Novice vs expert inter-rater reliability of the balance error scoring system in children between the ages of 5 and 14

Kuo, Keith; Hunter, Bradley C.; Obayashi, Mizuho; Lider, Joshua; Teramoto, Masaru; Cortez, Melissa; Hansen, Chuck

doi:10.1016/j.gaitpost.2021.02.026

Cited by 7 publications

(15 citation statements)

References 18 publications

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“…Although student reliability was substantial, there was a 20-point difference from experts with near-perfect reliability. This was consistent with similar studies that investigated student reliability compared to that of experts using other clinical tests [ 16 , 17 , 25 ]. This finding was not surprising as experience may be the most obvious explanation for such a discrepancy.…”

Section: Discussionsupporting

confidence: 92%

Reliability of the scapular dyskinesis test yes-no classification in asymptomatic individuals between students and expert physical therapists

Ramiscal

Bolgla

Cook

et al. 2022

Clin Shoulder Elbow

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Background: Scapular dyskinesis is considered a risk factor for the shoulder pain that may warrant screening for prevention. Clinicians of all experience screen scapular dyskinesis using the scapular dyskinesis test yes-no classification (Y-N), yet its reliability in asymptomatic individuals is unknown. We aimed to establish Y-N’s intra- and inter-reliability between students and expert physical therapists. Methods: We utilized a cross-sectional design using consecutive asymptomatic subjects. Six students and two experts rated 100 subjects using the Y-N. Cohen’s kappa (κ) and Krippendorff’s alpha (K-α) were calculated to determine intra- and inter-rater reliability. Results: Intra- and inter-rater values for experts were κ=0.92 (95% confidence interval [CI], 0.91–0.93) and 0.85 (95% CI, 0.84–0.87) respectively; students were κ=0.77 (95% CI, 0.75–0.78) and K-α=0.63 (95% CI, 0.58–0.67). Conclusions: The Y-N is reliable in detecting scapular dyskinesis in asymptomatic individuals regardless of experience.

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Section: Discussionsupporting

confidence: 92%

Reliability of the scapular dyskinesis test yes-no classification in asymptomatic individuals between students and expert physical therapists

Ramiscal

Bolgla

Cook

et al. 2022

Clin Shoulder Elbow

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“…The BESS has been scrutinized due to poor inter-rater reliability ( 63 ) and subjective scoring criteria ( 64 ). While the total BESS score (sum of errors across all poses) is most commonly used clinically, inter-rater reliability varies depending on the pose ( 46 , 63 ) and is higher in more experienced raters ( 65 ). Given the BESS's limited feasibility and low threshold for impairment found here, the NIH-SBT may be preferable for the assessment of static balance in moderate-to-severe TBI.…”

Section: Discussionmentioning

confidence: 99%

Balance impairment in patients with moderate-to-severe traumatic brain injury: Which measures are appropriate for assessment?

Joyce

Debert²,

Chevignard³

et al. 2022

Front. Neurol.

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Left untreated, balance impairment following moderate-to-severe traumatic brain injury (TBI) can be highly debilitating and hinder activities of daily life. To detect impairments, clinicians need appropriate assessment tools. The objective of this study was to evaluate the feasibility and utility of a battery of clinical balance assessments in adults with moderate-to-severe TBI within 6-months of injury. Thirty-seven adults with TBI [Glasgow Coma Scale score ≤ 12 (33 M/4 F) age 18–50 years] participated in balance testing. Assessments included the Balance Error Scoring System (BESS), National Institutes of Health Standing Balance Test (NIH-SBT), Functional Gait Assessment (FGA), Advanced Functional Gait Assessment (FGA-A), Tandem Gait Test (TGT), Berg Balance Scale (BBS), and Walking While Talking Test (WWTT). We identified pronounced ceiling effects on the BBS and FGA, two widely used clinical balance assessments. The NIH-SBT, WWTT, and FGA used in conjunction with the FGA-A, offered versatility in their capacity to assess patients across the balance severity spectrum. This study provides evidence to support a stepwise approach to balance assessment that can be adapted to the broad range of balance ability found in moderate-to-severe TBI.

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“…A two-hour training session was held for all raters, during which the TCMS-S scale was presented, training videos were analyzed, and the score was practiced. Any doubts that may have arisen were also answered [29]. The gold standard expert was a physical therapist with over ten years of clinical experience in the specific field of pediatric care, as well as five years of experience using the TCMS scale.…”

Section: Study Proceduresmentioning

confidence: 99%

“…The novice raters consisted of a master's student in physical therapy and a physical therapist without any clinical experience in pediatrics. Neither of the novice raters had any prior experience with the TCMS scale [18,19,26,29]. The gold standard expert administered the TCMS-S scale to the participants with CP in a face-to-face clinical setting.…”

Section: Study Proceduresmentioning

confidence: 99%

“…The results of assessments can be influenced by the level of experience and specific training of the rater, leading to differences from scores obtained by expert raters. There is evidence for this issue for widely used scales as the GMFM [26], the Test of Gross Motor Development [27,28], and the Balance Error Scoring System (BESS) [29], where novice raters have shown lower agreement and, consequently, higher Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). It is important to note that higher SEM and MDC indicate lower accuracy when interpreting results of clinical studies, assessing a patient's functional capacity, or making clinical decisions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy

López‐de‐Uralde‐Villanueva

2023

JCM

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The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy . However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater’s level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater’s experience level.

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Novice vs expert inter-rater reliability of the balance error scoring system in children between the ages of 5 and 14

Cited by 7 publications

References 18 publications

Reliability of the scapular dyskinesis test yes-no classification in asymptomatic individuals between students and expert physical therapists

Reliability of the scapular dyskinesis test yes-no classification in asymptomatic individuals between students and expert physical therapists

Balance impairment in patients with moderate-to-severe traumatic brain injury: Which measures are appropriate for assessment?

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy

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