Search Results (1,204)

Training distress is a multifactorial psychophysiological response resulting from the interaction of sustained high-intensity training, insufficient recovery, and additional psychosocial stressors. It manifests through mood disturbance, elevated perceived stress, fatigue, sleep disruption, and physical symptoms, and represents a precursor to maladaptive outcomes such as overtraining syndrome. The Multicomponent Training Distress Scale (MTDS) integrates these dimensions into a single monitoring framework; however, no validated Italian version has been available. The present study aimed to develop and provide a validation of the Italian Multicomponent Training Distress Scale (IMTDS). The IMTDS was administered to 536 Italian-speaking recreational and competitive sport participants (276 males, 260 females; age range = 16–35 years, M = 25.31, SD = 5.62). Exploratory Structural Equation Modeling supported the hypothesized six-factor structure (Depression, Vigor, Physical Symptoms, Sleep Disturbances, Stress, Fatigue), demonstrating acceptable model fit (CFI = 0.97, TLI = 0.92, RMSEA = 0.10). Internal consistency was satisfactory to high across subscales (ω = 0.82–0.88), and test–retest analyses indicated temporal stability. Intercorrelations among dimensions were consistent with theoretical expectations. These findings provide evidence that the IMTDS is a reliable instrument for monitoring training distress in Italian-speaking athletes. Full article

Objective: We aimed to assess whether modified OCT acquisition parameters improve GCIPL measurement reliability. Methods: Participants with multiple sclerosis (PwMS) and age- and sex-matched healthy controls (HC) underwent OCT (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) at baseline and after two and four weeks. At each visit, five macular scan protocols were acquired: standard (49 lines, high-speed [HS], automated real-time tracking [ART]: 9), high-ART (49 lines, HS, ART: 50), high-lines (97 lines, HS, ART: 9), high-resolution (49 lines, high-resolution [HR], ART: 9), and maximum (97 lines, HR, ART: 50). Reliability was assessed using intraclass correlation coefficients (ICC). Absolute test–retest reproducibility was quantified using the mean absolute difference (MAD). Results: Thirty-eight eyes from nine PwMS (mean age 34.1 ± 8.0 years, 44.4% female) and ten HC (31.7 ± 11.1 years, 50.0% female) were included. At baseline, mean GCIPL thickness ranged from 70.8 µm to 71.5 µm across protocols, demonstrating excellent inter-protocol agreement (ICC 0.99; 95% confidence interval [CI]: 0.98–0.99; p < 0.001) and only marginally higher values with increased ART. Test–retest reliability was excellent for all protocols, demonstrating marginally lower absolute measurement variability of high-ART and high-lines protocols (MAD 0.26–0.27; 95% CI: 0.21–0.32), while temporal agreement remained excellent and comparable across acquisition settings. Mean acquisition time ranged from 10.6 ± 1.6 s for the standard protocol to 231.9 ± 36.4 s for the maximum protocol. Conclusions: All OCT acquisition protocols demonstrated excellent inter-protocol and test–retest reliability for GCIPL measurements. The high-lines protocol provides the most favourable balance between measurement reliability and acquisition time, supporting its potential utility for longitudinal GCIPL monitoring. Full article

Objectives: To systematically synthesize existing evidence on functional biomechanical tests of the foot and ankle in physiotherapy and sports, focusing on their outcome measures, compatibility with wearable sensor technologies, and psychometric properties. Methods: We performed a systematic review (PRISMA-guided) of PubMed, Web of Science, PEDro, and SPORTDiscus from inception to December 2025. Eligible studies evaluated functional foot/ankle biomechanics in athletes, healthy adults, or adults with musculoskeletal foot/ankle conditions using wearable sensors (e.g., IMUs, wireless pressure insoles). Two reviewers independently screened, extracted data, and appraised methodological quality using the COSMIN Risk of Bias tool, applying property-specific ratings. Heterogeneity precluded meta-analysis; findings were narratively synthesized and tabulated. Results: Twenty full texts were reviewed; four studies (n = 83 participants) met the inclusion criteria. Wearable devices included foot- or trunk-mounted IMUs and wireless pressure insoles. Reported outcomes spanned temporal gait events and inner-stance phases, vertical ground reaction force (vGRF) and centre-of-pressure trajectories, running step rate/stride length, and jump counts in competition. Validity was most frequently assessed: foot-worn IMUs showed millisecond-level agreement with in-shoe pressure references for stance and inner-stance events; pressure insoles demonstrated acceptable agreement with force plates for vGRF/COP alongside fair-to-excellent test–retest reliability; foot- vs. shank-mounted IMUs provided strong agreement for running step rate and stride length; and competition-based jump detection using IMUs achieved high sensitivity. Across studies, reliability indices were inconsistently reported, measurement error (SEM/MDC) was sparse, and MCID was not reported. The COSMIN appraisal ranged from very good/adequate to inadequate, driven primarily by small sample sizes, non-gold-standard comparators, and incomplete psychometric reporting. Full article

This study evaluated the test–retest reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of frontal plane projection angles (FPPAs) across five single-leg tasks in individuals with patellofemoral pain (PFP). Two-dimensional video data was collected from ten individuals with predominantly unilateral PFP. Participants performed single-leg squat, single-leg landing, single-leg hop, forward step-down, and lateral step-down across two testing sessions. FPPAs were measured at peak knee flexion for each task, including trunk lean angle, knee FPPA, hip FPPA, and dynamic valgus index. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Our findings indicate that test–retest reliability and measurement error for trunk and lower limb FPPA varied across tasks in individuals with PFP. The lowest ICC was observed for hip FPPA, particularly during single-leg squat and lateral step-down tasks. Among the five tasks tested, the single-leg squat appeared to be the most demanding task, demonstrating the lowest ICCs, and highest SEM and MDC values across all four outcome measures (trunk lean angle, knee and hip FPPAs, and dynamic valgus index). The dynamic valgus index consistently showed larger SEM and MDC values than isolated hip or knee FPPAs, likely reflecting compounded measurement errors across segments. These findings provide preliminary insights, though confirmation in larger samples in persons with PFP is warranted. Full article

The aim of the present study was to analyze the validity and reliability of the My Jump Lab (My Jump Lab, Madrid, Spain) smartphone application for measuring the Dynamic Rebound Index (DRI) during drop jump testing. Seventeen physically active participants completed two testing sessions separated by 48 h. In each session, six drop jumps from a 40 cm box were performed while jump height, contact time and DRI were simultaneously recorded using a force platform and the app. Very large to nearly perfect correlations were observed between devices for all variables (r > 0.98). Agreement between methods was excellent, as indicated by the intraclass correlation coefficient (ICC > 0.97) and the concordance correlation coefficient (CCC > 0.93). Bland–Altman analysis revealed small systematic differences and narrow limits of agreement. The root mean square error (RMSE) was low, indicating minimal prediction error. Test–retest reliability between sessions was good for both devices (ICC = 0.825–0.925), and within-session reliability across attempts was high (ICC = 0.705–0.870). These findings indicate that My Jump Lab provides valid and reliable measurements of drop jump performance, including DRI, relative to a force platform, with potential utility in applied settings. Full article

Pre-elite female field hockey players have a high incidence of lower extremity injury, highlighting the need for practical and reliable screening approaches. A dual assessment combining Functional Performance Tests (FPTs) with movement quality scoring (QASLS) may provide a more comprehensive evaluation; however, its reliability in this population is unclear. Fifteen pre-elite female field hockey players (16.7 ± 0.7 years) completed an FPT battery (anterior reach (AR), single leg drop vertical jump–land (DVJL), single hop for distance (SHFD), side hop (SH)) on two occasions, 28 days apart. Movement quality was assessed by three raters using QASLS. Reliability was evaluated using ICC with 95% confidence intervals (CI), alongside standard error of measurement (SEM), smallest detectable difference (SDD), and percentage exact agreement (PEA). Test–retest reliability varied across tasks (ICC_2,1 0.33–0.90), with wide confidence intervals indicating uncertainty in several estimates. AR demonstrated the most consistent reliability, supporting its use for monitoring over time. In contrast, the DVJL and SH showed the greatest variability, likely reflecting higher task complexity, while the SHFD required relatively large performance changes to exceed measurement error. Intra-rater reliability for QASLS was consistent across the FPT battery (ICC_2,k 0.79–0.90), whereas inter-rater reliability was more variable (0.38–0.82), indicating rater-dependent differences. PEA demonstrated generally high agreement (60–100%), although lower agreement was observed for pelvic alignment components. These findings support the use of a dual assessment approach as a practicable profiling approach in pre-elite female field hockey, enabling practitioners to identify movement deficits not captured by performance metrics alone. However, variability in complex tasks and between raters highlights the need to consider measurement error and implement standardised rater training when profiling or monitoring performance. Full article

Vestibular schwannomas (VSs) are benign tumors of the vestibulocochlear nerve that often cause significant neurological and functional impairment, affecting patients’ overall quality of life (QoL). While clinical assessments have traditionally focused on hearing preservation and tumor control, patients often emphasize other critical symptoms such as dizziness, pain, cognitive difficulties and satisfaction with care. Therefore, patient-centered care that addresses the full range of patient experiences is essential. Despite its importance, patient-centered care in VS remains underexplored. This study will address this gap by psychometrically validating the German version of the Vestibular Schwannoma Quality of Life (VSQOL) Index, a newly developed QoL tool that includes key patient-centered domains. The primary objective is to validate the reliability and validity of the German VSQOL Index. The secondary aim is to assess VS patients’ experience of patient-centered care and its impact on their well-being. This multicenter, cross-sectional study will involve German-speaking VS patients from several clinical centers in Germany and Switzerland as well as an online cohort. Psychometric testing of the German VSQOL will include reliability assessments (e.g., Cronbach’s alpha, test–retest reliability), confirmatory factor analysis and convergent validity. In parallel, the study will assess patient-centered experiences of care using the EPAT questionnaire. Ethical approval has been obtained and all participants will be asked to provide written informed consent. The results will be shared through scientific publications and conferences, as well as with patient groups, in order to support improvements in clinical care. Full article

Background/Objectives: Valid and reliable measurement of dental anxiety is of importance in both clinical and research settings. The aim of this study was to adapt and evaluate the Swedish child and adolescent version of the index of dental anxiety and fear (IDAF). Methods: A total of 142 dental patients aged 10–15 completed the four-components (IDAF-4C) and stimulus module (IDAF-S). Convergent validity was evaluated by correlating IDAF with CFSS-DS and a single item question on self-reported dental anxiety (SQDA). Reliability was investigated using Cronbach’s alpha, test–retest measurements (n = 16) and interviews. Results: IDAF-4C had a high correlation to CFSS-DS (r = 0.72). IDAF-4C convergent validity to SQDA (r = 0.76) was higher than the correlation between CFSS-DS and SQDA (r = 0.62). Convergent validity between IDAF-S and CFSS-DS was high (r = 0.83). Test–retest for IDAF-4C resulted in a moderate ICC of 0.72 (95% CI 0.37–0.89) and a correlation coefficient of 0.74. The difference in skipped items suggests that IDAF has higher usability than CFSS-DS. Conclusions: IDAF-4C provides a reliable estimate of dental anxiety, while IDAF-S provides clinical insights in individual aspects of dental anxiety similar to CFSS-DS. Further research includes evaluating the specific phobia module of IDAF and include more test–retest participants. The Swedish child and adolescent version of IDAF-4C and IDAF-S show good psychometric properties and usability and may be used as a dental anxiety measurement among children and adolescents. Full article

Background/Objectives: Dyspnoea in heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) is multidimensional, yet conventional unidimensional scales do not capture its sensory and affective components. The Multidimensional Dyspnea Profile (MDP) addresses this gap; however, its psychometric properties have not been established in a dedicated HFrEF/HFmrEF cohort. We assessed structural validity, internal consistency, test–retest reliability, and construct validity of the MDP using COSMIN methodology. Methods: In this prospective, single-centre psychometric validation study, 101 clinically stable adults with HFrEF or HFmrEF were enrolled at a tertiary outpatient cardiac clinic in Riyadh, Saudi Arabia. Participants completed the MDP alongside Dyspnea-12, modified Medical Research Council scale, Kansas City Cardiomyopathy Questionnaire-12, Fatigue Severity Scale, and 6 min walk test. Test–retest data were obtained at 12 days in patients confirmed stable by the Global Rating of Change (n = 87). Psychometric evaluation included Cronbach’s α, intraclass correlation (ICC₂,₁), standard error of measurement, minimum detectable change (MDC₉₅), confirmatory factor analysis (comparative fit index [CFI], root mean square error of approximation [RMSEA], standardised root mean square residual [SRMR]), and 12 a priori construct hypotheses. A preliminary minimal clinically important difference (MCID) was estimated using anchor- and distribution-based methods. Results: The mean age was 55 ± 11 years and 80% were male. CFA supported the two-factor model (CFI = 0.96; RMSEA = 0.061; SRMR = 0.058). Cronbach α was 0.92 for the full scale, 0.88 for immediate perception, and 0.91 for emotional response. ICC_2,1 was 0.94 (95% CI: 0.91–0.96), and MDC₉₅ was 4.2 points. All 12 hypotheses were confirmed. The preliminary MCID was 8 points. Conclusions: The MDP is a reliable, valid, and clinically interpretable multidimensional dyspnoea measure in HFrEF/HFmrEF. The 8-point MCID is preliminary and requires confirmation in larger longitudinal intervention studies. Full article

Background: Performance-based tests (PBTs) objectively assess functional capacity and are increasingly applied in fibromyalgia (FM) to complement patient-reported outcomes (PROMs). However, evidence regarding their reliability, especially considering patients’ socio-occupational status, is limited. This study aimed to determine test–retest reliability of a standardized PBT battery in women with FM and to examine the influence of employment status on measurement stability. Methods: A total of 119 women were assessed (89 with FM). The battery included the 6 min walk test (6MWT), handgrip strength test (HST), and 8 feet up and go test (8FUGT). Test–retest reliability was examined using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Analyses were conducted for the total FM group and socio-occupational subgroups (actively working, claiming disability, and permanent disability). Results: All PBTs demonstrated excellent test–retest reliability. Measurement stability was consistently higher in controls. Absolute reliability indices confirmed acceptable measurement stability. However, the claiming disability group showed markedly higher SEM% and SRD% for HST, suggesting reduced reproducibility. The 6MWT and 8FUGT maintained excellent reliability and stability across all groups. PROMs showed good-to-excellent reliability. Conclusions: PBTs showed excellent reliability in women with FM. However, reliability varied across socio-occupational groups, particularly for HST in patients claiming disability. PROMSs showed lower reliability than PBTs. Full article

This manuscript develops and demonstrates a practical framework for evaluating automated classifiers used in communication research, using harmful language detection as an illustrative case. We combine (a) a structured review of documentation practices for 27 publicly available classifiers and their associated annotation processes with (b) a cross-dataset evaluation that re-tests each model beyond its original training context. Across 27 datasets, we extract and compare reporting on construct definitions, annotator instructions, and inter-annotator agreement, and we quantify generalization by applying each model to multiple out-of-domain test sets. We also benchmark a contemporary large language model (GPT-5) under a consistent prompting protocol to illustrate how LLM-based classification compares to fine-tuned classifiers. Results show that documentation is uneven and often insufficient for theory-driven measurement, inter-annotator agreement varies widely across datasets, and cross-dataset performance frequently drops substantially relative to within-dataset evaluations. Building on these findings and existing validation guidance, we provide a reusable checklist and decision flow to help researchers select, justify, and report classifier-based measures in ways that support transparency and cumulative science. Recommendations for researchers, reviewers, and journal editors stress aligning model selection with standards of validity, reliability, and transparency. Full article

Background: Shoulder injury is common among athletes who engage in sports where the upper limb is actively involved. These injuries can affect an athlete’s performance and ability to return to sports at the preinjury level. This study aimed to cross-culturally adapt the Subjective Patient Outcome for Return to Sports score in Greek (SPORTS-GR) and evaluate its reliability and construct validity. Methods: Sixty-five Greek athletes (18–40 years) diagnosed with shoulder pathology were included. The SPORTS-GR was adapted according to standard procedures, and its construct validity was examined via associations with the Shoulder Pain and Disability Index (SPADI-GR) questionnaire, which assesses pain and disability related to shoulder pathologies. Test–retest reliability was tested by repeating the SPORTS score questionnaire administration after 6–8 days. Eligible athletes were selected from the Hellenic Supreme Council of Military Sports. Results: Face validity was excellent with a ceiling effect of 35.4%. The construct validity was high, with strong negative correlations between the SPORTS-GR score and the SPADI-GR total score (r = −0.91, p < 0.001), pain subscale score (r = −0.84, p < 0.001), disability subscale score (r = −0.90, p < 0.001), and age (r = 0.26, p = 0.04). Test–retest reliability was also excellent (ICC = 0.98) with no significant systematic error (SEM = 0.09). Conclusions: The SPORTS-GR is valid and reliable for evaluating athletes’ return to sports with shoulder pathologies. Full article

Background: Balance is a key ability in rhythmic gymnastics, affecting not only technical performance but also the aesthetic and expressive quality of routines. Standard tests often do not reflect the real demands of the sport, where gymnasts must simultaneously maintain stability, manipulate apparatus, and follow the musical rhythm. Therefore, there is a need for a specific test that combines motor and cognitive challenges to provide a precise and reliable assessment of athletes’ functional abilities. Methods: The study involved 12 girls with an average age of 9 years. Participants underwent anthropometric measurements and were tested using standard motor tests as well as a specific balance test for rhythmic gymnasts (BTRG). Test reliability was assessed using a test–retest procedure, and construct validity was evaluated through factor analysis in comparison with existing balance tests. Results: The BTRG demonstrated high reliability (ICC = 0.96; CV = 6.4%; SEM = 0.18) and the ability to distinguish gymnasts from different programs. Factor analysis confirmed that the BTRG effectively measures specific balance in accordance with theoretical expectations. Conclusions: The new test provides a potentially valid and reliable tool for assessing specific balance in rhythmic gymnasts and maybe useful in the training process, athlete evaluation, and talent development; however, these finding should be interpreted with caution as they are preliminary and derived from pilot study. Full article

Background/Objectives: The Individualized Neuromuscular Quality-of-Life Questionnaire (INQoL) is a widely used measure of quality of life in patients with various neuromuscular diseases. This study aimed to adapt and test the validity and reliability of this measure in Hungarian patients with neuromuscular disease. Methods: According to the widely accepted method of validation, we first translated the original INQoL version into Hungarian, and then a native English speaker translated it back into English to test its validity. Following a pretest procedure, the INQoL was administered to 80 patients with various muscular diseases and 30 age-matched controls. The internal consistency and test–retest reliability were assessed. Concurrent validity was measured using the 36-item Short Form Survey (SF-36) questionnaire. Results: For all INQoL subscales, Cronbach’s alpha was above 0.7, demonstrating the reliability of the subscales. The highest Cronbach alpha value was for the Weakness subscale (0.983) and the lowest for the Treatment subscale (0.794). The intraclass correlation coefficient test values ranged from 0.810 (Treatment) to 0.988 (Pain), indicating excellent test–retest reliability. There was a strong correlation between the SF-36 Physical Function and multiple INQoL subscales, including Weakness (r = 0.754, p < 0.001), Fatigue (r = 0.704, p < 0.001), Activities (r = 0.744) p < 0.001, Independence (r = 0.791 p < 0.001), Body Image (r = 0.714 p < 0.001), and overall Quality of Life (r = 0.742 p < 0.001). Conclusions: Our findings indicate that the Hungarian-language adaptation of the questionnaire possesses adequate reliability and construct validity for assessing the quality of life in patients with muscular disorders. Full article

Conventional gel electrodes are the gold standard for surface electromyography (sEMG), yet their bulkiness, stiffness, and limited gel lifetime prevents seamless day-long integration with wearable robots. We integrated ultrathin skin-conformal temporary tattoo electrodes with a powered unilateral hip exoskeleton and compared signal quality during treadmill walking against gel. In this pilot study, five healthy participants completed three consecutive walking blocks at fixed speed: (1) using gel electrodes; (2) using tattoo electrodes to compare signal quality; and (3) using the same tattoo electrodes (not repositioned) after eight hours of wear to simulate a full day of typical device use and to evaluate potential degradation in signal quality over time. Electrodes were positioned on muscles not covered by the exoskeleton interface (tibialis anterior and gastrocnemius medialis), as well as on muscles located beneath the exoskeleton cuff, which were potentially subject to motion artifacts due to the application of external forces by the exoskeleton (rectus femoris and biceps femoris, BF). Across all muscles, for both gel and tattoo electrodes, the root mean square error (RMSE) between normalized sEMG envelopes and biological activation profile was 0.069 ± 0.048, and Pearson’s correlation coefficient (ρ) was 0.844 ± 0.091. Re-testing the same tattoo electrode pair after eight hours confirmed day-long stability without the need for recalibration. Statistical analysis revealed no significant differences in signal quality, also when applying assistive forces, between the two electrode types and across all muscles (RMSE, all p ≥ 0.3125; ρ, all p ≥ 0.1250), as well as no degradation after eight hours (RMSE and ρ: all p ≥ 0.0626, uncorrected). Finally, in a proof-of-concept session, BF activity measured with tattoo electrodes was found reliable to drive hip-extension assistance in real time. Collectively, these results show that tattoo electrodes deliver signal quality comparable to gel electrodes while offering a low-profile skin-conformal interface and day-long usability, making them a promising option for enhancing EMG-based control in wearable robots. Full article