{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:12:09Z","timestamp":1780549929998,"version":"3.54.1"},"reference-count":13,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuromuscular Diseases"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shortening of the long finger flexors (FDP) results in extension limitation of both wrist and fingers and can hinder important activities of the upper extremities in Duchenne muscular dystrophy (DMD). Early detection of FDP shortening is important for timely interventions, but reliable measurement of FDP length is difficult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop a new instrument to monitor FDP shortening more easily and precisely and to determine its intra -and interrater reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>The new instrument, called the \u2018FlexYonio\u2019, was clinically developed according to biomechanical standards to be able to monitor FDP length, by measuring range of motion of wrist extension with extended fingers. A prospective reliability study was conducted during annual outpatient visits of people with DMD at the neuromuscular center of the Radboudumc. Repeated measures were conducted and two raters assessed the FDP length with the new instrument using a standardized measurement protocol. Reliability was measured using intra class correlation coefficient (ICC) calculation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The \u2018FlexYonio\u2019 was easy to use and became part of the standard daily clinical care in DMD in the Radboudumc. For reliability, 86 arm\/hands were assessed; the intra- and interrater reliability were excellent with ICC &gt; 0.99. The within-rater limits of agreement were \u22126 to 8 degrees and the between-raters \u221211 to 13 degrees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The \u2018FlexYonio\u2019, in combination with the standardized measurement protocol, is a promising, easy to use, and reliable tool to support the monitoring of FDP shortening in people with DMD, who are able to extend their fingers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/22143602251362027","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T04:49:27Z","timestamp":1755492567000},"page":"209-215","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018FlexYonio\u2019; a reliable instrument to support monitoring the length of the long finger flexors in Duchenne muscular dystrophy (DMD)"],"prefix":"10.1177","volume":"13","author":[{"given":"Saskia LS","family":"Houwen- van Opstal","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike","family":"Pelsma","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda MEM","family":"van den Elzen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura JB","family":"Merkenhof","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara P","family":"Popping- De Vries","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan T","family":"Groothuis","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno","family":"van der Holst","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Rehabilitation and Physiotherapy, Leiden University Medical Center, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3452-9650","authenticated-orcid":false,"given":"Edith HC","family":"Cup","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23810"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30024-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-020-00613-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7316-9"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3233\/JND-221653"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9993(93)90004-T"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1347721"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/65.9.1339"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511996214"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880120313"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007455.pub2"}],"container-title":["Journal 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