Reliability and validity of the Tegner and Marx activity rating scales in Iranian patients with anterior cruciate ligament injury

Purpose.?The aims of this study were to culturally translate and validate the Persian version of Tegner and Marx activity rating scales and to investigate their psychometric properties in a sample of patients (n == 100) with anterior cruciate ligament (ACL) injury.

Method.?Four questionnaires were completed by the respondents: Tegner and Marx activity scales, Knee injury and Osteoarthritis Outcome Score (KOOS) and Short-Form 12 Health Survey (SF-12). The Tegner and Marx were re-administered to 45 patients in the retest session, with time interval of 2–6 days between the two sessions. Test–retest reliability and internal consistency were assessed using intra-class correlation coefficient (ICC) and Cronbach's alpha, respectively. To evaluate construct validity of Tegner and Marx compared to similar and dissimilar concepts of KOOS and SF-12, the Spearman's rank correlation was used.

Results.?Both Tegner and Marx activity scales have a high ICC level. The minimum Cronbach's alpha level of 0.70 was exceeded by Marx scale. In terms of construct validity, most of a priori hypotheses were confirmed.

Conclusions.?The Persian version of Tegner and Marx seems to be suitable for Iranian patients with ACL injury. Future studies are needed to investigate the psychometric properties of these questionnaires for Iranian patients with different knee problems.     

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.     

The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain

Purpose: The aims of this study were to translate the numeric rating scale (NRS) into Arabic and to evaluate the test–retest reliability and convergent validity of an Arabic Numeric Pain Rating Scale (ANPRS) for measuring pain in osteoarthritis (OA) of the knee.

Methods: The English version of the NRS was translated into Arabic as per the translation process guidelines for patient-rated outcome scales. One hundred twenty-one consecutive patients with OA of the knee who had experienced pain for more than 6 months were asked to report their pain levels on the ANPRS, visual analogue scale (VAS), and verbal rating scale (VRS). A second assessment was performed 48 h after the first to assess test–retest reliability. The test–retest reliability was calculated using the intraclass correlation coefficient (ICC_2,1). The convergent validity was assessed using Spearman rank correlation coefficient. In addition, the minimum detectable change (MDC) and standard error of measurement (SEM) were also assessed.

Results: The repeatability of ANPRS was good to excellent (ICC 0.89). The SEM and MDC were 0.71 and 1.96, respectively. Significant correlations were found with the VAS and VRS scores (p?<0.01).

Conclusions: The Arabic numeric pain rating scale is a valid and reliable scale for measuring pain levels in OA of the knee.

• Implications for Rehabilitation

• The Arabic Numeric Pain Rating Scale (ANPRS) is a reliable and valid instrument for measuring pain in osteoarthritis (OA) of the knee, with psychometric properties in agreement with other widely used scales.

• The ANPRS is well correlated with the VAS and NRS scores in patients with OA of the knee.

• The ANPRS appears to measure pain intensity similar to the VAS, NRS, and VRS and may provide additional advantages to Arab populations, as Arabic numbers are easily understood by this population.

     

Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome

Purpose: To culturally translate and validate the Persian version of Kujala Patellofemoral Scale (KPS) and evaluate the test-retest reliability, internal consistency, construct validity and ceiling or floor effects of this instrument in patients with patellofemoral pain syndrome (PFPS). Method: After standard forward and backward translations, 100 patients with PFPS completed the Persian versions of the KPS and Short-Form 36 Health Survey (SF-36) in the first visit. With time interval of 2–3 days after the first visit, 47 patients filled out the KPS in the second visit. Test-retest reliability and internal consistency were assessed using intraclass correlation coefficient (ICC_2,1) with 95% confidence interval (95% CI) and Cronbach’s α coefficient, respectively. The Spearman’s rank correlation (r_s) was used to assess the correlations between the Persian KPS and SF-36 subscales. Results: The acceptable level of ICC >0.70 (ICC = 0.96, 95% CI = 0.93–0.98) and Cronbach’s α coefficient >0.70 (α = 0.81) was obtained for the Persian KPS. There were low to moderate correlations (r_s = 0.25–0.60, p < .01) between the Persian KPS and Persian SF-36 subscales of mental and physical health components. However, correlations between the Persian KPS and SF-36 physical components were higher than correlations between the Persian KPS and SF-36 mental components. No ceiling and floor effects were seen for the Persian KPS. Conclusions: The Persian version of KPS is a reliable and valid outcome measure of disability and seems to be a suitable instrument for use in clinical practice of Iranian patients with chronic PFPS.

Implications for Rehabilitation

• The results on psychometric properties of the Persian Kujala Patellofemoral Scale are comparable with three validated versions obtained for the Finnish, Turkish and Chinese populations.

• Persian version of the Kujala Patellofemoral Scale has acceptable reliability/validity and now can be used in “clinical” and “research” settings of Iranian patients with chronic patellofemoral pain syndrome.

     

The Persian version of Trinity Amputation and Prosthetics Experience Scale: translation,factor structure,reliability and validity

Purpose.?The purpose of the present study was to translate the Trinity Amputation and Prosthetics Experience Scale (TAPES) into Persian and to investigate its psychometric properties.

Method.?A sample of 182 Persian-speaker individuals with lower limb amputation completed the TAPES questionnaire, of whom 103 individuals completed the Short Form 36 Health survey as well. The TAPES was re-administered to 41 participants in the retest session, with an interval of 5–7 days between the two sessions. Internal consistency, test-retest reproducibility, dimensionality, item internal consistency and discriminant validity and construct validity were assessed.

Results.?Cronbach's α's were greater than the cut-off point of 0.70 for all subscales with the exception of social adjustment subscale. Minimum intraclass correlation coefficient of 0.70 was exceeded by all subscales with the exception of social activity subscale. Principle component analysis performed on each section of the TAPES revealed loading of all items on their corresponding factors. The exceptions were item 4 of social adjustment subscale and the single item of weight subscale. Most items were stronger measures of their hypothesised subscale than the other subscales. In terms of construct validity, 75%% of a priori hypotheses were confirmed.

Conclusions.?The Persian version of TAPES seems to be a reliable and valid measure of psychological adaptation to artificial limb.     

Psychometric characteristics of Duruoz Hand Index in patients with traumatic hand flexor tendon injuries

Introduction.?The aim of the study was to assess reliability, validity and responsiveness of Duruoz Hand Index (DHI), which has been developed for evaluation of activity limitation in rheumatoid arthritis in patients with traumatic hand flexor tendon injuries.

Material and method.?Sixty-five patients older than 16 years who underwent surgical intervention after flexor tendon injuries were enrolled. Reliability was assessed by internal consistency (with Cronbach's-α) and test-retest intraclass correlation coefficient (ICC). Construct validity was estimated correlating the scale with the DASH and VAS-hd. Also responsiveness was estimated using standardised response mean (SRM) and effect size (ES).

Result.?Mean age of the patients was 30.25 ± 11.07 years and totally 140 fingers were evaluated. Cronbach's-α and ICC values of DHI were found to be 0.87 and 0.99, respectively. In validation study, highly significant correlation was detected between DHI with DASH and VAS-hd (r == 0.86, r == 0.54, p < 0.0001, respectively). SRM values and ES values (excepting workplaces subgroup score) were higher than 0.80 for total and all subgroup scores.

Conclusion.?DHI is a reliable, valid questionnaire to assess hand-related activity limitation in patients with traumatic hand flexor tendon injuries. Also, due to its high level responsiveness DHI can be used for assessing the clinical course of the traumatic hand flexor tendon injured patient.     

Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in Greek community-dwelling older adults

Purpose.?The cross-cultural adaptation and validation of Falls Efficacy Scale-International (FES-I) in community-dwelling seniors in Greece.

Method.?For cross-cultural adaptation, the back-translation procedure was utilised by four bi-lingual translators. For validation, 89 community-dwellings (50 males, 39 females) aged 61–90 years old (mean: 72.87 ± 6.04) completed four questionnaires adapted into Greek; two instrument specific ones, FES-I and Confidence in Maintaining Balance (CONFbal), and two generic Questionnaires, Short-form Health Survey (SF-36v2) and General Health Questionnaire (GHQ30). Additionally, three functional/balance tests were compared against the FES-I. All questionnaires and measurements were repeated after 7–10 days to explore repeatability.

Results.?Content validity was achieved as all participants found the questionnaire appropriate and comprehensible. Validity of the FES-I yielded moderate to strong correlations with CONFbal (r == 0.694, p<0.01), three SF-36 subscales (r ranging between 0.560 and 6.55, p<0.01), GHQ30 (r == 0.584, p<0.01) and one functional test (r == 0.638, p<0.01 for Timed Up and Go test). FES-I's test–retest reliability (ICC:0.951, SEM: 1.79, SDD:20.44%%, r == 0.950) and internal consistency (Cronbach's α == 0.925) were excellent, and responsiveness across fallers and non-fallers yielded a large effect size (0.89), indicating good discriminant validity.

Conclusions.?The Greek FES-I was valid, reliable, comprehensible and acceptable for the sample tested and may thus, be used in cross-cultural rehabilitation research and practice.     

Psychometric properties of a Chinese version of the home environment measure for motor development

Purpose.?This study examined the psychometric properties of the Chinese version of the Affordance in the Home Environment for Motor Development – Toddler version (AHEMD-Toddler-C) for children developing typically (DT) or having motor delays (MD).

Methods.?This was a methodology study. Parent–child dyads with DT (n == 106, mean age of 27.9 months) and with MD (n == 45, 23.6 months) were enrolled. For test-retest reliability, parents completed AHEMD-Toddler-C twice within 2 weeks. For convergent validity, correlations were analysed between AHEMD-Toddler-C and Home Observation for Measurement of the Environment Inventory (HOME), and between AHEMD-Toddler-C and family variables.

Results.?Test-retest reliabilities for AHEMD-Toddler-C were adequate except for Variety of Stimulation (VS) subscale. For convergent validity, the correlation coefficients between AHEMD and HOME were 0.44 (p <0.05). Two subscales of motor toys of AHEMD demonstrated convergent validity with Learning Material subscale of HOME and some family variables in children with MD. Inside Space subscale of AHEMD correlated with family variables. Outside Space (OS) subscale of AHEMD was not significantly correlated with HOME or family variables.

Conclusion.?AHEMD-Toddler-C is a new measure option to explore the relationships between home environment and motor development in Chinese-speaking countries. Nevertheless, VS and OS subscales should be used cautiously.     

Chinese translation and validation of the Kujala scale for patients with patellofemoral pain

Purpose: This study translated and validated the Kujala scale, a well-documented questionnaire for patients with patellofemoral pain, into Chinese version. Method: Chinese Kujala scale was translated from the original English version following the recommendations of the International Society for Pharmacoeconomics and Outcomes Research. Sixty four Chinese reading patients who are diagnosed of patellofemoral pain were recruited from multiple hospitals and physiotherapy clinics. Psychometric property was evaluated in terms of test-retest reliability and internal consistency. Convergent validity was examined by Spearman rank correlation coefficient tests by comparing its score with the validated Chinese version of WOMAC Osteoarthritis Index and SF-36. Results: Chinese Kujala scale demonstrated excellent reliability (ICC?=?0.968, p?<?0.001). Cronbach’s α of individual questions and its overall value were above 0.7. Strong correlation was found between the Chinese Kujala scale and the WOMAC Osteoarthritis Index (rho?=??0.708, p?<?0.001). Fairly weak correlations were also found between Chinese Kujala scale with the “physical” (rho?=?0.413–0.498, p?<?0.001) and “energy vitality” (rho?=?0.290, p?=?0.02) domains of SF-36. However, the relationship between the “bodily pain” was not significant (rho?=?0.136, p?=?0.284). Conclusion: The Chinese translated version of Kujala scale is a reliable and valid instrument for assessing the patellofemoral pain associated functional disturbances among the patient cohort.

Implications for Rehabilitation

• The Chinese translated version of Kujala scale is a reliable and valid instrument for assessing the functional disturbances associated with patellofemoral pain among the patient cohort.

• This instrument facilitates research among Chinese population and multinational studies.

     

Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations

Purpose.?To investigate the correlation between single limb support (SLS) phase (%% of gait cycle) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 Health Survey) in patients with knee osteoarthritis (OA).

Method.?A prospective observational study was employed with 125 adults with bilateral medial compartment symptomatic knee OA who underwent a physical and radiographic evaluation. Velocity, step length and SLS were assessed by a computerised mat (GAITRite). Patients completed the WOMAC and SF-36 Health Survey questionnaires.

Results.?Statistical analysis examined the correlations between SLS and both questionnaires, between Kellgren & Lawrence (K&L) scores and both questionnaires and between SLS correlations and K&L correlations. We found significantly stronger correlations between SLS and WOMAC-pain, WOMAC-function, the SF-36 pain sub-category, velocity and step length than between K&L scores and these parameters (Pearson's r == 0.50 vs. 0.26, 0.53 vs. 0.34, 0.50 vs. 023, 0.81 vs. 0.33, 0.77 vs. 0.37, respectively; all p < 0.05). Significant differences in SLS were found over WOMAC-pain, WOMAC-function and SF-36 overall score quartiles (p < 0.05 for all).

Conclusion.?We recommend integrating SLS as an objective parameter in the comprehensive evaluation of patients with knee OA.     

Psychometric evaluation of the functional walking test for children withcerebral palsy

Purpose.?This study examined the psychometric properties of the functional walking test (FWT).

Method.?Fifty-six subjects with cerebral palsy (CP) (21 females and 35 males, mean age 9 years 6 months, SD 3 years 9months, range 4–17 years) were assessed on two occasions, 6 months apart, using both the FWT and the gross motor function measure (GMFM).

Results.?Generalisability correlation coefficients (GCC) for all 11 items were high (0.91–0.99). Inter-rater reliability was also high with excellent consensus in the scores given by the eight raters (intra-class correlation coefficient and GCC 0.99). Intra-rater reliability was equally high (GCC 0.99). The internal consistency of the FWT was estimated using Cronbach's α as 0.95 and 0.94 at Time 1 and 2, respectively. The FWT had a high degree of correlation with the GMFM, when total scores were compared at Time 1 and 2 (Pearson's r == 0.86 and 0.87, n == 56, p < 0.01). The FWT also found statistically significant differences in total scores between the three Gross Motor Function Classification System (GMFCS) levels. The correlation between the FWT scores and GMFCS was ?0.70 at Time 1 and ?0.76 Time 2 (p < 0.01) indicating the construct validity of the FWT.

Conclusions.?This study has demonstrated that the FWT has sound psychometric properties and is valid and reliable in a sample population of ambulant children with CP.     

Assessment of fatigue in patients with fibromyalgia and chronic widespread pain. Reliability and validity of the Swedish version of the MFI-20

Objectives. Fibromyalgia (FM) and Chronic Widespread Pain (CWP) are common diseases in primary care and, in addition to the pain they cause, fatigue is a major problem. Fatigue is regarded as a multidimensional concept and instruments assessing fatigue should therefore cover several different dimensions. The Multidimensional Fatigue Inventory (MFI-20) measures five different dimensions of fatigue. The aim of the study was to investigate the test-retest reliability and convergent construct validity of the Swedish version of the MFI-20 in female patients with FM or CWP.

Methods. To investigate the convergent construct validity, 166 female patients with FM or CWP completed the Swedish version of the MFI-20 and a Visual Analogue Scale (VAS) measuring global fatigue. Thirty-six of the 166 patients completed the Swedish version of the MFI-20 on two occasions, one day apart to evaluate the test-retest reliability.

Results. Spearman's correlation coefficient revealed a significant association between each of the five subscales of the MFI-20 and the VAS for global fatigue. General Fatigue had the highest correlation with the VAS (rs = 0.62, p<0.001), while Reduced Motivation had the lowest (rs = 0.32, p<0.001). The intra-class correlation coefficients (ICC) were satisfactory for all the five subscales of the MFI-20.

Conclusion. The results of this study indicate that the Swedish version of the MFI-20 is a reliable tool for assessing the degree of fatigue in patients with FM or CWP. This study also supports the theory that fatigue is a multidimensional concept and different aspects of fatigue should be measured separately.     

World Health Organisation Disability Assessment Schedule II: Contribution to the Italian validation

Introduction.?The World Health Organisation Disability Assessment Schedule II (WHODAS II) is an instrument developed by the World Health Organisation in order to assess behavioural limitations and restrictions to participation experienced by an individual, independently from a medical diagnosis. The conceptual frame of reference of this instrument is the International Classification of Functioning, Disability and Health: ICF. Specifically, the instrument is designed to evaluate the functioning of the individual in six activity domains: Understanding and communicating, Getting around, Self-care, Getting along with people, Life activities, Participation in society.

Purposes.?Considering the widespread consent about the usefulness of the WHODAS II, the general aim of the present study is to provide a contribution to the validation of the Italian version.

Method.?The WHODAS II Italian version has been administered to a sample of 500 participants subdivided in two groups: 271 normal adults and 229 disabled adults. The disabled participants group has been subdivided in three sub-groups, according to their disability: 111 motor disabled, 45 mental disabled, 73 sensory disabled.

Results.?The mean Total score of the WHODAS II is 12.95 for the normal adults and 22.93 for the disabled group. Either group obtains the least impairment in the Self-care domain. This could be probably due to the presence of social-health workers in everyday life for all Italian disabled people. For the three disabled participant groups separately computed the mean Total score is: 28.66 for the motor disabled, 24.60 for the mental disabled, and 14.97 for the sensory disabled, confirming that sensory disabled do not perceive their disability as a personal functioning problem but a socially constructed one. Some subscales of WHODAS II show relatively strong floor effects. The Cronbach's Alpha calculated for each of the subscales is found to be high. The correlations of the subscales show strong correlations in all subscales.

Conclusions.?The WHODAS II is a useful instrument for measuring disability and functioning in normal and disabled people. It shows high reliability and a stable factor structure; although an additional psychometric evaluation of a representative sample of Italian disabled should be carried out in order to reach standard scores for each macro-category of disability.     

Cross-cultural adaptation,reliability and validity of the Arabic version of the reduced Western Ontario and McMaster Universities Osteoarthritis index in patients with knee osteoarthritis

Purpose: We adapted the reduced Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index for the Arabic language and tested its metric properties in patients with knee osteoarthritis (OA). Methods: One hundred and twenty-one consecutive patients who were referred for physiotherapy to the outpatient department were asked to answer the Arabic version of the reduced WOMAC index (ArWOMAC). After the completion of the ArWOMAC, the intensity of knee pain and general health status were assessed using the visual analog scale (VAS) and the 12-item short form health survey (SF-12), respectively. A second assessment was performed at least 48?h after the first session to assess test–retest reliability. The test–retest reliability was quantified using the intra-class correlation coefficient (ICC), and Cronbach’s alpha was calculated to assess the internal consistency of the Arabic questionnaire. The construct validity was assessed using Spearman rank correlation coefficients. Results: The total ArWOMAC scale and pain and function subscales were internally consistent with Cronbach’s coefficient alpha of 0.91, 0.89 and 0.90, respectively. Test–retest reliability was good to excellent with ICC of 0.91, 0.89 and 0.90, respectively. SF-12 and VAS score significantly correlated with ArWOMAC index (p?Conclusions: The ArWOMAC index is a reliable and valid instrument for evaluating the severity of knee OA, with metric properties in agreement with the original version.

• Implications for Rehabilitation

• Although, the reduced WOMAC index has been clinically utilized within the Saudi population, the Arabic version of this instrument is not validated for an Arab population to measure lower limb functional disability caused by OA.

• The Arabic version of reduced WOMAC (ArWOMAC) index is a reliable and valid scale to measure lower limb functional disability in patients with knee OA.

• The ArWOMAC index could be suitable in Saudi Arabia and other Arab countries where the language, culture and the life style are similar.

     

The Orpington Prognostic Scale for patients with stroke: Reliability and pilot predictive data for discharge destination and therapeutic services

Purpose.?To determine the inter-rater and test-retest reliability of the Orpington Prognostic Scale (OPS) in patients with stroke. Pilot data were gathered to evaluate its predictive validity for discharge destination and therapeutic services required on discharge.

Method.?Ninety-four consecutive patients, admitted to hospital due to stroke participated. Pairs of physiotherapists (PT) and occupational therapists (OT) assessed patients using the OPS on days 7 and 14 post stroke. For inter-rater reliability, one rater performed the OPS while the other observed, each scoring the scale independently. For test-retest reliability, two different raters tested the subjects separately within the same day. Data were gathered on the discharge destination and the number of follow-up services prescribed.

Results.?The inter-rater reliability as measured by the intraclass correlation coefficient (ICC) was 0.99 (95% CI 0.97 – 0.99). For test-retest reliability, the ICC was 0.95 (95% CI 0.90 – 0.98). The accuracy for predicting discharge to home using OPS ? 5.0 was 65% (95% CI 0.52 – 0.76). OPS scores were not related to number of follow-up services prescribed.

Conclusions.?Despite high inter-rater and test-retest reliability, the OPS has limited predictive accuracy for discharge destination and is a poor predictor of follow-up services.     

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.     

REPAS,a summary rating scale for resistance to passive movement: Item selection,reliability and validity

Purpose.?To establish: (i) item characteristics and item selection for the REPAS; (ii) internal consistency, inter-rater and test-retest reliability of the final REPAS version and its subtests; (iii) the association between the REPAS and selected other clinical scales of impairment and activity limitation.

Method.?Thirty-three neurological patients with central paresis. Two REPAS assessments with a one-week interval by two independent raters. Concurrent assessment of the Motricity Index, Box-and-Block test, Functional Ambulation Category, Timed walking, Barthel Index, Disability Rating Scale, Carer Burden Scale, and Hygiene Score.

Results.?Twenty-six of 52 REPAS items fulfilled the item selection criteria. The final test version showed a high internal consistency, inter-rater and test-retest reliability (correlation coefficients: 0.87 – 0.97, no significant difference between raters or with test repetition). Reliability of the arm and leg subtests was substantial (correlation coefficients: arm subtest 0.63 – 0.98, leg subtest 0.56 – 0.96). REPAS scores were moderately associated with basic ADL competence and a carer's burden with arm or leg adductor spasticity. The REPAS, arm subtest scores, degree of arm paresis and gross manual dexterity showed a moderately high association.

Conclusions.?The Ashworth scale-based guidelines assured comparability of test administration and scoring. The REPAS is a reliable and valid summary rating scale for resistance to passive movement.     

Cultural adaptation and validation of the Persian version of the Arthritis Impact Measurement Scales 2-Short Form in patients with osteoarthritis of the knee

Purpose.?To translate and validate the Persian version of the Arthritis Measurement Scales 2-Short Form (AIMS2-SF) in patients with osteoarthritis (OA) of the knee.

Method.?The translation and cultural adaptation of the original questionnaire was carried out in accordance with published guidelines. One hundred and fourteen consecutive Persian-speaking patients with OA of the knee were participated in this study. The Short Form Health Survey (SF-36) and visual analogue scales (VAS) for pain and joint stiffness were used to test convergent validity of the Persian AIMS2-SF. In addition, 35 randomly selected patients were asked to complete the questionnaire 3 days later for the second time.

Results.?The Persian AIMS2-SF showed statistically significant good convergent validity, as assessed with the relevant subscales of the Persian SF-36 and VAS for pain and joint stiffness. Cronbach's alpha coefficient for the Persian AIMS2-SF components ranged from 0.68 to 0.80. The Persian AIMS2-SF components showed good to excellent test–retest reliability with intraclass correlation coefficient ranged from 0.72 to 0.83 (p?<?0.01).

Conclusions.?The Persian version of the AIMS2-SF is a reliable and valid instrument to measure functional disability and health-related quality of life in patients with OA of the knee in Iran. It is simple and easy to use and now can be applied in clinical settings and future outcome studies in Iran.     

Reliability and validity of the Japanese-language version of the physical performance test (PPT) battery in chronic pain patients

Purpose.?To prepare a Japanese-language version of the Physical Performance Test (PPT) Battery and assess its reliability and validity.

Method.?Activity limitations by pain were evaluated by means of the Japanese-language version of the PPT Battery in 82 patients with chronic pain in the limbs and trunk. Two self-report questionnaires, one related to sensory evaluation of pain, and the other related to affective evaluation of pain, and the Functional Independence Measure (FIM), which evaluates activities of daily living, were simultaneously administered to the subjects.

Results.?The results for reliability showed that the ICC values for inter-rater reliability and intra-rater reliability were 0.91 or more for every item. The results for validity showed significant associations between the scores for all of the items on the Japanese-language version of the PPT Battery and the total scores on the FIM (p < 0.01). Significant associations were found between 5 of the 8 items on the Japanese-language version of the PPT Battery and affective state due to the pain.

Conclusions.?The Japanese-language version of the PPT Battery was shown to possess adequate reliability and validity as a scale for evaluating the activity limitations of patients with chronic limb or trunk pain. The results also suggested that it might be possible to improve the activity limitations of patients with chronic pain by improving their affective state in response to the pain.