A Chinese version of Iowa Infant Feeding Attitude Scale: reliability and validity assessment

Background

To achieve the goal of increasing the proportion and duration of breastfeeding in Taiwan, it is essential to assess the role of attitudes in determining which method of infant feeding will be chosen. Understanding maternal attitudes toward infant feeding methods may have utility in the development and implementation of public health policy and interventions facilitating increasing breastfeeding rates. However, no validated instrument to assess breastfeeding attitudes is available in Chinese for use in Taiwan.

Objective

To translate the Iowa Infant Feeding Attitude Scale (IIFAS) into Chinese and assess its psychometric properties among Taiwanese breastfeeding women.

Design

Methodological study.

Setting

One public hospital in Taichung city, Taiwan.

Participants

A convenience sample of 140 in-hospital breastfeeding women was recruited.

Methods

The IIFAS was translated into Chinese using forward translation, back-translation, semantic equivalence, and pilot testing. Predict validity and internal consistency was assessed. The final sample consisted of 120 women (14% attrition) that were interviewed by telephone at 6 weeks postpartum to record the breastfeeding duration and infant feeding method.

Results

One item was modified to better reflect the item content. In-hospital IIFAS scores significantly predicted breastfeeding duration as well as exclusive breastfeeding at 6 weeks postpartum. The Cronbach's alpha coefficient for internal consistency was 0.74.

Conclusions

This study provides evidence that the Chinese version of the IIFAS can be considered valid and reliable scale for assessing attitudes toward breastfeeding among breastfeeding women in Taiwan.     

Long-term reliability of the incremental shuttle walking test in clinically stable cardiovascular disease patients

Objective

The incremental shuttle walking test (ISWT) is a valuable tool for assessing changes in patients’ functional capacity during cardiac rehabilitation. However, studies have only assessed its test-retest reliability in the short term. The purpose of this study was to examine long-term test-retest reliability of the ISWT in clinically stable cardiac patients.

Design

Test-retest reliability assessment.

Setting

Continuous, community-based phase IV cardiac rehabilitation centre.

Participants

Thirty patients with cardiovascular disease (15 males, 15 females; age 55 to 80 years) volunteered to participate in the study.

Interventions

Participants undertook two ISWTs, a minimum of 8 weeks apart.

Main outcome measures

ISWT performance in metres.

Results

Overall, the mean distance walked in the pre-test was 502 ± 161 m and this did not differ from test to retest. The intraclass correlation coefficient was 0.80, indicating good test-retest reliability. Using the Bland and Altman method, there was a small mean test-retest difference (−7 m). The 95% limits of agreement were large, ranging from −203 m to 189 m.

Conclusions

Over long test-retest durations, there appears to be no learning effect in the ISWT, negating the need for a practice walk. The long-term random variation in the ISWT test is larger than in previous studies, probably due to greater physiological and psychological variation in the participants over 8 weeks compared with that seen in day-to-day testing. Factors influencing long-term test-retest reliability of the ISWT require further elucidation.     

Psychometric Evaluation of the Rasch-Based Depression Screening in Patients With Neurologic Disorders

Forkmann T, Norra C, Wirtz M, Gauggel S, Boecker M. Psychometric evaluation of the Rasch-based depression screening in patients with neurologic disorders.

Objectives

To provide a first evaluation of the Rasch-Based Depression Screening (DESC) in consecutive patients with neurologic disorders.

Design

Cross-sectional study.

Setting

Hospital specializing in neurologic disorders.

Participants

Eligible patients (N=323; mean age ± SD, 53.4±17.2y; 49.3% women) age 18 years and older.

Interventions

Not applicable.

Main outcome Measures

DESC with 2 parallel versions.

Results

Both versions of the DESC showed good item separation (DESC-I=4.96; DESC-II=4.94) and person separation (DESC-I=2.01; DESC-II=2.14) as well as item separation reliability (DESC-I=.96; DESC-II=.96) and person separation reliability (DESC-I=.80; DESC-II=.82). All items fit the Rasch model (infit and outfit mean squares ≤1.3). There were no signs of violation of unidimensionality. One item of DESC-I showed differential item functioning because of age and 1 item because of sex. Parallel test reliability of the 2 DESC forms was r equal to .92.

Conclusions

The DESC shows good psychometric characteristics that suggest high psychometric quality of the instrument in patients with neurologic disorders. Differential item functioning on single items needs further examination but should not substantially interfere with the valid interpretation of DESC sum scores.     

Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis

Pua YH, Wrigley TW, Cowan SM, Bennell KL. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis.

Objective

To examine the relative and absolute intrarater test-retest reliability of muscle strength and range of motion (ROM) measurements of the hip performed in people with hip osteoarthritis.

Design

Repeated measures.

Setting

Human movement laboratory of a university.

Participants

Participants (N=22; 10 men, 12 women; age range, 50-84y) with hip osteoarthritis.

Interventions

On 2 separate occasions, at least 1 week apart, isometric torque measurements were obtained from the hip rotators, flexors, abductors, and extensors. Passive ROMs in hip rotation, flexion, abduction, and extension were also determined.

Main Outcome Measures

Relative reliability was estimated using the intraclass correlation coefficient, model 2,2 (ICC_2,2). Absolute reliability was estimated using the coefficient of variation (CV) and the standard error (SE) of measurement.

Results

For measurements of muscle strength, ICC_2,2 ranged from .84 to .97, and the CV ranged from 8% to 15.7%. Hip extensors and internal and external rotators showed high ICC_2,2 (>.96) and low CV (<9.8%); hip abductors showed the lowest ICC_2,2 (.84) and the highest CV (15.7%). For ROM measurements, ICC_2,2 ranged from .86 to .97 and SE ranged from 3.1° to 4.7°. Hip flexion ROM showed the highest ICC_2,2 (.97) and an SE of 3.5°; hip extension ROM showed the lowest ICC_2,2 (.86) and the highest SE (4.7°).

Conclusions

Strength and ROM testing of the hip in people with hip osteoarthritis can be performed with good to excellent reliability.     

5-Repetition Sit-to-Stand Test in Subjects With Chronic Stroke: Reliability and Validity

Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity.

Objectives

To examine the (1) intrarater, interrater, and test-retest reliability of the 5-repetition sit-to-stand test (5-repetition STS test) scores, (2) correlation of 5-repetition STS test scores with lower-limb muscle strength and balance performance, and (3) cut-off scores among the 3 groups of subjects: the young, the healthy elderly, and subjects with stroke.

Design

Cross-sectional study.

Setting

University-based rehabilitation center.

Participants

A convenience sample of 36 subjects: 12 subjects with chronic stroke, 12 healthy elderly subjects, and 12 young subjects.

Interventions

Not applicable.

Main Outcome Measures

5-Repetition STS test time scores; hand-held dynamometer measurements of hip flexors, and knee flexors and extensors; ankle dorsiflexors and plantarflexors muscle strength; Berg Balance Scale (BBS); and limits of stability (LOS) test using dynamic posturography.

Results

Excellent intrarater reliability of intraclass correlation coefficient (ICC) (range, .970-.976), interrater reliability (ICC=.999), and test-retest reliability (ICC range, .989-.999) were found. Five-repetition STS test scores were also found to be significantly associated with the muscle strength of affected and unaffected knee flexors (ρ=-.753 to -.830; P<.00556) of the subjects with stroke. No significant associations were found between 5-repetition STS test and BBS and LOS tests in subjects with stroke. Cut-off scores of 12 seconds were found to be discriminatory between healthy elderly and subjects with stroke at a sensitivity of 83% and specificity of 75%.

Conclusions

The 5-repetition STS test is a reliable measurement tool that correlates with knee flexors muscle strength but not balance ability in subjects with stroke.     

Construct Validity and Test-Retest Reliability of the Climbing Stairs Questionnaire in Lower-Limb Amputees

de Laat FA, Rommers GM, Geertzen JH, Roorda LD. Construct validity and test-retest reliability of the Climbing Stairs Questionnaire in lower-limb amputees.

Objective

To investigate the construct validity and test-retest reliability of the Climbing Stairs Questionnaire, a patient-reported measure of activity limitations in climbing stairs, in lower-limb amputees.

Design

A cross-sectional study.

Setting

Outpatient department of a rehabilitation center.

Participants

Lower-limb amputees (N=172; mean ± SD age, 65±12y; 71% men; 82% vascular cause) participated in the study; 33 participated in the reliability study.

Interventions

Not applicable.

Main Outcome Measure(s)

Construct validity was investigated by testing 10 hypotheses: limitations in climbing stairs according to the Climbing Stairs Questionnaire will be greater in lower-limb amputees who: (1) are older, (2) have a vascular cause of amputation, (3) have a bilateral amputation, (4) have a higher level of amputation, (5) have more comorbid conditions, (6) had their rehabilitation treatment in a nursing home, and (7) climb fewer flights of stairs. Furthermore, limitations in climbing stairs will be related positively to activity limitations according to: (8) the Locomotor Capabilities Index, (9) the Questionnaire Rising and Sitting down, and (10) the Walking Questionnaire. Construct validity was quantified by using the Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation coefficient. Test-retest reliability was assessed with a 3-week interval and quantified using the intraclass correlation coefficient (ICC).

Results

Construct validity (8 of 10 null hypotheses not rejected) and test-retest reliability were good (ICC=.79; 95% confidence interval, .57-.90).

Conclusion

The Climbing Stairs Questionnaire has good construct validity and test-retest reliability in lower-limb amputees.     

Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks

Wang C-Y, Chen L-Y. Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks.

Objective

To examine the test-retest reliability of grip strength when using the mean value, the best value, and the first value of 2 grip strength measurements and to determine the cutoff value for separating those who were able or unable to perform a heavy task with their hands in a group of Taiwanese adults.

Design

Cross-sectional test-retest study.

Setting

Local community centers.

Participants

Community-dwelling older adults (N=469; age, ≥60y).

Interventions

Not applicable.

Main Outcome Measures

Self-reported measure of ability to perform heavy tasks with their hands and grip strength.

Results

The test-retest reliability of grip strength in older adults was good (intraclass correlation coefficient ≥.85) when using the mean value, the best value, or the first of 2 measurements. Optimum cutoff values were 28.5 and 18.5kg, and values with 75% sensitivity were 34 and 22kg for men and women, respectively.

Conclusions

The test-retest reliability of grip-strength measurement in a group of Taiwanese older adults was acceptable when the best value, the mean value, or the first of 2 measurements was used. The reported mean and cutoff values for grip strength also could serve as reference values for the public to monitor their grip strength performance and identify those at risk for early intervention.     

Reliability of the Dynamic Gait Index in individuals with multiple sclerosis

McConvey J, Bennett SE. Reliability of the Dynamic Gait Index in individuals with multiple sclerosis.

Objectives

To determine if the Dynamic Gait Index (DGI) is a reliable tool for assessing balance in people with multiple sclerosis (MS) and to determine the validity of the DGI by using the 6.1-m timed walk.

Design

Instrument reliability test: physical therapists viewed a videotape of 10 subjects with MS performing the DGI and scored their gait by using DGI criteria. Two weeks after the first session, therapists’ viewed the videotape again and scored subjects’ gait to establish interrater reliability.

Setting

Hospital-based outpatient rehabilitation clinic.

Participants

Eleven physical therapists and 10 people with MS.

Interventions

Not applicable.

Main outcome measures

Total DGI scores and each of the 8 DGI items were compared between and within raters (physical therapists). Time to walk 6.1m was compared with the total DGI score to examine concurrent validity.

Results

Interrater reliability for total DGI scores was .983, with each of the 8 items ranging from .910 to .976 (intraclass correlation coefficient, P<.05). Intrarater reliability for total DGI scores ranged between .760 and .986 (Pearson bivariate analysis, P<.05). An inverse relationship of −.801 (Pearson bivariate analysis, P<.01) existed between the total DGI scores and the 6.1-m walk.

Conclusions

The DGI is a reliable functional assessment tool that correlated inversely with timed walk, showing its concurrent validity.     

Intratester Reliability and Validity of Concentric Measurements Using a New Hand-Held Dynamometer

Janssen JC, Le-Ngoc L. Intratester reliability and validity of concentric measurements using a new hand-held dynamometer.

Objective

To assess the reliability of a new hand-held dynamometer (HHD) to perform concentric measurements, and to determine the agreement between the HHD and the criterion standard isokinetic dynamometer.

Design

Elbow flexion concentric measurements were performed on a mechanical arm using the HHD and the isokinetic dynamometer.

Setting

Engineering laboratory and university strength-testing facility.

Participants

Three patient profiles, differing in range of motion (ROM) and strength, were simulated by a mechanical arm.

Interventions

Not applicable.

Main Outcome Measures

Peak torque and ROM obtained from concentric elbow flexion profiles.

Results

Intratester reliabilities, measured with the intraclass correlation coefficient (ICC_1,1), of the peak torque and start and end ROM are excellent for both the HHD (.99, .98, and .99, respectively) and the isokinetic dynamometer (.99 for all 3 variables). The angle of peak torque was rated fair to good in intrareliability for both devices, at .64 (HHD) and .69 (isokinetic dynamometer). Validity, measured within the limits of agreement (LOA) between the 2 devices, was clinically acceptable for peak torque and start ROM, although not for end ROM and angle of peak torque.

Conclusions

It is possible to use the new HHD to obtain dynamic measurements of joint motion. Intratester reliability of the HHD is excellent and is in clinical acceptable agreement with the isokinetic dynamometer for peak torque and start ROM. End ROM was, however, not in agreement because of a systematic error in the isokinetic dynamometer measurement for 1 of the 3 tested profiles. Intratester reliabilities of the angle of peak torque were fair to good for both the HHD and isokinetic dynamometer, but the LOA were not clinically acceptable. Stability of the arm and speed of measurement might be confounding factors in this study.     

The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility

Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.

Objective

To determine the measurement properties and diagnostic utility of the JFK Coma Recovery Scale-Revised (CRS-R).

Design

Analysis of interrater and test-retest reliability, internal consistency, concurrent validity, and diagnostic accuracy.

Setting

Acute inpatient brain injury rehabilitation hospital.

Participants

Convenience sample of 80 patients with severe acquired brain injury admitted to an inpatient Coma Intervention Program with a diagnosis of either vegetative state (VS) or minimally conscious state (MCS).

Interventions

Not applicable.

Main outcome measures

The CRS-R, the JFK Coma Recovery Scale (CRS), and the Disability Rating Scale (DRS).

Results

Interrater and test-retest reliability were high for CRS-R total scores. Subscale analysis showed moderate to high interrater and test-retest agreement although systematic differences in scoring were noted on the visual and oromotor/verbal subscales. CRS-R total scores correlated significantly with total scores on the CRS and DRS indicating acceptable concurrent validity. The CRS-R was able to distinguish 10 patients in an MCS who were otherwise misclassified as in a VS by the DRS.

Conclusions

The CRS-R can be administered reliably by trained examiners and repeated measurements yield stable estimates of patient status. CRS-R subscale scores demonstrated good agreement across raters and ratings but should be used cautiously because some scores were underrepresented in the current study. The CRS-R appears capable of differentiating patients in an MCS from those in a VS.     

Psychometric Properties of a Scale to Assess the Severity of Bathing Disability

Gill TM, Gahbauer EA, Van Ness PH. Psychometric properties of a scale to assess the severity of bathing disability.

Objective

To develop and evaluate the psychometric properties of a new bathing disability scale.

Design

Reliability and validity study.

Setting

General community.

Participants

Two subsets of community-living older persons, selected from an ongoing longitudinal study, who had some degree of bathing disability or were at increased risk for bathing disability, as determined during a comprehensive assessment at 36 (N=199) and 54 (N=213) months, respectively.

Interventions

Not applicable.

Main Outcome Measures

The bathing disability scale was administered at 36, 54, and 72 months, and changes in scores were assessed between 36 and 54 months and 54 and 72 months, respectively, for the 2 subsets of participants. Convergent construct validity was evaluated by comparisons with changes in activity of daily living (ADL) disability, mobility disability, and the Short Physical Performance Battery (SPPB). Discriminative construct validity was determined by comparisons according to age and physical frailty. Responsiveness was evaluated by comparisons between participants who had and had not been hospitalized and, subsequently, by plotting correlations according to the timing of these hospitalizations.

Results

The test-retest reliability was high, with an intraclass correlation coefficient=0.76 (95% confidence interval=0.59−0.94). The internal consistency reliability was excellent with Cronbach α=0.91−0.97. Changes in scores on the bathing disability scale were positively correlated with changes in scores in ADL and mobility disability and inversely correlated with changes in scores on the SPPB. A greater decline in scores was observed among the oldest old and those who were physically frail, but these differences did not consistently achieve statistical significance. The scale was responsive to the occurrence and/or timing of intervening hospitalizations.

Conclusions

The bathing disability scale is reliable, valid, and responsive and may be suitable for use in clinical trials to evaluate the effectiveness of interventions to enhance independent bathing.     

A study to determine the reliability of an ankle dorsiflexion weight-bearing device

Objectives

To investigate the inter-observer and intra-observer reliability of measurement of ankle movement during a weight-bearing dorsiflexion lunge in healthy and injured groups.

Setting

Defence Medical Rehabilitation Centre, UK.

Participants

Seventeen healthy subjects, 11 subjects with ankle injuries and three trained observers.

Design

Each observer assessed subjects on two separate test days, 7 days apart. Each measurement was repeated six times and the results were averaged. Limits of agreement and intra-class correlation coefficients were calculated to give a measure of reliability.

Main outcome measures

A measurement tool designed at the Defence Medical Rehabilitation Centre, UK.

Results

Intra-observer 95% limits of agreement ranged from ±3.30 to ±3.66 cm for the healthy group and from ±2.35 to ±3.85 cm for patients. The inter-observer limits of agreement ranged from ±1.57 to ±2.65 cm for healthy subjects and from ±0.87 to ±3.46 cm for patients.

Conclusions

Results indicate acceptable inter-observer and intra-observer reliability for use of this rehabilitation assessment tool to measure the weight-bearing dorsiflexion lunge range of ankle motion when results are averaged over six repetitions.     

Validity and Reliability of Assessment Tools for Measuring Unsupported Sitting in People With a Spinal Cord Injury

Boswell-Ruys CL, Sturnieks DL, Harvey LA, Sherrington C, Middleton JW, Lord SR. Validity and reliability of assessment tools for measuring unsupported sitting in people with a spinal cord injury.

Objectives

To develop simple tests to assess the abilities of people with spinal cord injury (SCI) to sit unsupported and to assess the construct validity and test-retest reliability of these tests.

Design

Cross-sectional comparisons, convenience sample.

Setting

Biomechanical laboratory.

Participants

People (N=30) with SCI between the C6 and the L2 level of 2 months to 37 years duration before assessment. The sample was stratified by impairment level (at T8) and time since injury (1y postinjury).

Interventions

Not applicable.

Main Outcome Measures

On 2 separate occasions, participants performed tests that measured the distance of upper-body sway and maximal torso leaning, errors made during a coordinated stability task, timed dressing/undressing of the upper body and alternating arm reaching, and percentage change in seated upper body/arm reaching.

Results

All tests showed good construct validity in that they distinguished between participants with higher (C6-T7) and lower (T8-L2) level impairments (P<.05) and between participants with acute (≤1y) and chronic (>1y) lesions (P<.05). The tests also showed good to excellent test-retest reliability (intraclass correlation coeffiecient_3,1 range, .51-.91).

Conclusions

These simple and quick-to-administer tests have both construct validity and test-retest reliability. They would be appropriate for research and clinical purposes to quantify the abilities of people with SCI to sit unsupported.     

The CONFbal scale: a measure of balance confidence—a key outcome of rehabilitation

Objective

Optimising balance confidence is the goal of rehabilitation among people with mobility problems. The aim of this study was to examine the measurement properties of the CONFbal scale of balance confidence, and comment on its importance in rehabilitation. The 10-item CONFbal scale can also be referred to as a ‘falls self-efficacy scale’.

Study 1: Internal consistency and test-retest reliability

Design CONFbal was administered on two occasions, 1 week apart, using a standardised procedure.Setting Three day centres in south-west London.Participants Older people (n = 45, mean age 81 years, standard deviation 7) without any recent change in mobility.Results The 10 scale items were summed to give an index of balance confidence. Cronbach's alpha for the items was 0.91, with an intra-class correlation coefficient of 0.95. The within-subject standard deviation was 1.145, giving a minimal detectable change of three scale points. This suggests that a change in score of three points following treatment indicates a true difference.

Study 2: Concurrent validity

Setting Geriatric medical wards in three south-west London hospitals.Participants One hundred and fifty-three people (mean age 81 years, standard deviation 6) completed the test battery prior to discharge.Data CONFbal; postural instability; perceived unsteadiness; previous mobility; falls in the last 3 years.Results CONFbal scores (lower scores indicate greater balance confidence) were related to an index of postural instability [correlation coefficient (r) = 0.75], previous mobility (r = −0.76) and perceived unsteadiness (r = 0.48), but demonstrated a weak relationship with experience of falling (r = 0.26).

Conclusions

The CONFbal scale demonstrates excellent internal consistency, excellent test-retest reliability, and a small minimal detectable change which allows users to judge whether or not there has been a true clinical improvement. Relationships between the CONFbal scale and other relevant physical and psychological variables support its validity in this population.     

Parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis in children: Instrument reliability and validity

Background

Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change.

Objectives

To develop a suite of valid and reliable research instruments to appraise parents’ self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis.

Methods

The Parents’ Eczema Management Scale (PEMS) and the Parents’ Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales’ reliability and validity was conducted.

Setting and participants

A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia.

Results

Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents’ self-efficacy and outcome expectations had a significant influence on self-reported task performance.

Conclusions

Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.     

Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory

Collins S, van Hilten JJ, Marinus J, Zuurmond WW, de Lange JJ, Perez RS. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory.

Objective

To develop a questionnaire to evaluate symptoms of complex regional pain syndrome type I (CRPS-I), fibromyalgia, and repetitive strain injury to determine the test-retest reliability and investigate concurrence in the clinical manifestations of CRPS-I and fibromyalgia.

Design

The Trauma Related Neuronal Dysfunction Symptoms Inventory (TSI) was developed by determining the content validity and the practical use of the questionnaire. Furthermore, the test-retest reliability was assessed on 2 identical questionnaires filled out within a 7-day interval by CRPS-I and fibromyalgia patients.

Setting

Outpatient pain clinic of a Dutch medical center.

Participants

CRPS-I (n=26; mean age, 54y) and fibromyalgia patients (n=42; mean age, 45.4y).

Interventions

Not applicable.

Main Outcome Measure

Test-retest reliability calculated with intraclass correlation (ICC).

Results

Reliability scores were good for the whole questionnaire, its categories, and domains (ICC>.75) for both CRPS-I and fibromyalgia patients. Sensory complaints (except for change in cold perception), motor complaints, and visceral complaints (diarrhea and incontinence) were reported by both CRPS-I and fibromyalgia patients. A change in cold perception, discoloration, change in skin temperature, change in sweating behavior, change in the severity of edema during exercise, and trophic changes of skin were reported significantly more often by CRPS-I patients, whereas complaints of the (upper and lower) back, constipation, urine retention, and experiencing a dry mouth were reported significantly more often by fibromyalgia patients.

Conclusions

The TSI is a reliable instrument with good content validity, which can be used in the evaluation of similarities and differences between CRPS-I and fibromyalgia. The systematic evaluation of symptoms of CRPS-I and potentially related illnesses may provide a better basis for future research into the underlying mechanism(s).     

Interrater Reliability and Validity of the Stair Ascend/Descend Test in Subjects With Total Knee Arthroplasty

Almeida GJ, Schroeder CA, Gil AB, Fitzgerald GK, Piva SR. Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty.

Objective

(1) To determine the interrater reliability and measurement error of an 11-step stair ascend/descend test (STTotal-11) and stair up (ascend) test (STUp-11); (2) to seek evidence for the STTotal-11 and STUp-11 as valid measures of physical function by determining if they relate to measures of physical function and do not relate to measures not of physical function; and (3) to explore if the STTotal-11 and STUp-11 scores relate to lower-extremity muscle weakness and knee range of motion (ROM) in subjects with total knee arthroplasty (TKA).

Design

Cross-sectional study.

Setting

Academic center.

Participants

Subjects (N=43, 30 women; mean age, 68±8y) with unilateral TKA.

Interventions

Not applicable.

Main Outcome Measures

STTotal-11 and STUp-11 were performed twice, and scores were compared with scores on 4 lower extremity performance-based tasks, 2 patient-reported questionnaires of physical function, 3 psychologic factors, knee ROM, and strength of quadriceps, hip extensors, and abductors.

Results

Intraclass correlation coefficient was .94 for both the STTotal-11 and STUp-11, standard error of measurements were 1.14 seconds and .82 seconds, and minimum detectable change associated with 90% confidence interval was 2.6 seconds and 1.9 seconds, respectively. Correlations between stair tests and performance-based measures and knee and hip muscle strength ranged from Pearson correlation coefficient (r)=.40 to .78. STTotal-11 and STUp-11 had a small correlation with one of the patient-reported measures of physical function. Stair tests were not associated with psychologic factors and knee extension ROM and were associated with knee flexion ROM.

Conclusions

STTotal-11 and STUp-11 have good interrater reliability and minimum detectable changes adequate for clinical use. The pattern of associations supports the validity of the stair tests in TKA.