Feb 2021
Cited by 1 | Viewed by 2702
Abstract
Static pinch strength against a therapist’s gentle pull is evaluated using the pincer grasp component of the Fugl Meyer Assessment (FMA) to assess pinch impairment after stroke. In the pincer grasp component, therapists applied a gentle pull to distinguish between a score of [...] Read more.
Static pinch strength against a therapist’s gentle pull is evaluated using the pincer grasp component of the Fugl Meyer Assessment (FMA) to assess pinch impairment after stroke. In the pincer grasp component, therapists applied a gentle pull to distinguish between a score of 1 (moderate pinch impairment) and a score of 2 (no pinch impairment). The gentle pull is described as a resistance equivalent to a manual muscle test (MMT) score 4/5. The accepted use of “gentle” as a qualitative description for the pull results is a non-standardized subjective interpretation. The goal of this paper was to determine the quantitative value of the gentle pull applied by the therapists as in their clinical practice using a pinch–pull gripping system. The FMA protocol was used to standardize the body and fingers positions of three occupational therapists who were then instructed to apply a gentle pull of 4/5 MMT using their thumb and index fingers (in a tip-to-tip pinch). The results show that the therapists exerted a mean gentle pull (4/5 MMT score) of 6.34 ± 0.98 N with high reliability and acceptable repeatability. In investigating the ability of healthy subjects to resist the gentle pull, 50 adult male volunteers were instructed to pinch the pincer object and resist a dynamic loading exerted by the pinch–pull gripping system as much as possible to the moment the pincer object slips away. The results show that all subjects were able to exert a pulling force higher than the quantitative value of the gentle pull. Full article
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17 pages, 1820 KiB  
Article
Joint Assessment of Equilibrium and Neuromotor Function: A Validation Study in Patients with Fibromyalgia
by Rafael Lomas-Vega, Daniel Rodríguez-Almagro, Ana Belén Peinado-Rubia, Noelia Zagalaz-Anula, Francisco Molina, Esteban Obrero-Gaitán, Alfonso Javier Ibáñez-Vera and María Catalina Osuna-Pérez
Diagnostics 2020, 10(12), 1057; https://doi.org/10.3390/diagnostics10121057 - 6 Dec 2020
Cited by 12 | Viewed by 2761
Abstract
Objective: To develop and validate a tool for evaluating balance and neuromotor function in patients with fibromyalgia (FMS). Methods: Brainstorming, the nominal group technique, and pilot-testing were used to select a battery of 20 functional balance tests that were included in a screening [...] Read more.
Objective: To develop and validate a tool for evaluating balance and neuromotor function in patients with fibromyalgia (FMS). Methods: Brainstorming, the nominal group technique, and pilot-testing were used to select a battery of 20 functional balance tests that were included in a screening tool. A total of 108 subjects (62 with fibromyalgia syndrome, 22 aged over 65 years, and 24 healthy subjects) participated in this validation study. Factor validity, internal consistency, the ability to discriminate between patients and healthy subjects, and concurrent validity with the Fibromyalgia Impact Questionnaire (FIQ), the Central Sensitization Inventory (CSI), the 12-Item Short-Form Health Survey (SF-12), and other tools for measuring balance, such as the Dizziness Handicap Inventory (DHI), the Activities-Specific Balance Confidence Scale (ABC-16), the Falls Efficacy Scale-International (FES-I), and posturographic parameters, were evaluated. Results: The factorial analysis extracted four factors that explained 70% of the variance. The Alpha Cronbach value was 0.928. Concurrent validity of the screening tool with respect to other tools was high, and the receiver operating characteristic (ROC) curve analysis showed an AUC value of 0.932 for discriminating between healthy and FMS subjects. Severe balance disorder related to head movements in FMS patients was found. Conclusion: The 20-item JAEN (Joint Assessment of Equilibrium and Neuro-motor Function) screening tool is a valid and reliable tool for assessing balance in patients with FMS. Full article
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22 pages, 1461 KiB  
Article
Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis
by Melina N Haik, Francisco Alburquerque-Sendín, Ricardo A S Fernandes, Danilo H Kamonseki, Lucas A Almeida, Richard E Liebano and Paula R Camargo
Diagnostics 2020, 10(11), 928; https://doi.org/10.3390/diagnostics10110928 - 10 Nov 2020
Cited by 18 | Viewed by 5282
Abstract
Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify [...] Read more.
Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify individuals with acute and chronic RCRSP and described how these aspects interact to create biopsychosocial phenotypes in individuals with acute and chronic RCRSP. Individuals with acute (<six months of pain, n = 15) and chronic (≥six months of pain, n = 38) RCRSP were included. Sociodemographic data, biological data related to general clinical health status, to shoulder clinical condition and to sensory function, and psychosocial data were collected. Outcomes were compared between groups and a decision tree was used to classify the individuals with acute and chronic RCRSP into different phenotypes hierarchically organized in nodes. Only conditioned pain modulation was different between the groups. However, the tree combined six biopsychosocial aspects to identify seven distinct phenotypes in individuals with RCRSP: three phenotypes of individuals with acute, and four with chronic RCRSP. While the majority of the individuals with chronic RCRSP have no other previous painful complaint besides the shoulder pain and low efficiency of endogenous pain modulation with no signs of biomechanical related pain, individuals with acute RCRSP are more likely to have preserved endogenous pain modulation and unilateral pain with signs of kinesiophobia. Full article
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14 pages, 2895 KiB  
Article
Ultrasound Characterization of Patellar Tendon in Non-Elite Sport Players with Painful Patellar Tendinopathy: Absolute Values or Relative Ratios? A Pilot Study
by José L. Arias-Buría, César Fernández-de-las-Peñas, Jorge Rodríguez-Jiménez, Gustavo Plaza-Manzano, Joshua A. Cleland, Gracia M. Gallego-Sendarrubias and Ibai López-de-Uralde-Villanueva
Diagnostics 2020, 10(11), 882; https://doi.org/10.3390/diagnostics10110882 - 29 Oct 2020
Cited by 5 | Viewed by 2624
Abstract
Imaging findings in patellar tendinopathy are questioned. The aim of this pilot study was to characterize ultrasound measures, by calculating ultrasound ratio and neovascularization of the patellar tendon in non-elite sport players with unilateral painful patellar tendinopathy. Cross-sectional area (CSA), width, and thickness [...] Read more.
Imaging findings in patellar tendinopathy are questioned. The aim of this pilot study was to characterize ultrasound measures, by calculating ultrasound ratio and neovascularization of the patellar tendon in non-elite sport players with unilateral painful patellar tendinopathy. Cross-sectional area (CSA), width, and thickness of the patellar tendon were assessed bilaterally in 20 non-elite sport-players with unilateral painful patellar tendinopathy and 20 asymptomatic controls by a blinded assessor. Ultrasound ratios were calculated to discriminate between symptomatic and asymptomatic knees. The Ohberg score was used for characterizing neovascularization. We found that non-elite sport players with patellar tendinopathy exhibited bilateral increases in CSA, width, and thickness of the patellar tendon compared to asymptomatic controls (Cohen d > 2). The ability of ultrasound ratios to discriminate between painful and non-painful patellar tendons was excellent (receiver operating characteristic, ROC > 0.9). The best diagnostic value (sensitivity: 100% and specificity: 95%) was observed when a width ratio ≥ 1.29 between the symptomatic and asymptomatic patellar tendon was used as a cut-off. Further, neovascularization was also observed in 70% of non-elite sport players with unilateral patellar tendinopathy. A greater CSA ratio was associated with more related-disability and higher tendon neovascularization. This study reported that non-elite sport players with painful unilateral patellar tendinopathy showed structural ultrasound changes in the patellar tendon when compared with asymptomatic controls. Ultrasound ratios were able to discriminate between symptomatic and asymptomatic knees. Current results suggest that ultrasound ratios could be a useful imaging outcome for identifying changes in the patellar tendon in sport players with unilateral patellar tendinopathy. Full article
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17 pages, 1008 KiB  
Article
Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy
by Cristina Carmona-Pérez, Alberto Pérez-Ruiz, Juan L. Garrido-Castro, Francisco Torres Vidal, Sandra Alcaraz-Clariana, Lourdes García-Luque, Daiana Priscila Rodrigues-de-Souza and Francisco Alburquerque-Sendín
Diagnostics 2020, 10(9), 661; https://doi.org/10.3390/diagnostics10090661 - 1 Sep 2020
Cited by 4 | Viewed by 2912
Abstract
Objective: The aim of this study was to design and propose a new test based on inertial measurement unit (IMU) technology, for measuring cervical posture and motor control in children with cerebral palsy (CP) and to evaluate its validity and reliability. Methods: Twenty-four [...] Read more.
Objective: The aim of this study was to design and propose a new test based on inertial measurement unit (IMU) technology, for measuring cervical posture and motor control in children with cerebral palsy (CP) and to evaluate its validity and reliability. Methods: Twenty-four individuals with CP (4–14 years) and 24 gender- and age-matched controls were evaluated with a new test based on IMU technology to identify and measure any movement in the three spatial planes while the individual is seated watching a two-minute video. An ellipse was obtained encompassing 95% of the flexion/extension and rotation movements in the sagittal and transversal planes. The protocol was repeated on two occasions separated by 3 to 5 days. Construct and concurrent validity were assessed by determining the discriminant capacity of the new test and by identifying associations between functional measures and the new test outcomes. Relative reliability was determined using the intraclass correlation coefficient (ICC) for test–retest data. Absolute reliability was obtained by the standard error of measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90). Results: The discriminant capacity of the area and both dimensions of the new test was high (Area Under the Curve ≈ 0.8), and consistent multiple regression models were identified to explain functional measures with new test results and sociodemographic data. A consistent trend of ICCs higher than 0.8 was identified for CP individuals. Finally, the SEM can be considered low in both groups, although the high variability among individuals determined some high MDC90 values, mainly in the CP group. Conclusions: The new test, based on IMU data, is valid and reliable for evaluating posture and motor control in children with CP. Full article
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15 pages, 1372 KiB  
Article
Clinical Significance and Diagnostic Value of Pain Extent Extracted from Pain Drawings: A Scoping Review
by Marco Barbero, Marcos J. Navarro-Santana, María Palacios-Ceña, Ricardo Ortega-Santiago, Corrado Cescon, Deborah Falla and César Fernández-de-las-Peñas
Diagnostics 2020, 10(8), 604; https://doi.org/10.3390/diagnostics10080604 - 18 Aug 2020
Cited by 19 | Viewed by 4981
Abstract
The current scoping review aimed to map current literature investigating the relationship between pain extent extracted from pain drawings with clinical, psychological, and psycho-physiological patient-reported outcome measures in people with pain. Electronic databases were searched for cross-sectional cohort studies that collected pain drawings [...] Read more.
The current scoping review aimed to map current literature investigating the relationship between pain extent extracted from pain drawings with clinical, psychological, and psycho-physiological patient-reported outcome measures in people with pain. Electronic databases were searched for cross-sectional cohort studies that collected pain drawings using digital technology or a pen-on-paper approach and assessed for correlations between pain extent and clinical, psychological or psycho-physical outcomes. Data were extracted by two different reviewers. The methodological quality of studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. Mapping of the results included: 1, description of included studies; 2, summary of results; and 3, identification of gaps in the existing literature. Eleven cross-sectional cohort studies were included. The pain disorders considered were heterogeneous, ranging from musculoskeletal to neuropathic conditions, and from localized to generalized pain conditions. All studies included pain and/or pain-related disability as clinical outcomes. Psychological outcomes included depression and anxiety, kinesiophobia and catastrophism. Psycho-physical measures included pressure or thermal pain thresholds. Ten studies were considered of high methodological quality. There was heterogeneity in the associations between pain extent and patient-reported outcome measures depending on the pain condition. This scoping review found that pain extent is associated with patient-reported outcome measures more so in patients presenting with musculoskeletal pain, e.g., neck pain or osteoarthritis, rather than for those with neuropathic pain or headache. Full article
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10 pages, 383 KiB  
Article
Does the Keele STarT Back Screening Tool Contribute to Effectiveness in Treatment and Cost and Loss of Follow-Up of the Mechanical Diagnosis and Therapy for Patients with Low Back Pain?
by Takahiro Tsuge, Hiroshi Takasaki and Michio Toda
Diagnostics 2020, 10(8), 536; https://doi.org/10.3390/diagnostics10080536 - 30 Jul 2020
Cited by 3 | Viewed by 4327
Abstract
Background: Mechanical diagnosis and therapy (MDT) and the stratified approach using the Keele STarT Back Screening Tool (SBST) are examples of stratified low back pain (LBP) management. We investigated whether the medium–high risk in SBST can contribute to the time and sessions until [...] Read more.
Background: Mechanical diagnosis and therapy (MDT) and the stratified approach using the Keele STarT Back Screening Tool (SBST) are examples of stratified low back pain (LBP) management. We investigated whether the medium–high risk in SBST can contribute to the time and sessions until discharge from MDT (Question 1) and to the loss of follow-up before identifying a promising management strategy (Question 2). Methods: A retrospective chart study was conducted. Multiple regression modeling was constructed using 10 independent variables, including whether the SBST was medium–high risk or not for Question 1, and the 9/10 independent variables for Question 2. Results: The data of 89 participants for Question 1 and 166 participants for Question 2 were analyzed. SBST was not a primary contributing factor for Question 1 (R2 = 0.17–0.19). The model for Question 2 included SBST as a primary contributing factor and the shortest distance from the patient address to the hospital as a secondary contributing factor (93.4% correct classification). Conclusion: SBST status was not a primary contributing factor for time and sessions until discharge from MDT, but was a critical factor for the loss of MDT follow-up before identifying a promising management strategy. Full article
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8 pages, 685 KiB  
Article
Concurrent Validity of Digital Vascular Auscultation for the Assessment of Blood Flow Obliteration on the Radial Artery in Healthy Subjects
by María-Dolores Cortés-Vega, María Jesús Casuso-Holgado, Ángel Oliva-Pascual-Vaca, María-Isabel García-Bernal, Paula González-García and Cleofás Rodríguez-Blanco
Diagnostics 2020, 10(7), 494; https://doi.org/10.3390/diagnostics10070494 - 18 Jul 2020
Viewed by 2464
Abstract
This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned [...] Read more.
This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified; for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition (p < 0.001). A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated (k = 0.936, p < 0.001). Stethoscope sensitivity was 95%, and specificity was 99%. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients. Full article
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13 pages, 733 KiB  
Article
Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Validation Study in Axial Spondyloarthritis
by I. Concepción Aranda-Valera, Antonio Cuesta-Vargas, Juan L. Garrido-Castro, Philip V. Gardiner, Clementina López-Medina, Pedro M. Machado, Joan Condell, James Connolly, Jonathan M. Williams, Karla Muñoz-Esquivel, Tom O’Dwyer, M. Carmen Castro-Villegas, Cristina González-Navas, Eduardo Collantes-Estévez and on behalf of iMaxSpA Study Group
Diagnostics 2020, 10(6), 426; https://doi.org/10.3390/diagnostics10060426 - 24 Jun 2020
Cited by 20 | Viewed by 3840
Abstract
Portable inertial measurement units (IMUs) are beginning to be used in human motion analysis. These devices can be useful for the evaluation of spinal mobility in individuals with axial spondyloarthritis (axSpA). The objectives of this study were to assess (a) concurrent criterion validity [...] Read more.
Portable inertial measurement units (IMUs) are beginning to be used in human motion analysis. These devices can be useful for the evaluation of spinal mobility in individuals with axial spondyloarthritis (axSpA). The objectives of this study were to assess (a) concurrent criterion validity in individuals with axSpA by comparing spinal mobility measured by an IMU sensor-based system vs. optical motion capture as the reference standard; (b) discriminant validity comparing mobility with healthy volunteers; (c) construct validity by comparing mobility results with relevant outcome measures. A total of 70 participants with axSpA and 20 healthy controls were included. Individuals with axSpA completed function and activity questionnaires, and their mobility was measured using conventional metrology for axSpA, an optical motion capture system, and an IMU sensor-based system. The UCOASMI, a metrology index based on measures obtained by motion capture, and the IUCOASMI, the same index using IMU measures, were also calculated. Descriptive and inferential analyses were conducted to show the relationships between outcome measures. There was excellent agreement (ICC > 0.90) between both systems and a significant correlation between the IUCOASMI and conventional metrology (r = 0.91), activity (r = 0.40), function (r = 0.62), quality of life (r = 0.55) and structural change (r = 0.76). This study demonstrates the validity of an IMU system to evaluate spinal mobility in axSpA. These systems are more feasible than optical motion capture systems, and they could be useful in clinical practice. Full article
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11 pages, 1286 KiB  
Article
Prediction Model of Soleus Muscle Depth Based on Anthropometric Features: Potential Applications for Dry Needling
by Juan Antonio Valera-Calero, Ladislao Laguna-Rastrojo, Fernando de-Jesús-Franco, Eduardo Cimadevilla-Fernández-Pola, Joshua A. Cleland, César Fernández-de-las-Peñas and José Luis Arias-Buría
Diagnostics 2020, 10(5), 284; https://doi.org/10.3390/diagnostics10050284 - 7 May 2020
Cited by 11 | Viewed by 3010
Abstract
This study was conducted to investigate if anthropometric features can predict the depth of the soleus muscle, as assessed with ultrasound imaging, in a sample of healthy individuals to assist clinicians in the application of dry needling. A diagnostic study to calculate the [...] Read more.
This study was conducted to investigate if anthropometric features can predict the depth of the soleus muscle, as assessed with ultrasound imaging, in a sample of healthy individuals to assist clinicians in the application of dry needling. A diagnostic study to calculate the accuracy of a prediction model for soleus muscle depth, as assessed with ultrasonography, in the middle-third and distal-third of the calf, based on anthropometric features such as age, height, weight, body mass index (BMI), calf length, mid-third and distal-third calf girth, was conducted on 48 asymptomatic healthy subjects (75% male) involving a total of 96 calves. Multiple linear regression analyses were used to determine which variables contributed significantly to the variance in the soleus muscle depth at middle-third and distal-third of the calf by gender. Women were found to have a deeper soleus muscle than men (p < 0.001). Weight, height, BMI, and mid-third calf perimeter explained 69.9% of variance in men, whereas mid-third calf perimeter, calf length, height, and distal-third calf girth explained 73% of the variance in women of the distal-third soleus depth (p < 0.001). Additionally, mid-third calf girth and calf length explained 28.8% of variance in men, whereas mid-third calf perimeter, calf length, and weight explained 67.8% of variance in women of the mid-third soleus depth (p < 0.001). This study identified anthropometric features that predict soleus muscle depth, as assessed with ultrasound, in asymptomatic individuals, but these features are different in men and women. Our findings could assist clinicians in choosing the proper length of the needle to avoiding passing through the soleus during dry needling. Full article
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14 pages, 1746 KiB  
Article
Cross-Cultural Adaptation of the Dance Functional Outcome Survey (DFOS) for Spanish Dancers
by Blanca de-la-Cruz-Torres, Irene Barrera-García-Martín, Carlos Romero-Morales and Shaw Bronner
Diagnostics 2020, 10(3), 169; https://doi.org/10.3390/diagnostics10030169 - 20 Mar 2020
Cited by 2 | Viewed by 3782
Abstract
A growing number of research papers regarding Spanish-speaking dancers justifies the need for an adapted Spanish version of the Dance Functional Outcome Survey (DFOS). The objective of this study was to cross-culturally adapt and validate the DFOS for Spanish-speaking dancers. A sample of [...] Read more.
A growing number of research papers regarding Spanish-speaking dancers justifies the need for an adapted Spanish version of the Dance Functional Outcome Survey (DFOS). The objective of this study was to cross-culturally adapt and validate the DFOS for Spanish-speaking dancers. A sample of 127 healthy and injured professional and pre-professional dancers were recruited. Test-retest reliability of DFOS-Sp was examined using intraclass correlation coefficients. Construct validity compared DFOS-Sp to the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) using Pearson correlations. Principal component analysis identified factors and internal-item consistency. Sensitivity was evaluated by generating receiver operating characteristic and area under the curve analyses. A subgroup of 51 injured dancers were followed across three time-points to examine responsiveness using repeated measures analysis of variance. Injured scores were analyzed for floor and ceiling effects. The DFOS-Sp showed high test-retest reliability (ICC2,1 ≥ 0.92). DFOS-Sp scores had moderate construct validity compared with SF-36 physical component summary scores (r ≥ 0.56). Principal component analysis (PCA) supported uni-dimensionality explaining 58% of the variance with high internal consistency (α = 0.91).Area under the curve (AUC) sensitivity values were excellent (AUC ≥ 0.82). There were significant differences across time (p < 0.001), demonstrating responsiveness to change, with no floor or ceiling effects. The DFOS-Sp demonstrated acceptable test-retest reliability and validity in Spanish-speaking dancers, with comparable psychometric performance to the English-language version. Full article
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7 pages, 3415 KiB  
Brief Report
Panoramic Ultrasound Examination of Posterior Neck Extensors in Healthy Subjects: Intra-Examiner Reliability Study
by Juan Antonio Valera-Calero, Gracia María Gallego-Sendarrubias, César Fernández-de-las-Peñas, Joshua A. Cleland, Ricardo Ortega-Santiago and José Luis Arias-Buría
Diagnostics 2020, 10(10), 740; https://doi.org/10.3390/diagnostics10100740 - 24 Sep 2020
Cited by 14 | Viewed by 3797
Abstract
Previous studies analyzing morphometry of posterior cervical muscles with ultrasound (US) imaging have mainly used Brightness mode (B-mode). Our aim was to investigate the intra-examiner reliability of panoramic US imaging for assessing posterior-lateral cervical muscle layers. Panoramic US images of the neck at [...] Read more.
Previous studies analyzing morphometry of posterior cervical muscles with ultrasound (US) imaging have mainly used Brightness mode (B-mode). Our aim was to investigate the intra-examiner reliability of panoramic US imaging for assessing posterior-lateral cervical muscle layers. Panoramic US images of the neck at C4/C5 level were acquired in 25 asymptomatic subjects (40% women; mean age: 24 years) by an experienced assessor. The cross-sectional area (CSA) of the upper trapezius, splenius, semispinalis, multifidi, rotators, and levator scapulae was measured from panoramic US scans on two separate days. Intra-class correlation coefficients (ICC3,1), standard error of measurement (SEM), minimal detectable change (MDC) and mean, absolute and percent errors were calculated. In general, intra-examiner reliability was excellent with ICC3,1 ranging from 0.978 (trapezius) to 0.993 (semispinalis). The SEM ranged from 0.02 (multifidus) to 0.07 (semispinalis/levator), whereas the MDC ranged from 0.05 (cervical multifidus) to 0.19 (levator/semispinalis). Absolute error was lower than 0.11 cm2 (levator/semispinalis). No differences between males and females were found. This study found that intra-examiner/rater reliability of panoramic US imaging was excellent for assessing the CSA of the posterior-lateral neck extensor muscles in asymptomatic subjects. The current findings suggest that panoramic US may be a reliable technique for examining the size of the cervical extensor muscles in both males and females. Full article
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