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Within‐Day Test‐Restest Reliability of the Single Passive Leg Movement Technique: Evidence of Clinical Utility
Author(s) -
Broxterman Ryan M.,
Groot H. Jonathan,
Rossman Matthew J.,
Garten Ryan S.,
Venturelli Massimo,
Kwon OhSung,
Hydren Jay R.,
Gifford Jayson R.,
Richardson Russell S.
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.736.4
Subject(s) - medicine , hemodynamics , brachial artery , coefficient of variation , reliability (semiconductor) , reproducibility , clinical trial , photoplethysmogram , cronbach's alpha , cardiology , physical medicine and rehabilitation , physical therapy , blood pressure , mathematics , computer science , statistics , clinical psychology , power (physics) , physics , filter (signal processing) , quantum mechanics , computer vision , psychometrics
Passive leg movement (PLM) is emerging as a potentially better assessment of nitric oxide (NO)‐mediated vascular function than brachial artery flow‐mediated dilation, as it elicits a robust NO‐mediated increase in both leg vascular conductance (LVC) and leg blood flow (LBF). Typically, PLM is conducted with continuous movements spanning one to two minutes, with the assessment of alterations in LVC. However, single movement PLM with the assessment of alterations in LBF is more appealing as a clinical technique due to the relative ease of administration and minimal central hemodynamic effects. The reproducibility of the evoked physiological responses from single PLM is important for both clinical and research interpretation, but is currently unknown. Therefore, the current study investigated the within‐day test‐retest reliability of the hemodynamic responses elicited by single PLM. In nine subjects (7 men and 2 women), three single PLM trials were performed within the same visit, while second‐by‐second measurements of the central and peripheral hemodynamic responses were acquired with finger photoplethysmography and Doppler ultrasound, respectively. The peak change in LBF (ΔLBF peak ) was not significantly different across the three trials (Mean ± SD; Trial 1: 702.5 ± 483.3; Trial 2: 685.7 ± 421.9; Trial 3: 626.2 ± 383.0 ml min −1 , p = 0.77). The intra‐class correlation coefficient (ICC) for these trials was 0.73 (p < 0.0001), the Cronbach's Alpha 0.88, and the coefficient of variation (CV) 34.3 ± 23.3 %. The ΔLBF peak was not significantly different when the two most similar trials of the three were analyzed (Trial A: 728.1 ± 458.7; Trial B: 703.7 ± 387.2 ml min −1 , p = 0.639). The ICC was 0.95 (p < 0.0001), the Cronbach's Alpha 0.97, and the CV 13.3 ± 14.6 %. The ΔLBF peak and ΔLVC peak were significantly correlated across all three trials (r = 0.97, p < 0.0001) and the two most similar trials (r = 0.95, p < 0.0001), as determined by Pearson product‐moment correlation. These findings suggest that single PLM assessment of vascular function is reproducible, with clinical utility. For research purposes, conducting single PLM in triplicate greatly enhances the ability to detect within‐subject differences. Support or Funding Information This work was supported by National Institutes of Health Grant P01 HL091830 (to R.S.R.) and Veterans Affairs Rehabilitation Research and Development Service Grants E1697‐R and E6910‐R (to R.S.R.).