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Ambegaonkar JP, Jordan M, Wiese KR, Caswell SV. Kinesiophobia in Injured Athletes: A Systematic Review. J Funct Morphol Kinesiol 2024; 9:78. [PMID: 38651436 PMCID: PMC11036235 DOI: 10.3390/jfmk9020078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
Athletes have a high risk of injury. Kinesiophobia is a condition in which an individual experiences a fear of physical movement and activity after an injury occurs. Our purpose was to systematically review the literature about Kinesiophobia in athletes. A systematic review was conducted in February 2023 using PubMed, CINAHL, SPORTDiscus, Web of Science, Cochrane Library, and Medline. Studies were included if they were peer-reviewed, in English, within the last 20 years and included athletes who had been injured and tracked Kinesiophobia. Articles were checked for quality via the modified Downs and Black checklist. Fourteen studies were included in the review and had an average "fair" quality score. Authors examined Kinesiophobia in injured athletes with mostly lower-extremity injuries. Kinesiophobia was associated with lower physical and mental outcomes. Kinesiophobia exists in athletes and can affect both physical and mental factors. The Tampa Scale of Kinesiophobia (TSK) was the most common tool used to examine Kinesiophobia. Common mental factors associated with Kinesiophobia include anxiety, low confidence, and fear avoidance.
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Affiliation(s)
- Jatin P. Ambegaonkar
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA; (M.J.); (K.R.W.); (S.V.C.)
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Acar M, Öztürk D, Demirsöz M, Tekindal MA. The Validity and Reliability of the Turkish Version of the Disablement in the Physically Active Scale. J Sport Rehabil 2023:1-9. [PMID: 37156545 DOI: 10.1123/jsr.2022-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/23/2022] [Accepted: 03/05/2023] [Indexed: 05/10/2023]
Abstract
CONTEXT The Disablement in the Physically Active Scale (DPAS) was recently developed to evaluate the disability process and health-related quality of life. The aim of this study was to investigate the validity and reliability of the Turkish version of the DPAS in physically active individuals with musculoskeletal injury. METHODS The study sample comprised 64 physically active individuals with musculoskeletal injury aged 16-40 years. The DPAS was translated into Turkish according to the guidelines for cross-cultural adaptation. Short Form-36 was used concurrently to test the construct validity. The test-retest reliability of the Turkish version of the scale assessed by intraclass correlation coefficient and Cronbach α was calculated for internal consistency. RESULTS Confirmatory factor analysis carried out on the Turkish version of the DPAS was confirmed. Cronbach α was calculated to be .946. The intraclass correlation coefficients ranged between .593 and .924 (P < .001). The Turkish version of the scale showed significant correlations with domains of the Short Form-36 (P < .05). When the sensitivity of the study was evaluated, the highest correlation was found between DPAS total score and impairments (r = .906, P = .001), and the lowest correlation was between DPAS total score and quality of life (r = .637, P = .001). CONCLUSION The Turkish version of the DPAS is a reliable, valid, and practical tool. The Turkish version of the DPAS can be used by health professionals to understand quality of life, the disability process, and activity limitations in Turkish-speaking physically active people after musculoskeletal injuries.
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Affiliation(s)
- Manolya Acar
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Ankara,Turkey
| | - Demet Öztürk
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara,Turkey
| | - Mert Demirsöz
- Department of Bioistatistics, Faculty of Veterinary Medicine, Selçuk University, Konya,Turkey
| | - Mustafa Agah Tekindal
- Department of Bioistatistics, Faculty of Medicine Sciences, İzmir Katip Çelebi University, İzmir,Turkey
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McIntire R, Howard C, McIntosh H, Ricken R, Warren AJ, Volberding JL. Suburban firefighter perceptions of health and wellness using patient-reported outcome measures. Work 2023; 76:595-609. [PMID: 36911957 DOI: 10.3233/wor-220334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Firefighting is among the most dangerous professions and requires exceptional physical fitness and focus while working. Patient-reported outcomes are a commonly used method to evaluate subjective health information and may be utilized by fire departments to identify the health status of firefighters and provide insight to promote their health and wellness. OBJECTIVE This study is a novel analysis of firefighters' self-reported health to potentially identify musculoskeletal dysfunction, assist in therapeutic intervention, and improve overall health and wellness. METHODS Firefighters were evaluated using seven different self-reported health surveys to assess various physical capabilities and quality of life. The questionnaires were delivered via online format and administered once to provide a snapshot of a suburban Oklahoma fire department. RESULTS Using the Disablement in the Physically Active Scale, 14 of the 35 firefighters answered "slight, moderate, or severe" for the pain and motion variables. Only two of the firefighters indicated no stiffness or soreness after activity on the Nirschl Phase Rating Scale. The firefighters mean rating for "energy/fatigue" via the RAND-36 was 54.14 out of 100. CONCLUSION Firefighters frequently report pain, impaired motion, and soreness, indicating areas in which health and wellness interventions may be helpful. The incorporation of periodic health surveys into firefighter health and wellness programming can highlight the presence of concerns, as well as intervention effectiveness by subjective health status reporting. By combining the health surveys with aerobic and core strength exercises, fire departments may be able to monitor and improve firefighter health.
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Affiliation(s)
- Ryan McIntire
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Conner Howard
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Haddon McIntosh
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Rileigh Ricken
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Aric J Warren
- Department of Athletic Training, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jennifer L Volberding
- Department of Athletic Training, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Casanova MP, Nelson MC, Pickering MA, Larkins LW, Appleby KM, Grindley EJ, Baker RT. Disablement in the Physically Active Scale Short Form-8: psychometric evaluation. BMC Sports Sci Med Rehabil 2021; 13:153. [PMID: 34906195 PMCID: PMC8669416 DOI: 10.1186/s13102-021-00380-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/01/2021] [Indexed: 01/02/2023]
Abstract
Background Patient-centered care and evidence-based practice (EBP) are core competencies for health care professionals. The importance of EBP has led to an increase in research involving clinical outcomes; current recommendations emphasize collecting patient focused measures, thus increasing the need for psychometrically sound patient reported outcome measures (PROMs) of health. Disablement has been identified as a valuable multi-dimensional construct for patient care. The Disablement in the Physically Active Scale Short Form-8 (DPA SF-8) has been proposed as a tool to be used in the physically active population that assesses a physical summary component of health and a quality of life component however, further analysis is necessary to ensure the instrument is psychometrically sound. Methods Confirmatory factor analyses (CFAs) were conducted on the DPA SF-8 at each time point to ensure factor structure. Reliability of the scale and internal consistency of the subscales were assessed, and a minimal detectable change (MDC) calculated. Additionally, a minimal clinically important difference (MCID) was also established, and invariance testing across three time points and groups was conducted. Results The CFAs at all three visits exceeded recommended model fit indices. The interclass correlation coefficient value (.924) calculated indicated excellent scale reliability and Cronbach’s alpha for subscales PHY and QOL were within recommend values. The MDC value calculated was 5.83 and the MCID for persistent injuries were 2 points and for acute injuries, 3 points. The DPA SF-8 was invariant across time and across subgroups. Conclusions The DPA SF-8 met CFA recommendations and criteria for multi-group and longitudinal invariance testing, which indicates the scale may be used to assess for differences between the groups or across time. Our overall analysis indicates the DPA SF-8 is a valid, reliable, and responsive instrument to assess patient improvement in the physically active population. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00380-3.
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Affiliation(s)
| | - Megan C Nelson
- University of Idaho, 875 Perimeter Drive, Moscow, ID, 83844, USA
| | | | | | - Karen M Appleby
- Idaho State University, 921 South 8th Ave, Pocatello, ID, 83209, USA
| | - Emma J Grindley
- University of Idaho, 875 Perimeter Drive, Moscow, ID, 83844, USA
| | - Russell T Baker
- University of Idaho, 875 Perimeter Drive, Moscow, ID, 83844, USA.
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Le CY, Truong LK, Holt CJ, Filbay SR, Dennett L, Johnson JA, Emery CA, Whittaker JL. Searching for the Holy Grail: A Systematic Review of Health-Related Quality of Life Measures for Active Youth. J Orthop Sports Phys Ther 2021; 51:478-91. [PMID: 34592831 DOI: 10.2519/jospt.2021.10412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To identify the most suitable existing generic and condition-specific health-related quality of life (HRQoL) patient-reported outcome measures (PROMs) for active youth with and without a musculoskeletal injury, based on measurement properties, interpretability, and feasibility. DESIGN Systematic review of clinimetrics. LITERATURE SEARCH We searched MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO, and Scopus from inception to April 30, 2020. STUDY SELECTION CRITERIA Records with original data describing the evaluation of a PROM or PROM subscale in active youth (15-24 years old) with or without a musculoskeletal injury were included. Non-English studies and those including individuals with a cognitive, developmental, or systemic condition were excluded. DATA SYNTHESIS This review was conducted according to the COSMIN user manual for systematic reviews of PROMs and the PRISMA guidelines. The COSMIN user manual guided our measurement property evaluation and interpretability and feasibility description. RESULTS Of 6931 potential records, 21 studies were included. Eleven generic and 7 condition-specific PROMs were identified. No PROM received a final COSMIN recommendation of "A" because all lacked sufficient content validity. The 8-item Disablement in the Physically Active scale-mental summary component Short Form (DPA-MSC SF-8), Quality of Life Survey, and Functional Arm Scale for Throwers (FAST) were the most suitable existing PROMs, given their high-quality evidence for sufficient structural validity and internal consistency. CONCLUSION No definitively robust PROM for measuring generic or condition-specific HRQoL of active youth was identified. Until one exists, we recommend the DPA-MSC SF-8, the Quality of Life Survey, or the FAST and applying mixed methods to best characterize the HRQoL of active youth. J Orthop Sports Phys Ther 2021;51(10):478-491. doi:10.2519/jospt.2021.10412.
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Abstract
CONTEXT The increased emphasis on implementing evidence-based practice has reinforced the need to more accurately assess patient improvement. Psychometrically sound, patient-reported outcome measures are essential for evaluating patient care. A patient-reported outcome instrument that may be useful for clinicians is the Disablement in the Physically Active Scale (DPAS). Before adopting this scale, however, researchers must evaluate its psychometric properties, particularly across subpopulations. OBJECTIVE To evaluate the psychometric properties of the DPAS in a large sample using confirmatory factor analysis procedures and assess structural invariance of the scale across sex, age, injury status, and athletic status groups. DESIGN Observational study. SETTING Twenty-two clinical sites. PATIENTS OR OTHER PARTICIPANTS Of 1445 physically active individuals recruited from multiple athletic training clinical sites, data from 1276 were included in the analysis. Respondents were either healthy or experiencing an acute, subacute, or persistent musculoskeletal injury. MAIN OUTCOME MEASURE(S) A confirmatory factor analysis was performed on the full sample, and multigroup invariance testing was conducted to assess differences across sex, age, injury status, and athletic status. Given the poor model fit, alternate model generation was used to identify a more parsimonious factor structure. RESULTS The DPAS did not meet contemporary fit index recommendations or the criteria to demonstrate structural invariance. We identified an 8-item model that met the model fit recommendations using alternate model generation. CONCLUSIONS The 16-item DPAS did not meet the model fit recommendations and may not be the most parsimonious or reliable measure for assessing disablement and quality of life. Use of the 16-item DPAS across subpopulations of interest is not recommended. More examination involving a true cross-validation sample should be completed on the 8-item DPAS before this scale is adopted in research and practice.
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Affiliation(s)
- Russell T Baker
- Department of Movement Sciences, University of Idaho, Moscow.,WWAMI Medical Education Program, University of Washington School of Medicine, Moscow, ID
| | | | | | - Jayme G Baker
- Department of Movement Sciences, University of Idaho, Moscow
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Holman M, Casanova MP, Baker RT. Exploring the Psychometric Properties of the Disablement in the Physically Active Scale Short Form-8 in Adolescents. J Sport Rehabil 2020; 30:685-8. [PMID: 33027763 DOI: 10.1123/jsr.2020-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/08/2020] [Accepted: 07/06/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Patient-reported outcomes are widely used in health care. The Disablement in the Physically Active (DPA) Scale Short Form-8 (SF-8) was recently proposed as a valid scale for the physically active population. However, further psychometric testing of the DPA SF-8 has not been completed, and scale structure has not been assessed using a sample of adolescent athletes. OBJECTIVE To assess scale structure of the DPA SF-8 in a sample of adolescent high-school athletes. MAIN OUTCOME MEASURE(S) Adolescent athletes (n = 289) completed the DPA SF-8. Confirmatory factor analysis (CFA) was conducted to assess the psychometric properties of the scale. RESULTS The CFA of the DPA SF-8 indicated that the model exceeded recommended fit indices (Comparative Fit Index = .976, Tucker-Lewis Index = .965, Root Mean Square Error of Approximation = .061, and Bollen's Incremental Fit Index = .976). All factor loadings were significant and ranged from .62 to .86. Modification indices did not suggest that meaningful cross-loadings were present or additional specifications that could further maximize fit or parsimony. CONCLUSIONS The CFA of the DPA SF-8 met contemporary model fit recommendations in the adolescent athlete population. The results confirmed initial findings supporting the psychometric properties of the DPA SF-8 as well as the uniqueness of the quality-of-life and physical summary factors in an adolescent population. Further research (eg, reliability, invariance between groups, minimal clinically important differences, etc) is warranted to inform scale use in clinical practice and research.
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Parcell B, Simon JE. Global and region-specific patient-reported outcomes pre and post a division I football season. Phys Ther Sport 2020; 42:146-150. [PMID: 32014830 DOI: 10.1016/j.ptsp.2020.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Determine the change in global and region-specific PROMs among athletes from one NCAA Division I football team during one season. DESIGN Prospective cross-sectional study. SETTING Athletic training facility. PATIENTS OR OTHER PARTICIPANTS Fifty-three Division I collegiate football athletes (n = 54) were eligible (20.1 ± 1.4 years, 187.7 ± 8.3 cm, and 113.5 ± 25.6 kg) for analyses. Participants completed five PROMs (Disablement in the Physically Active Scale [DPA], Epworth Sleep Score [ESS], Headache Impact Test [Hit-6], Disabilities of the Arm, Shoulder, and Hand [DASH], and the Lower Extremity Functional Scale [LEFS]) before the season and the same five PROMs after the season. MAIN OUTCOME MEASURES A multivariate repeated measure analysis of variance (ANOVA) was conducted for all dependent variables. Alpha level was set at ɑ = 0.05. RESULTS The overall multivariate repeated measures ANOVA was significant for time (p = 0.01). Follow up one-way ANOVA's indicated the DPA (p < 0.01, mean decrease/worse of 6.6 points) and LEFS (p = 0.01, mean decrease/worse of 4.1 points) were statistically significant between time points. CONCLUSION Division I football can be detrimental to the physical, mental, and emotional health of the athletes. From these data, global and one region-specific PROM decreased over one season in one NCAA Division I football team.
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Hoch JM, Lorete C, Legner J, Hoch MC. The Relationship Among 3 Generic Patient-Reported Outcome Instruments in Patients With Lower Extremity Health Conditions. J Athl Train 2019; 54:550-555. [PMID: 31084504 DOI: 10.4085/1062-6050-350-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Generic patient-reported outcome (PRO) instruments are designed to capture health-related quality-of-life outcomes and to determine treatment effectiveness from the patient's perspective. Multiple generic PROs are used in clinical practice, and an investigation of the psychometric properties of these instruments in a high-functioning, physically active population is important for the future use of these instruments. OBJECTIVE To determine the relationship among 3 generic PROs: the modified Disablement in the Physically Active (mDPA) Scale, the Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF), and the Short Form 12 (SF-12) in physically active patients seeking treatment for a lower extremity health condition. DESIGN Cross-sectional study. SETTING Athletic training clinical facility, physical therapy clinic. PATIENTS OR OTHER PARTICIPANTS One hundred patients seeking rehabilitation services for a lower extremity health condition. MAIN OUTCOME MEASURE(S) All patients completed a demographic questionnaire and the 3 generic PROs at 1 time point during their rehabilitation: the mDPA-Total, mDPA-physical summary component (mDPA-PSC), mDPA-mental summary component (mDPA-MSC), the PROMIS-PF, and SF-12 mental component summary (SF-MCS) and physical component summary (SF-PCS). Separate Spearman rank (r) correlations were performed to assess the strength of the relationship among PRO instruments. The floor and ceiling effects were also examined. RESULTS A strong relationship was present between the SF-12 PCS and the mDPA-Total (r = -0.65), the mDPA-PSC (r = -0.64), and the PROMIS-PF (r = 0.65). Significant moderate relationships were identified between the mDPA-MSC and the SF-12 PCS (r = -0.43) and MCS (r = -0.53). Weak relationships were noted between the mDPA-Total and SF-12 MCS (r = -0.21) and the SF-12 MCS and mDPA-PSC (r = -0.10) and PROMIS-PF (r = 0.20). CONCLUSIONS The PROMIS-PF and mDPA had good convergent and divergent validity. Clinicians treating physically active patients should consider these instruments for use in clinical practice. Future researchers should examine additional psychometric properties of these instruments in physically active patients.
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Affiliation(s)
| | | | - Jamie Legner
- Children's Hospital of the King's Daughters, Norfolk, VA
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Lam KC, Harrington KM, Cameron KL, Valier ARS. Use of Patient-Reported Outcome Measures in Athletic Training: Common Measures, Selection Considerations, and Practical Barriers. J Athl Train 2019; 54:449-458. [PMID: 30933607 DOI: 10.4085/1062-6050-108-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Current evidence suggests that a low percentage of athletic trainers (ATs) routinely use patient-reported outcome measures (PROMs). An understanding of the perceptions of ATs who use (AT-USE) and who do not use (AT-NON) PROMs as well as any differences due to demographic characteristics (eg, use for patient care or research, job setting, highest education level) may help facilitate the use of PROMs in athletic training. OBJECTIVE To describe commonly used PROMs by AT-USE, the criteria by which AT-USE select PROMs, and reasons for non-use by AT-NON. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS A convenience sample of 1784 ATs (response rate = 10.7% [1784/17972]; completion rate = 92.2% [1784/1935]) who worked in a variety of settings. MAIN OUTCOME MEASURE(S) Participants completed an anonymous electronic online survey. Descriptive statistics were used to describe commonly used PROMs, PROM selection criteria, and reasons for PROM non-use. RESULTS Participants were classified as AT-USE (n = 370, 20.7%) or AT-NON (n = 1414, 79.3%). For the AT-USE group, the most common type of PROMs used were specific (eg, region, joint; n = 328, 88.6%), followed by single-item (n = 258, 69.7%) and generic (n = 232, 62.7%). Overall, the PROMs most frequently endorsed by the AT-USE group were the Numeric Pain Rating Scale (n = 128, 34.6%); Lower Extremity Functional Scale (n = 108, 29.2%); Disability of the Arm, Shoulder and Hand (n = 96, 25.9%); Owestry Disability Index (n = 80, 21.6%); and Foot and Ankle Ability Measure (n = 78, 21.1%). The most important criteria reported by AT-USE for selecting PROMs were that the measure was valid and reliable, easy for patients to understand, and easy for clinicians to understand and interpret. Common reasons for non-use were that PROMs were too time consuming for the clinician, too time consuming for the patient, and more effort than they were worth. CONCLUSIONS The Numeric Pain Rating Scale; Lower Extremity Functional Scale; Disability of the Arm, Shoulder and Hand; Owestry Disability Index; and Foot and Ankle Ability Measure were the PROMs most commonly endorsed by AT-USE and should be considered for athletic training use. To further facilitate the use of PROMs in athletic training, future authors should identify strategies to address organizational and time-constraint obstacles. Interpretation of our study findings may require caution due to a relatively low response rate and because "routine use" was not operationalized.
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Affiliation(s)
- Kenneth C Lam
- Athletic Training Programs, Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
| | - Katie M Harrington
- Athletic Training Programs, Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
| | | | - Alison R Snyder Valier
- Athletic Training Programs, Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ.,School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa
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Baker RT, Burton D, Pickering MA, Start A. Confirmatory Factor Analysis of the Disablement in the Physically Active Scale and Preliminary Testing of Short-Form Versions: A Calibration and Validation Study. J Athl Train 2019; 54:302-318. [PMID: 30741563 DOI: 10.4085/1062-6050-355-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The Disablement in the Physically Active (DPA) scale is a patient-reported outcome instrument recommended for use in clinical practice and research. Analysis of the scale has indicated a need for further psychometric testing. OBJECTIVE To assess the model fit of the original DPA scale using a larger and more diverse sample and explore the potential for a short-form (SF) version. DESIGN Observational study. SETTING Twenty-four clinical settings. PATIENTS OR OTHER PARTICIPANTS Responses were randomly split into 2 samples: sample 1 (n = 690: 353 males, 330 females, and 7 not reported; mean age = 23.1 ± 9.3 years, age range = 11-75 years) and sample 2 (n = 690: 351 males, 337 females, and 2 not reported; mean age = 22.9 ± 9.3 years, age range = 8-74 years). Participants were physically active individuals who were healthy or experiencing acute, subacute, or persistent musculoskeletal injury. MAIN OUTCOME MEASURE(S) Confirmatory factor analysis was conducted to assess the factor structure of the original DPA scale. Exploratory factor, internal consistency, covariance modeling, correlational, and confirmatory factor analyses were conducted to assess potential DPA scale SFs. RESULTS The subdimensions of the disablement construct were highly correlated (≥0.89). The fit indices for the DPA scale approached recommended levels, but the first-order correlational values and second-order path coefficients provided evidence for multicollinearity, suggesting that clear distinctions between the disablement subdimensions cannot be made. An 8-item, 2-dimensional solution and a 10-item, 3-dimensional solution were extracted to produce SF versions. The DPA SF-8 was highly correlated (r = 0.94, P ≤ .001, R2 = 0.88) with the DPA scale, and the fit indices exceeded all of the strictest recommendations. The DPA SF-10 was highly correlated (r = 0.97, P ≤ .001, R2 = 0.94) with the DPA scale, and its fit indices values also exceeded the strictest recommendations. CONCLUSIONS The DPA SF-8 and SF-10 are psychometrically sound alternatives to the DPA scale.
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Coulombe BJ, Games KE, Eberman LE. The Use of Patient-Reported Outcome Measures: Secondary School Athletic Trainers' Perceptions, Practices, and Barriers. J Athl Train 2019; 54:142-151. [PMID: 30095304 PMCID: PMC6464306 DOI: 10.4085/1062-6050-86-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Incorporating patient-reported outcomes (PROs) into daily routine is essential for patient-centered clinical practice. Secondary school athletic trainers (ATs) may encounter unique barriers that limit their willingness to use PROs. OBJECTIVE To explore how secondary school ATs who were using PROs perceived their application, benefits, and problems compared with those who did not. DESIGN Cross-sectional study. SETTING Web-based survey. PATIENTS OR OTHER PARTICIPANTS A total of 2984 secondary school ATs received an e-mail invitation, and 322 completed the survey (response rate = 10.8%). Respondents were 43 ± 10 years old, with most indicating at least 11 years as a Board of Certification-certified AT (n = 276, 85.7%). MAIN OUTCOME MEASURE(S) The ATs were invited to complete a Web-based survey regarding the uses and benefits of and problems with PROs. Those using PROs in clinical practice were asked their criteria for selecting the measures, whereas those not using PROs were asked their reasons for not using them. Dependent variables were endorsements of uses and benefits of and problems with PROs. RESULTS The most commonly cited uses of PROs were determining treatment effectiveness (193/264, 73%) and demonstrating effectiveness to administration (174/264, 66%). Improving communication with the patient (267/296, 90%) and helping to direct the plan of care (256/297, 86%) were the most frequently endorsed benefits of PROs. Time to score and analyze (152/284, 53%) and time for patients to complete (134/284, 47%) PROs were the problems encountered most often. For ATs not using PROs (223/262, 85%), the most frequent reason was the lack of a support structure (102/219, 46%). For ATs using PROs (39/262, 15%), quick completion times (32/39, 82%) was the most common criterion used to select individual measures. CONCLUSIONS A majority of secondary school ATs recognized the benefits of PROs and yet did not use them in clinical practice due to setting-specific barriers.
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Affiliation(s)
| | - Kenneth E. Games
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute
| | - Lindsey E. Eberman
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute
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Hoch JM, Sinnott CW, Robinson KP, Perkins WO, Hartman JW. The Examination of Patient-Reported Outcomes and Postural Control Measures in Patients With and Without a History of ACL Reconstruction: A Case Control Study. J Sport Rehabil 2018; 27:170-6. [DOI: 10.1123/jsr.2016-0105] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Context: There is a lack of literature to support the diagnostic accuracy and cut-off scores of commonly used patient-reported outcome measures (PROMs) and clinician-oriented outcomes such as postural-control assessments (PCAs) when treating post-ACL reconstruction (ACLR) patients. These scores could help tailor treatments, enhance patient-centered care and may identify individuals in need of additional rehabilitation. Objective: To determine if differences in 4-PROMs and 3-PCAs exist between post-ACLR and healthy participants, and to determine the diagnostic accuracy and cut-off scores of these outcomes. Design: Case control. Setting: Laboratory. Participants: A total of 20 post-ACLR and 40 healthy control participants. Main Outcome Measures: The participants completed 4-PROMs (the Disablement in the Physically Active Scale [DPA], The Fear-Avoidance Belief Questionnaire [FABQ], the Knee Osteoarthritis Outcomes Score [KOOS] subscales, and the Tampa Scale of Kinesiophobia [TSK-11]) and 3-PCAs (the Balance Error Scoring System [BESS], the modified Star Excursion Balance Test [SEBT], and static balance on an instrumented force plate). Mann-Whitney U tests examined differences between groups. Receiver operating characteristic (ROC) curves were employed to determine sensitivity and specificity. The Area Under the Curve (AUC) was calculated to determine the diagnostic accuracy of each instrument. The Youdin Index was used to determine cut-off scores. Alpha was set a priori at P < 0.05. Results: There were significant differences between groups for all PROMs (P < 0.05). There were no differences in PCAs between groups. The cut-off scores should be interpreted with caution for some instruments, as the scores may not be clinically applicable. Conclusions: Post-ACLR participants have decreased self-reported function and health-related quality of life. The PROMs are capable of discriminating between groups. Clinicians should consider using the cut-off scores in clinical practice. Further use of the instruments to examine detriments after completion of standard rehabilitation may be warranted.
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Madsen LP, Evans TA, Snyder KR, Docherty CL. Patient-Reported Outcomes Measurement Information System Physical Function Item Bank, Version 1.0: Physical Function Assessment for Athletic Patient Populations. J Athl Train 2016; 51:727-732. [PMID: 27912040 DOI: 10.4085/1062-6050-51.11.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The Patient-Reported Outcomes Measurement Information System (PROMIS) item banks have been validated for general populations, but their application to high-functioning patient populations remains speculative. OBJECTIVE To examine the measurement properties of the PROMIS physical function item bank, version 1.0, when applied to individuals representing high levels of physical ability. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association Division I and III collegiate athletic training rooms and intramural events. PATIENTS OR OTHER PARTICIPANTS A heterogeneous sample of 215 adults from Division I or Division III collegiate or recreational sports volunteered for this study. Participants were divided into 4 groups depending on sport activity and injury status: healthy collegiate (HC; 33 men, 37 women; age = 19.7 ± 1.1 years), injured and currently active in sport (IP; 21 men, 29 women; age = 19.9 ± 1.2 years), injured and currently not active in sport (INP; 12 men, 18 women; age = 19.7 ± 1.3 years), and healthy recreational (HR; 47 men, 18 women; age = 20.1 ± 1.4 years). MAIN OUTCOME MEASURE(S) Participants completed 2 assessments: (1) an injury-history questionnaire and (2) the PROMIS physical function item bank, version 1.0, in computer-adaptive form. Mean PROMIS physical function scores were determined for each group. RESULTS The PROMIS physical function score for the HC group (61.7 ± 6.0) was higher than for the IP (54.9 ± 7.5) and INP (44.1 ± 8.2) groups (P < .001). The IP group had a higher score than the INP group (P < .001). Mean PROMIS scores were not different between the HC and HR participants (mean difference = 1.9, P = .10). CONCLUSIONS The computer-adaptive PROMIS physical function item bank, version 1.0, accurately distinguished injury status in elite-level athletes on a physical function latent trait continuum. Although it was unable to distinguish HC athletes from HR athletes, exposing a possible ceiling effect, it offers potential for use as an outcome instrument for athletic trainers and other sports medicine clinicians.
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