TY - JOUR
T1 - Inter-rater reliability of manual muscle strength testing in ICU survivors and simulated patients
AU - Fan, Eddy
AU - Ciesla, Nancy D.
AU - Truong, Alex D.
AU - Bhoopathi, Vinodh
AU - Zeger, Scott L.
AU - Needham, Dale M.
N1 - Funding Information:
Acknowledgments This research is supported by the National Institutes of Health (Acute Lung Injury SCCOR grant P050 HL 73994). EF is supported by a Fellowship Award from the Canadian Institutes of Health Research and a Detweiler Traveling Fellowship from the Royal College of Physicians and Surgeons of Canada. DMN is supported by a Clinician-Scientist Award from the Canadian Institutes of Health Research. The funding bodies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
PY - 2010/6
Y1 - 2010/6
N2 - Objective: The goal of the paper is to determine inter-rater reliability of trained examiners performing standardized strength assessments using manual muscle testing (MMT). Design, subjects, and setting: The authors report on 19 trainees undergoing quality assurance within a multi-site prospective cohort study. Intervention: Inter-rater reliability for specially trained evaluators ("trainees'') and a reference rater, performing MMT using both simulated and actual patients recovering from critical illness was evaluated. Measurements and results: Across 26 muscle groups tested by 19 trainee-reference rater pairs, the median (interquartile range) percent agreement and intraclass correlation coefficient (ICC; 95% CI) were: 96% (91, 98%) and 0.98 (0.95, 1.00), respectively. Across all 19 pairs, the ICC (95% CI) for the overall composite MMT score was 0.99 (0.98- 1.00). When limited to actual patients, the ICC was 1.00 (95% CI 0.99-1.00). The agreement (kappa; 95% CI) in detecting clinically significant weakness was 0.88 (0.44- 1.00). Conclusions: MMT has excellent inter-rater reliability in trained examiners and is a reliable method of comprehensively assessing muscle strength.
AB - Objective: The goal of the paper is to determine inter-rater reliability of trained examiners performing standardized strength assessments using manual muscle testing (MMT). Design, subjects, and setting: The authors report on 19 trainees undergoing quality assurance within a multi-site prospective cohort study. Intervention: Inter-rater reliability for specially trained evaluators ("trainees'') and a reference rater, performing MMT using both simulated and actual patients recovering from critical illness was evaluated. Measurements and results: Across 26 muscle groups tested by 19 trainee-reference rater pairs, the median (interquartile range) percent agreement and intraclass correlation coefficient (ICC; 95% CI) were: 96% (91, 98%) and 0.98 (0.95, 1.00), respectively. Across all 19 pairs, the ICC (95% CI) for the overall composite MMT score was 0.99 (0.98- 1.00). When limited to actual patients, the ICC was 1.00 (95% CI 0.99-1.00). The agreement (kappa; 95% CI) in detecting clinically significant weakness was 0.88 (0.44- 1.00). Conclusions: MMT has excellent inter-rater reliability in trained examiners and is a reliable method of comprehensively assessing muscle strength.
KW - Diagnostic techniques and procedures
KW - Epidemiologic research design
KW - Muscle strength
KW - Muscle weakness
KW - Physical examination
KW - Reproducibility of results
UR - http://www.scopus.com/inward/record.url?scp=77954456408&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954456408&partnerID=8YFLogxK
U2 - 10.1007/s00134-010-1796-6
DO - 10.1007/s00134-010-1796-6
M3 - Article
C2 - 20213068
AN - SCOPUS:77954456408
SN - 0342-4642
VL - 36
SP - 1038
EP - 1043
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 6
ER -