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Circcumference browse Academia. Skip to main content. Log In Sign Up. Download Free PDF. Validity, responsiveness, intra- and inter-rater reliability of the weighted tape measure when measuring measurw circumference Hand Therapy, Apostolos Fakis. Vincent Jansenz. Download PDF. A short summary of this paper. Validity, responsiveness, intra- and inter-rater reliability of the weighted tape measure when measuge digital circumference.

Hand Therapy ; 31— DOI: Email: victoria. Circumferential measurements CMs are used by hand therapists to monitor measurre oedema. There are a digotal of tape measures available commercially to measure digital circumference, but none of them have any data to support their reliability or validity.

Observational measurement studies using a repeated measures design were undertaken to assess if a weighted tape measure, used with a digital circumference tape measure analysis, could provide accurate and reliable CMs of swollen digits. In study 1, validity and responsiveness were determined by two raters measuring 16 steel bars of known circumferences circumferenxe comparing the known measurements to those taken with the weighted tape.

In study 2, intra- and inter-rater reliability was assessed by three raters measuring 12 prosthetic digits. In study 3, 27 swollen digits were measured by three raters to assess intra- and inter-rater reliability of the raters using the weighted tape in a clinical setting.

The analysis of validity was based on the Bland—Altman plots. Reliability was based on the intraclass correlation coefficient ICC. There was digital circumference tape measure analysis agreement between the measurements taken by two assessors at the start and end of the trial and the actual circumference of the steel bars all mean differences divital mm.

A minimum change in circumference of 2 mm could be digital circumference tape measure analysis with the same rater and a change of 3 mm could be detected with a different rater.

On swollen digits the ICC digital circumference tape measure analysis were significantly greater than 0. The lowest values for inter-rater reliability were ICC 0. The weighted tape measure has been shown to be valid and reliable in this study when used with a protocol for measuring swollen digits. It was easy to use and may become a clinically useful analysie. Keywords: Oedema, swelling, digit, measurement, assessment tool Introduction should be using objective markers but also must ensure that the tools they use are both valid and reliable for In an age of accountability the need for objectivity when clinical decision-making and in research.

A valid tool is carrying out a comprehensive hand assessment should be one ddigital measures consistently the phenomenon for fundamental to hand therapy. Digital circumference tape measure analysis between different emasure at the same time. Weighted tape for measuring digital circumference correlation coefficient ICC has been used for assessing the Hospitals NHS Foundation Trust Research and Analusis intra- and inter-rater reliability and it reflects both the Analyais and the Derbyshire Research Ethics Committee association and agreement of ratings.

Analsis coefficients of 1 Description of the weighted tape equipment are rare, as mmeasure tool is perfect; so reliability is a property that is attained to varying degrees. This allows the clinician to end of the tape provides a standardized amount of differentiate between what is a real change circunference than tension.

The tape itself is made of 0. It was hoped that this slim tape would aid phenomenon being measured; hence, the responsiveness conformity around the digits, especially around flexed of an assessment tool is a context-specific attribute. The tape was The presence of dogital oedema digital circumference tape measure analysis patients attending for mounted in a small metal frame that includes a scale in hand therapy is of significance to the treating clinician.

This weight was selected, as the hand volumeter digital circumference tape measure analysis the assessment of oedema.

In terms of usability visible compression of a digit. The metal frame can be there are drawbacks of using this method of assessment: it stood upright in a wooden base unit Figure 1. The requires bulky specialist equipment, a water source, the protocol digital circumference tape measure analysis use can be obtained by contacting the exclusion of patients who cannot immerse the limb up to corresponding author.

The alternative to measuring hand volume in the clinic is to mezsure digital circumference using a tape measure. Here each digit can be assessed independently and Study 1: Validity and responsiveness without the use of expensive specialist equipment.

The objective was to determine anaalysis validity and respon- However, circumferential measures have also been criti- siveness of the weighted tape when measuring cylinders cized for variability in the tension used to tighten the tape of a known, fixed circumference.

In Palmada et al. In our study a weighted tape analyis registered design along with a protocol of use was designed in an attempt to try and meet the demands for a tool that is both accurate and reliable but still readily accessible and easy to use by all clinicians whatever their level of experience. Currently there is only one prototype weighted tape measure, which was used for this research study.

The design is registered with the UK patent office and Digital Circumference Tape Measure Zone thus protected from being copied. Anyone wishing to use it must contact the first author or the Hand Unit for permission to borrow the equipment. Methods Study design A series of studies using a repeated eigital design were undertaken to examine the validity, responsiveness and reliability of the weighted tape measure.

This 1, first measurement The measyre raters were randomly selected from 14 available professionals in the Hand Unit using random and that this level of validity was achieved by more than tables. All the raters in the three studies had time to anaoysis one rater.

The bar order was ran- domized in blocks of 16 to ensure no memory of the previous readings by the raters using NQuery Advisor software. When study 3 was com- plete, study 1 was repeated by the same digital circumference tape measure analysis and The objective was to determine the intra- and inter-rater raters.

This repeat measure at the end of study 3 was carried reliability of the weighted tape when measuring digital circumference tape measure analysis out to provide information on the validity of the weighted mdasure digits by three raters with different years of pro- tape over time 19 months and after repeated use. The anwlysis analysis was circumfreence with the Unlike maesure metal bars the prosthetic digits were not of Statistical Package for the Social Sciences, SPSS version uniform circumference along their length and thus this The distribution of the continuous phase introduced the need for accurate tape placement variables was tested using their histograms.

The results for and assessed the ability of the tape to conform. The data from the steel bars rather than from swollen digits were used for estimating the responsiveness digital circumference tape measure analysis the circumference of them was known and fixed. The lowest acceptable limit of agreement was set high to 0.

For all the measurements the difference between of the steel bars at the start digital circumference tape measure analysis the trial. Solid line: the mean difference Figures 2—5. Solid line: the mean circumferences Two were physiotherapists, one with cigital years and ages ranged from 4 to 84 years.

Dgital digits were cast in relaxed one with nine months of experience in hand therapy, and extension of the PIPJ varying in range from 68 to of one was an occupational therapist with five years of flexion and all digit types were represented at least once.

Three raters participated in this study, randomly The prosthetic digits were marked up by the investi- selected based on random tables from 14 available pro- gator on the volar surface and a tape then looped around fessionals who had been grouped by years of experience the digit to mark dorsally and laterally using a standard tape measure volar markings as described: 1 Proximal phalanx P1 — midway circumfrrence the distal crease tale the metacarpophalangeal joint MCP and the proximal crease of the PIPJ.

Each digit was measured twice by each rater in a single session and in random order. The order of the 12 digits was randomized in blocks of 12 using NQuery Advisor software. The digits were held by the investigator while the rater measured each of the three marked locations. Prior to progressing onto study 3, the raters were then asked to complete a questionnaire available on request regarding the tape measure and protocol for use, for example ease of use, problems encountered, time required Figure 4 Bland—Altman plot to illustrate the differences of to circumferene and perceived clinical usefulness.

Solid line: the mean difference ual circumference measures were used studies 2 and 3. The locations significance was set at P0. Therefore, we set the lower Djgital same raters for study 2 participated in study 3.

Foundation Trust, Digital circumference tape measure analysis Hand Unit invited patients to take part based on the study inclusion and exclusion Results criteria Box 1.

Written informed consent was obtained There was slightly more variation in the measurements by one of the researchers. Sixteen patients with 27 oede- than seen when measuring steel bars, but the agreement matous digits were measured by the three raters. There ICC in measurements was significantly higher than the were six men and 10 women, whose ages ranged 27—74 lower limit of acceptability 0.

There were also similar distribution between them 5 thumb, 6 index, 6 middle, ICC scores for all the raters indicating profession and 4 ring and 4 little fingers. As However, the Digital Circumference Tape Measure Data following changes were implemented to well as trauma wrist and digit fractures, 15 digits and improve its ease of use for study 3: surgery 6 digitsthere were three circumferdnce each from hands with tqpe regional pain syndrome and mesure plexus 1 The line on the perspex reading plate was darkened injury.

There was equal spread of digits from dominant to make cirucmference the scale easier. Vigital enables digital circumference tape measure analysis to establish if a fixed 3 To accommodate digits with severe flexion contrac- digital circumference tape measure analysis an alternative subject position was added to the protocol. This was not Inclusion criteria possible in the fully pronated position when PIPJ were qnalysis Digital Circumference Tape Measure Quality flexed.

The objective was to determine the intra- and inter-rater 4 Patient willing to allow non-permanent pen marks to be reliability of the weighted tape and protocol for use when made on the finger. Each digit was intrarater reliability, achieving 0. There was digital circumference tape measure analysis no relationship second digit measured in the same hand.

This is because between years of hand therapy experience and intrarater clinically each digit has a different challenge for the rater reliability. The ICC for all the Digital Circumference Tape Measure Error should be measured with the forearm in neutral rather locations after the first and second reading was signifi- than pronation.

The 27 digits were taken as independent obser- on oedematous digits at the proximal phalanx, PIPJ vations even if they were measured in the same hand. For the proximal phalanx and In this study, the lower digital circumference tape measure analysis limit was set at 0.

A sample size of at least 24 digits was calcu- benefit in using a second reading. The order in which lated based on an ICC of 0. The digit to be measured measurs assessed and recorded for PIPJ rape con- tracture using a goniometer. The digit was then marked Table digital circumference tape measure analysis Results of inter-rater reliability for all raters on up as described for study 2.

The 0. Middle phalanx 0. Weighted tape for measuring digital circumference Discussion clinician would have to judge that the patient is able to keep the digit still while lightly resting it on the weighted tape. The weighted tape is a new tool devised to address the The digits were marked up by an investigator and not by problems of measuring the circumference of digits. As each individual rater; this may affect reliability for repeat with all measurement tools it relies for validity and measurements over time if digital circumference tape measure analysis was variation in the reliability on the person using the tool to be familiar marking up.

It is believed that the protocol for marking with it and to follow a protocol.

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