1
|
Prüfer F, Pavlović M, Matko Š, Löfler S, Fischer MJ, Šarabon N, Grote V. Responsiveness of Isokinetic Dynamometry in Patients with Osteoarthritis after Knee and Hip Arthroplasty: A Prospective Repeated-Measures Cohort Study. Healthcare (Basel) 2024; 12:314. [PMID: 38338199 PMCID: PMC10855832 DOI: 10.3390/healthcare12030314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations of responsiveness-the ability to detect changes over time. This study aims to determine the responsiveness of ID in measuring PF in TKA and THA rehabilitation-is muscle strength a valid indicator for assessing improvement in rehabilitation processes? The pre- and post-surgery PF of 20 osteoarthritis patients (age 55-82) was assessed, using ID, performance-based and self-reported measures. Responsiveness was evaluated by comparing the observed relationship of changes in ID and PF scores with the a priori defined expected relationship of change scores. While the performance-based and self-reported measures showed significant improvements post-surgery (Cohen's d [0.42, 1.05] p < 0.05), ID showed no significant differences. Moderate correlations were found between changes in some ID parameters and selected functional tests (r ≈|0.5|, p < 0.05). Responsiveness was solely found for the peak torque of knee extension at 180°/s on the operated side. Responsiveness is an often-overlooked psychometric property of outcome measurements. The findings suggest that ID may not be fully responsive to the construct of PF after TKA and THA, raising questions about its role and usefulness in this context and the need for more appropriate assessment methods.
Collapse
Affiliation(s)
- Ferdinand Prüfer
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
| | - Monika Pavlović
- Faculty of Health Sciences, University of Ljubljana, SI-1000 Ljubljana, Slovenia;
| | - Špela Matko
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
| | - Michael J. Fischer
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
- Vamed Rehabilitation Center Kitzbühel, A-6370 Kitzbühel, Austria
| | - Nejc Šarabon
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
- Faculty of Health Sciences, University of Primorska, SI-6310 Izola, Slovenia
- Innorenew CoE, SI-6310 Izola, Slovenia
| | - Vincent Grote
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1100 Vienna, Austria (M.J.F.); (V.G.)
| |
Collapse
|
2
|
da Silva MCR, Machado DB, Mochizuki L, Cardoso MAJM, de Oliveira J, da Silva Gevaerd M, Ervilha UF, Cajueiro MOB, Domenech SC. Sensory Integration for Postural Control in Rheumatoid Arthritis Revealed by Computerized Dynamic Posturography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4702. [PMID: 36981611 PMCID: PMC10048986 DOI: 10.3390/ijerph20064702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/18/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease that impairs mobility. How does sensory information influence postural responses in people with RA? The aim of this study was to evaluate the postural control of people with RA during a sensory organization test, comparing how sensory information influences postural responses in people with rheumatoid arthritis compared with healthy people. Participants were 28 women with rheumatoid arthritis (RA group) and 16 women without any rheumatoid disease (Control group CG). The Sensory Organization Test (SOT) was performed on a Smart Balance Master® (NeuroCom International, Inc., Clackamas, OR, USA) and center of pressure (COP) was measured. SOT conditions: SOT1 (eyes open, fixed support surface and surround; SOT2) eyes closed, fixed support surface and surround; and SOT5) eyes closed, sway-referenced support surface, and fixed surround. To compare the demographic and clinical aspects between groups, independent t-test or Mann-Whitney's U-test were used. Differences were found between groups. Between SOT conditions, for CG and RA, COP was faster for SOT-5 than SOT-1, while SOT-1 and SOT-2 presented similar COP velocity. For SOT-2 and SOT-5, COP was larger for the RA group. For both groups, SOT-1 presented the smallest COP, and SOT-5 showed the largest COP.
Collapse
Affiliation(s)
| | - Deyse Borges Machado
- College of Health and Sport Sciences, State University of Santa Catarina, Florianópolis 88080-350, Brazil
| | - Luis Mochizuki
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil
| | | | - Juliane de Oliveira
- College of Health and Sport Sciences, State University of Santa Catarina, Florianópolis 88080-350, Brazil
| | - Monique da Silva Gevaerd
- College of Health and Sport Sciences, State University of Santa Catarina, Florianópolis 88080-350, Brazil
| | | | | | - Susana Cristina Domenech
- College of Distance Learning, State University of Santa Catarina, Florianópolis 88035-001, Brazil
| |
Collapse
|
3
|
Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Iram H, Farooq M. Psychometric Properties of the Urdu Translation of Berg Balance Scale in People with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042346. [PMID: 35206533 PMCID: PMC8872175 DOI: 10.3390/ijerph19042346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
Background: The most common assessment tool used in clinical settings to detect changes in balance performance is the Berg Balance Scale (BBS). Thus, the purpose of this study was to translate the BBS into Urdu and investigate the psychometric properties (acceptability, internal consistency reliability, interrater reliability, construct validity) for individuals with Parkinson’s disease (PD). Methods: Eighty patients of either gender with idiopathic Parkinson’s disease, stages I–III on the modified Hoehn–Yahr (H&Y) scale, with intact cognition according to the Mini Mental Score Examination (MMSE) score (greater than or equal to 24) and independent of transfers, were included in this study. The BBS was translated according to international guidelines based on forward and backward translation processes. The test-retest reliability as well as intra- and inter-observer reliability was assessed by calculating the intra-class correlation coefficient (ICC). The internal consistency of the entire BBS score was assessed by calculating Cronbach’s α. The convergent validity was assessed by correlating the scale with the Unified Parkinson Disease Rating Scale (UPDRS) parts II and III and the Activity-specific Balance Confidence Scale (ABCS). The construct validity was assessed using a factor analysis. Results: The mean age of the subjects was 62.35 ± 5.74 in years (range: 60–87 years). The ICC for intra- and inter-observer reliability was 0.95 (p < 0.0001) and 0.99 (p < 0.001), respectively. Cronbach’s α was calculated as 0.81, which showed acceptable internal consistency of the Urdu version of the BBS. The test-retest reliability (ICC) of the Urdu version of the BBS was determined as 0.97 for the total score, and ranged from 0.66–0.95 for individual items. In terms of validity, the Urdu version of the BBS was correlated with the ABCS (in the positive direction) and UPDRS-II and III (in the negative direction) (r = 0.53, p < 0.001; r = −0.68, p < 0.001, r = −0.78, p < 0.0001), respectively. Conclusion: The Urdu version of the BBS is a reliable and valid scale to be used in balance assessment of population diagnosed with PD with excellent psychometric properties.
Collapse
Affiliation(s)
- Muhammad Kashif
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
- Correspondence: (M.K.); (A.A.)
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
- Correspondence: (M.K.); (A.A.)
| | - Muhammad Ali Mohseni Bandpei
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
| | - Syed Amir Gilani
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
| | - Humaira Iram
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
| | - Maryam Farooq
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
| |
Collapse
|
4
|
Gaino JZ, Bértolo MB, Nunes CS, Barbosa CDM, Landim SF, Sachetto Z, Magalhães EDP. The effect of foot orthoses on balance, foot function, and mobility in rheumatoid arthritis: A randomized controlled clinical trial. Clin Rehabil 2021; 35:1011-1020. [PMID: 33586475 DOI: 10.1177/0269215521993316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare balance, foot function and mobility in patients with rheumatoid arthritis with and without foot orthoses. DESIGN Randomized controlled trial. SETTING Outpatient rheumatology clinic. SUBJECTS A total of 94 subjects with rheumatoid arthritis were randomized; of these, 81 were included in the analyses (Intervention group: 40; Control group: 41). INTERVENTION The Intervention Group received custom-made foot orthoses while the Control Group received none intervention. MAIN MEASURE The "Foot Function Index," the "Berg Balance Scale," and the "Timed-up-and-go Test" were assessed at baseline an after four weeks. The chosen level of significance was P < 0.05. RESULTS Average (standard deviation) participant age was 56.7 (±10.6) years old and average disease duration (standard deviation) was 11.4 (± 7.2) years. Groups were similar at baseline, except for comorbidity index and race. After four weeks, significant interaction group versus time was observed for Foot Function Index (change: Intervention group: -1.23 ± 1.58; Control group: -0.12 ± 1.16 - P = 0.0012) and for Berg Balance Scale (change: Intervention group: 2 ± 3; Control group: 0 ± 3 - P = 0.0110), but not for the Timed-up-and-go Test (change: Intervention group: -1.34 ± 1.99; Control group: -0.84 ± 2.29 - P = 0.0799). CONCLUSION Foot orthoses improved foot function and balance in patients with rheumatoid arthritis.
Collapse
Affiliation(s)
- Juliana Zonzini Gaino
- Department of Internal Medicine, Rheumatology, Faculty of Medical Sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Manoel Barros Bértolo
- Department of Internal Medicine, Rheumatology, Faculty of Medical Sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Caroline Silva Nunes
- Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Cecília de Morais Barbosa
- Department of Internal Medicine, Gerontology, Faculty of Medical Sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Síbila Floriano Landim
- Department of Internal Medicine, Rheumatology, Faculty of Medical Sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Zoraida Sachetto
- Department of Internal Medicine, Rheumatology, Faculty of Medical Sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Eduardo de Paiva Magalhães
- Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| |
Collapse
|
5
|
Lange E, Gjertsson I, Mannerkorpi K. Long-time follow up of physical activity level among older adults with rheumatoid arthritis. Eur Rev Aging Phys Act 2020; 17:10. [PMID: 32699561 PMCID: PMC7368988 DOI: 10.1186/s11556-020-00242-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/30/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Physical activity and exercise are acknowledged as important parts in the management of rheumatoid arthritis (RA). However, long-term maintenance of exercise is known to be difficult. The aim of this study was to evaluate change in physical activity and physical fitness after four years in older adults with RA who had previously participated in exercise with person-centred guidance compared to controls. METHOD A follow-up study was performed where older adults (> 65 years) who had participated in a randomized controlled trial where they were allocated to either exercise with person-centred guidance or home-based, light-intensity exercise (controls) were invited to one visit and assessed with performance-based test, blood-sampling and self-reported questionnaires. Forty-seven out of 70 older adults accepted participation, 24 from the exercise group and 23 from the control group. Comparisons of the result with baseline values were performed and explanatory factors for increase of physical activity were examined with logistic regression. RESULTS The result show that there was no significant difference in weekly hours of physical activity when groups where compared. However, participants in the exercise group rated significantly increased weekly hours of physical activity after four years (p = 0.004) when compared to baseline. Higher levels of fatigue, BMI and physical activity, at baseline were negatively associated with increased physical activity after four years. There was no significant difference in change of physical fitness between the groups. Within group analysis showed that the control group reported increased pain (p = 0.035), fatigue (p = 0.023) increased number of tender joints (p = 0.028) higher disease activity (p = 0.007) and worsening of global health (p = 0.004) when compared to baseline while the exercise group remained at the same level as at baseline. CONCLUSION These results indicate that introducing moderate- to high intensity exercise with person-centred guidance might favor increased physical activity after four years in older adults with RA. Previous partaking in moderate- to high intensity exercise might also be protective against increased disease activity, pain and fatigue over time.
Collapse
Affiliation(s)
- Elvira Lange
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Göteborg, Sweden
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Gjertsson
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Rheumatology and Inflammation research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kaisa Mannerkorpi
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30 Göteborg, Sweden
- University of Gothenburg Center for Person-centred Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
6
|
Christensen JC, Kittelson AJ, Loyd BJ, Himawan MA, Thigpen CA, Stevens-Lapsley JE. Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study. BMC Musculoskelet Disord 2019; 20:483. [PMID: 31656185 PMCID: PMC6815380 DOI: 10.1186/s12891-019-2817-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/05/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rates of total knee arthroplasty (TKA) procedures in younger, more medically complex patients have dramatically increased over the last several decades. No study has examined categorization of lower and higher functioning subgroups within the TKA patient population. Our study aimed to determine preoperative characteristics of younger patients who are lower functioning following TKA. METHODS Patients were categorized into higher and lower functioning subgroups defined using a median split of 1) postoperative Timed Up and Go (TUG) test times and 2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale scores. A split in age (65 years) was used to further classify patients into four categories: younger lower functioning, younger higher functioning, older lower functioning and older higher functioning. Measures from preoperative domains of health, psychological, physical performance and pain severity were examined for between-group differences. RESULTS Comparing mean values, the younger lower functioning subgroup using the TUG had significantly weaker knee extensor, slower gait speed, higher body mass index and greater pain compared to other subgroups. The younger lower functioning subgroup using the WOMAC physical function subscale demonstrated higher pain levels and Coping Strategies Questionnaire-Catastrophizing Subscale scores compared to the older lower functioning subgroup. CONCLUSIONS Poorer preoperative physical performance and pain severity appear to have the largest influence on early postoperative TKA recovery in younger lower functioning patients relative to both younger and older higher functioning patients.
Collapse
Affiliation(s)
- Jesse C Christensen
- Department of Physical Medicine and Rehabilitation, Eastern Colorado Geriatric Research Education and Clinical Center, 13001 E. 17th Pl, Aurora, CO, 80045, USA. .,Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.
| | - Andrew J Kittelson
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Brian J Loyd
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Michael A Himawan
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | | | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, Eastern Colorado Geriatric Research Education and Clinical Center, 13001 E. 17th Pl, Aurora, CO, 80045, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| |
Collapse
|
7
|
Meseguer-Henarejos AB, Rubio-Aparicio M, López-Pina JA, Carles-Hernández R, Gómez-Conesa A. Characteristics that affect score reliability in the Berg Balance Scale: a meta-analytic reliability generalization study. Eur J Phys Rehabil Med 2019; 55:570-584. [DOI: 10.23736/s1973-9087.19.05363-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
8
|
Cerón-Lorente L, Valenza MC, Pérez-Mármol JM, García-Ríos MDC, Castro-Sánchez AM, Aguilar-Ferrándiz ME. The influence of balance, physical disability, strength, mechanosensitivity and spinal mobility on physical activity at home, work and leisure time in women with fibromyalgia. Clin Biomech (Bristol, Avon) 2018; 60:157-163. [PMID: 30366245 DOI: 10.1016/j.clinbiomech.2018.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Fibromyalgia syndrome is a chronic disease consisting of widespread pain, fatigue, sleep disturbances, and cognitive impairments, among other symptoms, which affect daily physical activity. However, the influence of functional status on physical activity involved in leisure, household and work activities has not been researched previously. The main objective was to evaluate balance, strength, spinal mobility, mechanosensitivity and function levels as related factors of physical activity in female with fibromyalgia. METHODS Thirty-four patients with Fibromyalgia and 22 matched controls were included in a cross-sectional study. Dynamic and static balance, general and daily activities disability, lumbosacral mechanosensitivity, spinal range of motion, lower limb strength, physical activity in leisure, household and work activities were registered. We tested for differences between groups by using independent sample t-tests. The influence of demographics, symptoms and physical outcomes on physical activity was statistically analyzed using bivariate and multivariate regression analyses. FINDINGS There was a significant association between leisure-time physical activity scores and age (r = 0.564), spinal flexion (r = 0.512), spinal extension (r = 0.421) and the total range of spinal inclination (r = 0.533). Fifty-eight percent of the variance of leisure-time physical activity was explained by age and range of spinal flexion-extension. Similarly, functional mobility was associated with physical activity at home and work scores (r = 0.459), explaining 21% of its variance. INTERPRETATION A higher time spent in leisure, household and work activities was related to higher age, spinal range of motion and lower functional mobility in women with Fibromyalgia. Rehabilitation intervention programs should promote physical activity at home, work and leisure time.
Collapse
Affiliation(s)
- Laura Cerón-Lorente
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Spain.
| | - José Manuel Pérez-Mármol
- Instituto de Investigación Biosanitaria Granada (ibs.GRANADA), Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), Spain.
| | - María Del Carmen García-Ríos
- Instituto de Investigación Biosanitaria Granada (ibs.GRANADA), Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), Spain.
| | | | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria Granada (ibs.GRANADA), Department of Physical Therapy, Faculty of Health Science, University of Granada (UGR), Spain
| |
Collapse
|
9
|
Zonzini Gaino J, Barros Bértolo M, Silva Nunes C, de Morais Barbosa C, Sachetto Z, Davitt M, de Paiva Magalhães E. Disease-related outcomes influence prevalence of falls in people with rheumatoid arthritis. Ann Phys Rehabil Med 2018; 62:84-91. [PMID: 30278237 DOI: 10.1016/j.rehab.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/03/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) are at increased risk of falls, with potential adverse outcomes. There is a considerable variation across studies regarding the prevalence of falls and its correlation with clinical data, disease-related outcomes and physical performance tests. OBJECTIVE The aim of this study was to evaluate the prevalence of falls and its association with clinical data, disease-related outcomes and physical performance tests. METHODS In this cross-sectional study, 113 RA patients were divided into 3 groups - "non-fallers", "sporadic fallers" and "recurrent fallers" - and compared in terms of clinical data, Clinical Disease Activity Index (CDAI), lower-limb tender and swollen joint count, disability (Health Assessment Questionnaire-Disability Index [HAQ-DI]), Foot Function Index (FFI), Berg Balance Scale (BBS), Timed-up-and-go Test (TUG) and 5-Time Sit Down-To-Stand Up Test (SST5). Logistic regression analysis was performed to analyze the associations between the studied variables and the occurrence of falls, estimating odds ratios (ORs). We also analyzed the correlation between disease outcome measures (HAQ-DI and CDAI) and physical tests (BBS, TUG, SST5). RESULTS Falls and fear of falling were reported by 59 (52.21%) and 71 (64.5%) patients, respectively. Significant associations were found between "recurrent fallers" and vertigo (OR=3.42; P=0.03), fear of falling (OR=3.44; P=0.01), low income (OR=2.02; P=0.04), CDAI (OR=1.08; P<0.01), HAQ-DI (OR=3.66; P<0.01), Lower-limb HAQ (OR=3.48; P<0.01), FFI-pain (OR=1.24; P=0.03), FFI-total (OR=1.23; P=0.04), lower-limb tender joint count (OR=1.22; P<0.01), BBS score (OR=1.14; P<0.01), TUG score (OR=1.13; P=0.03) and SST5 score (OR=1.06; P=0.02). On multivariate analysis, CDAI was the only significant predictor of recurrent falls (OR=1.08; P<0.01). Physical performance test scores (BBS, TUG, SST5) were correlated with the CDAI and HAQ-DI. CONCLUSION The prevalence of falls in RA is high, most influenced by disease-related outcomes and linked to worse performance on physical tests (BBS, TUG and SST5).
Collapse
Affiliation(s)
- J Zonzini Gaino
- Department of internal medicine, rheumatology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - M Barros Bértolo
- Department of internal medicine, rheumatology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - C Silva Nunes
- Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - C de Morais Barbosa
- Department of internal medicine, gerontology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - Z Sachetto
- Department of internal medicine, rheumatology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - M Davitt
- Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil
| | - E de Paiva Magalhães
- Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil.
| |
Collapse
|
10
|
Lee IFK, Yau FN, Yim SSH, Lee DTF. Evaluating the impact of a home-based rehabilitation service on older people and their caregivers: a matched-control quasi-experimental study. Clin Interv Aging 2018; 13:1727-1737. [PMID: 30254432 PMCID: PMC6140694 DOI: 10.2147/cia.s172871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Previous studies evaluating home-based rehabilitation service (HBRS) merely focused on the period immediately after the patients’ discharge from hospitals. The present study focuses on HBRS that covers clients who have not been recently hospitalized. HBRS aims to meet older clients’ rehabilitation needs and support their caregivers in the community. This study intended to evaluate the impact of HBRS on the older clients’ health outcomes and hospital services utilization, and caregivers’ strain in providing care for clients. Methods This study used a matched-control quasi-experimental design with a 3-month follow-up to evaluate HBRS. The health outcome measures used for the older clients included Elderly Mobility Scale, Timed Up and Go test, Modified Barthel Index, Lawton’s Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, and World Health Organization Quality of Life Scale, Short Form, Hong Kong version (WHOQOL-BREF [HK]). Meanwhile, the Caregiver Strain Index was used to measure the caregivers’ caregiving strain. Data on clients’ hospital services utilization 3 and 6 months before and after the study were also collected and evaluated. Results The final sample consisted of 122 pairs of older clients and caregivers who live in a community in Hong Kong. In the follow-up after 3 months, the intervention group showed immensely substantial improvements across all the health outcome measures compared with the control group. The intervention group also demonstrated substantial reduction in the clients’ hospital services utilization compared with the control group. However, no significant differences in the clients’ hospital services utilization exist between the two groups in the follow-up after 6 months. Conclusion HBRS of this study is an effective intervention service to improve health outcomes and reduce hospital services utilization among older people living in the community. Moreover, HBRS of this study was effective in reducing the caregivers’ caregiving strain.
Collapse
Affiliation(s)
- Iris Fung-Kam Lee
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region,
| | - Felix Ngok Yau
- Nethersole Outreaching Rehabilitation Mission, Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong, Special Administrative Region
| | - Sally Suk-Ha Yim
- Nethersole Outreaching Rehabilitation Mission, Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong, Special Administrative Region
| | - Diana Tze-Fan Lee
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region,
| |
Collapse
|
11
|
Doll H, Gentile B, Bush EN, Ballinger R. Evaluation of the Measurement Properties of Four Performance Outcome Measures in Patients with Elective Hip Replacements, Elective Knee Replacements, or Hip Fractures. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1104-1114. [PMID: 30224116 DOI: 10.1016/j.jval.2018.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate the measurement properties of four performance outcome (PerfO) measures (timed up and go, four-step stair climb, long stair climb, and repeated chair stand) in three patient populations(elective total hip replacement [eTHR], elective total knee replacement [eTKR], and hip fracture [HF]). METHODS A cross-sectional and longitudinal design was used to assess the PerfO measurement properties using the US Food and Drug Administration guidance for industry around patient-reported outcome measures to support labeling claims. Patient-reported outcome measures and patient- and clinician-reported global concept items were completed along with four PerfO measures at visit 1 and two follow-up visits. Measurement properties assessed included reliability, construct validity, ability to detect change, and estimates of meaningful change. RESULTS A total of 280 patients (100 eTHR, 105 eTKR, and 75 HF) were recruited, with most (n = 276) providing data at visit 1. Most of the patients were female (64%) and retired (64%), and had at least one comorbidity (91%). Inter-rater and test-retest reliability ranged from good to excellent (0.73 ≤ intraclass correlation coefficient ≤ 0.95) for each PerfO measure. Known-groups validity was demonstrated for all PerfO measures, with those reporting less pain better physical functioning and those who did not use an assistive device having quicker mean completion times. Construct validity and ability to detect change were demonstrated and estimates of meaningful change derived. CONCLUSIONS This study found the measurement properties of four PerfO measures in samples of patients with eTHR, eTKR, and HF to be supported for consideration of future use, and provided estimates for interpretation of change.
Collapse
Affiliation(s)
- Helen Doll
- ICON Clinical Research, Abingdon, Oxfordshire, UK
| | | | - Elizabeth Nicole Bush
- Patient-Focused Outcomes Center of Expertise, Eli Lilly and Co., Indianapolis, IN, US
| | | |
Collapse
|
12
|
Performance on Balance Evaluation Systems Test (BESTest) Impacts Health-Related Quality of Life in Adult Spinal Deformity Patients. Spine (Phila Pa 1976) 2018; 43:637-646. [PMID: 28858190 DOI: 10.1097/brs.0000000000002390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective single-center study. OBJECTIVE Study investigates how dynamic balance performance complements 2D static radiographic measurements and demographics in terms of understanding health-related quality of life in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA Recent insights suggest that demographic variables have a stronger impact on health-related quality of life than 2D radiographic spinopelvic parameters in ASD patients. METHODS Nine healthy volunteers and 36 ASD patients following inclusion criteria were recruited. Demographics, Scoliosis Research Society Score-22r (SRS-22r), Oswestry Disability Index (ODI), Core Outcome Measures Index (COMI), 2D radiographic spinopelvic measurements, and performance on Balance Evaluation Systems Test (BESTest), and Trunk Control Measurement Scale (TCMS) were determined for each subject. Nonparametric tests, Spearman correlations, univariate, and stepwise-like linear multivariate regression analysis were performed. RESULTS BESTest and TCMS had significant lower values in the ASD group versus the control group (P = 0.000). In the ASD group, Cumulative Illness Rating Scale (CIRS) correlated fair to ODI, COMI (0.441 ≥ r ≥ 0.383, P < 0.021) and to SRS-22-r (r = -0.335, P = 0.046), Mini Mental State Examination correlated fair to COMI (r = -0.352, P = 0.035), "Pelvic Incidence minus Lumbar Lordosis" correlated fair to ODI (r = 0.361, P = 0.031), BESTest correlated moderate to ODI and COMI (r ≤ -0.505; P ≤ 0.002), TCMS correlated fair to ODI (r = -0.356; P = 0.033). CIRS and BESTest were significant predictive variables for COMI based on univariate analysis in ASD patients. Multivariate regression analysis including demographics, 2D static radiographic parameters, and dynamic balance scales identified BESTest as single independent variable (P = 0.000) to predict COMI (adjusted R = 0.285) in ASD patients. CONCLUSION BESTest has a higher potential than demographic and 2D radiographic spinopelvic parameters to predict quality of life in ASD patients. Further research is necessary to identify the impact of ASD on quality of life. LEVEL OF EVIDENCE 3.
Collapse
|
13
|
Koyama S, Tanabe S, Itoh N, Saitoh E, Takeda K, Hirano S, Ohtsuka K, Mukaino M, Yanohara R, Sakurai H, Kanada Y. Intra- and inter-rater reliability and validity of the tandem gait test for the assessment of dynamic gait balance. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1414304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Norihide Itoh
- Department of Advanced Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kazuya Takeda
- Department of Rehabilitation, Kawamura Hospital, Gifu, Japan
| | - Satoshi Hirano
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kei Ohtsuka
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ryuzo Yanohara
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Hiroaki Sakurai
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| |
Collapse
|
14
|
Mielenz TJ, Durbin LL, Cisewski JA, Guralnik JM, Li G. Select physical performance measures and driving outcomes in older adults. Inj Epidemiol 2017; 4:14. [PMID: 28459121 PMCID: PMC5420549 DOI: 10.1186/s40621-017-0110-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/30/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer. This systematic review assesses the evidence on the association between three physical functioning measures: the Short Physical Performance Battery, the Timed Up-and-Go test, and the Rapid Pace Walk with driving outcomes in older adults. METHODS Older adult studies published between 1994 and 2015 that included the Short Physical Performance Battery, the Timed Up-and-Go test, or the Rapid Pace Walk as a measure of physical functioning and included a driving-related outcome were identified through a comprehensive search and reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Thirteen studies involving 5,313 older adults met the inclusion criteria. Lower Short Physical Performance Battery scores were associated with reduced driving exposure and increased cessation in all three Short Physical Performance Battery studies. The Timed Up-and-Go test was not associated with the driving outcomes (cessation, ability, crashes, and citations) in either of the two Timed Up-and-Go studies. Poorer Rapid Pace Walk scores were associated with decreased driving ability in two studies and with reduced driving exposure in one study, but not associated with driving ability, crashes, citations, or cessation in the remaining five Rapid Pace Walk studies. CONCLUSIONS The Timed Up-and-Go test measure appears not to be a useful measure of physical functioning for the driving outcomes included here. The Rapid Pace Walk may be useful in studies of driving ability and exposure. More driving studies should consider using the Short Physical Performance Battery to determine if it may be useful as a risk factor assessment for identifying individuals at risk of certain driving outcomes.
Collapse
Affiliation(s)
- Thelma J. Mielenz
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
- Center for Injury Epdemiology and Prevention, Columbia University Medical Center, New York, NY USA
| | - Laura L. Durbin
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
| | - Jodi A. Cisewski
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
| | - Jack M. Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD USA
| | - Guohua Li
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., New York, NY 10032 USA
- Center for Injury Epdemiology and Prevention, Columbia University Medical Center, New York, NY USA
- Department of Anesthesiology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY USA
| |
Collapse
|
15
|
Patti A, Maggio MC, Corsello G, Messina G, Iovane A, Palma A. Evaluation of Fitness and the Balance Levels of Children with a Diagnosis of Juvenile Idiopathic Arthritis: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070806. [PMID: 28753965 PMCID: PMC5551244 DOI: 10.3390/ijerph14070806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/14/2017] [Accepted: 07/16/2017] [Indexed: 12/18/2022]
Abstract
Background: Juvenile idiopathic arthritis is a main cause of physical disability and has high economic costs for society. The purpose of this study was to assess the fitness levels and the postural and balance deficits with a specific test battery. Methods: Fifty-six subjects were enrolled in this study. Thirty-nine healthy subjects were included in the control group and seventeen in the juvenile idiopathic arthritis group. All subjects were evaluated using a posturography system. The fitness level was evaluated with a battery of tests (Abalakov test, sit-up test, hand grip test, backsaver sit and reach, the toe touch test). An unpaired t-test was used to determine differences. Pearson’s correlation coefficient was used to evaluate the correlation between the tests. Results: The battery of tests demonstrated that subjects in the juvenile idiopathic arthritis group have lower fitness levels compared to the control group. The juvenile idiopathic arthritis group showed low postural control with respect to the control group. Pearson analysis of the juvenile idiopathic arthritis group data showed significant correlations between variables. Pearson’s results from the control group data showed a similar trend. Conclusions: The results suggest that the battery of tests used could be an appropriate tool. However, we highlight that these conclusions need to be supported by other studies with a larger population scale.
Collapse
Affiliation(s)
- Antonino Patti
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
| | - Maria Cristina Maggio
- Department of Science for the Promotion of Health and Infant Maternal "G. D'Alessandro", University of Palermo, 90133 Palermo, Italy.
| | - Giovanni Corsello
- Department of Science for the Promotion of Health and Infant Maternal "G. D'Alessandro", University of Palermo, 90133 Palermo, Italy.
| | - Giuseppe Messina
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
- Posturalab Italy, 90131 Palermo, Italy.
| | - Angelo Iovane
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
| | - Antonio Palma
- Department of Psychology and Educational Science, University of Palermo, 90133 Palermo, Italy.
- Regional Sport School of Sicily CONI (Olympic National Italian Committee), 90141 Palermo, Italy.
| |
Collapse
|
16
|
Çınar E, Akkoç Y, Karapolat H, Durusoy R, Keser G. Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis? Eur J Rheumatol 2016; 3:5-9. [PMID: 27708961 DOI: 10.5152/eurjrheum.2015.15104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 06/15/2015] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE This study aimed to assess the impact of postural deformities caused by ankylosing spondylitis (AS) on balance problems. MATERIAL AND METHODS This study included 29 patients with AS and 21 healthy controls. For assessing exercise capacity and dynamic balance, timed up and go test, five times sit-to-stand test, gait speed, and 6-min walk test were performed. Romberg tests were used to evaluate static balance and proprioception, whereas Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Berg Balance Scale (BBS), Activity Specific Balance Confidence Scale (ABC), Dizziness Handicap Inventory (DHI), and functional reach test were used to assess dynamic balance and the risk of falling. Using Bath Ankylosing Spondylitis Metrology Index (BASMI) scores, patients with AS were divided into two groups: those with scores 0-4 were assigned to subgroup AS1, and those with scores 5-10 were assigned to subgroup AS2. RESULTS In the whole group of patients with AS, five times sit-to-stand test, tandem Romberg test with eyes closed, and BBS and ABC scores were significantly worse than the healthy controls (p<0.05). In the AS2 subgroup having more severe and advanced disease, five additional parameters, including timed up and go test, 6-min walk test, functional reach test, FGA, and DHI scores were also significantly worse than the healthy controls (p<0.05). Comparing the two subgroups with each other, only BBS scores were significantly worse in the AS2 subgroup than in the AS1 subgroup. CONCLUSION Although in clinical practice, poor balance is not a common problem in AS, possibly because of compensatory mechanisms, patients with AS have poorer static and dynamic balance than healthy subjects. Significantly worse BBS scores in the AS2 subgroup than in the AS1 subgroup may suggest the presence of more dynamic balance problems in advanced disease; however, future studies comprising larger samples are necessary to confirm this assumption.
Collapse
Affiliation(s)
- Ece Çınar
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, İzmir, Turkey
| | - Yeşim Akkoç
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, İzmir, Turkey
| | - Hale Karapolat
- Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, İzmir, Turkey
| | - Raika Durusoy
- Department of Public Health, Ege University School of Medicine, İzmir, Turkey
| | - Gökhan Keser
- Department of Internal Medicine, Division of Rheumatology, Ege University School of Medicine, İzmir, Turkey
| |
Collapse
|
17
|
Buster TW, Chernyavskiy P, Harms NR, Kaste EG, Burnfield JM. Computerized dynamic posturography detects balance deficits in individuals with a history of chronic severe traumatic brain injury. Brain Inj 2016; 30:1249-55. [DOI: 10.1080/02699052.2016.1183822] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
18
|
Rewald S, Mesters I, Lenssen AF, Emans PJ, Wijnen W, de Bie RA. Effect of aqua-cycling on pain and physical functioning compared with usual care in patients with knee osteoarthritis: study protocol of a randomised controlled trial. BMC Musculoskelet Disord 2016; 17:88. [PMID: 26887576 PMCID: PMC4758142 DOI: 10.1186/s12891-016-0939-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/10/2016] [Indexed: 01/22/2023] Open
Abstract
Background Over the last decade aquatic exercise has become more and more popular. One of the latest trends is aqua-cycling, where participants sit on a water-resistant stationary bike and, while immersed chest deep in the water, combine continuous cycling with upper body exercises that utilise water resistance. Since stationary cycling and aquatic exercises are frequently recommended to patients with knee osteoarthritis, combining both would seem an obvious step, and an aqua-cycling exercise programme for patients with knee osteoarthritis has indeed been developed. This study protocol gives a detailed description of the exercise programme and the methodology of a study to compare this programme with treatment involving usual care only. Methods The study is a single-blind, parallel-group, randomised controlled trial of Maastricht University Medical Centre+, the Netherlands. Inclusion criteria: knee pain of four to seven on a 10-point pain rating scale; a Kellgren/Lawrence score between one to three; ability to cycle; good mental health; sufficient language skills; indication for physical therapy in conjunction with impairments due to OA. Exclusion criteria: any contra-indication for aquatic exercise; planned total knee replacement; corticosteroid injection <3 months and/or hyaluronic acid injection <6 months; severe joint complaints (other than knee joint); symptomatic and radiological apparent hip OA; inflammatory joint diseases; inability to safely enter and exit the pool; fear of water. Participants will receive two 45-min moderate intense aqua-cycling sessions weekly over a period of 12 weeks in addition to usual care or usual care only. Usual care consists of an individual intervention plan comprising lifestyle recommendations, medication routine and referral to a physical therapist. Participants will be assessed at baseline, and at 12 and 24 weeks after baseline. The primary outcome is self-reported knee pain and physical functioning. Secondary outcomes are lower limb muscle strength, functional capacity, self-reported disease severity, physical activity level, quality of life, self-efficacy and fear of movement. Daily diaries will collect information on knee pain, physical functioning, level of physical activity, pain medication routine and physical therapy (control group only) or exercise participation over two 30-day periods (during the intervention period). Discussion To our knowledge the present study is the first randomised controlled trial evaluating the effects of aqua-cycling in the pre-surgical stage of knee osteoarthritis. This trial will demonstrate if the newly designed aqua-cycling intervention, in supplement to usual care, can help to improve impairments due to knee osteoarthritis. Trial registration Netherlands Trial Register NTR3766 (21-12-2012). Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-0939-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Stefanie Rewald
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Ilse Mesters
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - A F Lenssen
- Department of Physiotherapy, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Pieter J Emans
- Department of Orthopaedic Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Wiel Wijnen
- Department of Orthopaedic Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - Rob A de Bie
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| |
Collapse
|
19
|
Yu SP, Williams M, Eyles JP, Chen JS, Makovey J, Hunter DJ. Effectiveness of knee bracing in osteoarthritis: pragmatic trial in a multidisciplinary clinic. Int J Rheum Dis 2015; 19:279-86. [DOI: 10.1111/1756-185x.12796] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Shirley P. Yu
- Department of Rheumatology; Royal North Shore Hospital; Sydney NSW Australia
| | - Matthew Williams
- Department of Physiotherapy; Royal North Shore Hospital; Sydney NSW Australia
| | - Jillian P. Eyles
- Department of Physiotherapy; Royal North Shore Hospital; Sydney NSW Australia
- Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney; Sydney NSW Australia
| | - Jian Sheng Chen
- Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney; Sydney NSW Australia
| | - Joanna Makovey
- Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney; Sydney NSW Australia
| | - David J. Hunter
- Department of Rheumatology; Royal North Shore Hospital; Sydney NSW Australia
- Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney; Sydney NSW Australia
- Northern Clinical School; University of Sydney; Sydney NSW Australia
| |
Collapse
|
20
|
Telenius EW, Engedal K, Bergland A. Inter-rater reliability of the Berg Balance Scale, 30 s chair stand test and 6 m walking test, and construct validity of the Berg Balance Scale in nursing home residents with mild-to-moderate dementia. BMJ Open 2015; 5:e008321. [PMID: 26346874 PMCID: PMC4563250 DOI: 10.1136/bmjopen-2015-008321] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE When testing physical function, patients must be alert and have the capacity to understand and respond to instructions. Patients with dementia may have difficulties fulfilling these requirements and, therefore, the reliability of the measures may be compromised. We aimed to assess the inter-rater reliability between pairs of observers independently rating the participant in the Berg Balance Scale (BBS), 30 s chair stand test (CST) and 6 m walking test. We also wanted to investigate the internal consistency of the BBS. DESIGN Cross-sectional study. SETTING We included 33 nursing home patients with a mild-to-moderate degree of dementia and tested them once with two evaluators present. One evaluator gave instructions and both evaluators scored the patients' performance. Weighted κ, intraclass correlation coefficient (ICC) model 2.1 with 95% CIs and minimal detectable change (MDC) were used to measure inter-rater reliability. Cronbach's α was calculated to evaluate the internal consistency of the BBS sum score. RESULTS The mean values of the BBS scored by the two evaluators were 38±13.7 and 38.0±13.8, respectively. Weighted κ scores for the BBS items varied from 0.83 to 1.0. ICC for the BBS's sum score was 0.99, and the MDC was 2.7% and 7%, respectively. The Cronbach's α of the BBS's sum score was 0.9. The ICC of the CST and 6 m walking test was 1 and 0.97, respectively. The MDC on the 6 m walking test was 0.08% and 15.2%, respectively. CONCLUSIONS The results reveal an excellent relative inter-rater reliability of the BBS, CST and 6 m walking test as well as high internal consistency for the BBS in a population of nursing home residents with mild-to-moderate dementia. The absolute reliability was 2.7 on the BBS and 0.08 on the 6 m walking test.
Collapse
Affiliation(s)
- Elisabeth Wiken Telenius
- Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Knut Engedal
- Department of Psychiatry, Norwegian Centre of Aging and Health, Vestfold Health Trust, Tønsberg, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| |
Collapse
|
21
|
Alghadir A, Anwer S, Brismée JM. The reliability and minimal detectable change of Timed Up and Go test in individuals with grade 1-3 knee osteoarthritis. BMC Musculoskelet Disord 2015. [PMID: 26223312 PMCID: PMC4520098 DOI: 10.1186/s12891-015-0637-8] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The Timed Up and Go (TUG) test is quick and easy tests to assess patients’ functional mobility. However, its reliability in individuals with knee osteoarthritis (OA) has not been well established. The aims of this study were to determine the reliability and minimal detectable change of the TUG test in individuals with doubtful to moderate (Grade 1–3) knee OA. Methods Sixty-five subjects (25 male, 40 female), aged 45–70 years, with knee OA participated. Inter-rater reliability was assessed using two observers at different times of the same day in an alternating order. Intra-rater reliability was assessed on two consecutive visits with a 2-day interval. The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated to determine statistically meaningful changes. Results Intra-rater and inter-rater reliability were 0.97 (95 % confidence interval [CI], 0.95 – 0.98) and 0.96 (95 % confidence interval [CI], 0.94 – 0.97), respectively. The MDC, based on measurements by a single rater and between raters, was 1.10 and 1.14 seconds, respectively. Conclusions The TUG is a reliable test with adequate MDC for clinical use in individuals with doubtful to moderate knee OA.
Collapse
Affiliation(s)
- Ahmad Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Shahnawaz Anwer
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. .,Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India.
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
| |
Collapse
|
22
|
Physical performance is associated with working memory in older people with mild to severe cognitive impairment. BIOMED RESEARCH INTERNATIONAL 2014; 2014:762986. [PMID: 24757674 PMCID: PMC3971508 DOI: 10.1155/2014/762986] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/02/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical performances and cognition are positively related in cognitively healthy people. The aim of this study was to examine whether physical performances are related to specific cognitive functioning in older people with mild to severe cognitive impairment. METHODS This cross-sectional study included 134 people with a mild to severe cognitive impairment (mean age 82 years). Multiple linear regression was performed, after controlling for covariates and the level of global cognition, with the performances on mobility, strength, aerobic fitness, and balance as predictors and working memory and episodic memory as dependent variables. RESULTS The full models explain 49-57% of the variance in working memory and 40-43% of episodic memory. Strength, aerobic fitness, and balance are significantly associated with working memory, explaining 3-7% of its variance, irrespective of the severity of the cognitive impairment. Physical performance is not related to episodic memory in older people with mild to severe cognitive impairment. CONCLUSIONS Physical performance is associated with working memory in older people with cognitive impairment. Future studies should investigate whether physical exercise for increased physical performance can improve cognitive functioning. This trial is registered with ClinicalTrials.gov NTR1482.
Collapse
|
23
|
Abstract
BACKGROUND Current dynamic walking tests, used in studies with older adults with dementia, rely strongly on healthy cognitive and physical function. Therefore, the Groningen Meander Walking Test (GMWT) was developed specifically for people with dementia. The aim of the GMWT is to measure dynamic walking ability by walking over a meandering curved line, with an emphasis on walking speed and stepping accuracy, while changing direction. OBJECTIVE The purpose of this study was to investigate the feasibility, test-retest reliability, and minimal detectable change (MDC) of the GMWT. DESIGN A repeated-measures design was used. METHODS Forty-two people with dementia participated in the study. Adherence rate, adverse events, repetition of instructions during test performance, test duration, and number of oversteps were assessed. RESULTS The adherence rate was excellent, with no adverse events. No repetitive instructions were given during test performance, and test duration was short (mean=17.16 seconds) with few oversteps (mean=1.94 oversteps). Test-retest reliability for participants without a walking device was excellent for the GMWT time score (intraclass correlation coefficient [ICC]=.942), with an MDC of 2.96 seconds. Test-retest reliability for participants with a 4-wheeled walker (4WW) was moderate (ICC=.837), with an MDC of 10.35 seconds. For the overstep score, a marginal ICC of .630 was found, with an MDC of 4.38 oversteps. LIMITATIONS No fall data were available, and there was a volunteer bias. CONCLUSIONS The GMWT is a feasible test for people with dementia. With the GMWT time score, a reliable and sensitive field test to measure walking abilities in older adults with dementia is available. The GMWT overstep score can be used to give information about the execution according to protocol and should be emphasized during the instructions. Future studies need to investigate the validity of the GMWT.
Collapse
|
24
|
Abstract
STUDY DESIGN Prospective analysis of a longitudinal cohort with an embedded comparison group at a single time point. OBJECTIVES To determine the feasibility and effectiveness of an outpatient rehabilitation protocol that includes movement symmetry biofeedback on functional and biomechanical outcomes after total knee arthroplasty (TKA). BACKGROUND TKA reduces pain and improves functional ability, but many patients experience strength deficits and movement abnormalities in the operated limb, despite outpatient rehabilitation. These asymmetries increase load on the nonoperated limb, and greater asymmetry is related to worse functional outcomes. METHODS Biomechanical and functional metrics were assessed 2 to 3 weeks prior to TKA, at discharge from outpatient physical therapy, and 6 months after TKA in 11 patients (9 men, 2 women; mean ± SD age, 61.4 ± 5.8 years; body mass index, 33.1 ± 5.4 kg/m2) who received 6 to 8 weeks of outpatient physical therapy that included specialized symmetry training. Six-month outcomes were compared to a control group, matched by age, body mass index, and sex (9 men, 2 women; mean ± SD age, 61.8 ± 5 years; body mass index, 34.3 ± 5.1 kg/m2), that did not receive specialized symmetry retraining. RESULTS Of the 11 patients who received added symmetry training, 9 demonstrated clinically meaningful improvements that exceeded the minimal detectable change for all performance-based functional tests at 6 months post-TKA compared to pre-TKA. Six months after TKA, when walking, patients who underwent symmetry retraining had greater knee extension during midstance and had mean sagittal knee moments that were more symmetrical, biphasic, and more representative of normal knee kinetics compared to patients who did not undergo symmetry training. No patients experienced adverse events as the result of the protocol. CONCLUSION Adding symmetry retraining to postoperative protocols is clinically viable, safe, and may have additional benefits compared to rehabilitation protocols that focus on range of motion, strength, and return to independence. LEVEL OF EVIDENCE Therapy, level 4.
Collapse
|
25
|
Morrison E, Shoukath S, Tansley P, Grinsell D. Donor site morbidity of an islanded inferior gluteal artery myocutaneous flap with vascularized fascia lata. J Plast Reconstr Aesthet Surg 2013; 66:962-7. [DOI: 10.1016/j.bjps.2013.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/01/2013] [Indexed: 10/26/2022]
|
26
|
Bruun-Olsen V, Heiberg KE, Wahl AK, Mengshoel AM. The immediate and long-term effects of a walking-skill program compared to usual physiotherapy care in patients who have undergone total knee arthroplasty (TKA): a randomized controlled trial. Disabil Rehabil 2013; 35:2008-15. [PMID: 23614370 DOI: 10.3109/09638288.2013.770084] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To examine the immediate and long-term effects of a walking-skill program compared with usual physiotherapy on physical function, pain and perceived self-efficacy in patients after total knee arthroplasty (TKA). METHOD A single blind randomized controlled trial design was applied. Fifty-seven patients with primary TKA, mean age of 69 years (SD ± 9), were randomly assigned to a walking-skill program emphasizing weight-bearing exercises or usual physiotherapy. Outcomes were assessed before the interventions started at 6 weeks postoperatively (T1), directly after the interventions at 12-14 weeks (T2) and 9 months after the interventions (T3). Walking was the primary outcome, assessed by the 6 min walk test (6MWT). The secondary outcomes were timed stair climbing, timed stands, Figure-of-eight test, Index of muscle function, active knee range of motion, Knee Injury and Osteoarthritis Outcome Score and self-efficacy score. RESULTS From T1 to T2, a better 6MWT score was found in favor of the walking-skill program of 39 m (2-76), p = 0.04. The difference between the groups in 6MWT persisted at T3, 44 m (8-80), p = 0.02. No differences in other outcome measures were found. CONCLUSION The walking-skill program had better effect on walking than usual physiotherapy. Weight bearing was tolerated. Implications for Rehabilitation Weight-bearing exercises are tolerated by the patients in the early stage after TKA. Physiotherapy that focuses on learning different ways of walking through practice may be a plausible way to train patients after TKA.
Collapse
Affiliation(s)
- Vigdis Bruun-Olsen
- Department of Health Sciences, Institute of Health and Society, University of Oslo , Oslo , Norway and
| | | | | | | |
Collapse
|
27
|
Heiberg KE, Ekeland A, Bruun-Olsen V, Mengshoel AM. Recovery and prediction of physical functioning outcomes during the first year after total hip arthroplasty. Arch Phys Med Rehabil 2013; 94:1352-9. [PMID: 23385111 DOI: 10.1016/j.apmr.2013.01.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To investigate recovery of physical functioning in patients during the first year after total hip arthroplasty (THA), and to predict postoperative walking distance outcomes from preoperative measures. DESIGN A longitudinal prospective design was used. Data were analyzed by repeated-measures analysis of variance and multivariate regression analyses. SETTING Two hospitals. PARTICIPANTS Patients with hip osteoarthritis were consecutively included and assessed preoperatively (n=88), at 3 months (n=88), and at 12 months (n=64) after THA. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Physical functioning was assessed by objective measures-the 6-minute walk test (6MWT), stair climbing test, Index of Muscle Function, figure-of-eight, and active hip range of motion-and the subjective measures by Harris Hip Score and Hip dysfunction and Osteoarthritis Outcome Score. RESULTS In objective measures, improvements were found from preoperatively to 3 months in 6MWT (P<.01) and stair climbing test (P<.05) scores, while all measures had improved from 3 to 12 months (P≤.001). In contrast, all the subjective measures showed substantial improvements at 3 months, but small further improvements from 3 to 12 months (P<.001). Age, sex, preoperative 6MWT distance, and hip range of motion predicted 6MWT outcomes at 3 and 12 months (P≤.01). CONCLUSIONS The objective measures of physical functioning improved gradually during the first postoperative year, while the subjective measures showed large early improvements, but little further improvements. Younger age, male sex, and better scores of walking distance and hip flexibility before surgery predicted better score in walking distance at both 3 and 12 months after surgery.
Collapse
|
28
|
Evaluation of static and dynamic postural balance in children with juvenile idiopathic arthritis. Pediatr Phys Ther 2013; 25:150-7; discussion 157. [PMID: 23542191 DOI: 10.1097/pep.0b013e31828a2978] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate balance in children with lower limb involvement due to juvenile idiopathic arthritis (JIA). METHODS Twenty-five children with JIA manifesting lower extremity arthritis within the previous year and 36 children who were healthy (aged 8-18 years) were assessed by using the Biodex Balance System (BBS) (Biodex, Shirley, New York). Single-leg static balance (BBS level 12) and bilateral static and dynamic balance (BBS levels 2 and 7) were measured. Lower extremity strength, disease activity, function, and pain were also assessed. RESULTS : Ten subjects with JIA (40%) could not complete single-leg balance testing, while all controls did (P < .0001). Bilateral dynamic balance was impaired only at BBS level 2 (most unstable). Lower extremity weakness correlated with poor balance. CONCLUSION A significant proportion of children with leg arthritis have impaired balance. Proprioceptive exercises may emerge as an important therapy in the treatment of lower extremity arthritis.
Collapse
|
29
|
Heiberg KE, Bruun-Olsen V, Ekeland A, Mengshoel AM. Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery. Arthritis Care Res (Hoboken) 2012; 64:415-23. [DOI: 10.1002/acr.20681] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
30
|
Abstract
BACKGROUND Although flexibility traditionally has been the main focus for physical therapy in patients with ankylosing spondylitis (AS), there is now evidence for an increased risk of cardiovascular diseases (CVDs) in this group. OBJECTIVE The purposes of this study were: (1) to compare physical fitness (cardiorespiratory fitness, muscular capacity, flexibility, and balance) in patients with AS and controls and (2) to explore associations between physical fitness and disease activity in the patient group. DESIGN This was a cross-sectional study. METHODS The physical fitness variables were cardiorespiratory fitness (treadmill test for estimation of peak oxygen uptake [V(O(2))peak]), muscular capacity (push-ups test), balance (30-second single-leg stand and walking in a figure-of-eight pattern), and flexibility (Bath Ankylosing Spondylitis Metrology Index [BASMI]). The Ankylosing Spondylitis Disease Activity Score (ASDAS) was used to assess disease activity. Group differences and associations were tested with the chi-square test for categorical variables, the Mann-Whitney U test for ordinal variables, and analysis of covariance for continuous variables. RESULTS One hundred forty-nine of 250 of the invited patients with AS and 133 of 329 of the invited controls were included in the study. The mean ASDAS score of the patient group was 2.3 (range=0.5-4.7), and the median disease duration was 23 years (range=7-55). The patient group had significantly lower V(O(2)) peak values, with a mean difference of -2.7 mL·kg(-1)·min(-1) (95% confidence interval=-4.3, -1.1), and higher BASMI scores, with a mean difference of 1.6 (95% confidence interval=1.5, 1.8), compared with the control group. No group differences were found in balance or muscular capacity. In the patient group, significant inverse associations were found between ASDAS scores and V(O(2))peak and muscular capacity. LIMITATIONS The response rate was lower in the control group (40.4%) than in the patient group (59.6%). CONCLUSION The lower cardiorespiratory fitness and reduced flexibility in the AS group indicate that physical therapy programs should include cardiorespiratory fitness exercises as a basic component to reduce the risk of cardiovascular disease.
Collapse
|
31
|
French HP, Fitzpatrick M, FitzGerald O. Responsiveness of physical function outcomes following physiotherapy intervention for osteoarthritis of the knee: an outcome comparison study. Physiotherapy 2011; 97:302-8. [DOI: 10.1016/j.physio.2010.03.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 03/03/2010] [Indexed: 11/28/2022]
|
32
|
Bennell K, Dobson F, Hinman R. Measures of physical performance assessments: Self-Paced Walk Test (SPWT), Stair Climb Test (SCT), Six-Minute Walk Test (6MWT), Chair Stand Test (CST), Timed Up & Go (TUG), Sock Test, Lift and Carry Test (LCT), and Car Task. Arthritis Care Res (Hoboken) 2011; 63 Suppl 11:S350-70. [DOI: 10.1002/acr.20538] [Citation(s) in RCA: 275] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
33
|
Volkers KM, Scherder EJA. The effect of regular walks on various health aspects in older people with dementia: protocol of a randomized-controlled trial. BMC Geriatr 2011; 11:38. [PMID: 21827648 PMCID: PMC3176485 DOI: 10.1186/1471-2318-11-38] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 08/09/2011] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Physical activity has proven to be beneficial for physical functioning, cognition, depression, anxiety, rest-activity rhythm, quality of life (QoL), activities of daily living (ADL) and pain in older people. The aim of this study is to investigate the effect of walking regularly on physical functioning, the progressive cognitive decline, level of depression, anxiety, rest-activity rhythm, QoL, ADL and pain in older people with dementia. METHODS/DESIGN This study is a longitudinal randomized controlled, single blind study. Ambulatory older people with dementia, who are regular visitors of daily care or living in a home for the elderly or nursing home in the Netherlands, will be randomly allocated to the experimental or control condition. Participants of the experimental group make supervised walks of 30 minutes a day, 5 days a week, as part of their daily nursing care. Participants of the control group will come together three times a week for tea or other sedentary activities to control for possible positive effects of social interaction. All dependent variables will be assessed at baseline and after 6 weeks, and 3, 6, 9, 12 and 18 months of intervention. The dependent variables include neuropsychological tests to assess cognition, physical tests to determine physical functioning, questionnaires to assess ADL, QoL, level of depression and anxiety, actigraphy to assess rest-activity rhythm and pain scales to determine pain levels. Potential moderating variables at baseline are: socio-demographic characteristics, body mass index, subtype of dementia, apolipoprotein E (ApoE) genotype, medication use and comorbidities. DISCUSSION This study evaluates the effect of regular walking as a treatment for older people with dementia. The strength of this study is that 1) it has a longitudinal design with multiple repeated measurements, 2) we assess many different health aspects, 3) the intervention is not performed by research staff, but by nursing staff which enables it to become a routine in usual care. Possible limitations of the study are that 1) only active minded institutions are willing to participate creating a selection bias, 2) the drop-out rate will be high in this population, 3) not all participants will be able to perform/understand all tests. TRIAL REGISTRATION NTR1482.
Collapse
Affiliation(s)
- Karin M Volkers
- Department of clinical neuropsychology, VU university Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
| | - Erik JA Scherder
- Department of clinical neuropsychology, VU university Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
- Institute for human movement sciences, university of Groningen, A. Deusinglaan 1, 9713 AV Groningen, the Netherlands
| |
Collapse
|
34
|
Anemaet WK, Krulish LH. Fall Risk Assessments in Home Care: OASIS-C Expectations. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2010. [DOI: 10.1177/1084822310385084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The revised version of the Outcome and Assessment Information Set (OASIS-C) contains many changes to the data set including the addition of process measure items, which looks at specific evidence-based practices agencies have in place to address high-risk, high-volume, problem-prone areas. One of these process measure areas, namely, falls prevention, addresses agencies’ processes for assessing fall risk and implementing steps to reduce and prevent falls. This article identifies problems regarding home care falls, details the item in the data set pertaining to fall risk assessment, describes several possible falls risk assessments that can be used, and explores strategies to meet the OASIS-C process measure item for multifactor fall risk assessment. Tests that are multifactorial, along with other more specific focused risk-assessment tools are described.
Collapse
|
35
|
Uhlig T, Fongen C, Steen E, Christie A, Ødegård S. Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study. BMC Musculoskelet Disord 2010; 11:43. [PMID: 20205741 PMCID: PMC2845097 DOI: 10.1186/1471-2474-11-43] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 03/05/2010] [Indexed: 11/23/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic, inflammatory and systemic disease which affects the musculoskeletal system. Exercise programmes are reported to improve physical functioning in patients with RA. Tai Chi is a traditional Chinese martial art which combines slow and gentle movements with mental focus. The purpose of this study was to study in which way Tai Chi group exercise impacted on disease activity, physical function, health status and experience in RA patients, applying quantitative and qualitative methods. Methods Fifteen patients with RA (13 females, age 33-70 years) were recruited from a rheumatology department into a single group study. The patients were instructed in Tai Chi exercise twice weekly for 12 weeks. Assessments at baseline, 12 weeks, and 12 weeks follow-up were performed with a wide range of measures, including disease activity, self-reported health status, physical performance tests (Walking in Figure of Eight, Timed-Stands Test, and Shoulder Movement Impairment Scale). Qualitative data were obtained from a focus group interview conducted after completed intervention with taping and verbatim transcription. Review of the transcripts identified themes important to patients practicing Tai Chi. Results Within the group, Tai Chi practice lead to improved lower-limb muscle function at the end of intervention and at 12 weeks follow-up. Qualitative analyses showed that patients experienced improved physical condition, confidence in moving, balance and less pain during exercise and in daily life. Other experience included stress reduction, increased body awareness, confidence in moving and indicated that Tai Chi was a feasible exercise modality in RA. Conclusions Improved muscle function in lower limbs was also reflected when patient experiences with Tai Chi were studied in depth in this explorative study. The combination of qualitative and quantitative research methods shows that Tai Chi has beneficial effects on health not related to disease activity and standardised health status assessment, and may contribute to an understanding of how Tai Chi exerts its effects. Trial registration NCT00522054
Collapse
Affiliation(s)
- Till Uhlig
- National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | | | | | | | | |
Collapse
|
36
|
Russek LN, Fulk GD. Pilot study assessing balance in women with fibromyalgia syndrome. Physiother Theory Pract 2010; 25:555-65. [PMID: 19925263 DOI: 10.3109/09593980802668050] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of current study was to assess postural control and balance self-efficacy in people with fibro-myalgia syndrome [FMS]. Thirty-two females with FMS completed the Activity-specific Balance Confidence Scale, Berg Balance test, NeuroCom Balance Master sensory-organization test, and limits of stability. There was a high prevalence of reported falls and a low mean score on the Activity-specific Balance Confidence Scale. A significant number of subjects scored below the population norm fifth percentile score on the sensory-organization test composite, visual, and vestibular sections. Preliminary evidence suggests that women with FMS may present with deficits in postural control, sensory organization, and balance self-efficacy.
Collapse
Affiliation(s)
- Leslie N Russek
- Physical Therapy Department, Clarkson University, Potsdam, New York 13699-5880, USA.
| | | |
Collapse
|
37
|
Medley A, Thompson M. Usefulness of Variations of the Timed Up and Go in Apparently Healthy Individuals. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2009. [DOI: 10.1080/j148v23n04_01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
38
|
Kammerlind AS, Bergquist Larsson P, Ledin T, Skargren E. Reliability of clinical balance tests and subjective ratings in dizziness and disequilibrium. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190510010403] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
39
|
Eurenius E, Brodin N, Opava CH, THE PARA STUDY GROUP, Eurenius E, Brodin N, Opava CH, THE PARA STUDY GROUP. Clinical applicability of two tests of aerobic fitness in patients with rheumatoid arthritis. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190601035609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
de Figueiredo KMOB, de Lima KC, Cavalcanti Maciel AC, Guerra RO. Interobserver reproducibility of the Berg Balance Scale by novice and experienced physiotherapists. Physiother Theory Pract 2009; 25:30-6. [DOI: 10.1080/09593980802631330] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
41
|
Franzén E, Paquette C, Gurfinkel VS, Cordo PJ, Nutt JG, Horak FB. Reduced performance in balance, walking and turning tasks is associated with increased neck tone in Parkinson's disease. Exp Neurol 2009; 219:430-8. [PMID: 19573528 DOI: 10.1016/j.expneurol.2009.06.013] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 06/17/2009] [Accepted: 06/18/2009] [Indexed: 11/27/2022]
Abstract
Rigidity or hypertonicity is a cardinal symptom of Parkinson's disease (PD). We hypothesized that hypertonicity of the body axis affects functional performance of tasks involving balance, walking and turning. The magnitude of axial postural tone in the neck, trunk and hip segments of 15 subjects with PD (both ON and OFF levodopa) and 15 control subjects was quantified during unsupported standing in an axial twisting device in our laboratory as resistance to torsional rotation. Subjects also performed six functional tests (walking in a figure of eight [Figure of Eight], Timed Up and Go, Berg Balance Scale, supine rolling task [rollover], Functional Reach, and standing 360-deg turn-in-place) in the ON and OFF state. Results showed that PD subjects had increased tone throughout the axis compared to control subjects (p=0.008) and that this increase was most prominent in the neck. In PD subjects, axial tone was related to functional performance, but most strongly for tone at the neck and accounted for an especially large portion of the variability in the performance of the Figure of Eight test (r(OFF)=0.68 and r(ON)=0.74, p<0.05) and the Rollover test (r(OFF)=0.67 and r(ON)=0.55, p<0.05). Our results suggest that neck tone plays a significant role in functional mobility and that abnormally high postural tone may be an important contributor to balance and mobility disorders in individuals with PD.
Collapse
Affiliation(s)
- Erika Franzén
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
| | | | | | | | | | | |
Collapse
|
42
|
Kristensen MT, Foss NB, Kehlet H. Factors with independent influence on the 'timed up and go' test in patients with hip fracture. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2009; 14:30-41. [PMID: 18646243 DOI: 10.1002/pri.414] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE Data on performance times for the 'timed up and go' (TUG) test with analyses of factors, that eventually could affect the result in patients with hip fracture, have not been published to date. The aims of the present study, therefore, were to assess normative reference values of TUG performances and determine the influence of individual and clinical factors on TUG-test scores in patients with hip fracture. METHOD In this prospective, descriptive study, a total of 196 consecutive patients over the age of 60, and able to perform the TUG when discharged directly to their own homes from a specialized orthopaedic hip fracture unit, were evaluated. The association between TUG scores and categorical variables were examined, and linear regression was used to investigate the factors influencing performance times. RESULTS Univariate analysis showed significant differences between all categorical variables, except gender, but multivariate linear regression analyses showed that only a high pre-fracture function level, evaluated by the New Mobility Score (B = -11), was independently associated with having a good TUG score, while older age (B = 0.49), having an intertrochanteric fracture (B = 7), performing TUG with a walker (B = 15), and performing TUG in the later postoperative period (B = 0.39) were independently associated with having a poorer TUG score. CONCLUSIONS These preliminary normative reference values of TUG performances in patients with hip fracture can be used as references, to which individuals can expect to perform. Multivariate testing suggests that clinicians should use age, pre-fracture function, fracture type and walking-aid specific data when interpreting the TUG test results. Physiotherapists should be aware of this if TUG scores are to be used predictively or as an outcome measure in patients with hip fracture, especially in research.
Collapse
Affiliation(s)
- Morten Tange Kristensen
- Lund University, Department of Health Sciences, Division of Physiotherapy, Lund University Hospital, Lasarettsgatan 7, SE-221 85 Lund, Sweden.
| | | | | |
Collapse
|
43
|
Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism. Phys Ther 2008; 88:733-46. [PMID: 18356292 DOI: 10.2522/ptj.20070214] [Citation(s) in RCA: 541] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Distinguishing between a clinically significant change and change due to measurement error can be difficult. The purpose of this study was to determine test-retest reliability and minimal detectable change for the Berg Balance Scale (BBS), forward and backward functional reach, the Romberg Test and the Sharpened Romberg Test (SRT) with eyes open and closed, the Activities-specific Balance Confidence (ABC) Scale, the Six-Minute Walk Test (6MWT), comfortable and fast gait speed, the Timed "Up & Go" Test (TUG), the Medical OUTCOMES Study 36-Item Short-Form Health Survey (SF-36), and the Unified Parkinson Disease Rating Scale (UPDRS) in people with parkinsonism. SUBJECTS Thirty-seven community-dwelling adults with parkinsonism (mean age=71 years) participated. The Hoehn and Yahr Scale median score of 2 was on the lower end of the scale; however, the scores ranged from 1 to 4. METHODS Subjects were tested twice by the same raters, with 1 week between tests. Test-retest reliability was calculated using intraclass correlation coefficients (ICCs). Minimal detectable change was calculated using a 95% confidence interval (MDC(95)). RESULTS The ICCs for test-retest reliability were above .90 for the BBS, ABC Scale, SRT with eyes closed, 6MWT, and comfortable and fast gait speeds. The MDC(95) values for those functional tests were: BBS=5/56, ABC Scale=13%, SRT with eyes closed=19 seconds, 6MWT=82 m, comfortable gait speed=0.18 m/s, and fast gait speed=0.25 m/s. The ICCs for test-retest reliability of SF-36 scores were above .80, with the exception of the social functioning subscale. The MDC(95) values for the SF-36 ranged between 19% and 45%. The MDC(95) values for the UPDRS Activities of Daily Living section, Motor Examination section, and total scores were 4/52, 11/108, and 13/176, respectively. DISCUSSION AND CONCLUSION Minimal detectable change values are useful to therapists in rehabilitation and wellness programs in determining whether change during or after intervention is clinically significant. High test-retest reliability of scores for the BBS, ABC Scale, SRT with eyes closed, 6MWT, and gait speed make them trustworthy functional assessments in people with parkinsonism. The SF-36 and UPDRS provide quality-of-life and disease severity rating values in the ongoing assessment of people with parkinsonism.
Collapse
|
44
|
Brodin N, Eurenius E, Jensen I, Nisell R, Opava CH. Coaching patients with early rheumatoid arthritis to healthy physical activity: A multicenter, randomized, controlled study. ACTA ACUST UNITED AC 2008; 59:325-31. [PMID: 18311770 DOI: 10.1002/art.23327] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
45
|
Auger C, Demers L, Desrosiers J, Giroux F, Ska B, Wolfson C. Applicability of a toolkit for geriatric rehabilitation outcomes. Disabil Rehabil 2007; 29:97-109. [PMID: 17364761 DOI: 10.1080/09638280600731540] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To field test the applicability of a multidimensional toolkit for geriatric rehabilitation outcomes which includes nine standardized tools. Applicability is defined as context- and population-specific pragmatic qualities of an assessment tool such as respondent and examiner burden, score distribution and format compatibility. METHOD A sample of 48 older adults representing four diagnostic groups, as well as 26 caregivers, were assessed at home in the first month after discharge from intensive rehabilitation (T1) and 2 months later (T2). Pre-determined qualitative and quantitative applicability criteria were coded and compared at T1 and T2, as well as responsiveness. RESULTS A higher respondent burden was found for three self-report tools, as well as a ceiling effect on social functioning tools. Respondent burden, examiner burden and score distribution remained stable or diminished at T2. Format compatibility deteriorated only for the mobility test due to a higher proportion of non ambulatory participants (17%). Low to moderate associations between the tools corroborated that they were not redundant (rPearson <or= 0.77). Responsiveness estimates confirmed that mean scores were stable between T1 and T2. CONCLUSION Overall, the toolkit was found to be applicable at home after geriatric rehabilitation. Modifications are proposed to further improve its applicability. This study highlighted practical aspects that could alleviate the burden on research participants and facilitate the use of those tools for community follow-up for clinical and research purposes.
Collapse
Affiliation(s)
- Claudine Auger
- Research Centre, Montréal Geriatric University Institute, Canada.
| | | | | | | | | | | |
Collapse
|
46
|
Halsaa KE, Brovold T, Graver V, Sandvik L, Bergland A. Assessments of Interrater Reliability and Internal Consistency of the Norwegian Version of the Berg Balance Scale. Arch Phys Med Rehabil 2007; 88:94-8. [PMID: 17207682 DOI: 10.1016/j.apmr.2006.10.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the interrater reliability and the internal consistency of the Norwegian version of the Berg Balance Scale (BBS) when applied to patients in a geriatric department. DESIGN Interrater reliability was measured using the kappa statistics and intraclass correlation coefficients (ICCs). SETTING Geriatric rehabilitation unit and geriatric day hospital in Norway. PARTICIPANTS Eighty-three patients were included; 25 were inpatients in a geriatric rehabilitation unit, whereas 58 were admitted to a geriatric day hospital. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The BBS. RESULTS The kappa values for the different BBS items varied from 0.83 to 1.00, and the ICC for the sum score of the BBS was .998 (95% confidence interval, .996-.999). The mean value of the BBS was 44.4. There was a negative significant relation between age and the sum score (r=-.36). The sum scores of BBS ranged from 12 to 56. The patients were able to perform the BBS without ceiling effect. The score values 3 and 4 were more frequently used than the score values 0, 1, and 2. CONCLUSIONS The Norwegian version of the BBS seems to have an excellent interrater reliability and high internal consistency when applied to patients in geriatric rehabilitation.
Collapse
Affiliation(s)
- Karin E Halsaa
- Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway.
| | | | | | | | | |
Collapse
|
47
|
Auger C, Demers L, Swaine B. Making sense of pragmatic criteria for the selection of geriatric rehabilitation measurement tools. Arch Gerontol Geriatr 2006; 43:65-83. [PMID: 16257067 DOI: 10.1016/j.archger.2005.09.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Revised: 08/31/2005] [Accepted: 09/10/2005] [Indexed: 11/28/2022]
Abstract
In geriatric rehabilitation, the selection of the most appropriate measurement tools involves pragmatic as well as psychometric considerations. However, there is no consensus about the conceptual and operational definitions of the pragmatic criteria involved in this selection. The objective of this research was to identify such operational criteria through a literature search between 1995 and 2004. Results identified operational criteria that were grouped under four categories using a conceptual mapping methodology: respondent burden, examiner burden, score distribution and format compatibility. We recommend the umbrella term applicability to refer to this grouping of pragmatic qualities of a measurement tool. Examining the applicability of measurement tools should assist clinicians and researchers in selecting the most appropriate for use in geriatric rehabilitation.
Collapse
Affiliation(s)
- Claudine Auger
- Research Center, Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Road, Montreal, Que., Canada H3W 1W5.
| | | | | |
Collapse
|
48
|
Wang CY, Hsieh CL, Olson SL, Wang CH, Sheu CF, Liang CC. Psychometric Properties of the Berg Balance Scale in a Community-dwelling Elderly Resident Population in Taiwan. J Formos Med Assoc 2006; 105:992-1000. [PMID: 17185241 DOI: 10.1016/s0929-6646(09)60283-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND/PURPOSE To investigate the psychometric properties (acceptability, internal consistency reliability, interrater reliability, construct validity) and identify the most challenging items of the Berg Balance Scale (BBS) for elderly people living in the community. METHODS A total of 268 community-dwelling adults 65 years of age or older volunteered to participate in this study. Each subject's performance was assessed with the BBS, timed up and go (TUG) test, and usual gait speed. For testing interrater reliability, the other 68 community-dwelling older adults who met the criteria were also recruited. RESULTS The BBS demonstrated good internal consistency reliability (Cronbach's alpha = 0.77), good interrater reliability (ICC(2,1) = 0.87), and moderate correlation with the TUG and usual gait speed (Spearman's rho = -0.53 and 0.46, respectively). The BBS score of the mobility/IADL (instrumented activities of daily living) able group was also significantly higher than that of the disabled group. Among all items on the BBS, tandem stance (item 13) and one-legged stance (item 14) were found to be the most challenging items for the subjects in the sample. CONCLUSION The results of this study suggest that the internal consistency reliability, interrater reliability, and construct validity of the BBS are adequate for measuring balance in community-dwelling older adults. Among all items in the BBS, the tandem stance and one-legged stance are the most challenging items. Further study of their applicability for screening use in the community is warranted.
Collapse
Affiliation(s)
- Ching-Yi Wang
- Department of Physical Therapy, Tzu-Chi College of Technology, Hualien, Taiwan.
| | | | | | | | | | | |
Collapse
|
49
|
Christie A, Fongen C. Thai Chi may be safe though ineffective for rheumatoid arthritis. ACTA ACUST UNITED AC 2005; 51:267. [PMID: 16358449 DOI: 10.1016/s0004-9514(05)70013-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anne Christie
- National Resource Centre for Rehabilitation in Rheumatology, Norway
| | | |
Collapse
|
50
|
de Kleijn P, van Genderen FR, van Meeteren NLU. Assessing functional health status in adults with haemophilia: towards a preliminary core set of clinimetric instruments based on a literature search in Rheumatoid Arthritis and Osteoarthritis. Haemophilia 2005; 11:308-18. [PMID: 16011581 DOI: 10.1111/j.1365-2516.2005.01117.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
People with haemophilia experience a progressive deterioration of their functional health status. Regular clinical assessment of functional health status provides insight into their process of disablement. As such, the development of a core-set of measurement tools is warranted. The aim of this study was to gather data to prepare a (preliminary) core set of clinically relevant and feasible instruments to assess the functional health status of adults with haemophilia, and to indicate their psychometric qualities. Therefore, clinimetric instruments frequently used in two haemophilia-resembling diseases (Rheumatoid Arthritis and Osteoarthritis) were reviewed from the literature. An extensive search in Medline yielded 13 relevant review articles, incorporating a total of 182 instruments, of which 40 were appropriate for haemophilia. Of these 40 instruments 3 measure body structures, 13 body functions, 19 activities (of which 5 are performance based and 14 self-report based), and 3 measure participation. This classification is based on the International Classification of Functioning, Disability and Health. Detailed information regarding the psychometrics (reliability, validity and responsiveness) of four instruments is described fully in the literature, whereas the psychometrics of the majority of the other instruments are only partly described. The results of this literature study may contribute to the formation of a (preliminary) core set of clinimetric instruments to assess the functional health status of adults with haemophilia. Decisions on the final core set should be held within the Musculoskeletal Committee of the World Federation of Haemophilia.
Collapse
Affiliation(s)
- P de Kleijn
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | | |
Collapse
|