Reliability and validity of the Turkish version of ABILHAND-Kids’ questionnaire in a group of patients with neuromuscular disorders

This study was performed to examine the reliability and validity of the Turkish version of ABILHAND-Kids questionnaire which assesses manual functions of children with neuromuscular diseases (NMDs). A cross sectional survey study design and Rasch analysis were used to assess the reliability and validity of the Turkish version of scale. Ninety-three children with different neuromuscular disorders and their parents were included in the study. The scale was applied to the parents with face-to-face interview twice; on their first visit and after an interval of 15 days. The test–retest reliability was assessed with intraclass correlation coefficient (ICC), and internal consistency of the multi-item subscales by calculating Cronbach alpha values. Brooke Upper Extremity Functional Classification (BUEFC) and Wee-Functional Independency Measurement (Wee-FIM) were correlated to determine the construct validity. The ICC value for the test/retest reliability was 0.94. The internal consistency was 0.81. Floor (1.1%) and ceiling (11.8%) effects were not significant. There were moderate correlations between the Turkish version of ABILHAND-Kids and Wee-FIM (0.67) and BUEFC (?0.37). Rasch analysis indicated good item ?t, unidimensionality, and model ?t. The Turkish version of ABILHAND-Kids questionnaire was found to be a reliable and valid scale for the assessment of the manual ability of children with NMDs.     

Application of arthroscope and postoperative functional exercises in diagnosis and treatment of knee joint diseases

1Subjectandmethod1.1SubjectAcohortof78patients(aged12to77averaged43,33maleand45female)wereinvolved.23leftkneesand56rightkneeswereincluded.Inthesedisease,therewere26kneeswithhy-pertrophicarthritis,48kneeswithmeniscusinjury,3kneeswithsynoviumplicasyndrome,4kneeswithrheumatoidarthritis,2kneeswithinjuryofanteriorcruciateligament,1kneewithinjuryofpos-teriorcruciateligament,2kneeswithgoutarthritis,and2kneeswithotherdiseases(suchascongenitalanomaly).1.2MethodWehaveappliedarthroscopetoexaminewoundkne…     

Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?

Background and Purpose. Two of the most utilized outcome measures to assess knee joint range of motion (ROM) and intra‐articular effusion are goniometry and circumference, respectively. Neither goniometry nor circumference of the knee joint have been examined for both intra‐tester and inter‐tester in patients with total knee arthroplasty (TKA). The purpose of this study was to determine the intra‐tester and inter‐tester reliability of active and passive knee joint ROM and circumference in patients with TKA when administered by physiotherapists (testers) with different clinical experience. Method. The design was an intra‐tester, inter‐tester and intra‐day reliability study. Nineteen outpatients (10 females) having received a TKA were examined by an inexperienced and an experienced physiotherapist. Following a standardized protocol, active and passive knee joint ROM and circumference measurements were obtained using a universal goniometer and a tape measure, respectively. To establish reliability, intraclass correlation coefficients (ICC_2,1) and smallest real difference (SRD) were calculated. Results. The knee joint ROM and circumference measurements were generally reliable (ICC > 0.8) within and between physiotherapists (except passive knee extension). Changes in knee joint ROM of more than 6.6° and 10° (except active knee flexion) and knee joint circumference of more than 1.0 cm and 1.63 cm represent a real clinical improvement (SRD) or deterioration for a single individual within and between physiotherapists, respectively. Generally, the experienced tester recorded larger knee joint ROM and lower circumference values than that of the inexperienced tester. Conclusions. In clinical practice, we suggest that repeated knee goniometric and circumferential measurements should be recorded by the same physiotherapist in individual patients with TKA. Tester experience appears not to influence the degree of reliability. Copyright © 2009 John Wiley & Sons, Ltd.     

Individuals’ experience of living with osteoarthritis of the knee and perceptions of total knee arthroplasty

This study investigated the physical and psychosocial consequences of living with osteoarthritis (OA) in daily life and peoples’ views of total knee arthroplasty (TKA) and the role of physiotherapy. In-depth interview data were used from a prospective qualitative study conducted by the senior author (KY). Participants were 15 volunteers with knee OA who were awaiting TKA at a specialized orthopaedic tertiary care facility in Toronto. A modified grounded theory method approach was used to analyze the interview data. The findings showed that experiences for the participants with OA were conceptualized as a “breakpoint.” The breakpoint was centred on the experiences/processes of living with unremitting pain, the limitations of mobility, leisure and social activities, and the resulting consequences to the participant's physical and psychological well-being. In addition to the above experiences, participants also discussed their perceptions of TKA surgery. The findings showed that expectations of TKA were linked to participants’ knowledge of the procedure and its outcomes. The participants listed acquaintances, friends, family members, and doctors as the main sources of knowledge for TKA. On the basis of the above analysis, recommendations are made for developing a preoperative physiotherapy program that would focus on minimizing preoperative disability and maximizing postoperative recovery.     

Impact of postoperative functional exercise on recovery of knee joint followin g knee arthroscopic meniscectomy

INTRODUCTIONItiswellknownthatsemilunarplateiscapableofconductingload，absorbingconcussion，stablilizingkneejoit．Semilunarplatecanconduct４０％－６０％ofload，increasecontactarea，andreducepressureenduredbycartilageofkneejoint．MATERIALSANDMETHODSMaterialsFromJune１９９６toDecember２０００，７８patientswitharthroscopeconfirmedsemilunarplateinjuryandundergonemeniscectomyun－derkneearthroscopeparticipatedourstudy．Thesepatientsincluded３０menand４８womenaged１２－５８years（meanage…     

Recovery after functional exercises following arthroscopic debridement of knee joint in elderly persons with osteoarthritis of knee joint

INTRODUCTIONInrecentyears,arthroscopehasbecomeanewapproachfortreatmentofosteoarthritisofkneejoint.Weobtainedfavorableeffectofarthroscopicarticulardebridementinpatientswithbonyarthropathyofkneejoint.MATERIALSANDMETHODSMaterials104elderlypatientswithosteoarthritisofkneejointreceivedarthro-scopicdebridementfromJune1993toJune1998.Thesepatientsin-cluded41menand63women,agingfrom48-82years(meanage:61.3years).47hadlesioninleftknee,55inrightknee,2hadbilaterallesions,total106affectedknees.…     

Effect of functional exercises on spinal function recovery after thoracic and lumbar fracture operation

MATERIALSANDMETHODSMaterials26casesofthoracicandlumbarvertebrafractureaccompaniedwithspineinjurywereselectedsince1990,with18malesand8females,agerangingfrom18to56years(average38years).Injuryfactors:therewere12caseswithfallingout,8caseswithtrafficinjury,6caseswithcrashinjury.Injurysegment:therewere4casesinT11,8casesinT12,6casesinL1,4casesinL2,2casesinL3and2casesinL4.Spineinjury:AccordingtoFrankelStandard:Therewere10casesofAclass,6casesofBclass,4casesofCclass,5casesofDclassand1caseof…     

Postoperative function exercises promoting restoring of knee joint after old fracture of patella

BACKGROUND：Themainaimfortreatmentoffractureofpatellaistorestorecontinuityofkneejointextensionapparatusandanatomicreductionofkneejoint，avoidoccurrenceoftrau－maticarthritis．Problemsintreatmentofoldcomminutedfractureofpatellaarethesamewithfreshfracturethathasbeenagreedoninrecentyears．Exceptseriouscomminutedfractureofpatellacan＇tbereserved，removalofpatellashouldn＇tbeperformedtoothers．OrthopaedicsHospitalofShenyangcitythinksthattheidealmethodisrelaxofkneeextensionapparatus，reductiono…     

Reliability,validity and description of timed performance of the Jebsen–Taylor Test in patients with muscular dystrophies

Background

The Jebsen–Taylor Test evaluates upper limb function by measuring timed performance on everyday activities. The test is used to assess and monitor the progression of patients with Parkinson disease, cerebral palsy, stroke and brain injury.

Reliability,validity, and norms of the 2-min walk test in children with and without neuromuscular disorders aged 6–12

Purpose: The 2-min walk test may be more appropriate functional exercise test for young children. This study aimed to examine the 2-min walk test’s reliability; validity; and minimal clinically important difference; and to establish norms for children aged 6–12.

Methods: Sixty-one healthy children were recruited to examine the 2-min walk test’s reliability. Forty-six children with neuromuscular disorders (63% cerebral palsy) were recruited to test the validity. The normative study involved 716 healthy children without neuromuscular disorders (male?=?51%, female?=?49%). They walked at a self-selected speed for 2?min along a smooth, flat path 15 m in length.

Results: The mean distance covered in the 2-min walk test was 152.8 m (SD?=27.5). No significant difference was found in the children’s test-retest results (p?>?0.05). The intra- and inter-rater reliability were high (all intra-class correlation coefficients >0.8). All children, except one with neuromuscular disorders, completed the 2-min walk test, of which the minimal clinically important difference at 95% confidence interval was 23.2 m for the entire group, 15.7 m for children walking with aids, and 16.6 m for those walking independently.

Conclusions: The 2-min walk test is a feasible, reliable, and valid exercise test for children with and without neuromuscular disorders aged 6–12. The first normative references and minimal clinically important difference for children with neuromuscular disorders were established for children of this age group.

• Implications for rehabilitation

• The 2-min walk test is a feasible, safe, reliable, and valid time-based walk test for children aged 6–12 years.

• Normative references have been established for healthy children aged 6–12 years.

• Minimal clinically important difference at 95% confidence interval were calculated for children with neuromuscular disorders who walked without aids (i.e., independent and stand-by supervision) and those who walked with aids equal to 16.6 and 15.7 m, respectively.

• Distance covered by the healthy children in the 2?min did not correlate with age, gender, height, and weight of the children.

     

Genetics of arterial structure and function: towards new biomarkers for aortic stiffness?

Cardiovascular disease is the leading cause of death worldwide and premature arterial stiffening is a key contributor to this risk. A large body of evidence now points to arterial stiffness as an independent predictor of cardiovascular events. Stiffness can be assessed by a number of indices and is itself affected by factors including mean arterial pressure, vascular smooth muscle tone and structural elements in the vessel wall, such as elastin and collagen. In addition, aging, hypertension, diabetes and hypercholesterolaemia all exacerbate the stiffening process. Stiffness is highly heritable but, despite a clear genetic basis, the precise molecular pathways regulating stiffness are poorly understood. The present review provides an overview of the current literature and examines the evidence that links genetic factors to arterial wall properties. Although the findings support stiffness as a complex genetic trait, the precise nature of the genes contributing to this are still largely unknown. There are a number of candidate genes and many of these could potentially affect the structure and function of the arterial wall. Indeed, it is likely that genes involving signalling pathways and control of the vessel wall matrix will be as important as those involved in the renin-angiotensin system, adrenergic and other vasoactive systems. Identifying the genes involved is important, since it may suggest new biomarkers as well as provide novel drug targets to reduce arterial stiffness. Current pharmacological intervention is simply to reduce blood pressure, but there are emerging therapies; for example, targeted at breaking collagen cross-links or preventing their formation, which are promising new strategies to reduce arterial stiffness and its associated cardiovascular risk.     

Relationship between quality of training programs and internists’ subsequent practice performance

The influence of the quality of physicians’ medical school and residency training programs on subsequent practice performance has not been explored in depth. In this study, program directors and medical educators rated a large number of medical schools and residency programs based on their perceptions of the quality of each program's faculty, curriculum, program graduates, and national reputation. Performance of graduates of these programs was compared from among practicing board‐certified internists in three states who volunteered to undergo assessment. Methods to evaluate physician‐subjects included written evaluations of the subjects completed by professional associates and a written examination to measure medical knowledge and clinical decision making. The perceived quality of residency training programs was found to be weakly related to the physicians’ performance, as assessed by these measures. Differences were found in examination performance and in ratings by peer physicians of selected clinical skills, humanistic qualities, and communication skills. Perceived quality of medical schools did not appear in these analyses to be related to practice performance.