Validity and reliability of the Persian version of the PRAFAB questionnaire in Iranian women with urinary incontinence

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) is a common disorder in women that can affect a person's quality of life. There are several instruments to assess the severity of urinary incontinence. One of the common tools is the Protection, Amount, Frequency, Adjustment, Body image (PRAFAB) questionnaire. Therefore, this study was performed with the aim of assessing the validity and reliability of the Persian version of the PRAFAB questionnaire.

METHODS

First, the English version of the questionnaire was translated into Persian. Second, the psychometric properties of the Persian version were collected in 60 women with urinary incontinence referred to Al-Zahra Hospital by an expert team. Content validity (CV) was evaluated through CV index (CVI) and CV ratio (CVR). Construct validity was evaluated using exploratory factor analysis and reproducibility was tested based on test-retest reliability using intraclass correlation coefficient (ICC). Internal consistency was calculated using Cronbach's α.

RESULTS

The results showed acceptable CVI in relevancy, clarity, and simplicity, acceptable CVR for all items, good internal consistency (Cronbach's alpha = 0.738) and excellent repeatability (ICC = 0.98).

CONCLUSION

The Persian version of the PRAFAB questionnaire has acceptable validity and reliability and in future it can be used as a suitable evaluation instrument to assess urinary incontinence in Iranian women.

Psychometric Properties of the Persian Version of Cystic Fibrosis Questionnaire: Revised in Children with Cystic Fibrosis

Background

Cystic fibrosis is a progressive, fatal disease affecting the quality of life. The cystic fibrosis questionnaire-revised (CFQ-R) is an efficient tool to monitor health-related quality of life in patients. The aim of this study was to explore the psychometric properties of the child and parent versions of the Persian version of the CFQ-R in the Iranian population.

Methods

Fifty children with cystic fibrosis (6-11 years) and their parents were allocated in this methodological study to examine convergent validity, discriminant validity, test-retest reliability (n = 30), internal consistency, ceiling and floor effects, and agreement between two versions of the CFQ-R.

Results

Convergent validity was confirmed for parent proxy (P < 0.05). CFQ-R discriminated patients among stages of disease severity based on lung function, age, and BMI (P < 0.05). Test-retest analysis revealed good to excellent reliability (inter-class correlation coefficient (ICC) = 0.78-0.97). In most domains, lower quality of life scores was obtained in the parent proxy compared to the child version (P < 0.05). Domain-specific correlations were found between the child version and parent proxy (P < 0.05). Internal consistency was generally confirmed (α = 0.13-0.83 in child version and α = 0.25-0.87 in parent proxy). There were no floor effects. Ceiling effects were mostly seen for physical, digestion, and body image domains in the child version and for eating, weight, and school domains in the parent proxy.

Conclusions

The child version and parent proxy of the Persian CFQ-R are valid and reliable measures and can be applied in clinical trials to monitor the quality of life in children with cystic fibrosis. It is recommended to use both versions in conjunction to better interpret the quality of life aspects of children with cystic fibrosis.

Feasibility of the basic movements of Azeri dance in the balance and posture of a person with Parkinson's disease: ABA single-subject design

Background/aims

Basic movements of Azeri dance as an intervention may have an impact on the physical and mental status of people with Parkinson's disease. The aim of this study was to assess the feasibility and efficacy of basic movements of Azeri dance on the balance and static posture of a person with Parkinson's disease. The effects of basic movements of Azeri dance on quality of life, quality of sleep and the performance in activities of daily living were reported before and after the intervention.

Methods

In this single-subject experimental ABA design, a 64-year-old man with a 4-year history of Parkinson's disease was selected. The outcome measures consisted of the Functional Reach Test, Timed Up and Go Test, qualitative static posture analysis, Short Form Health Survey, Modified Barthel Index and Pittsburgh Sleep Quality Index.

Results

An increasing trend in balance from the initial baseline stage through to the end of the intervention stage was found. Static posture analysis showed that the patient's posture improved qualitatively. His quality of life score changed after the intervention; however, his sleep quality and activites of daily living scores did not change.

Conclusions

Basic movements of Azeri dance are useful in the rehabilitation of patients with Parkinson's disease who have balance issues and postural instability, but further research is warranted.

Evaluation of a Persian version of the Adelaide driving self-efficacy scale among Iranian older adults

OBJECTIVE

Our aim in the present study was to estimate the psychometric properties of the full-length Adelaide driving self-efficacy scale (ADSES) for use among community-based resident older adults in Tehran, Iran.

METHODS

We recruited older adults (60+ years) from various sampling units nested in the Tehran district's general urban population (20 subjects/questionnaire-item). The questionnaire was translated and back-translated by using recommended pathways. Multiple forms of validity and reliability, including Cronbach alpha, were estimated. Also, we measured intra-class correlation coefficient, and did confirmatory factor analysis (CFA).

RESULTS

A total of 243 participants (mean age: 65.8, 95%CI 65.4-66.3) met our inclusion criteria. For ADSES, the alpha coefficient was 0.77, the intraclass correlation coefficient was 0.97 (95% CI: 0.95-0.98), and the average item-test correlation was 0.67. Upon CFA, we found a 0.95 comparative fit index, a coefficient of determination = 92.6%, and standardized size of the residual = 0.04.

CONCLUSION

Our Persian language ADSES was found to have adequate validity and factor structure parameters for evaluating driving self-efficacy among community-based older adults in a non-western context. Our questionnaire is an essential first step toward evaluating driving self-efficacy among older adults, especially where no such tool is available, to help develop driving self-efficacy as a healthy aging measure.

The relationship between the sensory processing and occupational motor skills of children with autism spectrum disorder

Background/Aims

Motor skills difficulties may affect participation and communication in children with autism. Sensory processing problems are well-known problems in children with autism, so sensory processing could be important to predicate motor skills. The aim of this study was to examine the relationship between sensory processing and occupational motor skills and the ability to predict motor skill performances using sensory abilities.

Methods

A total of 31 children with autism participated in the study. The Sensory Profile questionnaire and Short Child Occupational Profile tool were used to assess the sensory ability and occupational motor skills of the children (boys=90.3%; mean age=5.45 years ± 1.73 years). The backward method of correlation coefficient analysis, multiple linear regression analysis, and multiple regressions were used for statistical analysis.

Results

There was a significant relationship between occupational motor skills and sensory processing capabilities of children. The regression prediction equation was statistically significant in all sections of sensory processing except for oral processing (F (6.24)=4.46, P=0.004), with a value of R2=0.527 and R2Adj=0.409. Modelling motor skills based on sensory processing capabilities of children showed that the regression prediction equation was statistically significant (F (2.28) =11.87, P<0.001); with the value of R2=0.459 and R2Adj=0.420. In the final model, the factors of auditory processing and multi-sensory were found effective in children's motor skills (P<0.05).

Conclusions

Sensory processing is related to occupational motor skills and can help to predict occupational motor skill issues of children with autism spectrum disorder. This could be helpful to develop appropriate treatments to improve the functional motor skills of children with autism.

Handwriting status among Iranian primary school students: a cross-sectional study

Background/Aims

Handwriting difficulties among school students are the primary reason for referral to school-based occupational therapy. Appropriate criteria and a complete view of the students' handwriting status are lacking in Iran. The purpose of this study was to gather comprehensive information about handwriting issues for therapists and related disciplines in Iran.

Methods

In this cross-sectional study, the handwriting status of 1262 Persian-language elementary school students (grades 2 and 3) from governmental schools was surveyed using the Persian handwriting assessment tool.

Results

There were statistically significant differences in handwriting components between second and third grade students except for word size and text slant. Handwriting components were different between boys and girls, and between right- and left-handed writers. Regression analysis revealed a positive relationships between age and grade and most of the handwriting components.

Conclusions

The results of this study have implications for teachers, therapists and other specialists who work and research on handwriting status of typically healthy students and students who are disabled in Iran. Handwriting skills improve over time and it seems that girls and right-handed writers are better writers regarding legibility.

The Persian Handwriting Assessment Tool for Primary School-Aged Children: Further Validation

Background

Handwriting problems are one of the common problems among students in the early years of education. The current study aimed to determine further validation aspects of the Persian Handwriting Assessment Tool (PHAT) in primary school-aged children.

Methods

The current methodological study was conducted on 452 healthy 8-10-year-old students in Tehran, Iran, selected via random cluster sampling method. Inclusion criteria were native Persian-speaking and no documented physical and mental impairments. Construct and structural validities were established by exploratory factor analysis (EFA) using principal axis factoring with Promax rotation and confirmatory factor analysis (CFA), respectively. Criterion validity was examined by expert opinion as the gold standard using Pearson correlation test. Internal consistency, test-retest, and inter-rater reliability were examined using Cronbach's alpha and intra-class correlation (ICC). Test-retest had a seven-day interval.

Results

The EFA results indicated two separate factors in the copying and dictation domains. Speed and orthographic error and size were considered as separate items. The CFA confirmed the factor structure. Criterion validity revealed low to moderate correlation (formation: 0.548, P<0.001; 0.503, P<0.001, spacing: 0.553, P<0.001; 0.307, P=0.030, alignment: 0.442, P<0.001; 0.358, P=0.011, size: -0.376, P=0.007; -0.445, P<0.001, and slant: 0.360, P=0.010; 0.372, P=0.008) in copying and dictation domain, respectively. Acceptable internal consistency (Cronbach's alpha: 0.72-0.99), excellent test-retest (ICC: 0.76-0.99), excellent inter-rater reliability between teachers (ICC: 0.86-0.95), and good to excellent inter-rater reliability between teachers and the occupational therapist (ICC: 0.60-0.95) were reported.

Conclusion

The results indicated that the PHAT was a valid and reliable tool for assessing handwriting in primary school-aged children.

Occupational performance status and reliability of the Canadian Occupational Performance Measure in children with cystic fibrosis

Background/Aims

Cystic fibrosis affects the respiratory system and may interfere with an individual's occupational performance. This study intended to evaluate the reliability of the Canadian Occupational Performance Measure in children with cystic fibrosis and to compare the occupational performance of children with cystic fibrosis to that of healthy participants.

Methods

A total of 21 children with cystic fibrosis were included in the reliability and comparison phases of this study and 30 healthy children were recruited for the comparison phase. The Canadian Occupational Performance Measure was used to collect data on occupational performance and satisfaction. Intraclass correlation coefficients and standard error measurements were obtained to evaluate the reliability of the Canadian Occupational Performance Measure. An independent t-test was used to compare the occupational performance of the two groups.

Results

The test–retest reliability using a 7-day interval was 0.86–0.87 (standard error: 1.79–1.91). The agreement between therapists' scores for inter-rater reliability ranged from 0.87 to 0.90 (standard error: 1.44–1.68). There was a significant difference in performance subscale scores between children with cystic fibrosis and healthy children (P<0.05). There was no significant between-group difference in satisfaction scores.

Conclusions

The Canadian Occupational Performance Measure is a reliable tool for evaluating the occupational performance of children with cystic fibrosis. Cystic fibrosis directly and indirectly affects occupational performance. Children with cystic fibrosis and their parents may require help and education in the performance and organisation of activities and occupations.

Occupational performance coaching: goal barriers and beneficial facilitators

Background/aims

Occupational performance coaching is a family-centred approach that helps mothers who have children with occupational performance challenges. This study sought to identify the barriers and facilitators to goal achievement and engagement with occupational performance coaching based on the experiences of mothers of children with cerebral palsy who were receiving occupational performance coaching.

Methods

This qualitative study was embedded within a randomised control trial. Twelve mothers of children with cerebral palsy who had received occupational performance coaching were interviewed using a semi-structured interview technique. Their responses were analysed using inductive content analysis.

Results

The most important barriers to goal achievement and engagement with coaching were societal, family-related and mother-related factors. The facilitators were new resources, family cohesion, mother-related factors and child-related factors.

Conclusions

Different factors can affect the outcomes of occupational performance coaching based on the viewpoint of mothers of children with cerebral palsy. Occupational therapists should consider societal, family and individual factors when using this intervention with clients.

Occupational performance in mothers of children with cerebral palsy

Background/Aims

Caring for children with cerebral palsy may affect different domains in the caregiver's life. This study aimed to compare the occupational performance of mothers of a child who has cerebral palsy with mothers of a typically developing child.

Methods

A total of 41 mothers with a child who has cerebral palsy and 45 mothers with a typically developing child were recruited in this cross-sectional study. The age-matched mothers had only one child. The Canadian Occupational Performance Measure was used to collect data on the occupational performance and satisfaction of mothers.

Findings

There was a statistically significant between-group difference in maternal occupational performance and occupational satisfaction (P<0.05), with mothers of children with cerebral palsy reporting lower scores for both. There were no relationships between demographic variables and the occupational performance and satisfaction of mothers with a child with cerebral palsy (P>0.05). The age of children with cerebral palsy had a direct positive relationship with the mothers' level of occupational satisfaction (P<0.05).

Conclusion

Mothers who take care of a child with cerebral palsy face significant reductions in occupational performance and satisfaction compared to mothers with a typically developing child, and therefore may need help and education in performing and organising their daily activities and roles.

Effectiveness of cognitive orientation to (daily) occupational performance (CO-OP) on children with cerebral palsy: A mixed design

BACKGROUND

Cerebral palsy (CP) is the most common cause of physical disabilities during childhood. Therapeutic interventions mainly focus on impairment reduction to address motor-based difficulties. In contrast, Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive approach, providing intervention at the level of activity and participation.

AIMS

This study aims to determine whether the CO-OP approach improves motor skills and achievement in motor-based occupational performance goals in children with CP.

METHODS AND PROCEDURES

In this mixed design research (i.e., a multiple baseline single case experimental design and a one-group pretest-posttest design), five children with CP participated in 12 CO-OP intervention sessions. Repeated measures of motor skills for the multiple baseline single case experimental design were taken using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); pre- and post-measures of parent/child perception of performance and satisfaction were identified using the Canadian Occupational Performance Measure (COPM); level of achievement was identified using Goal Attainment Scaling (GAS).

OUTCOMES AND RESULTS

According to the BOTMP results, all children were able to engage in the CO-OP intervention to improve motor performance. Significant differences after treatment were found in both performance and performance satisfaction ratings using the COPM as rated by parents and children. The GAS results showed progress in achievement levels for all children; all goals were achieved or exceeded.

CONCLUSIONS AND IMPLICATIONS

CO-OP intervention can be helpful in improving motor skills and achieving self-identified, motor-based goals in children with CP.

Dexterity and two-point discrimination of the hand in school-aged children with dysgraphia

Background: Dysgraphia as a problem with handwriting, affects student's performance in school activities and participation. The purpose of the study was to compare dexterity and two-point discrimination of the hand between learning disabled students with dysgraphia and healthy students. Methods: Forty-three students with developmental dysgraphia and 55 normal students in grade two to four from special and regular schools participated in this study. Hand dexterity and static/dynamic discriminative touch were assessed via Purdue Pegboard and Two-Point Discriminator respectively. Results: Significant differences were found in Purdue Pegboard scores between two groups except in doing the test with the left hand (p<0.05). Purdue Pegboard scores were significantly lower in left-handed children with dysgraphia compared to healthy children (p<0.05). There was no significant difference in dynamic two point discrimination between two groups of children (p>0.05). Static two-point discrimination of the thumb finger was significantly higher in children with dysgraphia (p<0.05). Conclusion: Hand dexterity affects handwriting performance in children with dysgraphia. There were no correlations between two-point discrimination and Purdue Pegboard scores of children with dysgraphia. Intervention should focus on other aspects of dexterity rather than sensory components. Hand dominancy also may be a factor influencing hand performance in dysgraphia.

Effect of eccentric exercise-induced muscle damage on electromyographyic activity of quadriceps in untrained healthy females

BACKGROUND

The aim of this study was to investigate muscle damage indicators and electromyography activities of quadriceps muscles at 25° of hip flexion in untrained healthy females after an eccentric exercise induced muscle fiber damage.

METHODS

A total of 14 healthy females participated in this pre-experimental study. The subjects performed maximal eccentric quadriceps contractions at 25˚ of hip flexion. Maximum voluntary extensor isometric and concentric moments, angle of maximum moment for concentric contractions, perceived pain intensity, and pain pressure threshold were examined before, immediately, 48 hours, 120 hours and 14 days after eccentric exercise. Additionally, electromyography of three parts of quadriceps muscle, knee flexion range of motion and thigh circumference were measured before and after eccentric exercise.

RESULTS

Significant reductions in maximum isometric moment and maximum concentric moment were observed at angular velocity of 60˚ per sec immediately after eccentric exercise (p<0.05). Both maximum isometric moment and maximum concentric moment recovered to the baseline 48 hours after eccentric exercise. Increased pain intensity and decreased knee joint range of motion manifested 48 hours after eccentric exercise. Pain pressure threshold for the quadriceps was higher 14 days after exercise as compared to 48 and 120 hours (p<0.05). No significant changes observed in electromyography and thigh circumference (p>0.05).

CONCLUSION

Eccentric exercise performed at 25˚ of hip flexion resulted in muscle fiber injuries within the quadriceps muscle. However, electromyography of quadriceps muscle was not significantly different than the baseline. The result indicates that hip joint position may modify the effect of eccentric exercise on muscle activation.