Responsiveness of Outcome Measures

Responsiveness of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL)

OBJECTIVE

To evaluate the responsiveness of the Spanish version of the Newcastle Stroke-specific Quality of Life measure (NEWSQOL) to assess quality of life in Spanish people after suffering a stroke.

DESIGN

A prospective observational study was conducted to assess the responsiveness of the Spanish version of NEWSQOL. The sample contained 128 patients who filled in the questionnaires before and after a physical therapy intervention. The responsiveness was assessed with p-values using the effect size (ES) and the standardized response means (SRMs) of the change. Besides, two other external criteria were used to distinguish patients who improved with the treatment from those who remained stable. This classification was based on one functional independence measure (the Barthel Index) and one disability measure (the modified Rankin Scale).

RESULTS

There was a statistically significant correlation (Spearman's coefficient = p < 0.01) between the domains of the Spanish version of NEWSQOL in relation to the Barthel Index and the modified Rankin Scale. All domains showed between marked-to-mild change responsiveness except sleep and relationships; mobility (ES 0.66 and SRM 0.92) and activities of daily living (ES 0.75 and SRM 0.87) were markedly responsive; communication (ES 0.38 and SRM 0.61) was moderately responsive; and pain, vision, cognition, feelings, emotions and fatigue were mildly responsive (ES 0.21-0.41 and SRM 0.23-0.44).

CONCLUSION

The Spanish version of NEWSQOL shows between marked and mild responsiveness to measure the perception of QoL in post-stroke patients. Therefore, its use can be suitable for evaluation studies, clinical trials and clinical practice.

Responsiveness of Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) after pelvic floor muscle training in women with stress and mixed urinary incontinence

OBJECTIVE

To evaluate the responsiveness of Brazilian-Portuguese version of Pelvic Floor Distress Inventory-20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7) after pelvic floor muscle training (PFMT) in women with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI).

STUDY DESIGN

This is an observational study with 72 women (51.8 ± 11.9SD years) with SUI (n = 33) and MUI (n = 39). Participants answered PFDI-20 and PFIQ-7 before and after PFMT, which consisted of a 12 weeks protocol supervised by a physiotherapist once a week with 30 min of a duration. Wilcoxon test, effect size (ES) and standardized response mean (SRM) were performed on baseline and after three months.

RESULTS

We found a significant reduction in PFDI-20 and PFIQ-7 after PFMT (p < 0.001), except for Pelvic Organ Prolapses Distress Inventory (POPDI-16), Colorectal-Anal Impact Questionnaire (CRAIQ-7) and Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7). The responsiveness of both questionnaires was considered moderate for PFDI-20 (ES = 0.49; SEM = 0.61; p < 0.0001) and PFIQ-7 (ES = 0.51; SEM = 0.52; p < 0.0001).

CONCLUSIONS

PFDI-20 and PFIQ-7 Brazilian Portuguese version presented moderate responsiveness in women with SUI and MUI who performed a PFMT.

Responsiveness of the Calf-Raise Senior test in community-dwelling older adults undergoing an exercise intervention program

Introduction

Mobility significantly depends on the ankle muscles’ strength which is particularly relevant for the performance of daily activities. Few tools are available, to assess ankle strength with all of the measurement properties tested. The purpose of this study is to test the responsiveness of Calf-Raise Senior Test (CRS) in a sample of elderly participants undergoing a 24-week community exercise program.

Methods

82 older adults participated in an exercise program and were assessed with CRS Test and 30-second chair stand test (CS) at baseline and at follow-up. Effect size (ES), standardized response mean (SRM) and minimal detectable change (MDC) measures were calculated for the CRS and CS tests scores. ROC curves analysis was used to define a cut-off representing the minimally important difference of Calf-Raise Senior test.

Results

Results revealed a small (ES = 0.42) to moderate (SRM = 0.51) responsiveness in plantar-flexion strength and power across time, which was lower than that of CS test (ES = 0.64, SRM = 0.67). The responsiveness of CRS test was more evident in groups of subjects with lower initial scores. A minimal important difference (MID) of 3.5 repetitions and a minimal detectable change (MDC) of 4.6 was found for the CRS.

Conclusion

Calf-Raise Senior Test is a useful field test to assess elderly ankle function, with moderate responsiveness properties. The cutoff scores of MDC and MID presented in this study can be useful in determining the success of interventions aiming at improving mobility in senior participants.

Responsiveness of Device-Based and Self-Report Measures of Physical Activity to Detect Behavior Change in Men Taking Part in the Football Fans in Training (FFIT) Program

The capacity of physical activity (PA) measures to detect changes in PA within interventions is crucial. This is the first study to examine the responsiveness of activPAL3™ and the International Physical Activity Questionnaire (IPAQ; Short Form) in detecting PA change during a 12-week group-based, men-only weight management program-Football Fans in Training (FFIT). Participants wore an activPAL3™ and completed the IPAQ pre- and post-program (n = 30). Relationships between change scores were assessed by Spearman's correlations. Mean or median changes in PA were measured using paired samples t-tests and Wilcoxon signed-rank tests. Responsiveness to change was assessed utilizing Standardized Response Mean (SRM). Both device-based and self-report measures demonstrated significant changes pre-post intervention, although these changes were not significantly correlated. The SRM values for changes in activPAL3™ metrics were: 0.54 (MET-mins/day); 0.53 (step counts/day); and 0.44 (MVPA/day), indicating a small to medium responsiveness to change. SRM values for changes in IPAQ scores were: 0.59 (for total PA mins/day); 0.54 (for total MET-mins/day); 0.59 (for walking MET-mins/day); 0.38 (for vigorous MET-mins/day); and 0.38 (for moderate MET-mins/day), revealing a small to medium responsiveness to change. These findings reveal that two commonly used device-based and self-report measures demonstrated responsiveness to changes in PA. While inclusion of both device-based and self-report measures is desirable within interventions it is not always feasible. The results from this study support that self-reported measures can detect PA change within behavioral interventions, although may have a tendency to overestimate changes compared with device-based measures on absolute values, but not standardized response values.

Measuring what matters in isometric multi-joint rate of force development

This study aimed to evaluate responsiveness (ability to detect change) of isometric force-time measures to neuromuscular fatigue in resistance-trained participants using two differing protocols that modified both the instructions provided to participants and the duration of the test. Both protocols were completed at two knee joint angles in the isometric squat test. Ten participants volunteered to take part in this study (age: 27.0 ± 4.5 years, strength training experience: 7.7 ± 2.6 years). Isometric peak force (ISqT^peak) and isometric explosive force (ISqT^exp) test protocols were assessed at two joint angles (knee angle 100° and 125°) pre-high intensity strength training, immediately post strength training, 24-h post, 48-h post and analysed for peak and RFD performance. Participants completed eight sets of three repetitions of the back-squat exercise as the high-intensity strength training. Results showed the highest standardised response means (SRM) detected was peak force using the ISqT^peak 100, SRM -1.97 compared to an SRM of -1.31 for RFD 200 ms in the ISqT^exp 125. Peak force was the most responsive variable using the ISqT^peak protocol, whereas the ISqT^exp protocol was most responsive for RFD measures. Therefore, ISqT^peak and ISqT^exp test protocols should not be used interchangeably to evaluate RFD variables.

Cross-cultural adaptation and validation of the Turkish version of Oxford hip score

INTRODUCTION

The purpose of this study was to translate the Oxford hip score (OHS) into Turkish and to evaluate the psychometric properties by testing the internal consistency, reproducibility, construct validity, and responsiveness in patients with hip osteoarthritis (OA).

PATIENTS AND METHODS

Oxford hip score was translated and culturally adapted according to the guidelines in the literature. Seventy patients (mean age 61.45 ± 9.29 years) with hip osteoarthritis participated in the study. Patients completed the Turkish Oxford hip score (OHS-TR), the Short-Form 36 (SF-36), and Western Ontario and McMaster Universities Index (WOMAC). Internal consistency was tested using Cronbach's α coefficient. Patients completed OHS-TR questionnaire twice in 7 days for determining the reproducibility. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Pearson correlation coefficient between the OHS-TR and WOMAC and SF-36 scores. Floor and ceiling effects were analyzed.

RESULTS

The internal consistency was high (Cronbach's α 0.93). The construct validity showed a significant correlation between the OHS-TR and WOMAC and related SF-36 domains (p < 0.001). The ICC's ranged between 0.80 and 0.99. There was no floor or ceiling effect in total OHS-TR score.

CONCLUSIONS

The OHS-TR questionnaire is valid, reliable, and responsive for the Turkish-speaking patients with hip OA.

Responsiveness of the Spanish Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaires Short Forms (PFDI-20 and PFIQ-7) in women with pelvic floor disorders

OBJECTIVE

To evaluate the responsiveness of the Spanish versions of Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7), in order to assess symptoms and quality of life in Spanish women with pelvic floor disorders.

STUDY DESIGN

Prospective observational study to assess the responsiveness in 85 women with pelvic floor disorders. PFDI-20 and PFIQ-7 were completed before and after Physiotherapy intervention. The responsiveness was assessed with the p values using the Wilcoxon signed-rank test, the standardized response means of the change (SRM) and the effect size (ES).

RESULTS

The Spanish PFDI-20 and PFIQ-7 and the subscales demonstrated small to good responsiveness. The responsiveness was higher for PFDI-20 than for PFIQ-7. The statistic for PFDI-20 was moderate to good (ES 0.68 and SRM 0.84; p<0.0001), and small to moderate for PFIQ-7 (ES 0.48 and SRM 0.57; p<0.0001). Regarding the subscales, the responsiveness was better for Pelvic Organ Prolapse Distress Inventory (POPDI) than Pelvic Organ Prolapse Impact Questionnaire (POPIQ) (ES 0.70 and SRM 0.78; ES 0.42 and SRM 0.47 respectively; p<0.0001). Moderate responsiveness was found for Urinary Distress Inventory (UDI) and Urinary Impact Questionnaire (UIQ) (ES 0.54 and SRM 0.67; ES 0.52 and SRM 0.61 respectively; p<0.0001). Colo-Rectal-Anal Distress Inventory (CRADI) and Colo-Rectal-Anal Impact Questionnaire (CRAIQ) showed poor responsiveness, small in both (ES 0.42, SRM 0.50 and p<0.0001; ES 0.34, SRM 0.39 respectively; p<0.001). All responsiveness was significant.

CONCLUSIONS

PFDI-20 and PFIQ-7 Spanish versions showed good responsiveness to evaluate the symptoms and the quality of life in Spanish women with PFD undergoing Physiotherapy treatment.