목적 : 본 연구의 목적은 활동분석과 프로세스 맵핑을 기반으로 한 Korean version of Modified Barthel Index(K-MBI) 가이드북을 제작하여 내용 타당도와 평가자 간 신뢰도 및 일치도를 확인하고자 하였다. 연구방법 : 본 연구에서는 활동분석과 프로세스 맵핑을 기반으로 한 K-MBI 가이드북을 개발하였다. 개발 된 K-MBI 가이드북에 대한 이해도 조사 및 수정을 하여 최종 가이드북을 제작하여 40명의 작업치료 전문가 집단에 내용 타당도를 검증하였다. 평가자 간 신뢰도 및 일치도 조사를 위해 기존의 K-MBI 검 사 지침에 근거하여 총 5명의 환자의 일상생활활동 동영상을 촬영하였다. 평가자 간 신뢰도와 일치도 조 사는 84명의 작업치료사가 교육 전과 후에 동일하게 동영상 속의 5명의 환자를 평가하여 확인하였다. 결과 : 내용 타당도 검증 결과는 개발된 K-MBI 가이드북 11개의 모든 항목에서 CVI 점수가 .93 이상으 로 높은 수준의 타당도를 나타내었다. 평가자 간 신뢰도에서는 ICC가 교육 전 .983, 교육 후에 .982로 교육 전과 후 모두 높은 수준의 신뢰도를 보였다. 정답률의 변화는 교육 전 48.37%에서 교육 후에 69.48%로 향상되었고, 평가자 간 일치도는 옷 입고 벗기 항목을 제외한 모든 항목에서 일치도가 향상 된 것으로 나타났다. 결론 : 본 연구의 결과를 통해 활동분석 및 프로세스 맵핑을 기반으로 한 K-MBI 가이드북은 일상생활활 동 평가에서 평가자 간의 신뢰도와 일치도를 향상되게 시키는 것으로 확인되었다.

Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed (n1=20), young left-handed (n2=21), and older right-handed (n3=20) groups. The AAUT was assessed by dividing 63 subjects into young right-handed (n1=25), young left-handed (n2=18), and older right-handed (n3=20) groups. Student’s t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.

Background: Numerous studies have used smartphone applications to measure the range of motion in different joints. In addition, studies measuring the active range of motion (AROM) of the craniocervical joint have revealed high reliability. However, the subjects in these studies were all healthy subjects. No study has yet been conducted to measure the inter-rater reliability for the AROM of the craniocervical joint in stroke patients. Objects: The purpose of this study was to investigate the inter-rater reliability of the AROM of the craniocervical joint using a smartphone. Methods: The participants included 21 subjects who had strokes (17 males and 4 females). Two raters evaluated six types of craniocervical AROM, including flexion, extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, rotation to the hemiplegic side, and rotation to the non-hemiplegic side, using a goniometer and a smartphone to investigate inter-rater reliability. The inter-rater reliability was analyzed by intraclass correlation coefficients (ICC). Results: The inter-rater reliability of the smartphone was good for extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, and rotation to the hemiplegic side [ICC(2,k)=.86∼.88] and excellent for flexion [ICC(2,k)=.95]. The inter-rater reliability for rotation to the non-hemiplegic side was moderate [ICC(2,k)=.72]. Conclusion: These results suggest that the smartphone offers high inter-rater reliability for measurements of the craniocervical AROM in patients with stroke.

The purpose of this study was to investigate inter- and intra- rater reliability in an interview and a computerized oral test. It was also examined whether rater characteristics influenced on their reliability and biases, and finally the scores of both tests were compared with those of the Versant test using an automated computer rating system. For the study, the data from 21 Korean university students and 18 Korean or native speakers of English raters with various characteristics were collected. Some of the main findings from the study were as follows. First, rater severity was significantly different in each test, but each rater consistently graded on both tests suggesting lower inter-rater reliability and higher intra-rater reliability. Secondly, rater severity was impacted by the rater characteristics such as mother tongue, gender, age, and major. Lastly, there existed a positive correlation among the scores of the three tests, indicating that the scores of human beings and computers are strongly related.

The purpose of this study were to determine the intra-rater and inter-rater reliability of shoulder passive range of motion measurement using the “Clinometer + bubble level”, a smartphone application and to compare with the intra-rater and inter-rater reliability of measurement using a goniometer. Twenty six patients with stroke were recruited for this study. Two raters measured the passive range of motion of four types of shoulder movements (forward flexion; FF, abduction; ABD, external rotation at 90° abduction; ER90 and internal rotation at 90° abduction; IR90) using a goniometer and a smartphone to determine within-day inter-rater reliability. A retest session was performed thirty minutes later to determine within-day intra-rater reliability. The reliability was assessed using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). The ICC (2,1) for the inter-rater reliabilities of the goniometer and smartphone were good in FF and ABD [ICC (2,1)=.75∼.87] and excellent in ER90 [ICC (2,1)=.90∼.95]. The intra-rater reliabilities for the goniometer and smartphone were good or more than good, with an ICC (3,1) value >.75, the exception was IR90 measured by rater 2 on the smartphone. These results suggest that smartphone could be used as an alternative method tool for measurement of passive shoulder range of motion in patients with stroke.

The purpose of the current study was to determine the intra- and inter-rater reliability of muscle thickness (MT) measurement of the psoas major (PM) using ultrasonography (US) conducted at different inward pressures of approximately .5 ㎏, 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Twelve healthy male subjects were recruited for the study. The thicknesses of both PMs of each subject were measured by two different examiners in a random manner to assess the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval (CI). ICC (2,1) was used to determine the inter-rater reliability and ICC (3,1) was used to assess the intra-rater reliability of the MT measurement of the PM. The results indicated higher ICC values for intra-rater reliability compared to inter-rater reliability. In addition, the value for intra-rater reliability with .5 ㎏ inward pressure [ICC=.99 (95%CI=.98∼.99)] was higher compared to 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Other inward pressures for intra- and inter-rater reliability in current study were also demonstrated to have excellent values (ICC=.94∼.99). These findings showed that maintaining consistent inward pressure is essential for maintaining reliability of the results when the MT of the PM is measured by different examiners in a clinical setting.

Ely's test is commonly used to assess rectus femoris muscle flexibility. however, a reliability limit of this test was demonstrated by a previous study. In this study, we present an alternative method using an application for a digital horizontal level in a smartphone (DHLS) to complement the reliability limit of Ely's test. The aim of this study was to examine the reliability of Ely's test using DHLS on the pelvis, compared to using visual observation (VO) of pelvic and hip motions. Nineteen patients with lumbar extension-rotation syndrome were recruited for this study. An examiner examined the rectus femoris flexibility (both pass/fail and goniometer scoring) through Ely's test using both DHLS and VO. A retest session was completed two hours later for within-day reliability and seven days later for between-day intra-rater test-retest reliability. Results showed higher Kappa values for pass/fail scoring and higher intraclass correlation coefficient values for goniometer scoring in Ely's test using DHLS, compared to using VO. Measurement error and Bland and Altman plots further demonstrated the degree of intra-rater variance during Ely's test using DHLS in a clinical setting, compared to using VO. These results demonstrated that Ely's test using DHLS showed acceptable reliability compared to using VO. Ely's test using DHLS could be widely used for measuring the rectus femoris muscle flexibility in patients with lumbar extension-rotation syndrome, although the inter-rater reliability needs to be established first.

목적 : 한글판 수정바델지수 체크리스트를 고안하고 기존 한글판 수정바델지수와 신뢰도를 비교 평가하기 위함이다. 연구방법 : 연구대상은 뇌병변 환자 30명을 대상으로 하였다. 한글판 수정바델지수 체크리스트(이하 K-MBI 체크리스트)는 기존의 한글판 수정바델지수(기존 K-MBI)와 수정바델지수(MBI) 원본을 참고하여 각 항목별 평가 내용을 세분화 및 체크리스트화 하였다. 30명의 환자를 대상으로 K-MBI 체크리스트를 사용하는 그룹과 기존 KMBI를 사용하 는 그룹으로 나누어 각 그룹에 2명의 치료사를 배정하였다. 결과분석은 평가자간 신뢰도를 알아보기 위해 총점수준에서 급간내상관계수를 구하였으며, 세부항목 수준에서 카파검정을 시행하였다. 결과 : 총점수준에서의 신뢰도는 K-MBI 체크리스트(ICC= .981)와 기존 K-MBI(ICC= .973)를 사용한 두 그룹 모두에서 매우 높은 검사자간 신뢰도를 보였다(p<.001). 세부항목별 일치도에서는 K-MBI 체크리스트를 사용한 그룹과 기존 K-MBI의 경우 모두 4개 항목에서 탁월한 일치도를 보였다. Mean K값은 K-MBI 체크리스트(.725)가 K-MBI(.699) 보다 높게 나타났다. 결론 : K-MBI 체크리스트와 기존의 K-MBI 모두 총점수준에서 높은 수준의 평가자간 신뢰도를 보였다. 세부항목수준에서 역시 두 그룹 모두 전 항목에서 상당한 수준 이상의 신뢰도를 확보하였으나, 항목 간에는 다소 차이가 있었다.

Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

The aim of this study was performed to determine the inter-rater reliability of the Stroke Rehabilitation Assessment of Movement (STREAM) translated in Korean. This was a new clinical measurement tool for evaluating the recovery of voluntary movement and basic mobility following stroke. A direct-observation reliability study was conducted on 20 patients who had strokes and were in a rehabilitation setting. Subjects were assessed by two physical therapists. The reliability of the STREAM scores was demonstrated by weighted kappa statistics for inter-rater agreement on scores for individual items ranged from .83 to 1.0, intraclass correlation coefficients for total score was .99, and for subscale scores was ranged from .96 to .99. The internal consistency of the STREAM scores was demonstrated by Cronbach alphas of greater than .99 on the subscales and overall. These high levels of reliability support the use of the STREAM translated in Korean instrument for the measurement of motor recovery following stroke.

The purpose of this study was to evaluate inter-rater reliability of the amplitude and first knee extension angles in deep tendon reflex test by using an electrical hammer. Twenty-five healthy adults participated in the study. Compound muscle action potential is elicited by tapping the knee tendon with an electrical hammer in deep tendon reflex tests. The amplitude and knee extension angle were simultaneously measured. The mean value of the amplitude and the knee extension angles through three time trials for each tester, are used for determining the inter-rater and Intra-class Correlation Coefficients (ICCs) reliabilities. According to the results, the ICCs of the amplitude is .280 and that of the knee extension angle is .789. Pearson correlation coefficients of the amplitude of the action potential and the knee extension angles are .685, showing significant statistically moderate correlation. Inter-rater reliability in the amplitude was not significant. More objective and quantitative deep tendon reflex tests should be done to obtain higher reliability in further studies.

Muscle tone (stiffness/hardness) or muscle compliance changes during muscle contraction. The purposes of this study were to assess the intrarater and interrater reliabilities of the Myotonometer®, electronic device that quantifies muscle tone. Two raters used the Myotonometer to assess the right bicep brachia and quadriceps muscles of 30 voluntary persons without any orthopedic or neurological problems (age range, 18~21 yrs). Muscles were measured in a relaxed state and during brief sustained voluntary maximal isometric contraction. Intrarater correlation coefficients were calculated for each muscle and for each condition (relaxed and contracted). Intrarater reliabilities (intraclass correlation coefficients, ICCs) ranged from .778 to .954, relaxed, biceps brachia), .926 to .963 (contracted, biceps brachia), .935 to .990 (relaxed, quadriceps) and .679 to .952(contracted, quadriceps). Interrater reliabilities ranged from .652 to .790 (relaxed, biceps brachii), .813 to .907 (contracted, biceps brachii), .831 to .950 (relaxed, quadriceps) and .849 to .937 (contracted, quadriceps). Myotonometer measurements had high to very high intrarater and interrater reliability for measurements of the biceps brachia and quadriceps muscles.

Various studies have been conducted to minimize the subjectivity and increase the accuracy in assessing written texts, and the present study focused on the scoring rubrics which were the basic criteria for evaluating writing. Three different scoring rubrics (holistic, analytic and multiple-trait scoring method) were compared in evaluating argumentative essays written by Korean high school students. The present study aims to investigate the rater-reliability of the three scoring methods, holistic, analytic, and multiple-trait scoring methods. Scores of the five raters which were obtained from using the three scoring methods were compared. It was found that there were significant mean differences in the three scoring methods. Raters gave the relatively low scores when they used the holistic scoring. Next, the highest inter-rater reliability was found in the multiple-trait scoring. All the three scoring methods showed an acceptable level of reliability above .07. However, raters showed the highest reliability when they used a multiple-trait scoring rubric. Also, high correlation was found among components of analytic and multiple-trait scoring methods, indicating that the multiple-trait scoring rubric can replace the analytic scoring rubric. Finally, raters expressed a favor over the multiple-trait scoring. The result of this study suggests some implications for writing assessment in Korean secondary English classes.

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, 20.4±2.2 yrs; height, 164.0±5.5 ㎝; weight, 58.7±7.3 ㎏) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

대동작 운동 수행능력 측정도구(GMPM)는 뇌성마비 아동의 움직임을 질적인 면에서 평가하기 위해 개발된 도구이다. 이 연구의 목적은 대동작 운동 수행능력 측정도구의 측정자간 신뢰도를 알아보는 것이다. 뇌성마비 아동 10명(평균 5.6세, 범위 4~8세)에게 GMPM 평가를 실시하였다. 평가 과정을 비디오로 녹화하여 각 속성 항목별로 3명의 평가자간의 급간내 상관계수로 일치도를 보았다. 전반적으로 측정자간 신뢰도는 '불량~보통'범주에 속했다. 이 연구의

In general, sitting balance is decreased in subjects with spinal cord injury. The purpose of this study was to evaluate the inter- and intra-rater reliability of the Functional Reach Test (FRT) which is used to measure sitting balance. The subjects of this study were 26 persons with spinal cord injury, and they were divided into three groups according to their injury level. Group I, II and III consisted of the following quadriplegics, , and paraplegics, respectively. Subjects sat on a mat table that was set at an 80 degree inclination. During three sessions, the length subjects could reach in the FRT test was measured by three physical therapists, and compared to each other. The results showed that intraclass correlation coefficients (2,1) were above 0.97 and inter-rater difference was not statistically significant. The one-way ANOVA demonstrated that reach differed between groups with lower thoracic lesion and the other test groups. In conclusion, we think modified FRT is useful and reliable method to measure the sitting balance in subjects with spinal cord injury.

This study was performed to determine the inter-rater reliability of the Chedoke-McMaster Stroke Assessment translated in Korean. This measures the physical impairments and disabilities that impact on the lives of individuals with stroke. The purposes of this measure were 1) to stage motor recovery to classify individuals in terms of clinical characteristics, 2) to predict rehabilitation outcomes, and 3) to measure clinically important change in physical function. Twenty-two subjects from physical therapy unit were assessed by two physical therapists. The ratings were compared by Spearman's rank correlation The correlation between two raters ranged from 0.85 to 0.98. Inter-rater reliability coefficient for total scores ranged from 0.95 to 0.97. This study confirms that the Chedoke-McMaster Stroke Assessment yields reliable results.

The purpose of this study was to examine the inter-rater reliability of the Korean translation of the GMFM(Gross Motor Function Measure). Three licensed physical therapists with varying amounts(2 - 6 years) of clinical experience served as raters. Thirty patients with cerebral palsy were subjects for this study. Subjects were 22 boys and 8 girls, aged 1 to 8 years. Reliability of each dimension and each total score of the GMGM were analyzed using ICCs(intraclass correlation coefficients). The reliability of each dimension score ranged from .76 to .98, with the walking, running, and jumping dimension having higher reliability values. The reliability of the total dimension score was .94. We conclude that the GMFM has inter-rater reliability for assessing gross motor function in patients with cerebral palsy.