Inter-rater and intra-rater reliability of isotonic exercise monitoring device for measuring active knee extension

Chonnanid Limsakul; Kiattisak Sengchuai; Rakkrit Duangsoithong; Nattha Jindapetch; Jermphiphut Jaruenpunyasak

doi:10.7717/peerj.14672

Inter-rater and intra-rater reliability of isotonic exercise monitoring device for measuring active knee extension

PeerJ. 2023 Jan 16:11:e14672. doi: 10.7717/peerj.14672. eCollection 2023.

Authors

Chonnanid Limsakul¹, Kiattisak Sengchuai², Rakkrit Duangsoithong², Nattha Jindapetch², Jermphiphut Jaruenpunyasak³

Affiliations

¹ Department of Rehabilitation Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
² Department of Electrical Engineering, Faculty of Engineering, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
³ Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.

Abstract

Background: The goal of this study was to assess the reliability of electromyography and range of motion measurements obtained using a knee exercise monitoring system. This device was developed to collect data on knee exercise activities.

Methods: Twenty healthy individuals performed isotonic quadriceps exercises in this study. The vastus medialis surface electromyography (sEMG) and range of motion (ROM) of the knee were recorded during the exercise using the isotonic knee exercise monitoring device, the Mobi6-6b, and a video camera system. Each subject underwent a second measuring session at least 24 h after the first session. To determine reliability, the intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) at the 95% confidence interval were calculated, and a Bland-Altman analysis was performed.

Results: For inter-rater reliability, the ICCs of the mean absolute value (MAV) and root mean square (RMS) of sEMG were 0.73 (0.49, 0.86) and 0.79 (0.61, 0.89), respectively. ROM had an ICC of 0.93 (0.02, 0.98). The intra-rater reliability of the MAV of the sEMG was 0.89 (0.71, 0.96) and the intra-rater reliability of RMS of the sEMG was 0.88 (0.70, 0.95). The ROM between days had an intra-rater reliability of 0.82 (0.54, 0.93). The Bland-Altman analysis demonstrated no systematic bias in the MAV and RMS of sEMG, but revealed a small, systematic bias in ROM (-0.8311 degrees).

Conclusion: For sEMG and range of motion measures, the isotonic knee exercise monitoring equipment revealed moderate to excellent inter- and intra-rater agreement. However, the confidence interval of ROM inter-rater reliability was quite large, indicating a small agreement bias; hence, the isotonic knee exercise monitor may not be suitable for measuring ROM. This isotonic knee exercise monitor could detect and collect information on a patient's exercise activity for the benefit of healthcare providers.

Keywords: Inter-rater reliability; Intra-rater reliability; Isotonic exercise device; Knee extension; Knee rehabilitation; Range of motion; Surface electromyography.

MeSH terms

Humans
Knee Joint*
Knee*
Lower Extremity
Range of Motion, Articular
Reproducibility of Results

Grants and funding

This work was supported by the Faculty of Medicine Research Foundation, Prince of Songkla University and Broadcasting and Telecommunications Research and Development Fund for Public Interest (BTFP). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.