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.     

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.

     

Reliability and validity of the Functional Assessment of Chronic Illness Therapy–Spiritual (FACIT–Sp) for Japanese patients with cancer

The reliability and validity of the Japanese version of the Functional Assessment of Chronic Illness Therapy–Spiritual (FACIT–Sp) scale were assessed. This scale was developed in the United States to assess quality of life (QOL) in relation to spirituality. Two surveys were conducted on each of 306 cancer patients. In addition to the FACIT–Sp, the Hospital Anxiety and Depression Scale (HADS) was administered. Cronbachs alpha reliability coefficient, an evaluation of internal consistency, for the FACIT–Sp subscales ranged from 0.81 to 0.91. There were no significant differences between the patients evaluated using the FACIT–Sp subscale and the HADS subscale with regard to degree of religious feelings. The correlation coefficients between the FACIT–Sp and the HADS depression and anxiety scales indicated a moderate correlation. These findings suggest that the Japanese version of the FACIT–Sp scale is satisfactory in terms of reliability and validity and is a useful tool in the study of spirituality among Japanese cancer patients.     

Test–Retest Reliability and Responsiveness of the Computerized Adaptive Test of Social Functioning in Persons With Stroke

ObjectiveTo examine the test–retest reliability, minimal detectable change (MDC), responsiveness, and efficiency of the Computerized Adaptive Test of Social Functioning (Social-CAT) in patients with stroke.DesignRepeated-assessments design.SettingA department of rehabilitation of a medical center.ParticipantsIn total, 31 patients with chronic stroke and 65 patients with subacute stroke were recruited.InterventionNot available.Main Outcome MeasureSocial-CAT.ResultsThe Social-CAT showed acceptable test–retest reliability (intraclass correlation coefficient, 0.80) and small random measurement error (MDC%: 18.0%). However, heteroscedasticity was found (r between the means and the absolute change scores: 0.32), so the MDC% adjusted cut-off score is recommended for determining real improvement. Regarding responsiveness, the Social-CAT showed large differences (Kazis’ effect size and standardized mean response: 1.15 and 1.09, respectively) in subacute patients. Regarding efficiency, the Social-CAT required an average of 5 items and less than 2 minutes for completion.ConclusionsOur findings indicate that the Social-CAT is a reliable and efficient measure with good test–retest reliability, small random measurement error, and good responsiveness. Thus, the Social-CAT is a useful outcome measure for routine monitoring of the changes in social function of patients with stroke.     

Reliability and validity of the Falls Efficacy Scale-International after hip fracture in patients aged ≥65 years

Abstract

Purpose: To assess the measurement properties of the Falls Efficacy Scale-International (FES-I) in patients after a hip fracture aged ≥ 65 years. Methods: In a sample of 100 patients, we examined the structural validity, internal consistency and construct validity. For the structural validity a confirmatory factor analysis was carried out. For construct validity predetermined hypotheses were tested. In a second sample of 21 older patients the inter-rater reliability was evaluated. Results: The factor analysis yielded strong evidence that the FES-I is uni-dimensional in patients with a hip fracture; the Cronbach’s alpha was 0.94. When testing the reliability, the intra-class correlation coefficient was 0.72, while the Standard Error of Measurement was 6.4 and the Smallest Detectable Change was 17.7 (on a scale from 16 to 64). The Spearman correlation of the FES-I with the one-item fear of falling instrument was high (r?=?0.68). The correlation was moderate with instruments measuring functional performance constructs and low with instruments measuring psychological constructs. Conclusions: Reliability and structural validity of the FES-I in patients after a hip fracture are good. The construct validity appears more closely related to functional performance constructs than to psychological constructs, suggesting that the concept measured by the FES-I may not capture all aspects of fear of falling.

• Implications for Rehabilitation

• The Falls Efficacy Scale-International (FES-I), which is commonly used to measure fear of falling in community-dwelling older persons, can also be used to assess fear of falling in patients after a hip fracture.

• The reliability and the structural validity of the FES-I for these hip patients are good, whereas the construct validity of the FES-I is not optimal.

• The FES-I may not capture all aspects of fear of falling and may be more closely related to functional performance than to psychological concepts such as anxiety.

     

Reliability and validity of the Chinese version of the Readiness for Hospital Discharge Scale–Parent Form in parents of preterm infants

BackgroundThe Readiness for Hospital Discharge Scale (RHDS)−Parent Form shows satisfactory reliability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Western countries. However, the reliability and validity of this instrument has not been evaluated in Chinese populations.ObjectivesEvaluate the psychometric features of the RHDS−Parent Form among Chinese parents of preterm infants.MethodsThe RHDS−Parent Form was translated into a Chinese version following an international instrument translation guideline. A total of 168 parents with preterm infants were recruited from the neonatal intensive care units of two tertiary-level hospitals in China. The internal consistency of this measure was assessed using the Cronbach's α coefficient; confirmatory factor analysis was conducted to evaluate the construct validity; and Pearson correlation coefficient was used to report the convergent validity.ResultsThe Chinese version of RHDS (C-RHDS)−Parent Form included 22 items with 4 subscales, accounting for 56.71% of the total variance. The C-RHDS−Parent Form and its subscales showed good reliability (Cronbach's α values 0.78–0.92). This measure and its subscales showed positive correlations with the score of Quality of Discharge Teaching Scale.ConclusionThe factor structure of C-RHDS−Parent Form is partially consistent with the original English version. Future studies are needed to explore the factors within this measure before it is widely used in Chinese clinical care settings.     

Construct and criterion validity of the DUFS and DEFS⁴ in Lithuanian patients with coronary artery disease

Background Fatigue has become an important symptom in clinical diagnosis and clinical trials among subjects with cardiovascular diseases and disease‐specific fatigue scales were developed in a Dutch and English version. Objective Various questionnaires for measuring fatigue have been developed, but currently no validated questionnaire targeted at subjects with cardiovascular disease and heart failure exists in the Lithuanian language. Methods Despite the rigor of the exploratory factor analysis and analyses of the psychometric properties of the disease‐specific Dutch Fatigue Scale and the Dutch Exertion Fatigue Scale (DUFS–DEFS) we adopted a confirmatory approach considered as the gold standard method for the evaluation of construct validity in psychometric inventories. To test the criterion validity of the DUFS and DEFS structural equation modelling was employed with the widely used and validated Multidimensional Fatigue Inventory (MFI). Results The a priori specification of a hypothesized five‐factor model of the MFI‐20 and a two‐factor model of the DUFS and DEFS appeared to have a good fit to the data in Lithuanian patients. The hypothesized model of the criterion validity of the DUFS and DEFS had a good fit and classes of disease severity showed statistically significant and clinically relevant differences on fatigue scores. Conclusion The construct validity and criterion validity of the DUFS and DEFS were confirmed in a Lithuanian sample of cardiac patients. The construct validity of the MFI was also supported and this fatigue measure can be used in Lithuanian settings of clinical practice and research.     

Effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia

Objective To explore the effects of acupuncture and balance facilitation of muscular tension on the early rehabilitatio n of patients with stroke and hemiplegia.Methods Divided the 96 patients with acute stroke hemiplegia into group A and Brandomly(group B as control) Evaluate the rehabilitation before and after therapy,and deal with the data in statistics.The courses are 26 t 28 days.In group A.stab negative channel and points of upper limb as well as positive channel and points of lower limb of paralysis side in flaccid paralysis tage,After the muscular tension resumed,stab positive points of upper limb and negative points of lower limb,and try to recover the balance of muscular tension,and avoid muscular spasm to establish normal moving pattern,Results Compared with control group,group A hac prominent difference on the process of musculwar tension resuming.Incidence rate of muscular spasm,the ration of reeducing of neurologic impairment scores and increasing of motor function integral(FMA),MBI of the ability of daily life(ALD)as well as index of quality of life(QLI),P&;lt;0.01, Conclusion A cuppuncture and balance facillitation of muscular tension are useful in the early rehabilitation in hemiplegia.     

The Modified – Modified Schober Test for range of motion assessment of lumbar flexion in patients with low back pain: A study of criterion validity,intra- and inter-rater reliability and minimum metrically detectable change

Purpose.?The objective was to estimate the psychometric properties of the Modified?–?Modified Schober Test (MMST).

Design.?This study compared range of motion measurements of lumbar flexion in low back pain (LBP) patients using the MMST with measurements calculated on X-rays as the gold standard, and compared the measurements taken by two independent examiners.

Method.?This study was conducted at the main hospital in the Outaouais area, Quebéc, Canada. Thirty-one subjects with LBP from private and public clinics participated in the study. After a warm-up session, measurements with the MMST were taken in neutral position and an X-ray technician took an exposure in the same position.

Results.?Pearson's correlation test (r) between measurements made with the MMST and the gold standard, intra-class correlation coefficient (ICC), minimum metrically detectable change (MMDC) and confidence interval (CI) were used to analyze the data. The MMST demonstrated moderate validity (r?=?0.67; 95%CI 0.44?–?0.84), excellent reliability (intra: ICC?=?0.95; 95%CI 0.89?–?0.97; inter: ICC?=?0.91; 95%CI 0.83?–?0.96) and a MMDC of 1?cm.

Conclusions.?In our sample of LBP patients, the MMST showed moderate validity but excellent reliability and MMDC.     

Reliability,validity and clinical utility of three types of pain behavioural observation scales for young children with burns aged 0–5 years

Pain measurement is a prerequisite for individualized pain management and research into pain interventions. There is a need for reliable and valid pain measures for young children with burns. The aim of this study was to investigate whether the pain observation scale for young children (POCIS), the COMFORT behaviour scale (COMFORT-B) and the nurse observational visual analogue scale (VAS obs) are reliable, valid and clinically useful instruments to measure pain in children with burns aged 0–5 years. Participating trained nurses (N = 102) rated pain of 154 children during hospitalization. Two trained nurses simultaneously assessed pain at fixed intervals by using the previous mentioned measures. Cronbach’s alpha for POCIS was .87 for background and .89 for procedural pain. Intraclass Correlation Coefficients (ICCs) were .75 for background and .81 for procedural pain. COMFORT-B observations yielded Cronbach’s alpha of .77 for background and .86 for procedural pain and ICCs of .83 for background and .82 for procedural pain. The VAS obs resulted in ICCs of .55 for background and .60 for procedural pain. Correlation coefficient between POCIS and COMFORT-B was .79 (p < .01), Standardized response mean was 1.04 for both POCIS and COMFORT-B. Background pain measured with POCIS and COMFORT-B was lower than procedural pain (p < .001). Nurses found POCIS easier and quicker to use, but COMFORT-B was found to indicate pain more accurately. Both POCIS and COMFORT-B are reliable, valid and practical scales for pain measurement in young children with burns and can be used in practice and research. The VAS obs was found to be unreliable.     

Test–retest reliability of Antonovsky’s 13-item sense of coherence scale in patients with hand-related disorders

Purpose: To report on the distribution and test-retest reliability of Antonovsky’s 13-item Sense of Coherence (SOC-13) Scale in patients with hand-related disorders (HRD). Links between the SOC-13 score and factors such as age, number of days between date of injury and start of rehabilitation, gender and educational level were explored.

Method: Survey with test–retest, using self-administered questionnaire. SOC-13 was completed before starting rehabilitation at an outpatient clinic after 14 days and three months. Adult patients with HRD were included.

Results: A total of 170 participants completed the SOC-13 at baseline (median SOC 71, range 30–91). The Intra-class Correlation Coefficient between baseline and 14 days was 0.84 (n?=?151), and baseline and three months was 0.79 (n?=?113). Weak correlations were found between SOC and age rs?=?0.17, p?rs?=?0.01, p?>?0.92. No difference was found in SOC score related to gender or educational level.

Conclusions: The SOC-13 scale showed reliability for patients with HRD. There was a weak connection between age and SOC without clinical relevance. SOC-13 has the potential to be a powerful tool to measure the ICF component personal factors, which could have an impact on patients’ rehabilitation outcomes.

• Implications for rehabilitation

• Antonovsky’s SOC-13 scale showed test-retest reliability for patients with hand-related disorders.

• The SOC-13 scale could be a suitable tool to help measure personal factors.

     

The Fugl–Meyer assessment of the upper extremity: reliability,responsiveness and validity of the Danish version

Objective: To translate the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) into Danish and to establish the inter-tester reliability, responsiveness, Minimal Clinically Important Difference (MCID) and concurrent validity of the FMA-UE in a population of stroke patients. Method: The translation was conducted in accordance with the principles outlined by the ISPOR Task Force for Translation and Cultural Adaption. Inter-rater reliability was assessed at baseline. Each patient was tested by two examiners and inter class correlation (ICC) was calculated. Responsiveness was assessed using receiver operating characteristic (ROC) curve statistics. The FMA-UE change score was used to assess sensitivity and specificity and to correctly determine which patients had improved. The MCID and the area under the curve (AUC) were established using the ROC. The FMA-UE’s concurrent validity with the Motor Assessment Scale was determined using Spearman’s rank correlation. Setting: The study took place at Skive Neurorehabilition, Denmark from May 2014 to February 2015. Participants: Inpatients, who were in the acute to sub-acute stage of stroke and aged?>?18 years. Interventions: Not applicable. Main outcome measure: The FMA-UE. Results: In 50 inpatients the ICC was 0.95, AUC was 0.87, with a sensitivity of 77%, a specificity of 89% and an MCID?≥?4. Concurrent validity was high, with r?=?0.94–0.95. Conclusion: The FMA-UE was successfully translated into Danish. An MCID?≥?4 was found. This study provides evidence that the FMA-UE is a reliable, responsive and valid instrument for measuring upper limb impairment after stroke.

• Implications for rehabilitation

• One of the most widely recognized measures of upper extremity motor impairment post-stroke is the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE).

• The psychometric properties of a measurement depends on the population and setting in which it is used.

• In this study, the FMA-UE is translated into Danish and the psychometric properties of FMA-UE is determined in a Danish population of patients with stroke.

• The FMA-UE is now available to use for clinicians in Denmark.

     

Reliability and Feasibility of the Pain Assessment in Advanced Dementia Scale–Korean Version (PAINAD-K)

BackgroundThere is currently no observational instrument for assessing pain in aged patients who are unable to provide self-report in long-term care hospitals in Korea.AimsThe goal of this research was to culturally adapt and test the validity, reliability, and feasibility of the Korean version of the Pain Assessment in Advanced Dementia Scale.DesignThis was a methodologic study aiming to translate the Pain Assessment in Advanced Dementia Scale.Participants/SubjectsThe inpatients in a 270-bed LTC hospital in D metropolitan city were assessed pain levels.MethodsThe Pain Assessment in Advanced Dementia (PAINAD) Scale was used as an observation scale to assess 192 long-term care hospital patients, with observation durations of 1 and 5 minutes.ResultsThe interrater reliability (1 minute) for the scale showed substantial kappa agreement of .62, and scores for the 1- and 5-minute observations showed almost perfect agreement of .95. The criterion validity of the scale (1 minute) was high relative to the Face-Legs-Activity-Cry-Consolability (FLACC) Scale, and low compared with the numeric rating scale (NRS). Discriminant validity was established between patients with and without pain. The feasibility of the Pain Assessment in Advanced Dementia Scale–Korean Version (PAINAD-K) (1 minute) indicated low sensitivity of 41.3% and high specificity of 92.6%.ConclusionsTherefore, the PAINAD-K is a valid and reliable tool to determine the absence of pain in non-verbal aged patients.     

Correlation of xenobiotic-metabolizing enzymes,oxidative stress and NFκB signaling with histological grade and menopausal status in patients with adenocarcinoma of the breast

BackgroundAdenocarcinoma of the breast is the most common cancer worldwide and accounts for the highest morbidity and mortality. The increasing global incidence of breast cancer emphasizes the need to understand the molecular mechanisms of breast tumorigenesis. The present study was designed to correlate changes in xenobiotic-metabolizing enzymes (XME), oxidative stress and NFκB signaling with histological grading and menopausal status in breast cancer patients.MethodSixty breast cancer patients histologically categorized as grades I, II and III, and as pre- and postmenopausal were chosen for the study. We analyzed phase I and phase II XME activities as well as the expression of the CYP isoforms CYP1A1 and CYP1B1, oxidative stress markers, and the expression of NFκB family members in tumor and adjacent tissues by immunohistochemical localization and Western blot analyses.ResultsThe breast tumors analyzed in the present study were characterized by increased activities of xenobiotic-metabolizing enzymes and enhanced oxidative damage to lipids, proteins, and DNA associated with variations in the expression of NFκB family members. The magnitude of the changes was however more pronounced in premenopausal patients and in grade III breast tumors.ConclusionThe present study delineates the correlation between XME-mediated oxidative stress and NFκB signaling that leads to the development of breast cancer.     

Prevalence of right–to–left shunt in patients with cluster headache

Recent investigations documented that the prevalence of right–to–left shunt (RLS) in patients with migraine with aura (MA) is significantly higher than in healthy controls and similar to prevalence of RLS in young patients with cryptogenic stroke (CS). Nevertheless, little data are available in the literature about RLS prevalence in the other forms of primary headache. The aim of this study was to investigate the occurrence of RLS in patients with cluster headache (CH). We enrolled 30 consecutive patients with CH diagnosis according to the IHS criteria and 40 controls. RLS was assessed with bilateral transcranial Doppler contrast (TCDc) monitoring of middle cerebral arteries. Eleven patients (37%) resulted positive to TCDc monitoring for evaluation of RLS. These data show that the presence of RLS in this group is more prevalent than in the general population and similar to that found in MA and in CS.     

Trends in anemia management in lung and colon cancer patients in the US Department of Veterans Affairs, 2002–2008

Purpose

In 2007, growing concerns about adverse impacts of erythropoiesis-stimulating agents (ESAs) in cancer patients led to an FDA-mandated black box warning on product labeling, publication of revised clinical guidelines, and a Medicare coverage decision limiting ESA coverage. We examined ESA therapy in lung and colon cancer patients receiving chemotherapy in the VA from 2002 to 2008 to ascertain trends in and predictors of ESA use.

Methods

A retrospective study employed national VA databases to “observe” treatment for a 12-month period following diagnosis. Multivariable logistic regression analyses evaluated changes in ESA use following the FDA-mandated black box warning in March 2007 and examined trends in ESA administration between 2002 and 2008.

Results

Among 17,014 lung and 4,225 colon cancer patients, those treated after the March 2007 FDA decision had 65% (lung OR 0.35, CI_95% 0.30–0.42) and 53% (colon OR 0.47, CI_95% 0.36–0.63) reduced odds of ESA treatment compared to those treated before. Declines in predicted probabilities of ESA use began in 2006. The magnitude of the declines differed across age groups among colon patients (p?=?0.01) and levels of hemoglobin among lung cancer patients (p?=?0.04).

Conclusions

Use of ESA treatment for anemia in VA cancer care declined markedly after 2005, well before the 2007 changes in product labeling and clinical guidelines. This suggests that earlier dissemination of research results had marked impacts on practice patterns with these agents.     

Anger and emotional distress in patients with migraine and tension–type headache

The objective was to evaluate the prevalence and the characteristics of anger and emotional distress in migraine and tension– type headache patients. Two hundred and one headache patients attending the Headache Center of the University of Turin were selected for the study and divided into 5 groups: (1) migraine, (2) episodic tension–type headache, (3) chronic tension–type headache, (4) migraine associated with episodic tension–type headache and (5) migraine associated with chronic tension–type headache. A group of 45 healthy subjects served as controls. All the subjects completed the State–Trait Anger Expression Inventory, the Beck's Depression Inventory and the Cognitive Behavioral Assessment. Anger control was significantly lower in all headache patients (p<0.05) except in migraineurs. Patients with migraine and tension–type headache showed a significantly higher level of angry temperament and angry reaction (p<0.05). In addition, chronic tension–type headache and migraine associated with tension–type headache patients reported a higher level of anxiety (p<0.05), depression (p<0.001), phobias (p<0.001) and obsessive–compulsive symptoms (p<0.01), emotional liability (p<0.001) and psychophysiological disorders (p<0.001). Our study shows that chronic tension–type headache and migraine associated with tension–type headache patients present a significant impairment of anger control and suggests a connection between anger and the duration of headache experience.