Effect of a lifestyle-integrated functional exercise (LiFE) group intervention (sLiFE) to falls prevention in non-institutionalized older adults. Protocol of a randomised clinical trial

Introduction

Personalized programs of integrated strength and balance activities have been shown their effectiveness in falls reduction in the older adults.

Objective

To measure whether a group intervention with the strength and balance principles of the sLiFE program is more effective than standard health advice in reducing the incidence of falls.

Methods

The study will comprise 650 participants with more than 65 years who live at home, observing established inclusion and exclusion criteria. Participants will be randomly assigned in two groups: group intervention (n = 325) and standard health advice (n = 325). The intervention group will follow the balance and strength activities described in the LiFE program manual. The group intervention will be carried out in groups of 12-14 and will consist of seven one-hour sessions over 12 weeks in health centres. Incidence of falls and quality of life will be assessed as primary outcome variables. Fear of falling and exercise adherence will be analysed as secondary outcome variables.

Discussion

Physical activity has been put forward as an effective treatment technique for these patients; however, long-term adherence to these programs remains a challenge. Group interventions could reduce dropout rates.

Conclusion

Falls represent a major health problem globally due to the disability they cause in older people. Prevention would help reduce not only their incidence but also the health costs derived from their treatment. Group intervention helps clinicians to save resources and time, being able to attend more people with the same quality of care.

Clinical trial registration

https://clinicaltrials.gov/study/NCT05912088?distance=50&term=NCT05912088&rank=1, identifier NCT05912088.

Synergy of Muscle and Cortical Activation through Vojta Reflex Locomotion Therapy in Young Healthy Adults: A Pilot Randomized Controlled Trial

BACKGROUND

Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography.

METHODS

A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy.

RESULTS

In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period.

CONCLUSIONS

The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy's potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.

Therapeutic Exercise Intervention Using Vibration Platforms for Glycemic Control in Type 2 Diabetes: A Pilot Study

Diabetes generates a great impact on society, as well as a concern for health professionals due to its high and increasing prevalence; there are several studies that demonstrate the effectiveness of vibration platforms and their benefits at a physiological level. The aim of this study will be to analyze the decrease in glycosylated hemoglobin and glycemia levels after the use of whole-body vibration platforms and the possible inclusion of this therapeutic option within the usual treatments. This is a double-blind, randomized controlled trial with parallel group design in a 1:1 ratio. The sample will be composed of people diagnosed with type 2 diabetes mellitus in in the Plasencia area (Cáceres, Extremadura). Participants will be randomly assigned to the intervention or control group using a randomization list and will follow the inclusion criteria: type 2 diabetics between 50 and 60 years of age and not taking diabetes medication. All participants will undergo a determination of glycosylated hemoglobin, blood pressure, lipid profile, weight and height, and different functional tests such as Time Up and Go, 10 Meters Walk Test, and 5 Sit To Stand. The experimental group will perform a whole-body vibration intervention on an oscillating platform for 12 weeks with a weekly frequency of three nonconsecutive days and a duration of 12 min. The exercises will consist of 60 s of work and 60 s with rest. The control group will carry out their normal life insisting on the importance of glycemic controls before and after their daily physical exercise. This study has been registered at clinical.trial.org, ID: NCT05968222. Whole-body vibration platforms have demonstrated their effectiveness in different pathologies such as stroke, fibromyalgia, sclerosis multiple, or Parkinson's. For that reason, an improvement in glycemic and lipid values and body composition are expected in people with diabetes after a whole-body vibration intervention for 12 weeks' duration. In addition, whole-body vibration platforms could be postulated as an alternative to usual treatments.

Validity of the telematic Fugl Meyer assessment scale - upper extremity (TFMA-UE) Spanish version

Background

Telematic assistance has become indispensable in recent years. The increased prevalence of Acquired brain injury and the sequels it causes, requires long-lasting multidisciplinary treatments. Validated tools to assess the evolution of the disabilities and limitations of this pathology are essential to individualize and prescribe adapted treatments. The aim has been to create the telematic version of the Fugl Meyer Assessment-Upper Extremity Motor Function (TFMA-UE) Spanish scale and its adaptation to the remote assessment of neurologic patients.

Methods

An adapted scale was designed based on the Fugl Meyer Assessment scale-telematic version (FMA-TV): TFMA-UE. This scale is composed by 21 items which evaluate the upper extremity motor function. Physiotherapists trained in this tool, evaluate the results obtained from applying the two versions (on-site and telematic) to compare the results.

Results

TFMA-UE was administered to 30 patients with acquired brain injury. It was applied on site and through the web platform selected by the patients in two different days. Patients completed all the scale in an easily way without help. The exploratory and confirmatory factor analysis confirmed a factorial structure with a factor (76.08% of the variance). The Cronbach's internal consistency index obtained was 0.98 and the weight kappa index used to measure agreement between the two versions was 0.78 which represents substantial agreement.

Conclusion

The Telematic Fugl Meyer Assessment-Upper Extremity Motor Function (TFMA-UE) scale is a viable, useful and easy to apply tool that allows the upper extremity motor function assessment of Acquired Brain Injury patients.

Optokinetic stimulation effects in the management of unilateral spatial neglect in patients with chronic stroke: study protocol for a randomised controlled trial

INTRODUCTION

Unilateral spatial neglect (USN) is a stroke complication of stroke. Optokinetic stimulation (OKS) is one of the treatments, but its effects on motor symptoms, such as poverty or alterations in movements on the affected side, are not clear yet. The aim of this study will be to evaluate the OKS effects on the perceptual and postural complications of patients with USN.

METHODS AND ANALYSIS

Randomised double-blinded clinical trial, with an intervention group that will undergo OKS and a control placebo group. The research will take place at the Faculty of Nursing and Physiotherapy, University of Salamanca, 102 patients older than 18 years with diagnosed USN will participate. The intervention group will receive 2 weekly OKS session for 10 weeks. Virtual reality glasses will be used for the application of a video. The video will project OKS at a preset speed and will request the participant's attention throughout the session. The control group will receive a placebo treatment, through a virtual reality video. The measurement variables will be posturography, Fluff test, line bisection, Fullerton Advance Balance Scale and Diller's cancellation test.

ETHICS AND DISSEMINATION

This study has been approved by the Ethics Committee University of Salamanca on February 2020 (registration number: 584). All patients in the study will be informed about the objective of the study and will give their written informed consent to participate in the study. The anonymised database will be available from the publication of the results for 10 years in the repository of the University of Salamanca GREDOS (https://gredos.usal.es/). The trial results will be shared with the scientific community at international conferences and by publication in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT04663646.

Activation Capacity of the Intrinsic Musculature of the Foot in Handball Athletes with Chronic Ankle Instability

Chronic ankle instability (CAI) is a common pathology in handball. The role of the intrinsic musculature of the foot in these players in relation to proprioception and stability has not been stablished. The objective of this study was to compare the ultrasound morphology of the heel fat pad of the foot in professional handball players to CAI in healthy players and establish relationships between CAI and physical and psychological variables. The study has been a descriptive observational case-control study in which 20 professional handball male players over 18 years of age were divided into 8 cases (CAI) and 12 controls (healthy). An ultrasound evaluation, the thickness and/or cross-sectional area at rest and the contraction measurement of the Abductor Digiti Minimi, Abductor Hallucis, Flexor Digitorum Brevis and Quadratus Plantae muscles were analyzed. Moreover, the compressibility index of the heel fat pad and the activation of the abdominal wall musculature (ultrasound), the flexion strength of the hallux and lesser toes (dynamometry), the foot functionality (Bristol Foot Score (BFS) questionnaire) and the psychological variables (self-reported questionnaires) were measured. There were no significant differences between the activation capacity values of the foot muscles of healthy and CAI athletes. Significant differences were found between groups regarding the BFS score (p = 0.007), d = 1.404), and significant correlations were also found between hallux flexion strength and lesser toes flexion strength in the total sample. Although there were no differences between the two groups, the identification of the activation pattern of these muscles in handball athletes is essential to the improvement of performance and preventing injuries such as CAI.

Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial

Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18-43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann-Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort.

Musculoskeletal Injuries and Risk Factors in Spanish CrossFit® Practitioners

CrossFit^® Training is a physical and sports-conditioning system based on constantly varied functional movements performed at high intensity. CrossFit^® has been shown to significantly improve general physical performance and body composition. Although there seems to be an association between the practice of CrossFit^® and musculoskeletal injuries, the relationship between CrossFit^® and injury risks has been poorly studied. The main objective of this study was to establish the relationship between CrossFit^® and musculoskeletal injuries. Secondary objectives were the analysis of various risk factors and injury and the comparison of the incidence of CrossFit^® injuries to that of other sports. An online questionnaire was distributed to gyms affiliated with CrossFit^®, Inc. in the Principality of Asturias, Spain in order to carry out a retrospective transversal descriptive study. The frequency of injuries in CrossFit^® is similar to most sports. Injuries are often minor and of short duration, with the shoulder being the most affected joint complex.

Reliability and Validity of the 10-Meter Walk Test (10MWT) in Adolescents and Young Adults with Down Syndrome

People with Down syndrome (DS) have gait deficits because motor milestones are usually reached later. Decreased gait speed or reduced stride length are some of the main deficits. The main objective of the present work was to assess the reliability of the 10-Meter Walk Test (10MWT) in adolescents and young adults with DS. The objective has been to analyze the construct validity of the 10MWT with the Timed up and go (TUG) test. A total of 33 participants with DS were included. Reliability was verified by intraclass correlation coefficient (ICC). The agreement was analyzed by the Bland-Altman method. Finally, construct validity was evaluated through Pearson correlation coefficient. The 10MWT intra-rater and inter-rater reliability were good (ICC between 0.76 until 0.9) and excellent (ICC > 0.9), respectively. The minimal detectable change for intra-rater reliability was 0.188 m/s. Also, it has demonstrated moderate construct validity (r > 0.5) considering the TUG test. The 10MWT has shown high intra- and inter-rater reliability and validity in adolescent and adults with SD and a moderate construct validity between TUG test and 10MWT.

Quality of Life and Side Effects Management in Cancer Treatment-A Cross Sectional Study

Cancer disease is a world problem which is increasing in its prevalence. Oncology patients have a multitude of symptoms derived from the treatments and from the disease itself that affect their quality of life to a greater or lesser extent. The aim of this study has been to discover the physical and psychological symptoms related to chemotherapy treatment in Spanish cancer patients in order to improve their quality of life. Symptoms from the previous week were taken into account and the Memorial Symptom Assessment Scale was used to measure the frequency, severity and associated distress of 32 symptoms. A total of 246 chemotherapy patients at the University Day Hospital in Salamanca completed the scale once while receiving chemotherapy treatment. A 95% confidence interval was considered. The most prevalent symptoms were a lack of energy (76.4%), anxiety (66.7%) and a dry mouth (60.6%). Lung cancer was the most prevalent cancer in men (26%) and breast cancer was the most prevalent cancer in women (72%). There is no consensus on which is the most prevalent symptom in this population and more studies will need to be carried out to determine the best treatment protocols. Symptom's prevalence knowledge could improve the patients' care to prevent or avoid complications and to improve the cancer patients' quality of life.

Effects of a Family Caregiver Care Programme in Musculoskeletal Pain and Disability in the Shoulder-Neck Region-A Randomised Clinical Trial

Life expectancy in Spain has increased and older people need more health care to improve their quality of life. The high demands of the population sometimes collapse health services, making them insufficient to cover their needs, which leads to the development of “non-professional caregivers”. These caregivers have suffered musculoskeletal injuries of the cervical spine and shoulders and should be guided and assessed on ergonomics, biomechanics, or kinesiotherapy. However, there are no interventions to help them care for themselves. This study presents the application of a physical exercise programme to prevent these disorders in women caregivers of dependent patients. It consists of a randomised controlled clinical trial with two groups: both received a family caregiver care programme, and the intervention group also received a physical therapeutic exercise programme for 12 weeks. A total of 62 caregivers completed the study, who were mostly daughters or wives of dependents. Of these, 70.97% presented a “moderate” pain intensity and a cervical disability of 13.72 ± 7.64 points in the NDI questionnaire in the initial evaluation. In the intervention group of caregivers, there was a significant decrease in the pain intensity and a significant increase (p < 0.05) in all cervical joint amplitude movements. Caregivers present a high prevalence of musculoskeletal disorders. The physical exercise programme was effective in reducing the intensity of pain, lumbar disability, and cervical disability of the family caregivers.

Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed an active approach for dealing with it. Objectives: To determine and characterize musculoskeletal pain in female family caregivers (FFCs) and assess the effects of adding a therapeutic exercise program to a family caregiver care program (FCCP) on the quality of life, physical conditions, and psychological well-being of FFCs. Methods: A multicenter randomized controlled clinical trial was conducted with 68 FFCs recruited in two public healthcare areas. The intervention and control groups received the same conventional FCCP for 6 h across 4 sessions. The intervention group received an additional 36 sessions of physical therapeutic exercise (PTE) program over 12 weeks. Results: All caregivers reported having pain in particular locations. Lower back pain and neck pain were the locations most frequently cited, with a prevalence of 69.4% and 56.7%, respectively. In total, 80% of participants presented moderate pain intensity. The intervention group showed a significant decrease in the intensity of the pain (p < 0.001), as well as in anxiety, depression, subjective burden perception (p < 0.01), and quality-of-life variables, including MCS (mental component summary) (p < 0.05) and PCS (physical component summary) (p < 0.001). Conclusions: A PTE program improved the musculoskeletal pain of FFCs in a clinically relevant way. The caregivers who improved the most were those who initially presented the most intense pain, had the greatest levels of disability, and had the lowest quality of life.

The Effect of Combining Transcranial Direct Current Stimulation Treatment and an Exercise Program on Fragility in a Population with Multiple Sclerosis: Cross-Over Design Trial

BACKGROUND

The relationship between fragility and neurological diseases is extensive and affects many patients with multiple sclerosis (MS), whose risk factors are related to fragility.

OBJECTIVE

To study the effects of exercise and transcranial direct current stimulation (tDCS) in MS patients with fatigue from four dimensions: functional mobility, balance, fatigue, and depression.

METHODS

A total of 12 patients who belonged to two associations of people with physical disabilities participated. Functional mobility, depression, balance, and fatigue were assessed before and after the intervention. Transcranial direct current stimulation and the exercise program were carried out over a 4-week period with a wash-out period of 5 months.

RESULTS

After the application of tDCS, we found significant improvements in balance (p < 0.05, g = 0.632), depression (p < 0.05, g = 0.402), functional mobility (p < 0.05, g = 0.297), and fatigue (p < 0.05, g = 0.526). After the exercise program, significant improvements were shown in balance (p < 0.01, g = 0.418), depression (p < 0.001, g = 0.540), functional mobility (p < 0.01, g = 0.262), and fatigue (p < 0.01, g = 0.742). Two-way mixed-measures ANOVA showed that all variables improved in both groups, with significant differences over time but not between groups. Secondary analysis showed significant correlations between balance and functional mobility (r = 0.671, p = 0.017), depression and fatigue (r = 0.586, p = 0.044) and between intensity of rehabilitation and balance (r = 0.622, p = 0.031).

CONCLUSION

Participating in an exercise program and receiving tDCS separately improved the variables of depression, balance, mobility, and fatigue.

Validation of the Spanish Versions of FACIT-PAL and FACIT-PAL-14 in Palliative Patients

Palliative patients require several types of care to improve their quality of life as much as possible, and valid and reliable assessment instruments are essential. The objective of this study is the Spanish validation of the Functional Assessment Chronic Illness Therapy-Palliative Care (FACIT-PAL) and its abbreviated version, FACIT-PAL-14, in palliative care patients. FACIT-PAL and FACIT-PAL-14 were translated into Spanish and administered to 131 terminal oncology patients in home palliative care units, hospital palliative care units, health center teams, and social health centers. The European Organization for Research and Treatment of Cancer questionnaire, EORTC-QLQ-C15-PAL version, was used to evaluate the criterion validity. The EORTC-QLQ-C15-PAL was employed as a "gold standard", and it obtained significant results with FACIT scales. FACIT-PAL-14, FACIT-PAL, and its subscales reported high internal consistency, from 0.640 to 0.816. The exploratory factor analysis for FACIT-PAL-14 found a structure in three factors that explained the 70.10% variance, and the FACIT-PAL scale found a structure of five factors. Physical wellbeing from FACIT-PAL highly correlated to the EORTC-QLQ-C15-PAL (r = 0.700), but social and family wellbeing was correlated to a lesser extent (r = -0.323). FACIT-PAL and the TOI (Toi Outcome Index) were also highly correlated with the EORTC-QLQ-C15-PAL, with values of r = -0.708 and r = -0.709, respectively. The Spanish versions of FACIT-PAL and FACIT-PAL-14 were demonstrated to be valid and reliable scales in palliative care patients.

Electromyographic Response of the Abdominal Muscles and Stabilizers of the Trunk to Reflex Locomotion Therapy (RLT). A Preliminary Study

Reflex locomotion therapy (RLT) was developed by Vaclav Vojta in 1954 as a diagnostic and treatment tool. This therapy is mainly used to rehabilitate children with motor disorders and risk of cerebral palsy. It is also used for adults with neurological and motor impairment. RLT is based on specific postures and regular stimulation points through which a series of reflex responses are triggered. The neurophysiological mechanisms of this therapy have recently been discovered. This study aims to objectively evaluate muscular responses at the abdominal level after stimulation in the first phase of reflex rolling by showing, with surface electromyography analysis (sEMG), the muscular activity in trunk stabilizing muscles (rectus abdominis, external oblique, internal oblique, and serratus anterior) before, during, and after the application of RLT. A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-STI condition. Regarding muscular electrical activity, statistically significant differences were determined in all muscles during right-sided stimulation in the VSTI condition (p < 0.001), but not in the non-STI condition. The mean increase in muscle activity in the VSTI condition during the first stimulation ranged from 7% to 20% in the different abdominal muscles. In conclusion, an sEMG response was observed in the abdominal muscles during stimulation of the pectoral area as described in RLT, compared to stimulation of non-described areas.

Kinesiotape effectiveness in mechanical low back pain: A randomized clinical trial

BACKGROUND: Low back pain (LBP) is the most common musculoskeletal disorder work-related health problem in Europe, affecting millions of workers. It is estimated that 60–80% of the population will suffer at least one episode of mechanical LBP during their life. OBJECTIVE: To evaluate the kinesiotape (KT) effectiveness in mechanical LBP. METHODS: This was a double blinded, randomized-controlled clinical trial. Twenty-eight nursing and cleaning auxiliaries from Salamanca received a manual therapy program and a bandage of KT or false kinesiotape (FKT). They received two sessions a week for three weeks and a follow-up one month after the last session. Pain, range of motion and function were measured at baseline, at the end of each session and a month after the last session. RESULTS: Work-related musculoskeletal disorders and LBP are responsible for a high prevalence of sick-leave and absenteeism. Manual therapy and KT has demonstrated to reduce pain and to increase range of motion and function being effective in this population. There are statistically significant results in both groups in all measurements for all variables. KT seems to be superior, however, both have a positive effect on LBP. Although benefits decrease, long-term treatments focusing on pain alleviation and functional recovery is needed to maintain the benefits achieved. CONCLUSION: KT was an effective complement for this treatment. Although both show improvements, KT is recommended. Future studies are needed to demonstrate KT properties, to establish a treatment protocol to prevent chronic LBP and to avoid sick leave and absenteeism.

Sedentary Behaviour and Its Relationship with Early Vascular Ageing in the General Spanish Population: A Cross-Sectional Study

Sedentary behaviour is associated with a greater predisposition to developing cardiovascular diseases. The aim of the study was to analyse the relationship between sedentary time and early vascular ageing. A total of 501 participants (49.70% men) were recruited through random sampling stratified by age group and sex. Vascular ageing was evaluated considering three criteria: (1) the vascular ageing index (VAI); (2) the carotid−femoral pulse wave velocity (cfPWV) 10th and 90th percentiles of the reference values in the European population by age; and (3) the Framingham’s heart age. The carotid intima−media thickness was measured using a Sonosite Micromaxx ultrasound, the presence of peripheral artery disease was assessed by calculating the ankle−brachial index using a VaSera VS-1500, and the cfPWV was measured with a SphygmoCor® device. Weekly sedentary hours were evaluated through a sitting time questionnaire. The average age of the population was 55.90 ± 14.24 years. The men spent more hours sitting per week (47.6 ± 16.6 vs. 36.8 ± 17.3 h/W), at work (16.7 ± 16.2 vs. 9.73 ± 14.9 h/W), and watching TV (21.6 ± 12.5 vs. 18.7 ± 11.9 h/W). In the logistic regression analysis, the individuals with early vascular aging (EVA), with respect to those with healthy vascular aging (HVA), spent more hours sitting per week (OR = 1.03 vs. OR = 1.02; p < 0.05) and watching TV (OR = 1.03 vs. OR = 1.03; p < 0.05), using the criteria of the European guideline and VAI, and more hours sitting when commuting (OR = 1.04; p < 0.05), using Framingham’s heart age to define EVA. The results of this study indicate that sedentary time is associated with early vascular ageing. Therefore, reducing sedentary time would improve vascular health.

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents]

INTRODUCTION

Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability.

PATIENTS AND METHODS

The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociacion de Dano Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes.

RESULTS

All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance.

CONCLUSION

The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.

Construct Validity of the Spanish Versions of the Memorial Symptom Assessment Scale Short Form and Condensed Form: Rasch Analysis of Responses in Oncology Outpatients

CONTEXT

The Memorial Symptom Assessment Scale (MSAS) is a self-rating instrument for the assessment of symptom distress in cancer patients. The Spanish version of the MSAS has recently been validated. However, we lack evidence of the internal construct validity of the shorter versions (short form [MSAS-SF] and condensed form [CMSAS]). In addition, rigorous testing of these scales with modern psychometric methods is needed.

OBJECTIVES

The aim of this study was to evaluate the internal construct validity and reliability of the Spanish versions of the MSAS-SF and CMSAS in oncology outpatients using Rasch analysis.

METHODS

Data from a convenience sample of oncology outpatients receiving chemotherapy (n = 306; mean age 60 years; 63% women) at a university hospital were analyzed. The Rasch unidimensional measurement model was used to examine response category functioning, item hierarchy, targeting, unidimensionality, reliability, and differential item functioning by age, gender, and marital status.

RESULTS

The response category structure of the symptom distress items was improved by collapsing two categories. The scales were adequately targeted to the study patients, showed overall Rasch model fit (mean Infit MnSq ranged from 0.98 to 1.05), met criteria for unidimensionality, and the reliability of scores was good (person reliability > 0.80), except for the CMSAS prevalence scale. Only four items showed differential item functioning.

CONCLUSION

The present study demonstrated that the Spanish versions of the MSAS-SF and CMSAS have adequate psychometric properties to evaluate symptom distress in oncology outpatients. Additional studies of the CMSAS are recommended.