Criteria for assessing the tools of disability outcomes research

Reliability and Validity of the Japanese Version of the Exercise Self-Efficacy Scale in Older People Undergoing Lower Extremity Arthroplasty

Current self-efficacy scales for physical activity focus on moderate-to-vigorous exercise in healthy adults, leaving limited options for those engaged in light-to-moderate physical activity. This study aimed to develop a Japanese version of the Exercise Self-Efficacy Scale (ESES-J) tailored for light-to-moderate-intensity activities and to assess its validity and reliability. Preoperative and postoperative patients undergoing lower-limb arthroplasty (113 participants) were evaluated using the General Self-Efficacy Scale (GSES) to establish criterion-related validity. The revised version of the Short Questionnaire to Assess Health-Enhancing Physical Activity, Oxford Hip Score, or Oxford Knee Score, and accelerometers were used to test the hypotheses. The ESES-J demonstrated strong internal consistency, good intraclass coefficient scores, and no systematic errors in the Bland-Altman analysis. The correlation with the GSES was moderate, confirming 80% of the hypotheses. The ESES-J demonstrated robust reliability and validity. Understanding self-efficacy among individuals with disabilities may lead to personalized health support to improve physical activity levels.

Cultural adaptation and psychometric validation of the exercise adherence Rating scale Mexican Spanish version (EARS-Mx)

OBJECTIVE

The aim has been to translate and cross-culturally adapt the Exercise Adherence Rating Scale (EARS) for Mexican Spanish speaking population with non-specific chronic low back pain and assess its psychometric properties.

METHODS

The study had two phases: translation and cultural adaptation, followed by psychometric validation. Reliability was assessed with internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficient); validity with construct validity (Spearman's correlation) and factor analysis; sensitivity to change with effect size and standardized response mean difference; feasibility by completion time in seconds; and ceiling/floor effects were calculated.

RESULTS

A total of 161 subjects were included. Cronbach's alpha (0.93; 95% CI 0.92-0.95) indicated good internal consistency, and intraclass correlation (0.95; 95% CI: 0.89-0.97) showed excellent test-retest reliability. Weak correlations between the EARS vs. the Visual Analogue Pain Rating Scale and the Roland Morris Disability Questionnaire were found (r = -0.29 and r = 0.00 respectively). All effect size values indicated that the scale presented a significant sensitivity to change. The average time to complete the EARS-Mx was 219 s. No ceiling or floor effect was detected.

CONCLUSION

The EARS-Mx showed semantic, conceptual, idiomatic, content and operational equivalence with respect to the original scale, and appropriate metric properties of reliability, validity, sensitivity to change and feasibility.

Real-Time Assessment of Resilience in Individuals with Spinal Cord Injury and Chronic Pain: A Feasibility, Reliability, and Validity Study

OBJECTIVE

This observational study examined the feasibility, between-person reliability, and convergent and discriminant validity of an Ecological Momentary Assessment (EMA) measure of resilience in individuals with spinal cord injury (SCI) and chronic pain.

DESIGN

Participants completed self-report assessments of resilience twice a day for seven days using 6-item EMA measure adapted from the SCI-QOL Resilience item bank. Data were collected via smartphone.

SETTING

General community.

PARTICIPANTS

Individuals with SCI and chronic pain (N=53, 54.7% male, 45.3% female).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Besides the 6-item EMA resilience measure, we included the full SCI-QOL Resilience Item Bank, the Connor-Davidson Resilience Scale (CD-RISC), the PROMIS Depression Short Form, the SCI-QOL Anxiety Short Form, the NIH Toolbox Perceived Stress Survey, the SCI-QOL Positive Affect and Well-Being Short Form, and the SCI-QOL Ability to Participate in Social Roles and Activities.

RESULTS

Our results showed that the Resilience EMA measure revealed high feasibility with an overall response rate of 88% and strong between-person reliability (above .90). The measure also demonstrated good convergent validity with related constructs, such as depression, anxiety, and social participation, and good discriminant validity with unrelated factors like age and injury level.

CONCLUSION

Our findings suggest that the EMA resilience measure is a reliable and valid tool for capturing the dynamic nature of resilience in real time. Our study highlights the importance of the application of a real-time assessment, given that understanding daily functioning and contributes to more person-centered rehabilitation interventions for individuals with SCI and chronic pain.

Psychometric properties of the Turkish version of the short form valued life activities disability questionnaire in patients with rheumatoid arthritis

BACKGROUND

 The Valued Life Activities Disability Questionnaire (VLA) assesses activity-related disability based on the International Classification of Functioning, Disability and Health. This questionnaire is the first to comprehensively assess the difficulties patients with rheumatoid arthritis (RA) have in performing activities and the level of support they receive.

OBJECTIVE

 The aim of this study, conducted between June 2023 and September 2023, was to translate and culturally adapt the short form of the VLA into Turkish (Tr-S-VLA) and assess its reliability and validity in patients with RA.

METHODS

 Ninety-three RA patients with a median age of 60.00 (8.00) years were included. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficient. Construct validity was assessed using factor analysis. Criterion validity was established by comparing the Tr-S-VLA with the Health Assessment Questionnaire (HAQ), the Rheumatoid Arthritis Disease Activity Index (RADAI-5) and the Short Form-36 (SF-36).

RESULTS

 The Tr-S-VLA demonstrated high internal consistency (α = 0.913) and excellent test-retest reliability (r = 0.750, p < 0.05). Positive correlations were found with the HAQ (r = 0.654, p < 0.05) and the RADAI (r = 0.657, p < 0.05). Negative correlations were found with physical functioning (r = -0.685, p < 0.05), physical role function (r = -0.528, p < 0.05), social functioning (r = -0.540, p < 0.05) and the general health subscale of the SF-36 (r = -0.435, p < 0.05). These correlations indicate that the Tr-S-VLA has criterion validity.

CONCLUSIONS

 The Tr-S-VLA is a valid and reliable tool for the assessment of activity-related disability in patients with RA.

Dutch translation, cross-cultural adaptation, validation, and reliability of the Back Pain Attitudes Questionnaire (Back-PAQ)

PURPOSE

To translate and cross-culturally adapt the Back Pain Attitudes Questionnaire (Back-PAQ) to Dutch for the Belgian and Dutch populations, and to investigate its measurement properties in the general population and physiotherapists.

METHODS

The adaptation followed established guidelines. Content validity, internal consistency, test-retest reliability (intraclass correlation coefficient), floor and ceiling effects, minimal detectable change (MDC), construct validity, and structural validity were assessed in physiotherapists and the general population. The modified Fear-Avoidance Beliefs Questionnaire (mFABQ) investigated the Back-PAQ's convergent validity, and Confirmatory Factor Analysis evaluated structural validity. Discriminant validity was assessed between physiotherapists and the general population.

RESULTS

Two hundred and sixty participants (mean age: 29 ± 13.3) completed the initial survey and 147 completed the test-retest survey. All Back-PAQ versions (34-item, 20-item, and 10-item) demonstrated good internal consistency, good to excellent test-retest reliability. Moderate correlations with the mFABQ (p < 0.001) and adequate discriminant validity between physiotherapists and the general population supported robust construct validity. The Back-PAQ 10 exhibited a good model fit and enables meaningful sub-score comparisons.

CONCLUSIONS

This collaboration produced a validated Dutch Back-PAQ suitable for use in both the Netherlands and Belgium. All versions demonstrated robust measurement properties, supporting their use in clinical and research settings assessing unhelpful beliefs in back pain management.

The Chinese version of the PERMA profiler: a validity and reliability study

BACKGROUNDS

Positive psychology offers a promising framework for enhancing mental health, particularly among maintenance hemodialysis (MHD) patients, whose psychological well-being is often compromised. This study aimed to develop and validate a Chinese version of the PERMA Profiler, tailored to assess flourishing in MHD patients and provide a reliable research tool.

METHODS

Following the translation and cultural adaptation of the original PERMA Profiler, 376 MHD patients were surveyed to assess its psychometric properties. Analyses included item analysis, exploratory and confirmatory factor analysis, criterion validity, and reliability testing.

RESULTS

The Chinese version retained all original items and exhibited strong psychometric properties. By validity analysis, the KMO value was 0.871. Factor analysis identified two dimensions: positive experience and self-actualization, accounting for 57.7% of the variance. Model fit indices (χ2/df = 3.23, RMSEA = 0.095) were acceptable. The scale showed strong internal consistency (Cronbach's α = 0.914) and test-retest reliability (r = 0.764).

CONCLUSION

The PERMA Profiler, adapted for a Chinese cultural context, is a reliable and valid tool for assessing flourishing in MHD patients. It offers a robust foundation for research and intervention to improve mental health outcomes in this population.

Preliminary Testing of the Discussion of Patient Life Goals Patient-Reported Outcome Measure for Dialysis Facilities

Rationale & Objectives

To test a new patient-reported outcome measure that assesses end-stage kidney disease (ESKD) maintenance dialysis patients' experience with life goals discussions with their dialysis facility care team.

Study Design

Observational cross-sectional study. Survey data collected via REDCap, paper form or telephone in a convenience sample of patients with ESKD receiving maintenance dialysis in the United States.

Settings & Participants

People aged 18 years or older with ESKD receiving maintenance hemodialysis or peritoneal dialysis in US dialysis facilities between the June and December 2020 study period.

Exposures

Testing of 6 items providing the core quality assessment and 1 item measuring whether 1 or more members of the treatment team discussed life goals with the patient.

Outcomes

Preliminary reliability and validity of the Discussion of Patient Life Goals survey (D-PaLS).

Analytic Approach

Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and item response theory methods, including the graded response model (GRM) and differential item functioning (DIF).

Results

Of 517 participants, 479 completed the survey via REDCap; 38 completed the survey via paper or telephone. EFA and CFA supported the unidimensionality of the 6 core items. GRM overall and item fit analyses and DIF analyses supported retention of all core items. Preliminary reliability data indicated very good internal consistency (Cronbach's alpha = 0.84). Known-groups validity was supported whereby individuals receiving home dialysis had more positive responses, than those receiving in-center hemodialysis.

Limitations

Study participants were not fully representative of the US ESKD dialysis population.

Conclusions

Preliminary analyses indicate the D-PaLS has excellent psychometric properties. The measure provides 2 important quality metrics: facilities' level of engagement talking with patients about their life goals and the percentage of patients reporting who on the treatment team talks with them about their life goals. Additional work is needed to establish comprehensive reliability and validity to support the clinical utility of this measure in patient care.

Outcome measures in rodent models for spinal cord injury and their human correlates

Pre-clinical research is intended to inform clinical research, however, communication between these researchers is lacking. A better understanding of what can be learned from animal and human models and what cannot, is essential. This includes a better understanding of where underlying constructs in outcome measures in rodents and humans align and where they diverge to improve dialogue between human and animal researchers. The goal of this review is to promote an understanding of similarities and differences in outcome measures and encourage consideration of these differences when planning, interpreting, and communicating findings from animal or human experiments. Seven individuals with a range of expertise in human and animal research and outcome measures reviewed rat and human measures focused on sensorimotor and functional outcomes. They then discussed where measures corresponded and where they did not, based on the underlying construct the assessment is intended to measure. Key findings are that measures of impairment (such as strength) often used in clinical trials are not commonly used in rodents. Measures such as speed and distance of locomotion are commonly assessed in humans and, while not commonly assessed in rodents, can be collected through existing outcome measures. Additional findings are that animal and human outcome measures are often developed and evaluated differently, with more standardized processes applied to human outcome measures. A deeper understanding and communication of similarities and differences in outcome measures, and where differences are necessary due to interspecies differences, may improve translation from animals to humans and humans to animals.

French validation of the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) with determination of cutoff scores: A valuable tool in clinical practice

Work difficulties are a primary issue of multiple sclerosis (MS). This is because disease onset usually occurs during a time when establishing a career and employment is of paramount importance. The MSWDQ-23 (Multiple Sclerosis Work Difficulties Questionnaire) was developed to assess work difficulties in MS. The WORKSEP project aimed to adapt and validate the French MSWDQ-23 and develop cutoff scores through a multicentric study in 14 centers across France. Two hundred and six persons with MS were recruited: 149 with relapsing-remitting MS and 57 with progressive forms of MS. They completed the MSWDQ-23 in French, the DEX to assess the subjective cognitive executive complaint, and the SF-36 evaluating mental (MC) and physical (PC) health-related quality of life. The results indicated that the French version of MSWDQ-23 has high internal consistency (Cronbach's α: 0.93) and test-retest reliability (ICC=0.83). A confirmatory factor analysis demonstrated a scale structure identical to the original English version comprising physical barriers (PB), psychological and cognitive barriers (PCB), and external barriers (EB). The construct and convergent validity were strong. A higher level of work difficulties at PB score was related to a higher level of disability at the EDSS and lower PC quality of life, and a higher level of PCB was related to higher cognitive executive complaints and lower MC quality of life. ROC curves based on the difference between employed and unemployed patients allowed for determining cutoff values of 32 for the total score, 37 for PB, and 27 for PCB. This study allowed the validation of the MSWDQ-23 in the French language and is the first to propose a cutoff. Determining the cutoff value enables identifying patients needing intervention and targets the limitations that MS patients may encounter in the workplace. This easy-to-use instrument provides the opportunity to propose an adapted rehabilitation program or work adjustments to improve the quality of life in patients with MS.

The patient enablement instrument for back pain turkish version, validity and reliability study

BackgroundThe only survey that assesses the ability of individuals with low back pain to self-manage their condition is the Patient Enablement Instrument for Back Pain (PEI-BP).ObjectiveThe study aims to create a Turkish version of PEI-BP and test its validity and reliability.Methods67 individuals (47 females, 20 males) with low back pain participated, comprising. Reliability was evaluated through test-retest reliability, internal consistency, and repeatability measures. Validity was assessed via structural, content, face validity analyses. Floor and ceiling effects were examined to ensure a comprehensive evaluation. Additionally, the relationship between PEI-BP and pain intensity, Brief Illness Perception Questionnaire (BIPQ), Fear Avoidance Beliefs Questionnaire (FABQ), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) was explored.ResultsThe Intraclass Correlation Coefficient value (0.795) and Cronbach's α (0.886) of PEI-BP were high. The goodness-of-fit values for the model, including fit indices and reference ranges, indicated strong validity. The PEI-BP demonstrated the absence of both floor and ceiling effects. Correlations between PEI-BP and pain intensity, BIPQ, FABQ, ODI, and SF-36 exhibited a range from weak to good (0.258 to -0.440).ConclusionsPEI-BP has demonstrated high reliability and good validity. PEI-BP can be used to evaluate Turkish-speaking individuals with low back pain.ClinicalTrials.gov ID: NCT06109246 (Date: 10/25/2023).

Working ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD): cross-cultural adaptation, reliability, and validity of the Turkish version

BACKGROUND

Dysmenorrhea is a gynecological condition that causes painful menstrual cramps in the uterus, most commonly seen in women of reproductive age. The aim was to perform the reliability and validity of the Turkish Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) score for evaluating individuals with dysmenorrhea. The evaluation of the reliability and validity of the Turkish version of the WaLIDD tool in the Turkish population is essential to ensure its accuracy, consistency, and cultural relevance in assessing the impact of dysmenorrhea.

METHODS

Cross-sectional, psychometric questionnaire research. 113 individuals with dysmenorrhea were included in the study. The reliability of the WaLIDD was evaluated using internal consistency and test-retest analyses, while its validity (both convergent and divergent) was assessed through correlation analysis. For correlation analysis WaLIDD, Premenstrual Syndrome Impact Questionnaire (PMS-IQ), Pain Disability Index (PDI), and Big Five Inventory-10 (BFI-10) were used.

RESULTS

The reliability analysis indicated that the questionnaire demonstrated an internal consistency value of 0.875 and an intraclass correlation coefficient (ICC) value of 0.778. Pearson correlation analysis indicated that the WaLIDD had a very well correlation with the PMS-IQ (0.726) and well correlation with the PDI (0.413). WaLIDD had a negligible correlation with the BFI-10 (0.088). There were no floor or ceiling effects observed in the Turkish version of the WaLIDD.

CONCLUSIONS

WaLIDD was found to be a well-structured, valid, and reliable instrument that can be used to evaluate women with dysmenorrhea. The Turkish version of WaLIDD can be used in Turkish women in clinical practices and research.

TRIAL REGISTRATION

This study was registered in ClinicalTrials.gov (NCT05829512).

Test-retest reliability and practice effects of shape trail test in stroke patients

OBJECTIVE

Executive dysfunction after stroke greatly affects stroke prognosis, so clinicians need to urgently focus on screening for it. This study aims to offer valuable data for research on post-stroke executive dysfunction by evaluating the test-retest reliability of the Shape Trail Test (STT) and the influence of the practice effect on scores among stroke patients.

METHODS

A total of 75 subacute stroke patients were included in the study. Based on the cutoff value for mild cognitive impairment(MCI) in the Chinese version of the Montreal Cognitive Assessment-Basic, the patients were divided into an MCI group and a cognitively normal (CN) group. The patients were asked to complete the Shape Trail Test (STT) on two different occasions within three days. The time taken to complete Part A and Part B were denoted as STT-A and STT-B respectively. The intraclass correlation coefficient(ICC), Pearson and Spearman correlation coefficients were used as metrics, and a paired t test was employed to evaluate the practice effect.

RESULTS

(1) The actual number of patients who completed the research was 71. The STT showed great test-retest reliability in stroke patients (ICC, STTA: 0.927 VS STTB: 0.881; Spearman, STTA: 0.824 VS STTB: 0.713, n = 71). The test-retest reliability of STTA is higher than that of STTB (ICC, STTA = 0.927＞STTB = 0.881; Spearman, STTA = 0.824＞STTB = 0.713; n = 71). The reliability of the MCI group was higher than that of the CN group (ICC, STTA:MCI = 0.94＞CN = 0.71; STTB:MCI = 0.87＞CN = 0.64). (2) Subgroup analysis revealed distinct practice effects between the MCI and CN groups. The MCI group showed no practice effect, while the CN group had a partial one. In the CN group, practice did not significantly impact STT-A scores (p = 0.782), but did affect STT-B scores (p = 0.035). In contrast, in the MCI group, no significant practice effects on the STT were observed (p > 0.05).

CONCLUSIONS

STT's test-retest reliability was moderate to high in stroke patients and varied by cognitive function. Subgroup analyses should precede assessments of STT's test-retest reliability in stroke patients. Patients with cognitive dysfunction showed no significant practice effects. Given that this research is carried out specifically within the Chinese context, extreme care should be taken in extending the study's findings to other populations.

REGISTRATION

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01322607.

The Cerebellar Neuropsychiatric Rating Scale

The triad of cerebellar ataxiology is the cerebellar motor, vestibular, and cerebellar cognitive affective / Schmahmann syndrome (CCAS). The CCAS affective component comprises 5 domains: Attentional control, Emotional control, Autism spectrum, Psychosis spectrum, and Social Skill Set, each with hypermetric / overshoot and hypometric / undershoot poles reflecting the dysmetria of thought and universal cerebellar transform theories. There is no validated screening instrument to assess neuropsychiatric impairments in patients with cerebellar disorders. To examine the psychometric properties of our Cerebellar Neuropsychiatric Rating Scale (CNRS) that explores these symptoms and behaviors in patients with cerebellar disorders, 21 adults with ataxia completed the CNRS and other validation measures: the Behavior Rating Inventory of Executive Function-Adult Version Informant Report, Adult Behavior Checklist, Older Adult Behavior Checklist, Neuropsychiatric Inventory Questionnaire. We examined CNRS internal consistency using Cronbach's alpha, assessed item to subscale correlations, studied ceiling and floor effects, and convergent construct validity between CNRS and validity measure subscales. Internal consistency was α > 0.70 for each of the five domains. Subscale structure was generally confirmed: 86% of correlations between CNRS and validity subscales were significant. There were no ceiling effects. Item to subscale correlations indicated adequate reliability for total scale and subdomains. NPI-Q and CNRS scores were correlated, and 86.4% (19/22) of conceptually related subscales were significant. The CNRS is a reliable and valid measure of cerebellar neuropsychiatry. Further development can refine the instrument and shed light on the patient experience of their affective dysregulation and its clinical meaningfulness.

Translation, cross-cultural adaptation, and measurement properties of the Arabic version of the fear avoidance components scale

PURPOSE

This study aimed to translate, validate, and cross-culturally adapt the original FACS into the Arabic language.

METHODS

The English version of the FACS was translated and culturally adapted into Arabic following international guidelines. The psychometric properties of the final version of the FACS-Arabic (FACS-A) were tested among 119 patients with different musculoskeletal (MSK) pain disorders.

RESULTS

The Cronbach's α for the FACS-A was 0.86. The test-retest reliability, measured with intraclass correlation coefficient, was 0.80. The FACS-A showed positive significant correlations with other psychological patient-reported measures, including the pain catastrophizing scale (PCS) (r = 0.545); p ≤ 0.01), Brief Pain Inventory (BPI)-pain score (r = 0.546; p ≤ 0.01), BPI-pain interference score (r = 0.511; p ≤ 0.01), and Hospital Anxiety and Depression Scale (HADS) (r = 0.451, 0.336, respectively; p ≤ 0.01). Confirmatory factor analysis of the FACS-A confirmed the two-factor structure found in the original English version.

CONCLUSION

This study determined the FACS-A to be a reliable and valid tool for the assessment of the fear-avoidance beliefs in Arabic-speaking individuals with MSK pain disorders.

Low back activity confidence scale: Cross-cultural adaptation, reliability, and validity of the Turkish version in individuals with non-specific low back pain

BackgroundThe Low Back Activity Confidence Scale (LoBACS) was developed to evaluate self-efficacy in individuals with low back pain (LBP).ObjectiveThis study aimed to assess the psychometric properties of Turkish version of LoBACS in individuals with non-specific LBP.MethodsThe study included 105 participants (66 female, 39 male) with a mean age of 40.94 ± 14.65 years. The cultural adaptation and psychometric evaluation of LoBACS followed international standards and COSMIN guidelines. Reliability was assessed using the Cronbach's α and Intraclass Correlation Coefficient (ICC). Structural validity was tested with Confirmatory Factor Analysis (CFA). Pearson correlation analysis examined the relationships between LoBACS and the Waddell Disability Index (WDI), Modified Oswestry Disability Index (MODI), Roland Morris Disability Questionnaire (RMDQ), International Physical Activity Questionnaire (IPAQ), Short Form-36 (SF-36), Fear Avoidance Beliefs Questionnaire (FABQ), and Visual Analog Scale (VAS).ResultsThe Turkish version of LoBACS showed high reliability (ICC = 0.850, Cronbach's α = 0.919). CFA and fit indices supported its validity. Correlations between LoBACS and other measures ranged from -0.192 to 0.542. No floor or ceiling effects were noted.ConclusionThe Turkish version of LoBACS is a reliable and valid tool for assessing self-efficacy in individuals with non-specific LBP, suitable for both research and clinical settings.

Turkish Translation and Psychometric Properties of the Peabody Developmental Motor Scale-2 in 0-24 Months Turkish At-Risk Infants

This study was designed to investigate the construct-concurrent validity and reliability of the Turkish version of the Peabody Developmental Motor Scale-2 (PDMS-2) in at-risk infants between 0-24 age in Turkey. In this study, 120 infants (70 males, 50 females) participated in the study (mean corrected age 20.18 ± 22.535 weeks). The PDMS-2 scale consists of two subdimensions, the Fine Motor Quotient (FMQ) and the Gross Motor Quotient (GMQ). Whereas the construct validity was assessed using confirmatory factor analysis, concurrent validity was investigated using the correlation between PDMS-2 and the Alberta Infant Motor Scale and the Hammersmith Infant Neurological Examination with Spearman's correlation analysis. The PDMS-2 was applied twice for test-retest reliability. Cronbach's alpha (α) and the intraclass correlation coefficient (ICC) were used for reliability. ICC value was with 95% CI. The overall reliability coefficient of the test was found to be Croncbach's α = 0.865. TICC values were found (ICC FMQ: 0.998, ICC GMQ: 0.998). Construct validity (χ 2 /SD = 4.396; root mean square error of approximation = 0.021; goodness-of-fit index = 0.951) and concurrent validity (r = 0.502-0.771; p < .05) were confirmed as acceptable. The PDMS-2 demonstrated good psychometric properties and can be used as a reliable and valid measure to assess neurodevelopmental aspects of Turkish at-risk infants.

The Strategy Use Measure (SUM): A new tool to evaluate the use of compensatory behavioural strategies for cognitive, emotional and behavioural impairments after acquired brain injury

The Strategy Use Measure (SUM) was developed as a systematic tool to assess cognitive, behavioural and emotional strategy use by clients and carers after acquired brain injury. Comprehensive content development was undertaken across four clinical service sites via expert clinician consultation and consensus, file review of strategies used in clinical practice, and consumer consultation. Statistical analysis was undertaken to evaluate items and assess reliability, validity and factor structure. Two final versions of the SUM were developed, for use with clients (SUM-ABI; 14 items) and carers (SUM-C; 24 items). Internal consistency for the total scales was sound (SUM-ABI = .90; SUM-C = .96) as was test-retest reliability (SUM-ABI = .87; SUM-C = .90). Meaningful factors were identified for both scales (SUM-ABI: Memory and Planning, Emotion and Mood, Cognitive Load; SUM-C: Executive Support, Emotion/Behaviour Support, Enhancing Task Performance, Motivation Support) with all subscales demonstrating strong internal consistency (≥.80). Construct validity for both scales was explored using validated measures. The SUM versions were evaluated against COSMIN instrument design standards and found overall to be reliable and valid, with promising utility in rehabilitation for clinicians and researchers.

Cross-cultural adaptation, reliability and validity of the Turkish version of the stroke exercise preference inventory

Introduction

While studies on version adaptation, validity, and reliability are common, no tools exist in Turkish literature to assess exercise preferences in stroke patients. This research aimed to translate the Stroke Exercise Preference Inventory (SEPI) into Turkish and evaluate its validity and reliability in stroke patients.

Methods

Ninety stroke patients completed the SEPI, Exercise Benefits/ Barriers Scale (EBBS), Behavioral Regulation in Exercise Questionnaire (BREQ-2), Stroke-Specific Quality of Life Scale (SSQoLS), and Frenchay Activities Index (FAI). The SEPI was translated into Turkish using a standard forward-backward translation process. Psychometric properties such as structural and construct validity, test-retest reliability, and internal consistency were assessed.

Results

Reliability analysis demonstrated high internal consistency for SEPI-13, with Cronbach's α values of 0.931. Validity testing revealed a 3-factor structure for SEPI-13, explaining 69.029% of total variance. CFA confirmed the model with acceptable fit indices. Construct validity showed good correlations with EBBS (r = -0.771; p < 0.001) and BREQ-2 (r = from -0.541 to 0.732; p < 0.001) for convergent validity, while divergent validity was supported by weak correlations with SSQoLS (r = 0.165; p = 0.120) and FAI (r = 0.137; p = 0.197). No floor or ceiling effects were observed for SEPI-13.

Discussion

The Turkish SEPI is a reliable and valid tool for assessing exercise preferences in stroke patients, aiding their rehabilitation.

Translation, cross-cultural adaptation, and measurement properties of the Traditional Chinese version of the Fear of Falling Avoidance Behavior Questionnaire in Taiwanese community-dwelling adults

PURPOSE

This study aimed to translate the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) into Traditional Chinese (FFABQ-TC) and to evaluate the psychometric properties of FFABQ-TC in Taiwanese adults.

METHODS

We translated and culturally adapted the FFABQ into Traditional Chinese, ensuring linguistic accuracy and cultural relevance. A total of 230 Taiwanese community-dwelling adults participated in the study. Test-retest reliability was assessed in 30 participants, while 200 participants were included in the validity analysis. Known-groups validity was investigated by comparing the FFABQ-TC scores between fallers and non-fallers. Convergent validity was examined by correlating FFABQ-TC scores with Activities-specific Balance Confidence Scale (ABC), Geriatric Fear of Falling Measure (GFFM), and Timed-Up-and-Go (TUG) test.

RESULTS

The FFABQ-TC demonstrated excellent test-retest reliability (Intraclass Correlation Coefficient = 0.884) and excellent internal consistency (Cronbach's alpha = 0.930). Known-groups analysis revealed that FFABQ-TC significantly differentiated between fallers and non-fallers. Convergent validity was examined and showed significant correlations of FFABQ-TC with the ABC, the GFFM, and TUG.

CONCLUSION

The psychometric properties of FFABQ-TC was established in Taiwanese adults for assessing FOF-related avoidance behaviors. The translated and adapted FFABQ-TC is a reliable and valid clinical tool for evaluating fall risk in this population.

Shear wave elastography in the assessment of gastrocnemius spastic muscle elasticity: influences of ankle position and muscle contraction

BACKGROUND

Following upper motor neuron syndromes (UMNS), intrinsic viscoelastic muscle properties such as elastic stiffness may be altered, which leads to muscle hyper-resistance to passive mobilization. So far, no gold standard assessment of hyper-resistance, whether clinical or instrumental, is available. Shear wave elastography (SWE) has been increasingly used for non-invasive evaluation of elastic stiffness of skeletal muscles in people with hyper-resistance.

AIM

Our study aimed to evaluate the validity of SWE at ankle neutral resting position (ANRP). Additional objectives included assessing the influence of ankle position, muscle contraction, and laterality on elastic stiffness, and evaluating the reproducibility and responsiveness of SWE.

DESIGN

Observational cohort study.

SETTING

Outpatients of the physical and rehabilitation medicine department of a university hospital in Brussels.

POPULATION

Thirty hemiparetic patients following UMNS with hyper-resistance in gastrocnemii muscles.

METHODS

Elastic stiffness was quantified by shear wave velocity (SWV) measurements of gastrocnemii muscles. A higher SWV corresponds to a higher elastic stiffness. Measurements were performed on the affected and less-affected limbs in ANRP, in passive dorsiflexion and during isometric contraction. Assessments were performed 3 times. Criterion validity, reproducibility, and responsiveness were evaluated. A linear mixed model was used to study position and laterality effect.

RESULTS

In ANRP, reproducibility was excellent and SWV was significantly higher in the affected limb than in the less-affected limb. This laterality effect disappeared in passive dorsiflexion and was even reversed during isometric contraction. SWV was significantly higher on both sides in passive dorsiflexion and during contraction than in ANRP.

CONCLUSIONS

Our results suggest that SWE measurements in ANRP are reliable and may provide a more valid measurement of gastrocnemii elastic stiffness following UMNS.

CLINICAL REHABILITATION IMPACT

SWE may be a useful clinical tool as an extension of the physical exam for longitudinal monitoring of passive muscle elastic stiffness, to assist with treatment decisions and to better quantify the therapeutic effect of procedures to reduce muscle overactivity. However, a standardized protocol should be used. ANRP seems to be the most valid position for assessing gastrocnemius elastic stiffness in neurological populations. This should be kept in mind for the choice of positioning in further studies.

Cross-cultural translation, validation, and responsiveness of the Pittsburgh Fatigability Scale - Italian version (PFS-I) in a mixed-sample of older adults

INTRODUCTION

Older adults experience fatigue which impacts health-related quality of life. The Pittsburgh Fatigability Scale (PFS) was specifically designed to assess perceived physical and mental fatigability in older adults. The aim of this study was to translate the PFS into Italian (PFS-I) and to investigate its psychometric properties.

METHODS

The PFS-I was translated in accordance with international standards. The following properties were evaluated: structural validity, internal consistency, hypotheses testing for construct validity, test-retest reliability using intraclass correlation coefficients (ICC), and minimal clinically important difference (MCID) for responsiveness.

RESULTS

The study included 87 older adults with cardiovascular/respiratory diseases (CVRD), 46 with Parkinson disease (PD), and 67 healthy controls (HC). The PFS-I Physical and Mental subscales scores were significantly different in these populations, with HC reporting the lowest fatigability. Exploratory and confirmatory factor analysis showed a two-factor structure for both subscales, with good internal consistency (Cronbach's alpha: 0.86 and 0.89, respectively). The PFS-I Physical subscale showed weak goodness-of-fit of the confirmatory factor analysis models, whereas the PFS-I Mental subscale was deemed acceptable. Construct validity of the PFS-I was excellent with 75% (18 out of 24) of hypotheses accepted. Test-retest reliability was analyzed in a subset of 23 patients with CVRD and showed excellent results for both the PFS-I Physical and Mental subscales (ICC = 0.93 and 0.92, respectively). MCID ranged between 6 and 7 points for the Physical and 7-9 points for the Mental subscale.

CONCLUSIONS

The PFS-I is a valid, reliable, and responsive instrument to assess perceived fatigability for healthy older adults as well as those with CRVD and PD.

Headache Disability Questionnaire: cross-cultural adaptation and validation of the Turkish version

BACKGROUND

The Headache Disability Questionnaire (HDQ) evaluates pain intensity, daily activities, work/school disruptions, and the impact on recreational activities. It was aimed to translate the HDQ into Turkish and evaluate its reliability and validity.

METHODS

This study included 130 participants, consisting of 105 females and 25 males. The original HDQ was translated into Turkish language using Beaton guidelines. Reliability was assessed using internal consistency and Intraclass Correlation Coefficient. Exploratory (EFA) and Confirmatory Factor Analysis (CFA) were conducted to evaluate the structural validity. For convergent validity, the Turkish version of the HDQ, along with the Headache Impact Test-6 (HIT-6) and Migraine Disability Assessment Scale (MIDAS), was administered to individuals with headaches. The HDQ was retested one week later to assess its reliability.

RESULTS

The Turkish version of the HDQ demonstrated good reliability, with ICC and Cronbach's α values of 0.842 and 0.914, respectively. Standard error measurement (SEM) and Minimal Detectable Change (MDC) values were 5.89 and 16.33 units. Bland-Altman plots confirmed a high level of agreement between initial and retest scores EFA revealed a two-factor structure, clustering items into Factor 1 (items 1, 2, 5, 7, and 9) and Factor 2 (items 3, 4, 6, and 8), which was subsequently confirmed by CFA. Convergent validity was confirmed through good correlations with HIT-6, and MIDAS. No ceiling or floor effects were observed.

CONCLUSIONS

The study demonstrates that the Turkish version of the HDQ is a valid and reliable instrument for evaluating the effect of headaches on daily living, exhibiting strong internal consistency and test-retest reliability, making it suitable for both clinical practice and research purposes.

TRIAL REGISTRATION

Trial registration date is January 30, 2021 (NCT04736654).

CLINICAL TRIALS REGISTRATION NUMBER

NCT04736654.

Reliability and validity of the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees

BACKGROUND

Prosthetic embodiment is the perception of the prosthesis as a part of the body, and it is important for acceptance and adequate and effective use of the prosthesis.

OBJECTIVE

The aim of this study was to investigate the validity and reliability of the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees.

METHODS

This cross-sectional study included a total of 88 lower limb amputees. Internal consistency was evaluated using Cronbach α coefficient. The test-retest reliability of the scale, which was reapplied after 7-10 d, was evaluated using intraclass correlation coefficient. Principal component analysis with Varimax rotation was used to analyze the factor structure. Spearman correlation coefficient with Trinity Amputation and Prosthesis Experience Scale subscales was calculated for concurrent validity.

RESULTS

The mean age of the participants was 45.13 ± 15.05 years, and 76.1% were male. Internal consistency (Cronbach α = 0.905) and test-retest reliability (intraclass correlation coefficient = 0.822) were high. 76.1% of the total variance could be explained by the 3 dimensions. Significant correlation was found with the Trinity Amputation and Prosthesis Experience Scale subscales (r = 0.542 for psychosocial adjustment subscale, r = -0.452 for activity restriction subscale, r = 0.490 for prosthesis satisfaction subscale, p < 0.001).

CONCLUSIONS

The results of this study showed that the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees is a valid and reliable tool that can be used to evaluate prosthetic rehabilitation outcomes.

Reliability and Validity of Four Step Tests in Older Adults With Dementia

OBJECTIVES

To determine the test-retest and inter-rater reliability, concurrent and discriminative validity of the Four Square Step Test (FSST), the Choice Stepping Reaction Time Test (CSRTT), the Maximum Step Length Test (MSLT), and the Alternate Step Test (AST) in older adults with dementia.

METHODS

Thirty-seven older adults with dementia who could walk independently for at least 10 m were recruited at community centers and day care centers for older adults. The participants completed the step tests conducted by two independent raters on three separate testing occasions within 3 weeks. In addition, the physical and cognitive function of the participants were evaluated at baseline.

RESULTS

The FSST, CSRTT, and MSLT showed good-to-excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.83-0.91), and the AST exhibited fair test-retest reliability (ICC = 0.70). All the step tests showed good-to-excellent inter-rater reliability (ICC = 0.75-0.94). The step tests had moderate-to-strong correlations with various physical and cognitive measures (Pearson correlation coefficients = 0.34-0.72). The MSLT side step and AST could differentiate between individuals who did and did not use a walking stick to ambulate (p ≤ 0.046). The FSST, CSRTT, and AST could differentiate between individuals with and without a major neurocognitive impairment (p ≤ 0.005).

CONCLUSION

The FSST, CSRTT, and MSLT were reliable and valid for examining the stepping performance of older adults with dementia. Clinicians can use these tests to evaluate the physical and cognitive function of this population and identify those with significant cognitive impairment.

TRIAL REGISTRATION

Clinical Trial Registration number: NCT04296123.

Four New Patient-Reported Outcome Measures Examining Health-Seeking Behavior in Persons With Type 2 Diabetes Mellitus (REDD-CAT): Instrument Development Study

BACKGROUND

The management of type 2 diabetes mellitus (T2DM) includes mastery of complex care activities, self-management skills, and routine health care encounters to optimize glucose control and achieve good health. Given the lifelong course of T2DM, patients are faced with navigating complex medical and disease-specific information. This health-seeking behavior is a driver of health disparities and is associated with hospitalization and readmission. Given that health-seeking behavior is a potentially intervenable social determinant of health, a better understanding of how people navigate these complex systems is warranted.

OBJECTIVE

To address this need, we aimed to develop new patient-reported outcome (PRO) measures that evaluate health-seeking behavior in persons with T2DM. These new PROs were designed to be included in the Re-Engineered Discharge for Diabetes-Computer Adaptive Test (REDD-CAT) measurement system, which includes several other PROs that capture the importance of social determinants of health.

METHODS

Overall, 225 participants with T2DM completed 56 self-report items that examined health-seeking behaviors. Classical Test Theory and Item Response Theory were used for measurement development. Exploratory factor analysis (EFA; criterion ratio of eigenvalue 1 to eigenvalue 2 being >4; variance for eigenvalue 1 ≥40%) and confirmatory factor analysis (CFA; criterion 1-factor CFA loading <.50; 1-factor CFA residual correlation >.20; comparative fit index ≥0.90; Tucker-Lewis index ≥0.90; root mean square error of approximation <0.15) were used to determine unidimensional sets of items. Items with sparse responses, low-adjusted total score correlations, nonmonotonicity, low factor loading, and high residual correlations of high error modification indices were candidates for exclusion. A constrained graded response model was used to examine item misfit, and differential item functioning was examined to identify item bias. Cronbach α was used to examine internal consistency reliability for the new PROs (criterion ≥0.70), and floor and ceiling effects were examined (criterion ≤20%).

RESULTS

Four unidimensional sets of items were supported by EFA (all EFA eigenvalue ratios >4; variance for eigenvalue 1=41.4%-67.3%) and CFA (fit statistics all exceeded criterion values). This included (1) "Health-Seeking Behavior: PCP-Specific" (6 items); (2) "Health-Seeking Behavior: General Beliefs" (13 items); (3) "Health-Seeking Behavior: Family or Friends-Specific" (5 items); and (4) "Health-Seeking Behavior: Internet-Specific" (4 items). All items were devoid of differential item functioning for age, sex, education, or socioeconomic status factors. "Health-Seeking Behavior: General Beliefs" was developed to include both a computer adaptive test and a 6-item short form version; all other PROs were developed as static short forms. The psychometric reliability of these new PROs was supported; internal consistency ranged from acceptable to excellent (Cronbach α=.78-.91), and measures were free of significant floor or ceiling effects (floor effects range: 0%-8.9%; ceiling effects range: 0%-8.4%).

CONCLUSIONS

The new REDD-CAT Health-Seeking Behavior PROs provide reliable assessments of health-seeking behaviors among those with T2DM.

Impact of cognition on test-retest reliability and concurrent validity of n-back for Chinese stroke patients

OBJECTIVE

The objective of this study was the measurement of the test-retest reliability of n-back in Chinese stroke patients.

METHODS

Seventy-five sub-acute stroke patients performed n-back twice in three days. The test-retest reliability of n-back was analyzed by correlation coefficient.

RESULTS

The n-back had excellent test-retest reliability in stroke patients. Pearson or Spearman coefficients ranged from 0.81 to 0.88. The intra-class correlation coefficients ranged from 0.72 to 0.87. The Chinese version of Montreal Cognitive Assessment-Basic (MoCA-BC) score was significantly correlated with the performance of n-back. MoCA-BC and n-back accuracy were significantly related in the Mild Cognitive Impairment (MCI) group (r = 0.60 in 1-back, p = .002; r = 0.43 in 2-back, p = .040). However, MoCA-BC was correlated with reaction time (RT) in the Cognitively Normal (CN) group (r = -0.44 in 1-back, p = .003; r = -0.36 in 2-back, p = .018). The test-retest reliability of CN group was mostly higher than that of MCI group RT: 0.71-0.76 in MCI, 0.80-0.88 in CN; accuracy: 0.80-0.85 in MCI, 0.75-0.86 in CN). The practice effect was observed in the CN group instead of the MCI group.

CONCLUSIONS

This study indicated that the test-retest reliability of n-back was high in stroke patients. N-back was correlated with cognition. It was preferable to conduct subgroup analyses according to the level of cognitive assessment of patients with stroke.

Validation of Serbian version of the LittlEARS® Early Speech Production Questionnaire for the assessment of early language development in typically developing children

OBJECTIVE

The LittlEARS® Early Speech Production Questionnaire (LEESPQ) was developed to provide professionals with valuable information about children's earliest language development and has been successfully validated in several languages. This study aimed to validate the Serbian version of the LEESPQ in typically developing children and compare the results with validation studies in other languages.

METHODS

The English version of the LEESPQ was back-translated into Serbian. Parents completed the questionnaire in paper or electronic form either during the visit to the paediatric clinic or through personal contact. A total of 206 completed questionnaires were collected. Standardized expected values were calculated using a second-order polynomial model for children up to 18 months of age to create a norm curve for the Serbian language. The results were then used to determine confidence intervals, with the lower limit being the critical limit for typical speech-language development. Finally, the results were compared with German and Canadian English developmental norms.

RESULTS

The Serbian LEESPQ version showed high homogeneity (r = .622) and internal consistency (α = .882), indicating that it almost exclusively measures speech production ability. No significant difference in total score was found between male and female infants (U = 4429.500, p = .090), so it can be considered a gender-independent questionnaire. The results of the comparison between Serbian and German (U = 645.500, p = .673) and Serbian and English norm curves (U = 652.000, p = .725) show that the LEESPQ can be applied to different population groups, regardless of linguistic, cultural or sociological differences.

CONCLUSION

The LEESPQ is a valid, age-dependent and gender-independent questionnaire suitable for assessing early speech development in children aged from birth to 18 months.

Validity of the Musculoskeletal Tumor Society Score for lower extremity in patients with bone sarcoma or giant cell tumour of bone undergoing bone resection and reconstruction surgery in hip and knee

BACKGROUND

The Musculoskeletal Tumor Society Score (MSTS) is widely used to evaluate functioning following surgery for bone and soft-tissue sarcoma. However, concerns have been raised about its content validity due to the lack of patient involvement during item development. Additionally, literature reports inconsistent results regarding data quality and structural validity. This study aimed to evaluate content, structural and construct validity of the Danish version of the MSTS for lower extremity (MSTS-LE).

METHODS

The study included patients from three complete cohorts (n = 87) with bone sarcoma or giant cell tumour of bone who underwent bone resection and reconstruction surgery in hip and knee. Content validity was evaluated by linking MSTS items to frameworks of functioning, core outcome sets and semi-structured interviews. Data quality, internal consistency and factor analysis were used to assess the underlying structure of the MSTS. Construct validity was based on predefined hypotheses of correlation between the MSTS and concurrent measurements.

RESULTS

Content validity analysis revealed concerns regarding the MSTS. The MSTS did not sufficiently cover patient-important functions, the item Emotional acceptance could not be linked to the framework of functioning, the items Pain and Emotional acceptance pertained to domains beyond functioning and items' response options did not match items. A two-factor solution emerged, with the items Pain and Emotional acceptance loading highly on a second factor distinct from functioning. Internal consistency and construct validity showed values below accepted levels.

CONCLUSION

The Danish MSTS-LE demonstrated inadequate content validity, internal consistency, and construct validity. In addition, our analyses did not support unidimensionality of the MSTS. Consequently, the MSTS-LE is not a simple reflection of the construct of functioning and the interpretation of a sum score is problematic. Clinicians and researcher should exercise caution when relying solely on MSTS scores for assessing lower extremity function. Alternative outcome measurements of functioning should be considered for the evaluation of postoperative function in this patient group.

Cross-cultural adaptation, validation and psychometric properties of the Arabic version of the Nordic Musculoskeletal Questionnaire in office working population from Saudi Arabia

BACKGROUND

Office-workers who suffer from musculoskeletal pain/disability may experience reduced productivity and absenteeism from work. The Nordic Musculoskeletal Questionnaire (NMQ) is a valid, simple screening tool for the history and presence of self-perceived musculoskeletal symptoms in both general public and occupational settings.

OBJECTIVE

To translate and culturally adapt the NMQ into Arabic language and examine its psychometric properties.

METHODS

The published guidelines were followed to translate and adapt the NMQ into Arabic using a forward-backward process. Construct validity involved comparing NMQ responses with disability-related musculoskeletal questionnaires in different body regions, including the Neck Disability Index (NDI), Oswestry Disability Index (ODI), Quick-Disability of the Arm, Shoulder, and Hand (Quick-DASH), and Reduced Western Ontario and McMaster Universities Osteoarthritis Index (ArWOMAC). The reliability was evaluated using Cronbach's alpha for internal consistency and prevalence-adjusted bias-adjusted kappa (PABAK) for test-retest reliability.

RESULTS

The Arabic NMQ (Ar-NMQ) revealed excellent internal consistency (Cronbach's alpha = 0.85). For the test-retest reliability, the PABAK coefficient ranged between 0.50 and 1. The Ar-NMQ demonstrated strong construct validity. Participants reporting neck pain showed significantly elevated disability scores on the NDI (p < 0.05), while those with back pain exhibited higher ODI scores (p < 0.05). Moreover, individuals reporting shoulder, elbow, and wrist pain and disability displayed elevated Quick-DASH scores (p < 0.05). Similarly, participants reporting hip/thighs, knees, and ankle/feet pain/disability demonstrated significantly higher disability in ArWOMAC (p < 0.05).

CONCLUSION

The NMQ was successfully translated and adapted into Arabic language, providing a reliable and valid instrument for assessing pain in specific body regions in the Arabic-speaking population.

The Sensory Processing Measure - Second Edition: A Critical Review and Appraisal

This paper aims to provide an overview and critique of the newly updated Sensory Processing Measure - second edition (SPM-2) to assist clinicians in understanding its strengths and limitations and in selecting an appropriate sensory processing scale that best meets their clients' needs. Using four established research methodological quality critique tools, the SPM-2's family of age-related versions was evaluated by administering the tools separately and discussed their scoring and findings to reach a consensus on all ratings. The tools identified several strengths and weaknesses of the SPM-2. The SPM-2's items on its age-related versions scored well in the criteria of internal consistency, test-retest reliability, explanation of the instrument design, construct validity, content validity, criterion validity and ease of administration, and scoring. However, a lack of normative data for participant groups outside of the United States, methodological limitations, and a lack of investigation into some important psychometric properties, particularly responsiveness, were identified as notable weaknesses of the SPM-2's items on its age-related versions based on the critique criteria. Overall, despite the areas needing further development and investigation, the SPM-2 is considered a psychometrically sound tool that provides a reliable and valid approach to measuring aspects of the sensory processing construct across the lifespan.

Reliability and Validity of the German Version of the AO Spine Patient Reported Outcome Spine Trauma Questionnaire

STUDY DESIGN

A single-center validation study.

OBJECTIVE

To translate and cross-culturally adapt the AO Spine PROST (Patient Reported Outcome Spine Trauma) into German, and to test its psychometric properties among German-speaking Swiss spine trauma patients.

METHODS

Patients were recruited from a level-1 Swiss trauma center. Next to the AO Spine PROST, the EQ-5D-3L questionnaire was used for concurrent validity. Questionnaires were filled out at two-time points for test-retest reliability. Patient characteristics were analyzed using descriptive statistics. For content validity, floor, and ceiling effects, as well as any irrelevant and missing questions were analyzed. Construct validity of the AO Spine PROST questionnaire to the EQ-5D-3L was tested using Spearman correlation tests.

RESULTS

The AOSpine PROST was translated and adapted into German using established guidelines. We included 179 patients. The floor effect for all items was well within the optimal range (below 15%), while the ceiling effect of seven items was within the optimal range. None of the items displayed a problematic floor or ceiling effect. The overall test-retest reliability of the total PROST score was excellent, with an ICC of .83 (95% CI .69-.91). The Spearman correlation coefficient between the total PROST summary score and EQ-5D-3 L was ρ = .63.

CONCLUSIONS

The German version of the AO Spine PROST questionnaire demonstrated very good validity and reliability results.

Reliability and concurrent validity of 30-s and 5-time sit-to-stand tests in older adults with knee osteoarthritis

INTRODUCTION

Sit-to-stand (STS) movement is fundamental in daily life. STS tasks have been used to assess lower limb muscle strength, balance control, and functional abilities in various populations, but limited information is available on their use in older individuals with knee osteoarthritis.

OBJECTIVE

We here examined the intra-rater, inter-rater, and test-retest reliability of the 30-s and 5-time STS tests, and calculated the standard error of measurement (SEM) and minimal detectable change (MDC). Moreover, we explored the concurrent validity of these tests by analysing their correlation with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis.

METHOD

This cross-sectional study included 60 older participants diagnosed with knee osteoarthritis. Baseline demographic information and data on pain, stiffness, and physical function using the modified Western Ontario and McMaster Universities Osteoarthritis (WOMAC) were obtained. Participants performed the 30-s and 5-time STS tests as well as knee muscle strength assessment using a hand-held dynamometer. After 1 week, 30 participants were reassessed to evaluate test-retest reliability.

RESULTS

The 30-s and 5-time STS tests had excellent intra-, inter-, and test-retest reliability (intraclass correlation coefficients: 0.990-1.000, 0.996-0.999, and 0.841-0.853, respectively) with a large SEM and MDC. Both STS tests significantly correlated with knee extensor and flexor strength and all modified WOMAC domains (Pearson's correlation coefficients: 0.28-0.61, p < 0.05).

CONCLUSION

The 30-s and 5-time STS tests are reliable assessment tools and correlate with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. Key Points • The 30-s and 5-time STS test can serve as surrogate measures in various aspects of knee health, including muscle strength, pain levels, stiffness, and overall physical function, in older adults with knee osteoarthritis. • Both these STS tests are dependable tools, accessible for both experienced and inexperienced assessors to administer effectively.

Psychometric properties of the Brazilian-Portuguese version of the Falls Behavioral Scale in people with Parkinson's disease

PURPOSE

To verify the psychometric properties of the Brazilian-Portuguese version of the Falls Behavioral (FaB-Brazil) Scale in Parkinson's disease (PD).

MATERIAL AND METHODS

Participants (n = 96) were assessed by disease-specific, self-report and functional mobility measures. Internal consistency of the FaB-Brazil scale was evaluated using Cronbach's alpha and inter-rater and test-retest reliability using intraclass correlation coefficients (ICC). The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, and convergent and discriminative validity were evaluated.

RESULTS

Internal consistency was moderate (α = 0.77). Excellent inter-rater (ICC = 0.90; p < 0.001) and test-retest (ICC = 0.91; p < 0.001) reliability were found. The SEM was 0.20 and MDC was 0.38. Ceiling and floor effects were not found. Convergent validity was established by the positive correlations between the FaB-Brazil scale and age, modified Hoehn and Yahr, PD duration, Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Motor Aspects of Experiences of Daily Living, Timed Up & Go and 8-item Parkinson's Disease Questionnaire, and negative correlations between the FaB-Brazil scale and community mobility, Schwab & England, and Activities-specific Balance Confidence scale. Females showed greater protective behaviors than males; recurrent fallers showed greater protective behaviors than non-recurrent fallers (p < 0.05).

CONCLUSIONS

The FaB-Brazil scale is reliable and valid for assessing people with PD.

Psychometric properties of the Turkish version of Central Sensitization Inventory-9 in patients with chronic musculoskeletal pain

The aim of the study was to assess the psychometric properties of the Turkish version of Central Sensitization Inventory-9 (CSI-9) in patients with chronic musculoskeletal pain. The methodological study included 92 patients with chronic musculoskeletal pain. The original version of the CSI-9 was translated and culturally adapted into Turkish. The internal consistency and test-retest reliability were evaluated with Cronbach's α and the intraclass correlation coefficient (ICC), respectively. The assessment of reproducibility was conducted with the standard error of measurement (SEM) and minimal detectable difference (MDD) values. Convergent validity was explored by correlation analysis between the CSI-9 and Central Sensitization Inventory (CSI-25), Brief Pain Inventory (BPI), and European Quality of Life Survey-5 Dimensions (EQ-5D). The structural validity was assessed with factor analysis. Floor and ceiling effects were also analyzed. We found a very good internal consistency (Cronbach's α of 0.83) and excellent test-retest reliability (ICC of 0.96) of the Turkish CSI-9. The SEM demonstrated a range between 0.19 and 1.12, and the MDD was observed to vary from 1.17 to 1.35. The CSI-9 correlated significantly with the CSI-25 ( r  = 0.77, P  < 0.001), the pain severity subscale of the BPI ( r  = 0.41 to 0.53, P  < 0.001), the pain interference subscale of the BPI ( r  = 0.21 to 0.58, P  = 0.02 to P  < 0.001), the EQ-5D ( r  = 0.24 to 0.48, P  < 0.05), and the EQ-5D visual analog scale ( r  = -0.41, P  < 0.001). One factor was identified within the CSI-9. Our data suggest that the Turkish CSI-9 is reliable and valid outcome measure for assessing CS in patients with chronic musculoskeletal pain.

The Validity and Reliability of a Smartphone Application for Measuring Wrist and Metacarpophalangeal Joint Motion

Background Accurate measurement of the range of motion (ROM) is crucial for guiding upper extremity rehabilitation. Inaccurate measurements can mislead clinicians and harm patient compliance. This study aimed to evaluate the validity and reliability of a smartphone application (Angulus) for measuring wrist and metacarpophalangeal (MCP) joint ROM. Methodology This study included 64 volunteers with no prior wrist injuries. The wrist flexion/extension, radial/ulnar deviation, and MCP joint flexion/extension ROM were assessed by an experienced physiotherapist (Assessor 1) using the Angulus and a standard two-arm goniometer. The validity of Angulus was evaluated by correlating it with the goniometer measurements using the Pearson correlation coefficient. For the reliability analysis, an inexperienced biomedical engineer (Assessor 2) performed the same measurements using Angulus twice in different sessions, in addition to Assessor 1. The intra-rater and inter-rater reliability were tested using the intraclass correlation coefficient. Results The mean age of the participants was 29.5 ± 8.2 years, with 62% being female. The validity of the Angulus app measurements was indicated by the adequate to excellent correlation between the Angulus and goniometer measurements (ranging from 0.44 to 0.81). The intra-rater reliability of the Angulus app was excellent for Assessor 1 (ranging from 0.76 to 0.90) and adequate to excellent for Assessor 2 (ranging from 0.71 to 0.88). The inter-rater reliability of Angulus was excellent (ranging from 0.91 to 0.96). Conclusions Angulus is a valid and reliable method to measure the wrist and MCP joint ROM.

Validity, reliability, and responsiveness of Persian version of mini-balance evaluation system test among ambulatory people with multiple sclerosis

BACKGROUND AND PURPOSE

Mini-Balance Evaluation Systems Test (mini-BESTest) is a widely used measure to assess balance impairments. This study aimed to assess the validity, reliability, responsiveness, and minimal clinically important change (MCIC) of the Persian mini-BESTest among ambulatory People with Multiple Sclerosis (PwMS).

METHODS

Fifty ambulatory PwMS participated in this study. Persian mini-BESTest validated against Berg Balance Scale (BBS) and Timed-Up and Go (TUG) with/without a cognitive task. To assess the reliability, the Persian mini-BESTest was re-administered for a sample of 30 participants after 1 week. Also, 32 PwMS were tested before and after a 4-week of balance and gait training to assess the responsiveness.

RESULTS

No floor/ceiling effect was found for the mini-BESTest total score. There were significant excellent correlations (p < .001) between mini-BESTest and BBS (r = 0.71), TUG (r = -0.76), and cognitive TUG (r = -0.73). No strong correlations were observed between the subscales (r = 0.37-0.55). Test-retest reliability and internal consistency of Persian mini-BESTest total score were excellent, with Intra-class Correlation Coefficient (ICC3,1 and Cronbach's alpha level of 0.89 and 0.80, respectively. The minimal detectable change was 4 points. The Persian mini-BESTest had acceptable responsiveness (AUC = 0.83), and MCIC was 5 points.

CONCLUSION

The Persian mini-BESTest is a valid, reliable, and responsive measure of balance performance in Iranian ambulatory PwMS.

Child and adolescent participation measurement tools and their translations: A systematic review

BACKGROUND

Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures, the reliability and validity of the translated versions remain uncertain. To address this gap in knowledge, this study aims to identify tools for assessing the participation of children aged 5-18 years and to appraise the psychometric properties of their translated versions.

METHODS

Four electronic databases were searched for peer-reviewed studies published in English. Preferred Reporting Items for Systematic Reviews guidelines was followed. Study titles and abstracts were screened by four independent reviewers. Data were extracted for both original and translated versions of eligible tools. Instrument quality assessments were performed using the Outcome Measures Rating Form Guidelines. Any discrepancies were resolved by consensus.

RESULTS

Out of the 31 measurement tools examined, 18 tools had at least one translated version available, and among those original measurement tools, a total of 58 translated versions were identified. The most widely translated tool was the Physical Activity Questionnaire for Children (12 languages), and the most frequently translated language was Chinese (7 tools). Most translated versions verified internal consistency and content validity. Only three translated versions were verified inter-rater reliability, and seven translated versions were tested criterion validity with the gold standard tools assessing participation of children (e.g., accelerometer, Pediatric Evaluation of Disability Inventory and four 24-h recalls). None of the translated versions were tested for intra-rater reliability and responsiveness.

CONCLUSIONS

These findings can support the selection of psychometrically sound tools for children with disabilities, given their culture and language, and tool quality.

The Japanese Version of the Daily Record of Severity of Problems for Premenstrual Symptoms: Reliability and Validity Among the General Japanese Population

Purpose

The validity and reliability of the Japanese version of the Daily Record of Severity of Problems (DRSP-J) have already been confirmed in a population with premenstrual symptoms. This study aimed to assess the validity and reliability of the DRSP-J in the general population.

Patients and Methods

We analyzed data from 113 Japanese women with regular menstrual cycles who applied to participate in an ongoing study. Participants were recruited regardless of the severity of premenstrual symptoms, and their menstrual cycles were monitored using the DRSP-J for two cycles. Reliability was examined using Cronbach's α, a measure of internal consistency, and test-retest reliability. Structural validity was assessed using a principal component analysis (PCA). The Hospital Anxiety and Depression Scale (HADS) and EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) were used to examine concurrent validity. The agreement between the clinical diagnoses based on the diagnostic criteria for premenstrual syndrome/premenstrual dysphoric disorder and that based on the DRSP-J score was examined using the kappa coefficient.

Results

Cronbach's α for DRSP-J total score was 0.96. The DRSP-J total score showed high test-retest reliability. The PCA showed a two-factor model describing "Mood" and "Behavior/Physical" symptoms. The DRSP-J total score was highly correlated with the HADS total and EQ-5D-5L scores. The classification of "moderate to severe premenstrual syndrome" and "premenstrual dysphoric disorder" by clinical methods and the criteria based on the DRSP-J were in good agreement (kappa values = 0.78).

Conclusion

The DRSP-J is a reliable and valid measure of premenstrual symptoms in the general Japanese population, including those with few or no symptoms.

The Hausa Northwick Park Neck Pain Questionnaire: translation, cross-cultural adaptation and psychometric assessment in patients with non-specific neck pain

PURPOSE

To translate and cross-culturally adapt the Northwick Park Neck Pain Questionnaire (NPQ) into Hausa and assess its psychometric properties.

MATERIALS AND METHODS

The NPQ was translated and cross-culturally adapted into Hausa using recommended guidelines. A consecutive sample of 92 Hausa-speaking patients with non-specific neck pain recruited from three tertiary hospitals in north-western Nigeria, completed the questionnaire to assess factorial validity (using confirmatory factor analysis), convergent validity (by correlating the Hausa-NPQ with the Numerical Pain Rating Scale [NPRS]), and internal consistency (using Cronbach's α). A subsample of 50 patients completed the questionnaire again 3 days after the first administration to assess relative reliability using intraclass correlation coefficients (ICC) and absolute reliability using standard error of measurement (SEM), smallest detectable change (SDC), and 95% limits of agreement (LOA).

RESULTS

The factor analysis confirmed a single-factor structure with excellent internal consistency (α = 0.94). The questionnaire showed a strong positive correlation with the NPRS (rho = 0.68). The ICC was 0.86, with SEM and SDC of 6.32 and 17.5, respectively. The LOA was - 29.3 to + 37.1 with no evidence of proportional bias.

CONCLUSIONS

The Hausa-NPQ is a valid and reliable measure of disability due to neck pain.

Immersive Virtual Reality to Assess Arm Kinematics among Older Adults with and without Major Neurocognitive Disorder - An Exploratory Cross-Sectional Study

Despite the recommendation of improving assessment objectivity and frequency, the use of immersive virtual reality to measure and quantify movement quality remains underexplored. In this study, we aimed to evaluate the reliability, validity and usability of an immersive virtual reality application, KinematicsVR, to assess upper limb kinematics among older adults with and without major neurocognitive disorder. The KinematicsVR involves the drawing of three-dimensional straight lines, circles and squares using a controller in a virtual environment. Twenty-eight older adults with or without major neurocognitive disorder were recruited. Reliability was evaluated through correlations on test-retest and validity through correlations between KinematicsVR variables and other functional tests (TEMPA, BBT-VR and Finger-Nose Test). The usability of the KinematicsVR was assessed with the System Usability Scale questionnaire. Kinematic indexes were compared between eight adults with major neurocognitive disorder and eight matched controls. Results indicated that most variables provided by the KinematicsVR had excellent reliability for tasks involving the drawing of straight lines and circles, but moderate reliability for tasks involving the drawing of squares. Secondary analyses showed that the usability of the application was excellent but few significant and strong correlations were observed between variables of the KinematicsVR and the scores of the TEMPA scale, Finger-Nose Test and BBT-VR. Adults with major neurocognitive disorder, when compared to other older adults, made larger and less linear hand movements. These findings provide perspectives for the use of immersive virtual reality to improve assessment frequency and objectivity through the autonomous measure of upper limb kinematics in older adults.

Self-Report Measures of Fatigue for People With Multiple Sclerosis: A Systematic Review

BACKGROUND AND PURPOSE

The symptom of fatigue impairs function in people with multiple sclerosis (MS). Choosing appropriate measures to assess fatigue is challenging. The purpose of this article is to report the findings of a systematic review of patient-reported fatigue measures for people with MS.

METHODS

PubMed, CINAHL, and Embase databases were searched through January 2020 using terms related to fatigue and MS. Studies were included if the sample size was 30 or more or smaller samples if adequately powered, and if information about measurement characteristics (ie, test-retest reliability, content validity, responsiveness, interpretability, or generalizability) of the measure(s) could be extracted. Study quality was appraised with the 2-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Data about measurement characteristics, psychometrics, and clinical utility were extracted and results were synthesized.

RESULTS

Twenty-four articles met inclusion criteria with information about 17 patient-reported fatigue measures. No studies had critical methodologic flaws. Measurement characteristic data were not available for all measures. Clinical utility varied in time to complete and fatigue domains assessed.

DISCUSSION AND CONCLUSIONS

Five measures had data pertaining to all properties of interest. Of these, only the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) had excellent reliability, responsiveness data, no notable ceiling/floor effects, and high clinical utility. We recommend the MFIS for comprehensive measurement and the FSS for screening of subjective fatigue in people with MS.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A443 ).

Validating the Fatigue Scale for Motor and Cognitive Function (FSMC) in chronic stroke

BACKGROUND

Post-stroke fatigue can manifest as both physical and mental fatigue. The Fatigue Scale for Motor and Cognitive Functions (FSMC) evaluates fatigue on the motor and cognitive domains separately, however, the psychometric properties of this measure in stroke have not been reported.

OBJECTIVE

To determine the internal consistency, test-retest reliability, and concurrent validity of the FSMC in chronic stroke.

METHODS

Thirty-four participants with chronic stroke (55.26±12.27 years of age; 59.53±89.21 months post-stroke) completed the FSMC on two separate visits. Internal consistency and reliability of the FSMC were examined using Cronbach's alpha and two-way mixed effects intraclass correlation coefficients (ICC), respectively. Correlation between the FSMC and the Fatigue Severity Scale and Visual Analog Scale-Fatigue was used to assess concurrent validity.

RESULTS

Internal consistency was excellent (Cronbach's alpha > 0.9) and reliability was moderate to good (ICC = 0.72-0.81) for all FSMC scores. The FSMC demonstrated moderate to good concurrent validity with the Fatigue Severity Scale (ρ= 0.66-0.72) but only fair concurrent validity with the Visual Analog Scale-Fatigue (ρ= 0.37-0.44).

CONCLUSION

The FSMC is a valid and reliable measure of post-stroke fatigue and may be a useful tool to examine physical fatigue and cognitive fatigue in chronic stroke.

Psychometric Properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Resilience Short Form in a Sample With Spinal Cord Injury

OBJECTIVE

To explore the psychometric properties (eg, data distribution characteristics, convergent or discriminant validity, internal consistency reliability) of the Spinal Cord Injury-Quality of Life measurement system (SCI-QOL) Resilience 8-item short form (SF) in comparison to the criterion standard resilience measure, Connor Davidson Resilience Scale (CD-RISC) in a sample of individuals with spinal cord injury (SCI).

DESIGN

Descriptive statistics were calculated to examine variable data distribution characteristics. Correlation analyses were conducted for convergent and discriminant validity. Reliability statistics were calculated for resilience and other validity measures.

SETTING

General community.

PARTICIPANTS

Individuals with SCI (N=202; 51.5% male, 48% female).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Patient-Reported Outcomes Measurement Information System measures (depression, anxiety, ability to participate in social roles and activities, pain intensity, fatigue, sleep disturbance), SCI-QOL short forms (SF) (resilience, positive affect and well-being, mobility), CD-RISC, National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function - perceived stress (NIH Toolbox-perceived stress), and the Satisfaction with Life Scale were administered.

RESULTS

The mean and SD for the SCI-QOL Resilience SF (mean=48.60; SD=8.20) approximated the normative mean (mean=50, SD=10). The SCI-QOL Resilience SF scores were essentially normally distributed though somewhat kurtotic, with skew=-0.17 and excess kurtosis=1.4; internal consistency reliability was good (Cronbach's alpha=0.89). Convergent validity was supported by significant moderate correlations in expected directions between the SCI-QOL Resilience SF and measures of CD-RISC resilience, depressive symptoms, anxiety, social participation, positive affect and well-being, stress, and satisfaction with life. Discriminant validity was supported by small non-significant correlations between the SCI-QOL Resilience SF and age, sex, injury level, time since injury, pain intensity, mobility, sleep disturbance, and fatigue.

CONCLUSION

The SCI-QOL Resilience SF demonstrated good convergent and discriminant validity. Our study showed that the SCI-QOL Resilience SF is a psychometrically valid tool that can reliably estimate levels of resilience in the SCI population.

Influence of radiological factors, psychosocial factors, and central sensitization-related symptoms on clinical symptoms in patients with lumbar spinal canal stenosis

BACKGROUND

No study to date has concurrently evaluated the impact of radiological factors, psychosocial factors, and central sensitization (CS) related symptoms in a single lumbar spinal canal stenosis (LSS) patient cohort.

OBJECTIVE

To investigate the associations between these factors and clinical symptoms in LSS patients.

METHODS

We recruited 154 patients with LSS scheduled for surgery. Patient-reported outcome measures and imaging evaluation including clinical symptoms, psychosocial factors, CS-related symptoms, and radiological classifications. Spearman's rank correlation coefficient and multiple regression analyses were employed.

RESULTS

Spearman's correlation revealed CS-related symptoms positively correlated with low back pain (r= 0.25, p< 0.01), leg pain (r= 0.26, p< 0.01), and disability (r= 0.32, p< 0.01). Pain catastrophizing positively correlated with leg pain (r= 0.23, p< 0.01) and disability (r= 0.36, p< 0.01). Regression analysis showed that pain catastrophizing was associated with disability (β= 0.24, 95%CI = 0.03-0.18), and CS-related symptoms with low back pain (β= 0.28, 95%CI = 0.01-0.09). Radiological classifications were not associated with clinical symptoms.

CONCLUSION

Our findings suggest that psychosocial factors and CS-related symptoms, rather than radiological factors, seem to contribute to clinical symptoms in patients with LSS.

Reliability of five-minute vs. one-hour heart rate variability metrics in individuals with spinal cord injury

Background

A previous study showed low reliability of 1-h HRV outcomes in participants with spinal cord injury (SCI), but it was not certain whether the low reliability was due to the unrestricted activity of participants. We aimed to investigate test-retest reliability of HRV metrics in individuals with SCI using a 1-h measurement in a supine position.

Methods

Individuals with SCI underwent two sessions of 1-h recording of the time between consecutive R waves (RR-intervals) in a supine position. HRV outcomes were obtained from a single 5-min data segment and for the full 1-h recording. HRV parameters of interest were: standard deviation of all normal-to-normal R-R intervals (SDNN) and square root of the mean of the squared differences between successive R-R intervals (RMSSD) (time domain); and high frequency power (HF), low frequency power (LF), very low frequency power (VLF), ultra-low frequency power (ULF) and total power (TP) (frequency domain). Relative reliability was assessed by intraclass correlation coefficient (ICC). Absolute reliability was assessed by coefficient of variation (CV) and Bland-Altman limits of agreement (LoA).

Results

Data from 37 individuals (14 with tetraplegia and 23 with paraplegia) were included. Relative reliability was higher for the 1-h (ICCs ranged from 0.13-0.71) than for the 5-min duration (ICCs ranged from 0.06-0.50) in the overall SCI group for all HRV metrics. Participants with tetraplegia had lower relative reliability compared to participants with paraplegia in all HRV metrics for the 5-min duration (ICCs ranged from -0.01-0.34 vs. 0.21-0.57). For the 1-h duration, participants with paraplegia showed higher relative reliability than participants with tetraplegia in all HRV metrics (ICCs ranged from 0.18-0.79 vs. 0.07-0.54) except TP (ICC 0.69 vs. 0.82). In terms of absolute reliability, the CVs and LoAs for the 1-h duration were better than for the 5-min duration. In general, time domain metrics showed better reliability than frequency domain metrics for both durations in participants with tetraplegia and paraplegia. The lowest CV and narrowest 95% LoA were found for SDNN in 5-min and 1-h durations overall and in both lesion levels.

Conclusions

The supine position did not provide better reliability compared to unrestricted activity in participants with SCI. HRV analysis using a 5-min duration is of limited value in SCI due to poor reliability. For the 1-h analysis duration, interpretation of the reliability of HRV varies according to lesion level: it is recommended to take lesion level into account when interpreting reliability measures.

Assessing Gait & Balance in Adults with Mild Balance Impairment: G&B App Reliability and Validity

Smartphone applications (apps) that utilize embedded inertial sensors have the potential to provide valid and reliable estimations of different balance and gait parameters in older adults with mild balance impairment. This study aimed to assess the reliability, validity, and sensitivity of the Gait&Balance smartphone application (G&B App) for measuring gait and balance in a sample of middle- to older-aged adults with mild balance impairment in Pakistan. Community-dwelling adults over 50 years of age (N = 83, 50 female, range 50-75 years) with a Berg Balance Scale (BBS) score between 46/56 and 54/56 were included in the study. Data collection involved securing a smartphone to the participant's lumbosacral spine. Participants performed six standardized balance tasks, including four quiet stance tasks and two gait tasks (walking looking straight ahead and walking with head turns). The G&B App collected accelerometry data during these tasks, and the tasks were repeated twice to assess test-retest reliability. The tasks in quiet stance were also recorded with a force plate, a gold-standard technology for measuring postural sway. Additionally, participants completed three clinical measures, the BBS, the Functional Reach Test (FRT), and the Timed Up and Go Test (TUG). Test-retest reliability within the same session was determined using intraclass correlation coefficients (ICCs) and the standard error of measurement (SEM). Validity was evaluated by correlating the G&B App outcomes against both the force plate data and the clinical measures using Pearson's product-moment correlation coefficients. To assess the G&B App's sensitivity to differences in balance across tasks and repetitions, one-way repeated measures analyses of variance (ANOVAs) were conducted. During quiet stance, the app demonstrated moderate reliability for steadiness on firm (ICC = 0.72) and compliant surfaces (ICC = 0.75) with eyes closed. For gait tasks, the G&B App indicated moderate to excellent reliability when walking looking straight ahead for gait symmetry (ICC = 0.65), walking speed (ICC = 0.93), step length (ICC = 0.94), and step time (ICC = 0.84). The TUG correlated with app measures under both gait conditions for walking speed (r -0.70 and 0.67), step length (r -0.56 and -0.58), and step time (r 0.58 and 0.50). The BBS correlated with app measures of walking speed under both gait conditions (r 0.55 and 0.51) and step length when walking with head turns (r = 0.53). Force plate measures of total distance wandered showed adequate to excellent correlations with G&B App measures of steadiness. Notably, G&B App measures of walking speed, gait symmetry, step length, and step time, were sensitive to detecting differences in performance between standard walking and the more difficult task of walking with head turns. This study demonstrates the G&B App's potential as a reliable and valid tool for assessing some gait and balance parameters in middle-to-older age adults, with promise for application in low-income countries like Pakistan. The app's accessibility and accuracy could enhance healthcare services and support preventive measures related to fall risk.

Reliability, Validity and Responsiveness of the Slovenian Version of the Patient Evaluation Measure (PEM-Slo) in Patients with Wrist and Hand Disorders

Introduction

The Patient Evaluation Measure (PEM) is a region-specific patient reported outcome measure (PROM) for hand and wrist disorders, first introduced in English for patients with hand surgery in 1995. The purpose of the study was to assess the psychometric properties of the translated and cross-culturally adapted Slovenian version of PEM (PEM-Slo).

Methods

The study was designed as a single-centre observational prospective study conducted from July 2020 to March 2021. The psychometric evaluation was performed on fifty-one patients with miscellaneous hand and wrist disorders. Reliability was tested for internal consistency and test-retest reliability. Convergent and divergent validity, responsiveness, floor and ceiling effect, and interpretability with the determination of minimal detectable change (MDC) and minimal clinically important difference (MCID) were assessed.

Results

The PEM-Slo has excellent internal consistency (Cronbach's α 0.932) and good to excellent test-retest reliability (intraclass correlation coefficient=0.874). Convergent validity was proved with high to moderate correlations of PEM-Slo with DASH, grip strength and self-care, usual activities, and pain EQ-5D-5L subscales, whereas no correlation of PEM-Slo with EQ-5D-5L mobility and anxiety/depression subscale confirmed divergent validity. The PEM-Slo responsiveness was high (standardised response mean=1.42, effect size=1.25). MDC was 18.01 and MCID was 17.31. No floor or ceiling effect was found.

Conclusion

The PEM-Slo is a reliable, valid and responsive PROM for Slovenian-speaking patients with hand and wrist disorders.

Test-retest reliability of short- and long-term heart rate variability in individuals with spinal cord injury

STUDY DESIGN

Cross-sectional.

OBJECTIVES

To investigate test-retest reliability of heart rate variability (HRV) metrics in SCI without restriction of activity over long (24-h) and shorter durations (5-min, 10-min, 1-h, 3-h and 6-h).

SETTINGS

University hospital in Khon Kaen, Thailand.

METHODS

Forty-five participants (11 with tetraplegia and 34 with paraplegia) underwent two 24-h recordings of RR-intervals to derive time and frequency HRV metrics. Relative reliability was assessed by intraclass correlation coefficient (ICC) and absolute reliability by coefficient of variation (CV) and Bland-Altman limits of agreement (LoA).

RESULTS

For 5- and 10-min durations, eight of eleven HRV metrics had moderate to excellent reliability (ICC 0.40-0.76); the remaining three were poor (ICC < 0.4). HRV values from 1-h and 3-h durations showed moderate to excellent reliability (ICC of 0.46-0.81), except for 1-h reliability of ULF and TP (ICC of 0.06 and 0.30, respectively). Relative reliability was excellent (ICC of 0.77-0.92) for 6-h and 24-h durations in all HRV metrics. Absolute reliability improved as recording duration increased (lower CVs and narrower LoAs). Participants with high AD risk (SCI level at or above T6) showed lower test-retest reliability of HF and LF values than participants with low AD risk.

CONCLUSION

Relative reliability of HRV was excellent for 6-h and 24-h. The best absolute reliability values were for 24-h duration. Time-domain outcomes were more reliable than frequency domain outcomes. Participants with high risk of AD, particularly those with tetraplegia, showed lower reliability, especially for HF and LF.

Suitability of the Attitudes to Aging Questionnaire Short Form for Use among Adults in Their 50s: A Cross-Sectional e-Survey Study

This cross-sectional e-survey study examines the suitability (reliability and validity) of the 12-item Attitudes to Aging Questionnaire Short Form (AAQ-SF) for use among adults in their 50s. The AAQ-SF instrument was originally designed to capture subjective perceptions of physical change, psychosocial loss, and psychological growth by asking people aged 60 and beyond how they feel about growing older. Our sample comprised 517 people residing in three Canadian provinces. Respondents completed the Attitudes to Aging Questionnaire Short Form, the Rosenberg Self-Esteem Scale, and a short sociodemographic profile. Our findings replicate the original AAQ-SF structure for physical change, psychosocial loss, and psychological growth, with a promising internal consistency range for the third subscale. In our sample, psychological growth is best represented as 'Self' and 'Generativity', with a particularly greater capacity to explain variations in scores for item 18 and item 21. Physical change and psychosocial loss scores strongly differed based on perceived health and chronic illness presence. Psychosocial loss and psychological growth were moderately correlated with two aspects of self-esteem. We relate these patterns of findings within the context of prevailing growth and development theory and their perceived implications within the context of COVID-19 and post-pandemic life.

Psychometric properties of the mock interview rating scale for autistic transition-age youth

Background

Employment is a major contributor to quality of life. However, autistic people are often unemployed and underemployed. One potential barrier to employment is the job interview. However, the availability of psychometrically-evaluated assessments of job interviewing skills is limited for autism services providers and researchers.

Objective

We analyzed the psychometric properties of the Mock Interview Rating Scale that was adapted for research with autistic transition-age youth (A-MIRS; a comprehensive assessment of video-recorded job interview role-play scenarios using anchor-based ratings for 14 scripted job scenarios).

Methods

Eighty-five transition-age youth with autism completed one of two randomized controlled trials to test the effectiveness of two interventions focused on job interview skills. All participants completed a single job interview role-play at pre-test that was scored by raters using the A-MIRS. We analyzed the structure of the A-MIRS using classical test theory, which involved conducting both exploratory and confirmatory factor analyzes, Rasch model analysis and calibration techniques. We then assessed internal consistency, inter-rater reliability, and test-retest reliability. Pearson correlations were used to assess the A-MIRS' construct, convergent, divergent, criterion, and predictive validities by comparing it to demographic, clinical, cognitive, work history measures, and employment outcomes.

Results

Results revealed an 11-item unidimensional construct with strong internal consistency, inter-rater reliability, and test-retest reliability. Construct [pragmatic social skills (r = 0.61, p < 0.001), self-reported interview skills (r = 0.34, p = 0.001)], divergent [e.g., age (r = -0.13, p = 0.26), race (r = 0.02, p = 0.87)], and predictive validities [competitive employment (r = 0.31, p = 0.03)] received initial support via study correlations, while convergent [e.g., intrinsic motivation (r = 0.32, p = 0.007), job interview anxiety (r = -0.19, p = 0.08)] and criterion [e.g., prior employment (r = 0.22, p = 0.046), current employment (r = 0.21, p = 0.054)] validities were limited.

Conclusion

The psychometric properties of the 11-item A-MIRS ranged from strong-to-acceptable, indicating it may have utility as a reliable and valid method for assessing the job interview skills of autistic transition-age youth.