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Intra- and inter-rater reliability of the assessment of capacity for myoelectric control
Limb Deficiency and Arm Prosthesis Centre, Orebro University Hospital, SE-701 85 Orebro, Sweden; Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-4247-2236
Limb Deficiency and Arm Prosthesis Centre, Orebro University Hospital, SE-701 85 Orebro, Sweden.
Karolinska Institute, Stockholm, Sweden.
2006 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 2, p. 118-23Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine the reliability of the Assessment of Capacity for Myoelectric Control (ACMC) in children and adults with a myoelectric prosthetic hand.

DESIGN: Intra-rater and inter-rater reliability estimated from reported assessments by 3 different raters.

PATIENTS: A sample of convenience of 26 subjects (11 males, 15 females) with upper limb reduction deficiency or amputation and myoelectric prosthetic hands were video-taped during a regular clinical visit for ACMC. Participants' ages ranged from 2 to 40 years.

METHODS: After instruction, 3 occupational therapists with no, 10 weeks' and 15 years' clinical experience of myoelectric prosthesis training and follow-up independently rated the 30 ACMC items for each patient. The ratings were repeated after 2-4 weeks. Inter- and intra-rater reliability in items was examined by using weighted kappa statistics and Rasch-measurement analyses.

RESULTS: The mean intra-rater agreement in items was excellent (kappa 0.81) in the more experienced raters. Fit statistics showed too much variation in the least experienced rater, who also had only good (kappa 0.65) agreement in items. The stability of rater calibrations between first and second assessment showed that no rater varied beyond chance (>0.50 logit) in severity. The mean inter-rater agreement in items was fair; kappa 0.60, between the experienced raters and kappa 0.47 between raters with no and 10 weeks' experience.

CONCLUSION: Overall, the agreement was higher in the more experienced raters, indicating that reliable measures of the ACMC require clinical experience from myoelectric prosthesis training.

Place, publisher, year, edition, pages
2006. Vol. 38, no 2, p. 118-23
National Category
Orthopaedics Surgery
Research subject
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-27827DOI: 10.1080/16501970500312222ISI: 000236049600007PubMedID: 16546769OAI: oai:DiVA.org:oru-27827DiVA, id: diva2:609004
Available from: 2013-03-04 Created: 2013-03-04 Last updated: 2018-01-11Bibliographically approved
In thesis
1. Upper limb reduction deficiencies in Swedish children: classification, prevalence and function with myoelectric prostheses
Open this publication in new window or tab >>Upper limb reduction deficiencies in Swedish children: classification, prevalence and function with myoelectric prostheses
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Upper limb reduction deficiency (ULRD) is a rare condition that has been known ever since the 6th century B.C. This is a lifelong deficiency which in an afflicted child can lead to practical limitations, social restrictions and physical problems. The overall aim of this research was to increase the knowledge about children with upper limb reduction deficiencies from three perspectives: the deficiencies themselves, the use of prostheses and the well being of the affected children. To validate information regarding ULRD in the Swedish Register for Congenital Malformations (SRCM), all infants reported to this register during 1973-1987 were re-classified according to a more detailed classification. The result was compared with a clinic-based register at the Limb Deficiency and Arm Prostheses Centre in Örebro, Sweden. The findings indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.

The presence of scoliosis and trunk asymmetry was studied in 60 persons with transverse ULRD. Nineteen persons (31%) had a scoliosis of between 10 and 19º and 30 persons had minor curves of between 5 and 10º. There was a significant correlation between leg length inequality and side of the convexity, with the convexity directed towards the side of the shorter leg in 21 of 28 persons. This indicates that children with transverse ULRD may have a transient scoliosis of postural origin of no clinical significance.

A new observation-based test, the Assessment of Capacity for Myoelectric Control (ACMC), which measures a person’s capacity to control a myoelectric prosthetic hand during the performance of ordinary daily tasks, was developed. Occupational therapists completed 210 assessments of 75 persons. Rasch rating scale analysis was used for validation and reliability estimations. The results demonstrate internal scale and person response validity.

The external reliability of ACMC was established by scorings from three raters with different degrees of experience on 27 videotapes of client performance. The major finding in this study was that in order to obtain reliable measures from the ACMC the raters have to have some experience of this group of clients. Until the ACMC can adjust for rater severity, the same rater should perform the ACMC when it is used for follow-up or clinical trials.

In a study of 62 children we found that, overall, children with ULRD who have been fitted with a myoelectric prosthetic hand are just as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency which have to be considered differently in boys and girls. Most children who have been provided with a myoelectric prosthesis at an early age continue to use the prosthesis.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2004. p. 43
Keywords
children, upper limb, deficiency, register validation, scoliosis, arm prosthesis, measurement, occupational therapy, psychopathology, depression
National Category
Pediatrics
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-27809 (URN)91 -7140 - 091 - 5 (ISBN)
Public defence
(Swedish)
Opponent
Supervisors
Available from: 2013-03-04 Created: 2013-03-01 Last updated: 2017-10-17Bibliographically approved

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Hermansson, Liselotte M.Bodin, Lennart

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