INTRODUCTION

Strength is a key modifiable risk factor for hamstring strains with significant differences between injured and non-injured sides in the lengthened position. Ensuring the test-retest reliability of measurement protocols ensures consistent injury prevention, rehabilitation and return-to-sport planning.

To evaluate the test-retest reliability of hamstring strength protocols in both standardized and lengthened positions among healthy adults.

Test-retest reliability study.

Human Performance Laboratory, Fr. Roque Ruano building, University of Santo Tomas, Espana Manila.

Ten healthy adults (six males and four females; mean age: 26.5 ± 4.03 years).

Absolute and relative peak torque for concentric and eccentric hamstring and quadriceps were measured at 60°/sec, 180°/sec and 240°/sec in the standardized position (hip and knee flexed at 90°). In the lengthened position (hip flexed at 85° and knee at 30°), isometric knee flexion and peak torque for concentric and eccentric hamstring and quadriceps were assessed at 60°/sec and 180°/sec. Strength ratios were calculated for both positions.

Intraclass Correlation Coefficient (ICC) values demonstrated good to excellent reliability for peak torque measurements, with higher reliability in the standardized position (ICC 0.83-0.94) than in the lengthened position (ICC 0.79-0.96). Conventional and functional ratios varied, with lower ICCs for the right leg in the standardized position (ICC 0.32-0.92) and moderate to good reliability in the lengthened position (ICC 0.63-0.87).

Standardized and lengthened positions provide reliable assessments of absolute and relative peak torque for hamstring and quadriceps muscles during concentric and eccentric contractions across all speeds, including conventional and functional strength ratios.

BACKGROUND

Feasibility studies are a necessary first step in assessing the practicality of methods and procedures used in a more extensive study. Others emphasize that feasibility studies aim to test the practical aspects of a future study and use the results to inform modifications that can enhance the study design and increase the chances of success in the more extensive study. Before conducting the main study, we rigorously refined data collection procedures based on the best available evidence, informed by the scoping review, expert consultation, and pilot testing.

To evaluate the feasibility and practicality of the proposed research methodology and to identify and address potential challenges associated with data collection. The specific objective is to determine the intra-rater reliability in determining MVIC, which is part of the procedure in the sEMG protocol.

This study is composed of two phases: (Phase 1) a pragmatic pilot study using an experienced biomechanist to refine the protocol. Thorough preparation, including a dry run and expert review, preceded the pilot study. (Phase 2) a preliminary testing phase to evaluate the protocol and to assess the intra-rater reliability of the MVIC used in the sEMG protocol. A high speed treadmill, Nexus software, Vicon and Delsys sEMG systems were used to capture kinematic and muscle activity data during high-speed running, enabling a comprehensive biomechanical analysis.

The final protocol underwent a feasibility and acceptability assessment based on five pre-defined metrics: recruitment efficacy, optimization of data acquisition methodologies, data integrity and completeness, procedural tolerability, and resource allocation efficiency. Pilot testing anomalies and their respective corrective actions were systematically documented. Furthermore, the intra-rater reliability of the maximum voluntary isometric contraction (MVIC) measurement exhibited a range from moderate to excellent, as determined by statistical analysis.

This study successfully demonstrated the feasibility and practicality of our research methods. We evaluated all identified parameters and completed the assessments on schedule. The feasibility study proved valuable in identifying and addressing challenges encountered during data collection, such as equipment malfunctions and logistical hurdles. The study also demonstrated a moderate to excellent intra-rater reliability of MVIC assessment.

Most medical complications following acute stroke are preventable (such as cardiac events, pneumonia, bed sores and venous thrombosis). This was a study on the frequency of medical complications and their association with key performance indicators. Methods: The study used a cross-sectional baseline audit of stroke care practices. The audit captured details on the nature of the stroke, patient demographics, characteristics of hospital care, and compliance with six key quality indicators in Philippine Academy of Rehabilitation Medicine Clinical Practice Guideline on Stroke Rehabilitation. Patient records were retrospectively consecutively sampled. Results: A total of 1,683 patients were included in the audit which came from 49 hospitals. Medical complications were seen in 182 patients (11.2%). Pneumonia contributed to half the medical complications (50%), followed by respiratory failure (7.7%) and gastrointestinal bleeding (3.8%). Presence of medical complications were associated with in-patient mortality (OR 3.3 (95% CI 2.1-5.3)) and prolonged hospital stay (16.1 ± 20.7 days vs 9.6 + 10.9 days). The best predictor model for pneumonia included variables of not having a swallow screen within the first 24 hours, having a nasogastric tube inserted, not achieving medical stability, not having a stroke unit in the admitting hospital, having suffered a previous stroke and being older. Conclusion: Non-adherence to evidence-based stroke care rehabilitation guidelines contributed significantly to medical complications in an audit of Filipino stroke patients

Objective: Our study aims to establish interrater reliability in performing the step-by-step procedure of selected pain provocation tests for hamstrings and special tests for lower extremity musculoskeletal injuries. Study Design: An interrater reliability study Setting: University of Santo Tomas - Sports Science Laboratory Participants: Ten healthy adults (five females, five males; age = 22.2 ± 0.42) from the university community. Main outcome measures: Interrater reliability of performing step-by-step procedures for selected pain provocation tests for hamstrings (painful resisted knee flexion 90°, painful resisted knee flexion 30°, active slump test, Puranen-Orava Test, bent knee stretch) and special tests for lower extremity musculoskeletal injuries (Lachman’s test, McMurray’s test, posterior drawer test, valgus, and varus stress test). Results: Fleiss kappa showed perfect agreement (κ = 1.00) for all test procedures except for Lachman’s test procedure 1 (κ= -0.11 [95% CI, -0.36 to 0.14]), active slump test procedure 4 (κ= -0.03 [95% CI, -0.28 to 0.23]), active slump test procedure 5 (κ= -0.11 [95% CI, -0.28 to 0.23]), and active slump test procedure 6 (κ= -0.05 [95% CI, -0.31 to 0.20]), which resulted in negative agreements. Conclusions The researcher developed protocols for each special and provocative test were consistent in measuring the intended procedures, and the raters were generally consistent with their ability to measure these tests.