Transcultural adaptation and testing psychometric properties of the Korean version of the Foot and Ankle Outcome Score (FAOS)

This study was performed to translate and transculturally adapt the English version of the Foot and Ankle Outcome Score (FAOS) into a Korean version, and to test psychometric properties of the Korean FAOS in terms of internal consistency, test–retest reliability, convergent validity, and dimensionality. Translation and transcultural adaptation of FAOS into a Korean version was performed according to internationally recommended guidelines. Internal consistency (N?=?294) and test–retest reliability (N?=?21) were evaluated. Convergent validity was analyzed using correlation with pain visual analogue scale (VAS) score. All subscales, except for the quality of life (Q) subscale (Cronbach’s alpha, 0.615), showed satisfactory internal consistency (Cronbach’s alpha?>?0.7). Cronbach’s alpha of function in daily living (ADL) was highest (0.962), which might represent the redundancy of the items. All five subscales showed satisfactory reliability with ADL subscale showing the highest ICC (intraclass correlation coefficient; 0.851) and Q subscale the lowest ICC (0.718). Pain VAS score showed the highest correlation with pain (P) subscale of FAOS (r?=?0.675, p?<?0.001) and the lowest correlation with Q subscale (r?=?0.495, p?<?0.001). In the dimensionality test, a factor analysis was performed using the total items to rank their relative significance, which showed seven components solution. Considerable portion of the items showed a similar dimension according to their original subscales, except for ADL items. Translation and transcultural adaptation of FAOS into the Korean language was performed successfully. The items were understandable, and the subscales showed satisfactory test–retest reliability. Some minor revision might be needed to enhance the internal consistency of Q subscale and reduce the redundancy of ADL subscale.     

Foot and Ankle Kinematics in Rheumatoid Arthritis: Influence of Foot and Ankle Joint and Leg Tendon Pathologies

Objective

From early onset of the disease, patients with rheumatoid arthritis (RA) experience walking impairments. Pathologic effects of RA on foot and ankle structures have been studied clinically, but little is known as to how they relate to kinematic changes during gait. The aim of this study was to explore the relationship between clinically observed pathologies of foot and ankle joints and leg tendons and the corresponding gait kinematics.

Methods

The gait of 25 subjects with varying stages of RA was recorded and foot and ankle kinematics were assessed. Magnetic resonance imaging was performed for each subject: first metatarsophalangeal (MTP) joint, midfoot, and hindfoot synovitis, erosion scores, and leg tendon involvement were determined. The joint alignment and motion score represented daily clinical assessment. The 95% confidence intervals of the Spearman's correlation coefficient tests were used to explore the relationships between the clinical and kinematic parameters.

Results

Maximum first MTP joint dorsiflexion at preswing was related to reduced first MTP joint passive motion, first MTP joint synovitis and erosion, midfoot synovitis and erosion, and hindfoot erosion. Midfoot pronation range of motion during single stance was related to subtalar alignment and Achilles tendon involvement. Hindfoot eversion range of motion during single stance was related to subtalar alignment and peroneus longus tendon involvement. Involvement of the tibialis posterior tendon could not be identified as an independent factor influencing foot or ankle kinematics.

Conclusion

Our findings suggest moderate to strong relationships between foot and ankle gait kinematics and structural pathologies.     

Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy

Introduction A reliable and valid clinical tool to capture symptoms and signs of diabetic sensorimotor polyneuropathy (DSP) for use in clinical research trials is urgently needed. The validated Toronto Clinical Neuropathy Score (TCNS) was modified to improve sensitivity to early DSP changes. We aimed to assess the reproducibility of this modified tool, the mTCNS and to determine its validity relative to the precursor TCNS. Methods Sixty‐five patients (six Type 1, 59 Type 2 diabetes) with diabetes duration 13 ± 8 years were accrued from four study sites and examined on 2 days for internal consistency and inter‐ and intra‐rater reliability of the mTCNS. In the absence of a single quantitative gold‐standard measure for DSP, results of the mTCNS were compared with the precursor TCNS for the purpose of estimating validity. Results Internal consistency of the two domains within the mTCNS was good (Cronbach's alpha 0.78). Very good inter‐rater reliability for the mTCNS was demonstrated by an intra‐class correlation coefficient for the mTCNS of 0.87 (95% confidence interval, 0.79–0.91), which was similar in magnitude to that of the TCNS (0.83; 95% confidence interval, 0.75–0.89). Intra‐rater reliability testing of the mTCNS showed moderate to good correlation for individual symptoms and sensory tests (Cohen's kappa values of 0.54–0.73). The mTCNS shared moderate correlation with the precursor TCNS (Pearson correlation coefficient, 0.58). Discussion The mTCNS, a clinical score with higher face validity for tracking mild to moderate DSP, has sufficient reliability and validity relative to its precursor TCNS for use in clinical research.     

Reliability and validity: a quick review

The purpose of this article is to provide a brief review of reliability and validity testing. These concepts are important to researchers who are choosing techniques and/or developing tools that will be applied and evaluated in diabetes education practice. Several types of reliability and validity testing are defined, and an easy-to-use check sheet is provided for research purposes. Following testing for the basic aspects of reliability and validity such as face and construct validity, a tool may be appropriate for use in practice settings. Those conducting comprehensive outcomes evaluations, however, may desire additional validation such as testing for external validity. Diabetes educators can and should incorporate rigorous testing for these important aspects when conducting assessments of techniques and tools relating to diabetes self-management training.     

Gouty Involvement of Foot and Ankle: Beyond Flares

The foot and ankle are common locations of deposition of monosodium urate (MSU) crystals, as indicated by the clinical manifestations presented by patients with gout, which are not limited to the acute inflammation of the big toe. We present a narrative literature review aimed to update the gout involvement of foot and ankle and how it affects the quality of life. Cumulative reports indicate that gout, even at the non-tophaceous stage, could cause pain, gait impairment and limit the mobility at lower limbs. These patients may present difficulties in some activities of daily living such as choosing footwear, thus leading to an impaired quality of life. Gout is a curable disease by dissolving MSU crystals but remains unclear how this could modify some of these foot and ankle manifestations, especially when structural damage has already occurred. Furthermore, a collaboration between rheumatologists and podiatrists seems helpful to understand, relieve these symptoms and improve the quality of life in gouty patients.     

Evidence for reliability,validity and responsiveness of Turkish Foot and Ankle Ability Measure (FAAM)

Purpose

To translate and culturally adapt the Foot and Ankle Ability Measure (FAAM) into Turkish and assess the psychometric properties of the translated version.

Methods

The FAAM was translated into Turkish according to Beaton’s recommendations and it is called FAAM-T. Ninety-eight patients (39 males, mean ± SD age 35.0 ± 14.0 years; range 16–71 years) with different foot and ankle complaints were included, and the score was completed twice by each participant after 7 days of the first assessment to assess test–retest reliability based on the inter-rater correlation coefficient, whereas Cronbach’s alpha evaluated internal consistency. External validity was evaluated with correlations between the FAAM-T, Foot Function Index (FFI) and Short Form-36 (SF-36). The distribution of floor and ceiling effects was determined.

Results

The test–retest reliability was 0.90 for both FAAM-T subscales. Cronbach’s alpha coefficient was 0.95 and 0.91 for FAAM-T activity of daily living (ADL) and FAAM-T Sport subscales, respectively. The FAAM-T ADL and Sport subscales demonstrated very good correlation with the FFI (r = 0.70 and 0.63, respectively). The FAAM-T ADL and Sport subscales had a high level of association with physical functioning and the physical component scale (r = 0.71, r = 0.70 and r = 0.51, r = 0.55, respectively; P = 0.001) of the SF-36. The weakest associations were found between the FAAM-T ADL, FAAM-T Sport subscales and the SF-36 the vitality (r = 0.27, P = 0.008 and r = 0.28, P = 0.01, respectively).

Conclusions

The study provides preliminary evidence that the FAAM-T is reliable, valid and responsive outcome measurement of patients with foot and ankle pathologies.

     

Reliability and validity of adolescent self-reported drug use in a family-based study: a methodological report

Given the sensitive topic of drug abuse and the private nature of the family, researchers must overcome a number of methodological obstacles when studying drug abuse and the family. The purpose of this study was to determine whether adolescents would provide honest and accurate answers to drug use questions in the context of their homes with their families participating in the same survey. Although there is no direct objective validation of the self-report measures used in this study, evidence from the analysis of the survey data suggests that adolescent self-reports are, in most cases, reliable and valid, and that the setting in which respondents complete questionnaires does not, in general, result in systematic reporting bias.     

Reliability and validity of a steadiness score

OBJECTIVES: To determine the internal consistency and construct and predictive validity of three survey questions regarding steadiness in a sample of community-dwelling lower-income older adults. DESIGN: A 6-month prospective cohort study. SETTING: Community-based. PARTICIPANTS: Three hundred fifty-seven older adults who completed a baseline and 6-month follow-up interviewer-administered survey. These older adults received care at a single, public health system and were judged by insurance status to be of low income. MEASUREMENTS: Self-report measures of steadiness while walking and transferring; difficulty in mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs); chronic illness; falls; hospitalization; and sociodemographic characteristics. RESULTS: The three steadiness questions showed good internal consistency (0.88); construct validity in Pearson correlations with mobility (0.57), ADL (0.53), and IADL scores (0.41); and predictive validity. With regard to predictive validity, steadiness was predictive of falls, hospitalization, and decline in ADL and IADL function over a subsequent 6-month period. CONCLUSION: Steadiness questions are a potentially valuable addition to survey research and clinical screening to identify persons with current impairment status and falls and disability risk.     

Chinese adaptation and validation of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with knee osteoarthritis

Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used instrument to assess the symptoms and functional status in people with knee injuries, including knee osteoarthritis. While China ranked the top country in the absolute number of people aged 65 or above, yet there is no validated Chinese version of this outcome measurement. This study translated and validated the KOOS into Chinese version. Chinese KOOS was translated from the original English version following standard forward and backward translation procedures recommended by the International Society for Pharmacoeconomics and Outcomes Research. Survey was then conducted in clinical settings by a questionnaire comprised Chinese KOOS, WOMAC Osteoarthritis Index, and Short Form 36 health survey (SF-36). One hundred Chinese reading patients with knee osteoarthritis were recruited from the orthopaedic out-patient department in hospitals. Internal consistency of the instrument was measured by Cronbach alpha. Construct validity was examined by Spearman’s rank correlation coefficient (ρ) tests by comparing its score with the validated Chinese version of WOMAC Osteoarthritis Index and SF-36, while the test–retest reliability was evaluated by administering the questionnaires twice. Cronbach alpha values of individual questions and its overall value were above 0.70. Fairly strong association was found between the Chinese KOOS and the WOMAC Osteoarthritis Index (ρ = ?0.37 to ?0.86, p < 0.001). Diverse relationship was observed between Chinese KOOS and SF-36. Excellent test–retest reliability (ICC = 0.89–0.92) was demonstrated. The Chinese translated version of KOOS is a reliable and valid instrument for patients with knee osteoarthritis. The findings of current study might promote multinational investigations in this patient group.     

Cross-cultural adaptation and validation of the reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS)

HOOS was developed as an extension of the Western Ontario and McMaster Universities’ Osteoarthritis Index questionnaire for measuring symptoms and functional limitations related to the hip(s) of patients with osteoarthritis. To determine the validity and reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS) vis-à-vis hip osteoarthritis, the original HOOS was translated into a Thai version of HOOS, according to international recommendations. Patients with hip osteoarthritis (n = 57; 25 males) were asked to complete the Thai version of HOOS twice: once then again after a 3-week interval. The test–retest reliability was analyzed using the intraclass correlation coefficient (ICC). Internal consistencies were analyzed using Cronbach’s alpha, while the construct validity was tested by comparing the Thai HOOS with the Thai modified SF-36 and calculating the Spearman’s rank correlation coefficients. The Thai HOOS produced good reliability (i.e., the ICC was greater than 0.9 in all five subscales). All of the Cronbach’s alpha showed that the Thai HOOS had high internal consistency (Cronbach’s alpha greater than 0.8), especially for the pain and ADL subscales (0.89 and 0.90, respectively). The Spearman’s rank correlation for all five subscales of the Thai HOOS had moderate correlation with the Bodily Pain subscale of the Thai SF-36. The pain subscale of the Thai HOOS had a high correlation with the Vitality and Social Function subscales of the Thai SF-36 (r = 0.55 and 0.54)—with which the symptom subscale had a moderate correlation. The Thai version of HOOS had excellent internal consistency, excellent test–retest reliability, and good construct validity. It can be used as a reliable tool for assessing quality of life for patients with hip osteoarthritis in Thailand.     

The validity and reliability of the Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis

The goal of our study was to develop a Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis (RA) and to assess its reliability, validity, and sensitivity to change. The Turkish version of RAOS was developed according to cross-cultural guidelines by using the “translation–back translation” method. Fifty-eight patients with RA were assessed with it. To assess its validity, patients were also evaluated with Turkish versions of the Health Assessment Questionnaire, five subscales of Arthritis Impact Measurement Scales, and the Rheumatoid Arthritis Quality of Life questionnaire. Test–retest reliability of the RAOS questionnaire was calculated on 58 patients within 1 week. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. Sensitivity to change after the 4-week home-based exercise program was evaluated with paired t test comparisons. The Turkish version of the RAOS met set criteria of reliability and validity. The random ICC for the five subscales ranged from 0.76 to 0.94. Interitem correlation measured by Cronbach’s alpha ranged from 0.81 to 0.94. Correlations were found between RAOS subscales and all of the evaluation parameters (p < 0.01). RAOS subscales showed significant improvements after the 4-week home exercise program except for the symptom and quality of life subscales (p < 0.05). The effect sizes were ranged from 0.20 to 0.37 and were considered small. The results of this study showed that the Turkish version of RAOS was reliable, valid, and responsive in patients with rheumatoid arthritis.