The Lambeth Conventions are guidelines intended to be of practical value in the investigation of arrhythmias induced by ischaemia, infarction, and reperfusion. They cover the design and execution of experiments and the definition, classification, quantification, and analysis of arrhythmias. Investigators are encouraged to adopt the conventions in the hope that this will improve uniformity and interlaboratory comparisons.
More than 10 000 Americans seek medical treatment for sports, recreational activity, and exercise-related injuries on a daily basis. 20 Researchers have estimated that 50% to 80% of these injuries are overuse in nature and involve the lower extremity. 1,11,25 In the military, physical training and exercise-related injuries account for 30% of hospitalizations and 40% to 60% of all outpatient visits, with 10 to 12 injuries per 100 soldier-months.12 Although the risk of musculoskeletal conditions and injuries is multifactorial, 7,9,10,15,[17][18][19] preliminary evidence suggests that neuromuscular and strength training programs may be beneficial for preventing the occurrence of these conditions. 7,9,10,15,[17][18][19] However, tools that assess movement to help predict those at highest risk for musculoskeletal conditions and injuries have been lacking for both athletic and military populations. The Functional Movement Screen (FMS) is a relatively new tool that attempts to address multiple movement factors, with the goal of predicting general risk of musculoskeletal T T STUDY DESIGN: Reliability study. T T OBJECTIVES:To determine intrarater testretest and interrater reliability of the Functional Movement Screen (FMS) among novice raters. T T BACKGROUND:The FMS is used by various examiners to assess movement and predict timeloss injuries in diverse populations (eg, youth to professional athletes, firefighters, military service members) of active participants. Unfortunately, critical analysis of the reliability of the FMS is currently limited to 1 sample of active college-age participants. T T METHODS:Sixty-four active-duty service members (mean SD age, 25.2 3.8 years; body mass index, 25.1 3.1 kg/m 2 ) without a history of injury were enrolled. Participants completed the 7 component tests of the FMS in a counterbalanced order. Each component test was scored on an ordinal scale (0 to 3 points), resulting in a composite score ranging from 0 to 21 points. Intrarater test-retest reliability was assessed between baseline scores and those obtained with repeated testing performed 48 to 72 hours later. Interrater reliability was based on the assessment from 2 raters, selected from a pool of 8 novice raters, who assessed the same movements on day 2 simultaneously. Descriptive statistics, weighted kappa (κ w ), and percent agreement were calculated on component scores. Intraclass correlation coefficients (ICCs), standard error of the measurement, minimal detectable change (MDC 95 ), and associated 95% confidence intervals (CIs) were calculated on composite scores. T T RESULTS:The average SD score on the FMS was 15.7 0.2 points, with 15.6% (n = 10) of the participants scoring less than or equal to 14 points, the recommended cutoff for predicting time-loss injuries. The intrarater test-retest and interrater reliability of the FMS composite score resulted in an ICC 3,1 of 0.76 (95% CI: 0.63, 0.85) and an ICC 2,1 of 0.74 (95% CI: 0.60, 0.83), respectively. The standard error of the measurement of the composite test was...
Arrhythmia scores have been used in recent years to facilitate the analysis of arrhythmias, particularly in relation to regional myocardial ischaemia. The recent Lambeth Conventions recommended caution in the use of arrhythmia scores since their use may be misleading. In the present study seven scoring systems were examined in an attempt to validate the use of arrhythmia scores. A strong positive correlation was present between all seven scores. Furthermore, the scores all correlated with the incidences of ventricular fibrillation, ventricular tachycardia, and ventricular premature beats in early myocardial ischaemia. All seven scores successfully detected statistically significant reductions in the incidence of ventricular fibrillation resulting from the administration of two drugs. Some of the scores occasionally showed statistically significant reductions when effects on the raw arrhythmia data were not statistically significant. In this respect, parametric statistical analysis of arrhythmia scores may be a more sensitive method of quantifying arrhythmias than non-parametric analysis of binomially distributed raw data such as the incidence of ventricular fibrillation (in accordance with the power of such tests) indicating that the scores have precision. However, none of the scores incorrectly showed a statistically significant reduction when the raw data expressed a statistically significant or non-significant increase, indicating that the scores have accuracy. In conclusion, it is possible to design many arrhythmia scores that show changes in arrhythmia severity when more conventional analyses show only non-statistically significant trends. When used in conjunction with raw arrhythmia data, comprehensive drug dose ranges, and appropriate parametric statistical tests, arrhythmia scores facilitate the quantification of arrhythmias. It is recommended that arrhythmia scores should be used only for quantifying group data and model building and not for prognostic purposes in individuals.
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