Biomedical subjects

J W Youdas

Publications and source records attributed to J W Youdas.

15 recordsLinked to original sources

PubMed2000

Measurements of temporal aspects of gait obtained with a multimemory stopwatch in persons with gait impairments.

STUDY DESIGN: Repeated measures of 14 temporal factors of gait obtained with a multimemory stopwatch from a variety of subjects with locomotor impairments. OBJECTIVES: To estimate the intratester and intertester reliability of 14 temporal factors of gait by using a multimemory stopwatch; to compare novice and expert clinicians at mastery of making these temporal measurements. BACKGROUND: Temporal gait measures are useful for describing the effectiveness of treatment interventions in patients with locomotor impairments. METHODS AND MEASURES: Eleven adult subjects (mean age, 48.4 years; SD, 5.7 years), 10 with locomotor impairments and 1 elderly adult, ambulated along a 6-m walkway 3 times at a self-selected walking speed. The subjects were videotaped from the side as they walked. Four physical therapists independently analyzed the videotapes on 2 occasions; 2 examiners were recent graduates, and 2 others had 23 years of clinical experience. Intraclass correlation coefficients were used to estimate intratester reliability. A component of variance analysis quantified the sources of variation. RESULTS: Intraclass correlation coefficients for each of the 14 variables varied from 0.88 to 0.98. The major contributor to variance was subject, followed by trial, error, and tester; the tester factor generally contributed less than 1% to the total variance. CONCLUSIONS: Reliable measurements of the temporal aspects of gait can be made by using a multimemory stopwatch and videotape in a clinical setting on patients with various locomotor problems. Our data suggest that measurements obtained by more experienced physical therapists were no more reliable than those made by recent graduates.

Adolescent↗

PubMed2000

Lumbar lordosis and pelvic inclination in adults with chronic low back pain.

BACKGROUND AND PURPOSE: The causes of lumbopelvic imbalances in standing have been widely accepted by physical therapists, but there is a lack of scientific evidence available to support them. We examined the association between 9 variables and pelvic inclination and lumbar lordosis during relaxed standing. SUBJECTS: Thirty men and 30 women with chronic low back pain (CLBP) for at least 4 months were examined (mean age=54.9 years, SD=9, range=40.4-69.8). METHODS: Multiple linear regression modeling was used to assess the association of pelvic inclination and the magnitude of lumbar lordosis in standing with age, sex, body mass index (BMI), Oswestry Back Pain Disability Questionnaire (ODQ) scores, physical activity level, hip flexor muscle length, abdominal muscle force, and range of motion (ROM) for lumbar flexion and extension. RESULTS: In women, age, BMI, and ODQ scores were associated univariately and multivariately with pelvic inclination. In men, lumbar extension ROM was related univariately to pelvic inclination; age, lumbar extension ROM, and ODQ scores were associated multivariately. Lumbar lordosis was associated univariately with only lumbar extension ROM for women and men. A weak correlation was found between angle of pelvic inclination and magnitude of lumbar lordosis in standing (r=. 31 for women, r=.37 for men). CONCLUSION AND DISCUSSION: The odds ratio of having CLBP is increased if the score on the double-leg lowering test for abdominal muscles exceeds 50 degrees for men and 60 degrees for women. In patients with CLBP, the magnitude of the lumbar lordosis and pelvic inclination in standing is not associated with the force production of the abdominal muscles.

Adult↗

PubMed1999

Reproducibility of lumbar spine range of motion measurements using the back range of motion device.

STUDY DESIGN: Single-group repeated measures for single rater reliability. OBJECTIVES: To describe the intratester reliability for measurements of active lumbar spine mobility and pelvic inclination during standing obtained with the back range-of-motion (BROM) device. BACKGROUND: The BROM device has often been used to quantify lumbar spine active range of motion. No studies have reported the reliability of the BROM device in a clinical setting. METHODS AND MEASURES: One examiner measured all 3 planes of lumbar range of motion in 40 nonimpaired subjects. For each plane of motion, 2 BROM device measurements were made. Intraclass correlation coefficients were calculated to express the intratester reliability for each plane of motion measured. RESULTS: Intraclass correlation coefficients were in the range of 0.67 to 0.94 for lumbar measurements with the BROM device. CONCLUSIONS: Intratester reliability was fair to poor for sagittal plane measurements and pelvic inclination. Measurements obtained by the same examiner for lumbar lateral flexion and rotation with the BROM device, however, were reliable.

Adult↗

PubMed1996

Lumbar lordosis and pelvic inclination of asymptomatic adults.

BACKGROUND AND PURPOSE: We examined the association between pelvic inclination and lumbar lordosis during relaxed standing and eight variables thought to contribute to lordosis. SUBJECTS: Ninety subjects (45 men, 45 women) without back pain or a history of surgery were examined. The mean age was 54.8 years (SD = 8.5) for male subjects and 58.9 years (SD = 8.8) for female subjects. METHODS: Multiple linear regression modeling was used to assess the association of pelvic inclination and size of lumbar lordosis in a standing position with age, gender, body mass index, physical activity level, back and one-joint hip flexor muscle length, and performance and length of abdominal muscles. RESULTS: Abdominal muscle performance was associated with angle of pelvic inclination for women (R2 = .23), but not for men. Standing lumbar lordosis was associated with abdominal muscle length in women (R2 = .40), but it was multivariately associated with length of abdominal and one-joint hip flexor muscles and physical activity level in men (R2 = .38). No correlation was found between angle of pelvic inclination and depth of lumbar lordosis in a standing position. CONCLUSION AND DISCUSSION: Neither univariate nor multivariate regression models account for variability in the angle of pelvic inclination or size of lumbar lordosis in adults during upright stance; no correlation was found in standing between these two variables. The use of abdominal muscle strengthening exercises or stretching exercises of the back and one-joint hip flexor muscles to correct faulty standing posture should be questioned.

Abdominal Muscles↗

PubMed1996

Level of intrateam agreement on candidate scores in a structured interview process.

This study examined the intrateam reliability of a structured interview process used to help select students to a professional education program in physical therapy. Two hundred and twenty academically qualified applicants were interviewed by one of six two-member teams using a standardized format. Each member of a team independently rated the applicant on each of four performance skills using a 5-point ordinal scale; the maximal total score possible was 16 points. A weighted kappa (Kw) statistic was used to estimate intrateam agreement for both 1993 and 1994 on each performance skill and overall interview score. We observed wide variation in intrateam Kw scores for each of the four performance skills between the 1993 and 1994 admission cycles. According to Kw values for overall score agreement, five of the six interview teams either remained the same or increased at least one level between 1993 and 1994. Intrateam variability may be reduced by having team members review specific criteria used to rate a skill before the interview process commences each year.

Adult↗

PubMed1995

Stimulus-response compatibility effects in a manual tracking task.

The purpose of this study was to determine whether there are stimulus-response (S-R) compatibility effects in a manual tracking task for male and female subjects of different ages. 20 healthy men and 20 healthy women in each of three different age groups (20 to 39, 40 to 59, and 60 to 79 years) participated (total N = 120). Subjects performed extension and flexion movements of the index finger metacarpophalangeal joint to track a computer-screen cursor along a target sine wave. The hand and forearm were positioned so that the finger movement was either vertical or horizontal, and the computer monitor was positioned so that the voluntary cursor movement was either vertical or horizontal. Each subject performed four different tracking tests corresponding to the four different ensembles of hand-forearm position and monitor position. There were significant differences in tracking performance between test ensembles in both women and men aged 60 to 79 years, and the compatible ensembles showed the superior performance. The results suggest that S-R compatibility effects exist in elderly women and elderly men performing a finger-movement tracking task, and these effects are consistent with impaired information processing in elderly persons. More research is needed on how S-R compatibility affects performance in persons with cerebral lesions.

Adult↗

PubMed1995

Reliability of measurements of lumbar spine sagittal mobility obtained with the flexible curve.

Presently, there is no available scientific information that examines the interchangeability of tangent and trigonometric methods used to calculate measurements of sagittal mobility of the lumbar spine obtained with a flexible curve. Repeated measurements of the lumbar curvature were made with a flexible curve by using a standardized protocol on 10 healthy volunteers under three conditions: 1) standing, 2) sitting with maximum trunk forward bending, and 3) lying prone with maximum backward bending. Measurements were made by a team of two physical therapists working together; one therapist instructed the subject, and the other therapist performed the measurement. Agreement between the tangent and trigonometric methods was assessed graphically by plotting the difference between methods against the mean value of each pair of readings for each of the three conditions. Measurements differed by 4 to 7 degrees for each of the three positions of the lumbar spine. We believe such error is clinically acceptable and should not affect the clinical decision made on the basis of the measurement.

Adult↗

PubMed1994

Reliability of goniometric measurements of active arm elevation in the scapular plane obtained in a clinical setting.

Our purpose was to determine the intratester and intertester reliability of measurements of both scapular and glenohumeral rotation during active arm elevation in the scapular plane with a new device, the scapulohumeral goniometer (SHG). Ten physical therapists, with 1 to 29 years of clinical experience, obtained repeated measurements on 45 subjects who were 27 to 82 years old. All subjects were tested in a uniform standing position with the handheld SHG, which was positioned over the subject's scapula and posterior shoulder according to operationally defined landmarks. For both scapular and glenohumeral rotation, 50% of the time the first and second measurements made on a patient by the same physical therapist differed by 3 degrees or more. Ten percent of the time, these measurements differed by 8 degrees or more. Measurements of active range of movement of scapular and glenohumeral rotation made by the same physical therapist during arm elevation in the scapular plane are clinically unacceptable when obtained with the current techniques for positioning the SHG. Clinical decisions based on results of active scapular and humeral motion in the scapular plane as measured on a patient by the same therapist with an SHG should be made with caution, because of the variability associated with this procedure.

Adult↗

PubMed1993

Reliability of goniometric measurements and visual estimates of ankle joint active range of motion obtained in a clinical setting.

We examined intratester and intertester reliability for goniometric measurements of ankle dorsiflexion (ADF) and ankle plantar flexion (APF) active range of motion (AROM). Parallel-forms intratester reliability for ankle AROM measurements obtained by the universal goniometer (UG) and by visual estimation (VE) and intertester reliability for VE of ADF and APF were examined. Repeated measurements were obtained on 38 patients with orthopedic problems by 10 physical therapists in a clinical setting. For intratester reliability of measurements obtained with UG, intraclass correlation coefficients (ICC) for all physical therapists were 0.64 to 0.92 (median, 0.825) for ADF and 0.47 to 0.96 (median, 0.865) for APF. Intertester reliability was quantified with use of ICC. ICCs for measurements obtained by UG were 0.28 for ADF and 0.25 for APF; ICC of VE for ADF was 0.34 and was 0.48 for APF. ICC for parallel-forms intratester reliability obtained with UG and VE ranged from 0 to 0.94 (median, 0.58) for ADF and 0 to 0.86 (median, 0.625) for APF. Thus, a physical therapist should use a goniometer when making repeated measurements of ankle joint AROM. Considerable inconsistency exists when two or more physical therapists make repeated goniometric and visual measurements of ankle motion on the same subject. Physical therapists may erroneously conclude that a patient's AROM has changed because of treatment when the change could be attributed to a lack of intertester reliability.

Adolescent↗

PubMed1993

Reliability of measuring forward head posture in a clinical setting.

We believe there is a need to identify a practical method for determining objective measurement of forward head posture. In our study, we determined the within-tester and between-tester reliabilities for clinical measurements of static, sitting, forward head posture using the cervical range of motion (CROM) instrument. Repeated measurements were made using a standardized protocol on 40 patients seated in a standardized position. The seven testers had from 1 to 8 years of clinical experience. All measurements were recorded by the same investigator. The intraclass correlation coefficient (ICC[1,1]) was used to quantitate within-tester and between-tester reliability. Measurements of forward head position performed by the same physical therapist had high reliability (ICC = 0.93). Good reliability (ICC = 0.83) was demonstrated when different physical therapists measured the forward head posture of the same patient. We concluded that measurements of forward head posture made by physical therapists trained in the correct use of the CROM instrument are reliable. This reliability is important for determining the effectiveness of treatment programs. On the basis of our data, the CROM instrument will assist clinicians in the objective evaluation and reassessment of the patient population demonstrating forward head posture.

Adult↗

PubMed1992

Normal range of motion of the cervical spine: an initial goniometric study.

The purposes of this study were (1) to determine normal values for cervical active range of motion (AROM) obtained with a "cervical-range-of-motion" (CROM) instrument on healthy subjects whose ages spanned 9 decades, (2) to determine whether age and gender affect six cervical AROMs, and (3) to examine the intratester and intertester reliability of measurements obtained. Measurements were made on 337 subjects (171 females and 166 males) whose ages ranged from 11 to 97 years. Measurements were taken by five physical therapists with 7 to 30 years of clinical and teaching experience. Among male and female subjects of the same age, females had a greater AROM than did males for all AROMs except neck flexion. Among both males and females, each of the six cervical AROMs decreased significantly with age. From two pilot studies separate from the acquisition of the normal database, we determined our intratester and intertester reliabilities for making neck AROM measurements with the CROM instrument. We concluded that AROM measurements on the cervical spine with the CROM instrument demonstrated good intratester and intertester reliability, because the intraclass correlation coefficients were generally greater than .80.

Adolescent↗

PubMed1991

Reliability of measurements of cervical spine range of motion--comparison of three methods.

To determine reliabilities within and between persons measuring cervical active range of motion (AROM) three methods were examined: use of a cervical-range-of-motion (CROM) instrument, use of a universal goniometer (UG), and visual estimation (VE). Measurements were made on 60 patients with orthopedic disorders of the cervical spine who were divided into three groups of 20 subjects each. All subjects were tested in a standardized seated position using operationally defined goniometric placements and nongoniometric estimation techniques. Cervical flexion and extension, lateral flexion, and rotation were measured. Intraclass correlation coefficients (ICCs) were used to quantify within-tester and between-tester reliability. We found that goniometric measurements of AROM of the cervical spine made by the same physical therapist had ICCs greater than .80 when made with the CROM device or the UG. When different physical therapist measured the same patient's cervical AROM, the CROM device had ICCs greater than .80, whereas the UG and VE generally had ICCs less than .80.

Adult↗

PubMed1988

A quantitative analysis of donor site morbidity after vascularized fibula transfer.

Eleven patients with free vascularized fibula graft transplants to the upper extremity were studied for donor-side morbidity effects. Based on their surgical follow-up times, the patients were divided into either group 1 (5 +/- 2 months) or group 2 (21 +/- 8 months) to examine the effects of surgical trauma more closely. Gait evaluation was performed using two walkways containing different ground conditions. Knee and ankle-foot motion was measured using a three-dimensional electrogoniometer. Basic temporodistance factors and ground reactions were obtained from foot switches, instrumented floor mats, and a force plate. A modified Cybex II isokinetic dynamometer was used to quantitate ankle-foot strengths. Moderate knee and ankle-foot motion changes were seen while walking on the level, sideslope, and ramp in patients evaluated less than 10 months after their surgical procedure. Minimal joint motion effects were discovered in patients with follow-up times longer than 10 months. Muscle strengths were significantly impaired in both groups, especially foot inversion and eversion. An inverse relationship existed between the length of resected fibula and ankle evertor muscle strength. Donor side morbidity does not appear to be caused by surgical soft-tissue trauma exclusively. These patients need to be studied for several more years to determine the long-term functional effects of free vascularized fibular graft transfer.

Adult↗

PubMed1983

Strength changes in the normal quadriceps femoris muscle as a result of electrical stimulation.

The purpose of this study was to examine the effectiveness of an electronic muscle stimulator in strengthening normal quadriceps femoris muscle without the assistance of simultaneous isometric muscle contraction. The sample consisted of 58 subjects who were randomly divided into three independent groups. One group (n = 19) served as controls; one group (n = 20) underwent daily stimulation of the right quadriceps femoris muscle using a specified protocol; and one group (n = 19) underwent isometric strengthening of the quadriceps femoris muscle using a specified protocol. The mechanical force of isometric quadriceps femoris muscle contraction was recorded weekly for the three groups, and the initial and final values were subjected to an analysis of covariance. The electrical-stimulation and isometric-exercise groups had statistically significant increases in quadriceps femoris muscle torque when compared with the nonexercised controls (p less than .001). The data supported the use of this electronic stimulator as an appropriate device for strengthening skeletal muscle without voluntary effort.

Adult↗

PubMedDate not supplied

Three-dimensional kinematics of the taped ankle before and after exercise.

The practice of prophylactic ankle taping or wrapping to reduce the incidence of inversion ankle sprains in athletes has come under attack. The purpose of this study was to measure objectively one ankle taping technique's ability to withstand the stresses placed upon it by a standardized exercise routine. Electrogoniometers were used to measure the three-dimensional ankle motion of 20 subjects walking on a level surface and a 10 degrees sideslope. The evaluations were carried out under these three conditions: (1) both ankles untaped, (2) both ankles taped before exercises, and (3) both ankles taped after exercise. The results from this study indicate that the tape does indeed restrict those motions associated with inversion ankle sprain. Methods similar to those described in this study could be used in the evaluation of many current training room practices and thereby provide an objective rationale for their application.

Adult↗