Italian translation of the VISA-A score for tendinopathy of the main body of the Achilles tendon

Purpose. To translate and adapt the English VISA-A questionnaire to Italian, to perform reliability and validity evaluations of the Italian VISA-A version in patients with tendinopathy of the main body of the Achilles tendon.

Methods. The VISA-A English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The VISA-A-I questionnaire was then administered to 50 male athletes (average age 26.4, range 18 – 49 years) with a diagnosis of tendinopathy of the main body of the AT. For test-retest evaluation, the 50 patients were asked to complete the questionnaire at first examination, and 30 minutes following the end of this examination.

Results. The kappa statistics for 50 patients was 0.80 (range 0.7 – 0.86). There were no significant differences between the scores immediately after the consultation and 30 minutes later.

Conclusions. Italian and the English versions of the VISA-A questionnaire evaluate the same aspects of clinical severity in patients with tendinopathy of the main body of the Achilles tendon.     

Italian translation of the VISA-A score for tendinopathy of the main body of the Achilles tendon

Purpose. To translate and adapt the English VISA-A questionnaire to Italian, to perform reliability and validity evaluations of the Italian VISA-A version in patients with tendinopathy of the main body of the Achilles tendon. Methods. The VISA-A English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The VISA-A-I questionnaire was then administered to 50 male athletes (average age 26.4, range 18 - 49 years) with a diagnosis of tendinopathy of the main body of the AT. For test-retest evaluation, the 50 patients were asked to complete the questionnaire at first examination, and 30 minutes following the end of this examination. Results. The kappa statistics for 50 patients was 0.80 (range 0.7 - 0.86). There were no significant differences between the scores immediately after the consultation and 30 minutes later. Conclusions. Italian and the English versions of the VISA-A questionnaire evaluate the same aspects of clinical severity in patients with tendinopathy of the main body of the Achilles tendon.     

High volume ultrasound guided injections at the interface between the patellar tendon and Hoffa's body are effective in chronic patellar tendinopathy: A pilot study

Purpose. To evaluate a novel conservative management modality for patellar tendinopathy.

Methods. We recruited nine patients with patellar tendinopathy who had failed conservative management and showed evidence of neovascularisation on power Doppler scanning. A high volume ultrasound guided injection at the interface between the patellar tendon and Hoffa's body. The injection contained 10 ml 0.5% Bupivacaine, 25 mg Hydrocortisone, and between 12 and 40 ml normosaline. 100 mm visual analogue scales (VAS) for pain and for function, and Victorian Institute of Sport Assessment – Patellar tendon (VISA-P) questionnaires at an average of 9 months from the injection.

Results. All but one patient (whose pain was unchanged) improved (p = 0.028). The mean improvement in function 2 weeks after injection was 58 mm on VAS (interquartile range 27 – 88, p = 0.018). The mean improvement in pain 2 weeks after injection was 56 mm on a VAS scale (interquartile range 32 – 80, p = 0.018). At a mean follow up of 9 months, an improvement of 22 points from a baseline score of 46 on the VISA-P questionnaire (100 being normal) was established.

Conclusion. High volume injections to mechanically disrupt the neovascularisation in patellar tendinopathy are helpful in the management of this condition. Controlled trials would be warranted to investigate in a more conclusive fashion this management modality.     

Multimodal management of patellar tendinopathy in basketball players: A retrospective chart review pilot study

BackgroundThe aim of this observational study was to document changes in pain, dysfunction, and fear of movement in basketball players using a multimodal rehabilitation approach for managing patellar tendinopathy.MethodsA multimodal treatment approach was utilized with basketball athletes during a competitive season. Numeric pain rating scale (NPRS), Victorian Institute of Sport Assessment Patellar (VISA-P) questionnaire, and a Tampa Scale of Kinesiophobia were used as outcome measures to assess for patellar tendon pain and knee function. A single group, pre-test/post-test, de-identified, retrospective chart review was performed at the end of the season.ResultsNine basketball players were diagnosed and treated for patellar tendinopathy during the course of a single season. VISA-P questionnaire scores were significantly higher at the end of the season, with a mean increase of 30 points (95% CI 22–38 p < 0.05). This magnitude of improvement exceeds the minimum clinically important difference of the VISA-P of 13 points. The NPRS during training over the previous week was significantly improved by 4.6 points (95% CI 2.6–6.6) from the start of treatment to the end of the season.ConclusionDry needling, Extracorporeal Shockwave Therapy (ESWT), hands on manual therapy, and corrective exercise may be safe and effective strategies to reduce patellar tendon pain and improve knee function. Future research involving a larger sample size, control group, and randomization is indicated.     

Validity and reliability of the French translation of the VISA-A questionnaire for Achilles tendinopathy

Purpose: The Victorian Institute of Sport Assessment – Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF.

Method: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test–retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n?=?31), at-risk athletes (n?=?63) and healthy people (n?=?22).

Results: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (±?18) for the pathological group, 99 (±?1) for the healthy group and 94 (±?7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36.

Conclusions: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French-speaking patients with Achilles tendinopathy.

• Implication for Rehabilitation

• The VISA-AF questionnaire is a reliable translation of the original VISA-A, from English into French, which is one of the most widespread languages in the world.

• The VISA-AF questionnaire is now a valid instrument that can be used by clinicians and researchers to assess the severity of pain and disability of French-speaking subjects with Achilles tendinopathy.

• The VISA-AF is a questionnaire to assess the severity of Achilles tendinopathy symptoms but is not a diagnostic tool.

     

Traumatic patellar tendinopathy

Purpose. In patellar tendinopathy, there is anterior knee pain with tenderness of the attachment of the patellar tendon over the lower pole of the patella. The condition is commonly associated with athletic overuse, but we have encountered it in some patients following direct blunt trauma to the anterior aspect of the knee. We describe the history and management of patients with traumatic patellar tendinopathy.

Method. Between April 2000 and August 2006, we managed eight otherwise healthy well trained athletes who developed signs and symptoms compatible with classical patellar tendinopathy after a direct trauma to the anterior aspect of the patellar tendon during sport activity.

Results. The clinical diagnosis of patellar tendinopathy was confirmed clinically and at imaging by MRI and ultrasound scans. Patients responded to conservative or surgical management, in the same way as patellar tendinopathy secondary to overuse.

Conclusion. A single direct traumatic event can lead to chronic tendon problems. Hence, in addition to overuse injury, patellar tendinopathy can follow a direct trauma and exhibit the same clinical features. Further research is required to better understand the pathophysiology of the clinical condition.     

Achilles and patellar tendinopathy: Current understanding of pathophysiology and management

Purpose.?Achilles and patellar tendinopathy cause significant morbidity in professional and recreational athletes. Both the Achilles and patellar tendons are weight-bearing tendons that lack a true tendon sheath but are surrounded by paratenon.

Method.?A review of the literature to outline the characteristics of tendinopathy in these two tendons, and to discuss current concepts of pathophysiology, use of imaging in the diagnosis and aid to clinical management strategies in tendinopathy.

Results.?Achilles and patellar tendinopathy share common histopathology such as intratendinous failed healing response and neoangiogenesis.

Conclusion.?Achilles and patellar tendinopathy cause much morbidity in the athletic and non athletic population attending sports medicine and rheumatology clinics. Tendinopathy is essentially an ‘overuse’, degenerative condition. Neovascularisation evident on Doppler ultrasound correlates well with pain and poor function. Peritendinous injections and eccentric training decrease neovascularity, relieve pain and improve outcome. Although surgery is the last resort in those patients failing conservative management, it is still unclear how the removal of adhesions and excision of affected tendinopathic areas affects healing and vascularity, or resolves pain.     

Translation and validation of Chinese version of International Knee Documentation Committee Subjective Knee Form

Purpose.?To translate, cross-culturally adapt and validate the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF-C) to Chinese.

Method.?Forward and backward translations were conducted by two bilingual professional translators. Content validity was verified by a panel of a senior orthopaedic surgeon and six physiotherapists. The IKDC-SKF-C was tested on 84 patients. Psychometric testing included internal consistency (Cronbach's α) and test–retest reliability. Convergent validity used Spearman's correlation coefficient (rho) tests by comparing its score with the Chinese version of SF-36.

Results.?The Internal consistency was excellent with Cronbach's α == 0.97. Test-retest reliability was supported with an ICC == 0.87. The IKDC-SKF-C was moderately related to concurrent measures of physical function and bodily pain (r == 0.64, p <0.05).

Conclusion.?The translated Chinese IKDC-SKF is a reliable and valid tool with equal measurement properties and conceptual equivalent to the original version.     

Quadriceps tendinopathy — a forgotten pathology for physiotherapists? A systematic review of the current evidence-base

Abstract

Background: The evidence-base surrounding the pathophysiology and management of specific tendinopathies has evolved over the past 20 years. Recent research examining lower limb tendinopathies has focussed primarily on Achilles and patellar tendon injuries. However, on further examination of the different types of patella/knee tendinopathies, confusion has arisen surrounding the diagnosis and management of patellar compared to quadriceps tendinopathy.

Objectives: The purpose of this paper was to critically examine the evidence-base surrounding the diagnosis and management of quadriceps tendinopathy.

Methods: A systematic literature search of published and unpublished literature databases was conducted to identify literature pertaining to quadriceps tendinopathy. Data from each paper were extracted to examine four key areas related to quadriceps tendinopathy: nomenclature, prevalence, assessment, and management.

Results: Twelve studies satisfied the eligibility criteria and were included in the review. On analysis, little literature has been published solely informing clinicians on the pathology, diagnosis, or management of quadriceps tendinopathy. The terms patellar tendinopathy and jumper’s knee have been incorrectly used interchangeably with quadriceps tendinopathy. Activities such as repetitive squatting and prolonged knee flexion have been associated with the development of this tendinopathy. Sports such as football and volleyball have been cited as causative factors. Quadriceps tendinopathy’s principal diagnostic feature is pain on palpation of the quadriceps/patella interface, and resisted knee extension with the knee hyperflexed. There are no clear recommendations on how to specifically treat quadriceps tendinopathy.

Conclusion: Quadriceps tendinopathy is less commn than patellar tendinopathy. Possibly as a result of this, little is known about how to assess and manage this particular knee tendinopathy. Further research is required to determine the optimal management strategy for patients diagnosed with quadriceps tendinopathy, acknowledging the biomechanical and anatomical difference of the quadriceps compared to the patellar tendon.     

The use of medical infrared thermography in the detection of tendinopathy: a systematic review

Background: Tendinopathy is a common sports-related injury. A variety of assessment tools are available but none are diagnostic. We aimed to evaluate the utility of Medical Infrared Thermography (MIT) as a tendinopathy detection tool.

Objectives: To guide clinical assessment paradigms by reviewing and critically evaluating the application of MIT for detecting and staging tendinopathy.

Methods: PubMed, Web of Science, OVID and Cochrane Library were searched for papers evaluating the use of MIT for tendinopathy detection, published in English from inception to March 2015. Reference lists and citing articles were also searched. Six of 748 studies fulfilled the inclusion criteria and were quality assessed.

Results: There is strong evidence for the role of MIT in the detection of chronic lateral elbow epicondylalgia and limited for patellar tendinopathy, with statistically significant side to side temperature differences when comparing injured to non-injured limbs, characterised by the presence of ‘hot spots’ over a clinically diagnosed tendinopathy. However, MIT of rotator cuff tendinopathy shows no significant difference between injured and non-injured. No work was found on Achilles tendinopathy, plantar fasciitis, gluteal or wrist tendinopathy.

Conclusion: The available evidence suggests a role for MIT in the detection of lateral epicondylitis and patellar tendinopathy, however the utility for grading pathology or staging recovery have not been studied in sufficient detail to clarify the relationship between thermographic measurement and severity. There was inconclusive evidence to support the role of MIT in the detection of rotator cuff and various other tendinopathies, and this research is therefore warranted.     

No closing time,gents! Room and Rossow's 'The share of violence attributable to drinking'

Abstract

Background: The Alcohol Use Disorder Identification Test (AUDIT) developed by the WHO is designed to identify individuals along the full spectrum of alcohol misuse. This study aimed to develop and validate a Bahasa Malaysia language version (AUDIT-M) of the AUDIT.

Methods: AUDIT was translated to Bahasa and back translated to English. The first version was pilot tested. The final version was administered to all the patients who were identified as alcohol users from the outpatient psychiatric clinic, or were admitted to the psychiatric ward of the University Malaya Medical Centre. Patients completed a demographic questionnaire, English and Bahasa Malaysia versions of AUDIT, M.I.N.I., CAGE, and the Bahasa Malaysia version of the WHOQoL-Bref-M.

Results: Factor analysis of AUDIT-M yielded two factors similar to the factor structure of the English version. The Cronbach α coefficients for the total AUDIT-M was 0.823; and 0.816 and 0.68 for the two AUDIT-M factors. There was a significant correlation between the AUDIT and AUDIT-M scores (Spearman’s ρ?=?0.979, p?p?p?Conclusion: The AUDIT-M questionnaire has acceptable psychometric properties and is suitable for the assessment and identification of AUD in Malaysia.     

Adaptation of the Amsterdam Inventory for Auditory Disability and Handicap into Spanish

Purpose: Self-report questionnaires have been suggested as valuable assessment tools in audiology, especially when investigating the effect of hearing impairment on the everyday lives of adults. Many self-report questionnaires have been developed for English-speaking populations; however, there is a lack of this type of questionnaire for Spanish-speaking patients. The aim of the present research was to adapt the Amsterdam Inventory for Auditory Disability and Handicap (AIADH) into Spanish. Methods: The AIADH consists of 30 questions that deal with real-life listening situations. Each question is accompanied by a picture representing the situation being addressed. Six Spanish-English bilingual speakers and one Spanish-English bilingual speaker participated in the translations and back translations of the English version of the AIADH. Once the adaptation was finalized, 189 normal-hearing and hearing-impaired Spanish-speaking participants completed the Spanish version of the AIADH (S-AIADH). Results: Statistical analysis showed a high Cronbach’s alpha coefficient, indicating good internal reliability. Test-retest scores were highly correlated. Also, the S-AIADH showed good criterion validity. Statistically significant differences for all questionnaire item responses were observed between normal-hearing and hearing-impaired respondents. Conclusions: The AIADH has been adapted into Spanish. Normative data in percentiles have been obtained for clinical use with Spanish-speaking populations, to explore self-reported performance for the hearing functions proposed by the ICF.

Implications for Rehabilitation

• The clinical setting represents an artificial situation and it is not possible to directly assess the patient’s hearing performance in real life situations. For this reason, the use of self-report questionnaires is recommended.

• Self-report questionnaires are especially useful when investigating hearing disability in a range of listening activities. Thus, hearing rehabilitation can be tailored according to the specific needs of the patient.

• Self-report questionnaires such as the AIADH may assist to determine the benefits of hearing rehabilitation for the patient throughout a range of activities, for which hearing in essential.

     

Development and validation of the Italian version of the Spinal Cord Independence Measure III

Purpose.?To provide a translation and cultural adaptation of the Spinal Cord Independence Measure version III scale for Italy (i-SCIM3) and to validate this version of the scale.

Method.?i-SCIM3 was developed involving a forward–backward translation and administered to patients with spinal cord lesions (SCL) admitted to two centers. Two raters for each center evaluated patients at admission and discharge. Psychometric testing included reliability by internal consistency (Cronbach's α) and test–retest reliability. The validity of i-SCIM3 was assessed by comparing it with the Italian version of Functional Independence Measure? (FIM?).

Results.?One hundred three adult patients with SCL (84 males) with a mean age of 50.33?±?15.35 years were recruited. Seventy-four patients were paraplegic and 29 patients were tetraplegic. The median time elapsed between the two evaluations was 77.5 days (interquartile range, 53–144 days). Internal consistency, inter-rater reliability, and test–retest reliability were satisfactory overall, showing values higher than 0.90. The validity of i-SCIM3 was confirmed by the close correlation with FIM results both at admission and discharge (r?=?0.91, p?<?0.01). The sensitivity to change of i-SCIM3 was similar to that of FIM.

Conclusion.?i-SCIM3 was found to be a consistent, reliable, and valid scale for use in the clinical setting. It is the first validated scale in Italian for patients with SCL.     

Rehabilitation Complexity Scale: Italian translation and transcultural validation

Purpose: The aim of the present study was translation, cultural adaption and validation of the extended version 12 of the Rehabilitation Complexity Scale (RCS-E) in a sample of patients with stroke and total hip replacement. Method: The cross-cultural validation required RCS-E forward–backward translation, revision by an expert committee and its application in an Intensive Rehabilitation setting through a retrospective collection of data from clinical records. The evaluation of the psychometric properties was carried out by analyzing the correlations between RCS-E score and other measures (Functional Independence Measure, Braden, Morse, Cumulative Illness Rating Scale) and the assessment of reliability in terms of reproducibility (inter-observer agreement) and repeatability (intra-observer agreement). Results: The backward and forward processes of translation of the scale did not create problems of interpretation of terms. Some adaptation was required for the items nursing (N), medical care (M) and therapeutic intensity (TI) due to differences on the national health system structure. The Italian version of the scale proved to be valid, reliable with high reproducibility and repeatability. Conclusions: The Italian version RCS-E has been successfully validated, showing good psychometric properties, which partly reproduce the results obtained for the original version. However, some assumption was made for some items thus preventing possible comparison with other countries.

• Implications for Rehabilitation

• Admittance at an Intensive Rehabilitation care setting in Italy requires to evaluate the complexity of rehabilitation needs.

• The Rehabilitation Complexity Scale (RCS-E) has proved to be reliable for assessing clinical complexity and consequently for planning rehabilitation needs.

• The Italian version of RCS-E has been successfully validated, showing good psychometric properties, which reproduce the results obtained for the original version.

• The items included in the therapy intensity subscale do not fit the Italian health system rules for intensity of rehabilitation care and needs adaptation.

     

High volume image guided injections in chronic Achilles tendinopathy

Purpose. To determine the effectiveness of high volume image guided injections (HVIGI) for chronic Achilles tendinopathy.

Methods. We included in the study 30 consecutive patients (mean age 37.2 years, range 24 – 58 years) with Achilles tendinopathy for a mean of 35.8 months (range 2 – 276 months) who had failed to improve after a three-month programme of eccentric loading of the gastro-soleus complex. Patients were injected with 10 ml of 0.5% Bupivacaine Hydrochloride, 25 mg Hydrocortisone acetate, and up to 40 ml of injectable normal saline. A study-specific questionnaire and the Victorian Institute of Sport Assessment – Achilles tendon (VISA-A) were retrospectively administered to assess short- and long-term pain and functional improvement.

Results. Some 21 patients (70%) responded. Patients reported significant short-term improvement at 4 weeks of both pain (mean change 50 mm, [SD 28, p < 0.0001], from a mean of 76 mm [SD 18.2], to a mean of 25 mm [SD 23.3]), and function scores (mean change 51 mm, [SD 31.2, p < 0.0001], from a mean of 78 mm [SD 20.8], to a mean of 27 mm [SD 28.4]). Patients also reported significant long-term improvement in symptoms using the VISA-A questionnaire (mean change 31.2 points, [SD = 28, p < 0.0001], from a mean of 44.8 points [SD 17.7], to a mean of 76.2 points [SD 24.6]) at a mean of 30.3 weeks from the injection.

Conclusions. HVIGI significantly reduces pain and improves function in patients with resistant Achilles tendinopathy in the short- and long-term.     

The Italian version of the Sickness Impact Profile-Roland Scale for chronic pain: cross-cultural adaptation,reliability, validity and sensitivity to change

Purpose.?As no adapted form of the 23-item Sickness Impact Profile (SIP)-Roland Scale for patients with chronic pain has ever been validated in the Italian population, the aim of this study was to translate, culturally adapt and validate an Italian version.

Methods.?The development of the Italian version involved translation and back-translation, a final review by an expert committee and the testing of the pre-final version to establish its correspondence with the original. The psychometric testing included testing reliability by internal consistency (Cronbach's α) and test-retest repeatability (intraclass coefficient correlation; ICC), construct validity by comparison with an 11-point pain intensity numerical rating scale (NRS; Pearson's correlation) and the Short Form Health Survey (SF-36; Pearson's correlation) and sensitivity to change by calculating the minimum detectable change (MDC).

Results.?It took 3 months to obtain a shared version of the scale, which was administered to 243 subjects and proved to be satisfactorily acceptable. It had a high degree of internal consistency (α == 0.860) and test-retest reliability (ICC == 0.972). Construct validity testing revealed a moderate correlation with the NRS (r == 0.418), close correlations with the SF-36 physical subscales and moderate-poor correlations with the mental and social subscales; the MDC was 2.33.

Conclusions.?The SIP-Roland scale was successfully translated into Italian, showing satisfactory psychometric properties. The measure can be recommended for use in research and clinical practice to improve the assessment of physical dysfunction in subjects with chronic pain.     

Surgery for chronic Achilles tendinopathy produces worse results in women

Purpose. To report the middle term outcome in male and female patients who underwent surgery for chronic recalcitrant Achilles tendinopathy.

Methods. We tried to match each of the 58 female patients with a diagnosis of tendinopathy of the main body of the Achilles tendon with a male patient with tendinopathy of the main body of the Achilles tendon who was within two years of age at the time of operation. A match accordingly was possible for 41 female subjects.

Results. Female patients were shorter and lighter than male patients. They had similar BMI, lower calf circumference, similar side-to-side calf circumference differences, and greater subcutaneous body fat than men. Of the 41 sedentary patients, only 25 reported an excellent or good result. Of these, three had undergone a further exploration of the Achilles tendon. The remaining patients could not return to their normal levels of activity despite prolonged supervised post-operative physiotherapy, with cryotherapy, massage, ultrasound, pulsed magnetic, and laser therapy.

Conclusion. Females experience more prolonged recovery, more complications, and a greater risk of further surgery than males with recalcitrant Achilles tendinopathy.     

Translation,cross-cultural adaptation and psychometric properties of the Back Beliefs Questionnaire in Modern Standard Arabic

Purpose To translate and cross-culturally adapt the Back Beliefs Questionnaire (BBQ) into modern standard Arabic and examine its validity, acceptability and reliability in Arabic-speaking patients with low back pain (LBP). Method The BBQ was forward, back-translated and reviewed by an expert committee. Seventeen bilingual patients completed Arabic and English BBQs. LBP patients (n?=?199) completed the Arabic BBQ. Sixty-four repeated it a week later, and 151 completed the Arabic Fear-avoidance Beliefs Questionnaire (FABQ). Results The expert committee followed advice from the developers to maintain Arabic equivalence of “back trouble(s)”. Patients found the questionnaire comprehensible and acceptable. Agreement between the English and Arabic versions of the BBQ was acceptable, ICC?= 0.65 (0.25–0.86). Most item-by-item agreement ranged from fair to moderate (K?=?0.12–0.54). Mean (SD) of BBQ, FABQ total, work and physical activity subscales were 25.31(6.13), 44.76(19.49), 21.17(10.10) and 13.95(6.65). The BBQ correlated with the FABQ at r?=??0.33, work subscale r?=??0.29 and physical activity r?=??0.30 (all p?α?=?0.73 indicated high internal consistency. Test–retest reliability was high, ICC?=?0.80 (0.68–0.87). Item-by-item agreement ranged from fair to acceptable (K?=?0.31–0.66). Conclusions The Arabic BBQ has good comprehensibility and acceptability, acceptable agreement with the English BBQ, high internal consistency and test–retest reliability. We recommend its use with Arabic-speaking LBP patient to determine their beliefs and attitudes about their back pain, as they have been shown to be important predictors of persistent LBP disability.

• Implications for Rehabilitation

• There are limited valid and reliable outcome measures for back pain in Arabic. The Back Beliefs Questionnaire (BBQ) is a tool that measures attitudes and beliefs about back pain.

• We recommend the use of our valid and reliable, translated and cross-culturally adapted tool with Arabic-speaking patients.

• The tool can measure attitudes and beliefs concerning the future consequences of LBP, with regards to recovery and return to work in this sample.

• Findings will improve back pain management options aimed at reducing back pain disability though challenging and modifying beliefs in the Middle East or with migrant populations in the West.

     

Biomechanical differences between military patients with patellar tendinopathy and asymptomatic controls during single-leg squatting and gait – A statistical parametric mapping study

BackgroundPrior identification of biomechanical differences between patients with patellar tendinopathy and healthy controls has utilised time-discrete analysis which is susceptible to type I error when multiple comparisons are uncorrected. We employ statistical parametric mapping to minimise the risk of such error, enabling more appropriate clinical decision-making.MethodsLower-limb biomechanics of 21 patients with patellar tendinopathy and 22 controls were captured during walking and three types of squats. A statistical parametric mapping two-sample t-test was used to identify kinematic and kinetic differences between groups for each joint. Paired t-tests were used to compare pain before and after tasks, in patients with patellar tendinopathy.FindingsDuring walking, cases demonstrated reduced knee joint power during initial contact and hip joint power during terminal stance. In squatting, cases demonstrated increased knee abduction angles at various time points of the small knee bend and single-leg squat. Cases demonstrated reduced knee internal rotation moment during the deepest portion of the single-leg squat and single-leg decline squat.InterpretationGait appears unaffected by patellar tendinopathy, likely due to low task difficulty. Elevated knee abductions angles during squatting were confirmed as a key difference in patients with patellar tendinopathy. Reduced knee internal rotation moments in patients were attributed to a potential reduction in hip external rotator strength and possible pain avoidance strategy; however further evidence is required to substantiate these claims. Findings provide a clear rationale for rehabilitation programs to focus on knee stabilisation and strengthening of the muscles surrounding the hip.     

Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration: a preliminary study

BACKGROUND: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is an established instrument to measure the perceived work relationship between physicians and nurses. The survey addresses areas of autonomy and decision making, interprofessional education and relations, psychosocial care, teamwork, and shared responsibility. The aim of this prelimiary study was to adapt the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration for use in Turkey and test its psychometric properties and utility in clinical and research practice. METHODS: The process of cross-cultural adaptation and validation followed the guidelines provided in the existing literature. First, three bilingual health professionals independently translated the original questionnaire into Turkish and a consensus version was generated. Then, three other translators, blind to the original questionnaire, performed a back translation into English to confirm the accuracy of the translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of two nurses and two physicians. The field-testing for face validity was done in a group of ten monolingual physicians and nurses. Reliability was assessed with test-retest reliability and construct validity was confirmed with factor analysis. RESULTS: The mean time of questionnaire administration was 3 minutes and 45 seconds. The test-retest reliability was 0.75, and Cronbach's coefficient alpha was 0.71 for the entire sample. The findings of the factor analysis indicated that the Turkish version of Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was comprised of the following four factors: 'physician-nurse relationships', 'shared education', 'nursing role in patient care', and 'accountability and responsibility of nurses.' CONCLUSION: The overall findings of this study indicate that the Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is a psychometrically sound tool with satisfactory measurement characteristics including construct validity and internal consistency reliability. This instrument may be useful in assessing the effectiveness of educational programs designed to enhance collaboration between physicians and nurses, whether these programs are aimed at residents and graduate nursing students or practicing physicians and nurses.