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Cortes AA, Mombello FL, Aviles CJ, Corvalan M, Nuñez A, Carcuro U G, Escudero MI, Pellegrini MJ. Cross-cultural adaptation and validation of the Short Musculoskeletal Function Assessment (SMFA) into Spanish (Chile). Res Sports Med 2024; 32:556-566. [PMID: 36695507 DOI: 10.1080/15438627.2022.2163395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/21/2022] [Indexed: 01/26/2023]
Abstract
The purpose of this protocol was to adapt and validate the English version of the Short Musculoskeletal Function Assessment (SMFA) into Chilean Spanish according to the World Health Organisation guidelines. This is a cross-sectional study of 897 surveys of patients with non-traumatic surgical orthopaedic pathologies. We analysed internal consistency, validity, and acceptability, including correlation with the short form 36 (SF-36) medical score. The validation included 900 participants with a response rate of 99,66%, with excellent internal consistency (Cronbach's α = 0.962). The Dysfunction and Bother Index items showed a value of 0.952 and 0.884 respectively, eliminating one item in the Dysfunction sub-scale. The principal component analysis was forced to four factors explaining 55.5% of the variance. SMFA-CL sub-scales are significantly correlated with SF-36 components and subcomponents. The first version of the SMFA-CL version (Spanish-Chilean) scale is reported. This culturally adapted score demonstrated a high rate of reliability, validity, and ability to objectively evaluate foot and ankle pathologies.
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Affiliation(s)
- Aaron A Cortes
- Clinica Universidad de los Andes, Chile, Research Area, DIDeP
| | | | | | | | - Alfredo Nuñez
- Universidad de Chile Hospital Clinico, Orthopaedic Department, Chile
| | | | - Mario I Escudero
- Universidad de Chile Hospital Clinico, Orthopaedic Department, Chile
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Lindahl M, Juneja H. I'll be back - Predictive validity of adults' expectations for recovery after fractures - A longitudinal observational study. Injury 2023:S0020-1383(23)00246-2. [PMID: 36925373 DOI: 10.1016/j.injury.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Recovery after fractures due to accidents relates to all aspects of the biopsychosocial model. Therefore, it is difficult for the patients to foresee the consequences of the fractures. This study aimed to examine 1) patients' expectations regarding the impact of the injury on everyday life, 2) predictive validity of their expectations after six months, and 3) factors that predict a return to work. PATIENTS AND METHODS Patients were 18-64 years old and hospitalized with simple or compound/multiple fractures due to an accident. During admission, structured interviews were conducted with a questionnaire covering working conditions, expectations regarding recovery, sports, economy, family, household, and return to work. Additionally, mental and physical status were covered with Short Musculoskeletal Function Assessment questionnaire (SMFA) and Short Form 36, and working conditions were uncovered too. After six months, telephonic interviews were conducted with the 164 available patients to elucidate the impact of the fractures on everyday life, their health status, and sick leave. Likelihood ratios, post-test probabilities, and logistic regression analysis were performed to establish if patients' expectations predicted recovery, economy, sports, family, household, and return to work. RESULTS Few patients' baseline expectations about everyday life were met. The likelihood ratios were small, and the post-test probabilities for expectations consistent with outcomes were between 18% and 68%, with recovery as the lowest and participation in sports as the highest. In the multivariate analysis, patients' expectations did not predict short-term (less than two months) or long-term sick leave (more than three months). Self-rated health and the bother index of SMFA were significant short-term and long-term predictors for sick leave. Additionally, vitality, pain, and decision latitude at work predicted sick leave of less than two months. CONCLUSION A few days after the accident, patients' expectations about everyday life are not associated with outcomes six months later. Likelihood ratios indicate difficulties for the patients in predicting fractures' consequences on various aspects of everyday life. Return to work was associated with self-rated health and the bother index of SMFA. Future research should examine if fracture patients can benefit from comprehensive, individual counseling during admission to set appropriate expectations.
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Affiliation(s)
- Marianne Lindahl
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark.
| | - Hemant Juneja
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
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Lindahl M, Teljigović S, Nielsen NO. Six-months outcome after fracture for working-age persons analyzed using the International Classification of Functioning, Disability, and Health - a prospective cohort observational study. Physiother Theory Pract 2022:1-14. [PMID: 35257632 DOI: 10.1080/09593985.2022.2048932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fractures following trauma affect physical and mental health for working-age persons, and the International Classification of Functioning, Disability, and Health (ICF) can help therapists understand the fractures' impact on daily lives. PURPOSE To examine self-reported functioning and outcomes six months after upper and lower body fractures and compare limitations using the ICF. METHODS Data were collected from 160 patients with fractures as part of a prospective cohort study. The primary outcome measure was the Short Musculoskeletal Function Assessment questionnaire that covers all domains of the ICF. Moreover, sick leave, sense of coherence, and physical activity were reported. RESULTS Six months after the injury, function had improved significantly, but patients reported problems on all domains in the ICF with few differences between the upper and lower body groups. Leisure activities caused problems for 63 (38.8%) of the patients and bothered 86 (53.8%). Problems performing work bothered 63 (39.4%) with no significant difference between the groups, although a significantly higher proportion in the upper body group had returned to work within two months (p < .001). CONCLUSION Six months after fractures, adults reported problems on all ICF domains, especially on the participation dimension, which therapists should address in the rehabilitation process.
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Affiliation(s)
- Marianne Lindahl
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Sanel Teljigović
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
| | - Nina Odgaard Nielsen
- Center of Nutrition and Rehabilitation, University College Absalon, Roskilde, Denmark
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Teljigovic S, Søgaard K, Sandal LF, Dalager T, Nielsen NO, Sjøgaard G, Holm L. Individualised physical exercise training and enhanced protein intake in older citizens during municipality-based rehabilitation: protocol for a randomised controlled trial. BMJ Open 2020; 10:e041605. [PMID: 33243811 PMCID: PMC7692977 DOI: 10.1136/bmjopen-2020-041605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Successful rehabilitation of the growing number of older citizens receiving healthcare services can lead to preservation of functional independence and improvement in quality of life. Adequate intake of dietary protein and physical training are key factors in counteracting the age-related decline in strength performance and physical function. However, during rehabilitation, many older people/persons have insufficient protein intake, and difficulties in performing exercise training with sufficient intensity and volume. The primary aim of this trial is to investigate if individualised physical exercise training programmes combined with increased protein intake (IPET+P) can improve measures on all International Classification of Functioning, Disability and Health levels, such as strength, gait speed and health-related quality of life, when compared with care as usual in municipality-based rehabilitation alone (usual care, UC) or care as usual in combination with increased protein intake (UC+P). Further, the trial investigates whether UC+P will potentiate more significant improvements in outcome measures than UC. METHODS AND ANALYSIS The trial is a three-armed multicentre, block-randomised controlled trial consisting of a 12-week intervention period with a 1-year follow-up. Citizens above 65 years referred to rehabilitation in the municipality without restricting comorbidities are eligible. Participants are randomised to either a UC group, a UC group with protein supplementation receiving 27.5 g protein/day (UC+P), or an IPET+P supplementation of 27.5 g protein/day. The Short Musculoskeletal Function Assessment questionnaire is the primary outcome. ETHICS AND DISSEMINATION Approvals from The Ethics Committee in Region Zealand, Denmark (SJ-758), and the General Data Protection Regulation at the University of Southern Denmark, Odense (10.330) have been obtained. TRIAL REGISTRATION NUMBER NCT04091308.
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Affiliation(s)
- Sanel Teljigovic
- Department of Physiotherapy, University College Absalon, Naestved, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Louise Fleng Sandal
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Tina Dalager
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Holm
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Karaismailoglu B, Yetismis SC, Kaynak G, Karaismailoglu B. Reliability and validity of culturally adapted Turkish Short Musculoskeletal Function Assessment questionnaire (SMFA-TR). Int J Rheum Dis 2020; 23:928-938. [PMID: 32578961 DOI: 10.1111/1756-185x.13885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/23/2020] [Accepted: 05/24/2020] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to culturally adapt and validate the Turkish version of the Short Musculoskeletal Function Assessment Questionnaire (SMFA-TR) which primarily assesses the functional status of patients. METHODS The translation and cross-cultural adaptation of SMFA to Turkish was made by the standardized procedure and tested for clinimetric quality. The following analyses were made to evaluate clinimetric quality of the SMFA-TR: reliability with factor analysis and Chronbach's α (construct validity), correlations between SMFA-TR and Short Form (SF)-36 (concurrent validity), test-retest reliability (intraclass correlation analyses), floor and ceiling effects. The questionnaire was applied to 166 patients with musculoskeletal problems. All patients filled in the SMFA-TR and the validated Turkish SF-36 questionnaire. Forty-two patients returned to complete the same questionnaires at 10 days. RESULTS Factor analysis revealed a 4-factor structure of the SMFA-TR. Cronbach's α values were over 0.88 for both original subscales (dysfunction and bother) of the SMFA. Internal consistency (0.88-0.94) and test-retest reliability coefficients (0.90-0.98) were high for both subscales. Turkish SF-36 questionnaire conventional subscales showed significant correlations with SMFA-TR subscales. No floor or ceiling effects were found. CONCLUSION The Turkish version of the SMFA was found to be reliable and valid for Turkish-speaking patients with musculoskeletal injuries or disorders.
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Affiliation(s)
- Bedri Karaismailoglu
- Department of Orthopedics and Traumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Salih Candost Yetismis
- Department of Orthopedics and Traumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gokhan Kaynak
- Department of Orthopedics and Traumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Berna Karaismailoglu
- Department of Infectious Diseases and Clinical Microbiology, Ayancik State Hospital, Sinop, Turkey
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de Graaf MW, Reininga IHF, Wendt KW, Heineman E, El Moumni M. The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma. Clin Rehabil 2019; 33:923-935. [PMID: 30722686 PMCID: PMC6482597 DOI: 10.1177/0269215519828152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 01/11/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess test-retest reliability, construct validity and responsiveness of the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) in patients who sustained acute physical trauma. DESIGN A longitudinal cohort study. SETTING A level 1 trauma center in The Netherlands. SUBJECTS Patients who required hospital admission after sustaining an acute physical trauma. INTERVENTION Patients completed the SMFA-NL at six weeks, eight weeks and six months post-injury. MAIN MEASURE The measures used were The Dutch Short Musculoskeletal Function Assessment. Test-retest reliability (between six and eight weeks post-injury) using intraclass correlation coefficients, the smallest detectable change and Bland and Altman plots. Construct validity (six weeks post-injury) and responsiveness (between six weeks and six months post-injury) were evaluated using the hypothesis testing method. RESULTS A total of 248 patients (mean age: 46.5, SD: 13.4) participated, 145 patients completed the retest questionnaires (eight weeks) and 160 patients completed the responsiveness questionnaires (six months). The intraclass correlation coefficients indicated good to excellent reliability on all subscales (0.80 to 0.98). The smallest detectable change was 17.4 for the Upper Extremity Dysfunction subscale, 11.0 for the Lower Extremity Dysfunction subscales, 13.9 for the Problems with Daily Activities subscale and 16.5 for the Mental and Emotional Problems subscale. At group level, the smallest detectable change ranged from 1.48 to 1.96. A total of 86% of the construct validity hypotheses and 79% of the responsiveness hypotheses were confirmed. CONCLUSION This study showed that the SMFA-NL has good to excellent reliability, sufficient construct validity and is able to detect change in physical function over time.
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Affiliation(s)
- Max W de Graaf
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Inge HF Reininga
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Klaus W Wendt
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik Heineman
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mostafa El Moumni
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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de Graaf MW, Reininga IHF, Wendt KW, Heineman E, Moumni ME. Structural Validity of the Short Musculoskeletal Function Assessment in Patients With Injuries. Phys Ther 2018; 98:955-967. [PMID: 30107487 DOI: 10.1093/ptj/pzy098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 06/18/2018] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Short Musculoskeletal Function Assessment (SMFA) is a widely used patient-reported outcome measure, originally having 2 elements of outcome: the function index and the bother index. In multiple studies, it has been argued that the SMFA should be scored using 3, 4, or 6 subscales instead. Therefore, there is inconsistency with the number of underlying dimensions of the SMFA. OBJECTIVE The aim of this study was to evaluate the structural validity of the various proposed subscale configurations of the SMFA in a broad range of Dutch patients with injuries. DESIGN This study used a prospective cohort design. METHODS Participants with injuries were asked to complete the Dutch SMFA (SMFA-NL) at 5 to 8 weeks postinjury. The structural validity of the 6 different factor structures that have been proposed in other studies was evaluated using confirmatory factor analyses. Internal consistency was analyzed using Cronbach alpha. RESULTS A total of 491 patients participated (response rate = 74%). A 4-factor structure showed an acceptable fit (root-mean-square error of approximation [RMSEA] = 0.070, comparative fit index = 0.973, Tucker-Lewis index = 0.971). Other models, including the original 2-index structure, showed insufficient structural validity in Dutch patients with injuries. The 4-factor structure showed sufficient discriminant validity and good internal consistency (Cronbach alpha ≥ 0.83). LIMITATIONS It is unclear whether conclusions are generalizable across different countries, people who are elderly, and people without injuries. CONCLUSION In a broad range of patients with injuries, the SMFA-NL may be best scored and interpreted using a 4-factor structure. Other factor structures showed insufficient structural validity.
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Affiliation(s)
- Max W de Graaf
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, PO Box 30 001, 7900 RB Groningen, The Netherlands
| | - Inge H F Reininga
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen
| | - Klaus W Wendt
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen
| | - Erik Heineman
- Department of Surgery, University Medical Center Groningen, University of Groningen
| | - Mostafa El Moumni
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen
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