1
|
Cheng KC, Lau KMK, Cheng ASK, Lau TSK, Lau FOT, Lau MCH, Law SW. Use of mobile app to enhance functional outcomes and adherence of home-based rehabilitation program for elderly with hip fracture: A randomized controlled trial. Hong Kong Physiother J 2022; 42:99-110. [PMID: 37560168 PMCID: PMC10406639 DOI: 10.1142/s101370252250010x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/11/2022] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Mobile app has been used to improve exercise adherence and outcomes in populations with different health conditions. However, the effectiveness of mobile app in delivering home-based rehabilitation program to elderly patients with hip fracture is unclear. OBJECTIVE The aim of this study was to test the effectiveness of mobile app in delivering home-based rehabilitation program for improving functional outcomes and reducing caregiver stress with enhancing adherence among the elderly patients with hip fracture. METHODS A randomized controlled trial with an intervention period of two months was performed. Eligible participants were randomized into either experimental group with home-based rehabilitation program using a mobile app or control group with home-based rehabilitation program using an exercise pamphlet. Primary outcomes were Modified Functional Ambulatory Category (MFAC), Elderly Mobility Scale (EMS) and Lower Extremity Functional Scale (LEFS). Secondary outcomes were exercise adherence and Modified Caregiver Strain Index (M-CSI). The outcomes were collected at pre-discharge training session, one month and two months after hospital discharge. RESULTS A total of 50 participants were enrolled, with 19 participants in the experimental group and 20 participants in the control group. Eleven participants had withdrawn from the study. The experimental group showed higher exercise adherence than the control group in first month (p = 0 . 03 ). There were no between-group differences in MFAC, EMS, LEFS and M-CSI at the first month and second month. CONCLUSION Use of the mobile app improved exercise adherence, yet it did not improve physical performance, self-efficacy and reduce caregiver stress when compared to a standard home rehabilitation program for elderly patients with hip fracture. Further studies to investigate the benefits of mobile apps are required. (ClinicalTrials.gov ID: NCT04053348.).
Collapse
Affiliation(s)
- Kui Ching Cheng
- Physiotherapy Department, Tai Po Hospital, 9 Chuen on Road, Tai Po New Territories, Hong Kong SAR, China
| | - Kin Ming Ken Lau
- Physiotherapy Department, Tung Wah Eastern Hospital 19 Eastern Hospital Road, Causeway Bay, Hong Kong SAR, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences The Hong Kong Polytechnic University, 11 Yuk Choi Road Hung Hom, Kowloon, Hong Kong SAR, China
| | - Tin Sing Keith Lau
- Physiotherapy Department, Tai Po Hospital, 9 Chuen on Road, Tai Po New Territories, Hong Kong SAR, China
| | - Fuk On Titanic Lau
- Physiotherapy Department, Tai Po Hospital, 9 Chuen on Road, Tai Po New Territories, Hong Kong SAR, China
| | - Mun Cheung Herman Lau
- CUHK Medical Centre, 9 Chak Cheung Street Shatin, New Territories, Hong Kong SAR, China
| | - Sheung Wai Law
- Department of Orthopaedics and Traumatology CUHK Medical Centre, 9 Chak Cheung Street Shatin, New Territories, Hong Kong SAR, China
| |
Collapse
|
2
|
Lin CI, Mayer F, Wippert PM. Cross-cultural adaptation, reliability, and validation of the Taiwan-Chinese version of Cumberland Ankle Instability Tool. Disabil Rehabil 2020; 44:781-787. [PMID: 32539475 DOI: 10.1080/09638288.2020.1774928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose: To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chinese version (CAIT-TW), and to evaluate the validity, reliability and cutoff score of CAIT-TW for Taiwan-Chinese athletic population.Materials and methods: The English version of CAIT was translated to CAIT-TW based on a guideline of cross-cultural adaptation. 77 and 58 Taiwanese collegial athletes with and without chronic ankle instability filled out CAIT-TW, Taiwan-Chinese version of Lower Extremity Functional Score (LEFS-TW) and Numeric Rating Scale (NRS). The construct validity, test-retest reliability, internal consistency and cutoff score of CAIT-TW were evaluated.Results: In construct validity, the Spearman's correlation coefficients were moderate (CAIT-TW vs LEFS-TW: Rho = 0.39, p < 0.001) and strong (CAIT-TW vs NRS: Rho= 0.76, p < 0.001). The test retest reliability was excellent (ICC2.1 = 0.91, 95% confidential interval = 0.87-0.94, p < 0.001) with a good internal consistency (Cronbach's α: 0.87). Receiver operating characteristic curve showed a cutoff score of 21.5 (Youden index: 0.73, sensitivity: 0.87, specificity 0.85).Conclusions: The CAIT-TW is a valid and reliable tool to differentiate between stable and instable ankles in athletes and may further apply for research or daily practice in Taiwan.Implications for rehabilitationFor athletes, chronic ankle instability is prevalent and causes negative sequela, such as lowered quality of daily life, affected functional performance, and may cause post traumatic osteoarthritis.The psychometric properties of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool showed moderate to strong construct validity, excellent test retest reliability, a good internal consistency and a cutoff score of 21.5.The validity and reliability of the Taiwan-Chinese version of the Cumberland Ankle Instability Tool are to enable clinicians to evaluate and manage ankle instability in Taiwanese who speaks Mandarin Chinese.
Collapse
Affiliation(s)
- Chiao-I Lin
- Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Frank Mayer
- University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Potsdam, Germany
| | - Pia-Maria Wippert
- Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| |
Collapse
|
3
|
Cross-cultural adaption and validation of simplified Chinese version of the lower extremity function scale in patients with knee osteoarthritis. Clin Rheumatol 2020; 39:3041-3048. [PMID: 32318972 DOI: 10.1007/s10067-020-05077-5] [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: 01/10/2020] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The lower extremity function scale (LEFS) is widely used to investigate patients' functional status due to musculoskeletal dysfunction of the lower extremity. The aims of this study were to translate and cross-culturally adapt the LEFS into simplified Chinese (SC-LEFS) and evaluate the psychometric properties in patients with knee osteoarthritis (OA). METHODS The SC-LEFS was translated and cross-culturally adapted on the basis of guideline. Patients scheduled for knee arthroplasty (108) were invited in this study. The Cronbach's alpha coefficient was employed to assess the internal consistency. The test-retest reliability was determined by intra-class correlation coefficient (ICC). Pearson's correlation coefficient was detected to evaluate the criterion validity between the SC-LEFS and WOMAC/SF-36/range of motion (ROM). Construct validity was assessed by exploratory factorial analysis. Additionally, responsiveness analysis was conducted with effect size (ES) and standardized response mean (SRM). RESULTS The results revealed good internal consistency (Cronbach's alpha = 0.975) and good test-retest reliability (ICC = 0.937). Strong correlations were observed between the SC-LEFS and WOMAC pain/function/total, physical component summary of SF-36, and ROM. We confirmed the SC-LEFS as a two-factor structure with factor 1 and factor 2 explaining 73.781% and 5.546% of the variance, respectively. The ES (1.74) and SRM (1.95) indicated a good responsiveness. CONCLUSIONS The SC-LEFS has been nicely adapted into simplified Chinese. It was proved to be reliable and valid for knee OA patients from China mainland who are undergoing arthroplasty. Furthermore, additional research should be conducted to assess these findings in other dysfunctions of lower extremity in a larger sample size. Key Points • The present study firstly cross-culturally adapted the lower extremity function scale (LEFS) into simplified Chinese and applied for patients with knee osteoarthritis in China mainland. • The psychometric properties including reliability, validity, and responsiveness were evaluated in SC-LEFS. • The SC-LEFS turned out to be a reliable and valid tool for clinical physicians and researchers assessing patients with knee osteoarthritis.
Collapse
|
4
|
Alnahdi AH. Measurement properties of the 15-item Arabic lower extremity functional scale. Disabil Rehabil 2020; 43:3839-3844. [DOI: 10.1080/09638288.2020.1754927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Ali H. Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Lourduraj DB, Barnawal SP, Pattabi K, Gnanasekaran V, Sadhasivam A, Vinod KS, Sharma D, Jayaram Y. Application of the Lower Extremity Functional Scale and Its Correlation with Lymphedema Health-Related Quality of Life on Lower Limb Filarial Lymphedema Patients. Lymphat Res Biol 2019; 18:254-260. [PMID: 31532703 PMCID: PMC7310210 DOI: 10.1089/lrb.2019.0045] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: This study carried out as a part of the lymphedema (LE)—osteoarthritis project to know the feasibility and applicability of lower extremity functional scale (LEFS) and LE health-related quality of life (LEHRQoL) among filarial LE patients of the lower extremity. Materials and Methods: Following inclusion and exclusion criteria 30 LE patients and 30 controls were recruited in the study. After obtaining informed written consent, Tamil version of the two “self-reporting assessment tools” LEFS and LEHRQoL were applied to all the participants by two examiners independently. Feasibility was assessed by the time schedule. Internal consistency and the correlation between two examiners was assessed by calculating Cronbach's alpha and Karl Pearson correlation coefficient and Spearman rank correlation respectively. Results: The mean time taken for completing the LEFS and LEHRQoL questionnaire was 5 minutes and 2 seconds and 12 minutes and 8 seconds respectively. Internal consistency reliability assessment showed good internal consistency for both the examiners (Cronbach's alpha 0.816 and 0.812). There was a strong positive correlation for the cases (r = 0.956, p < 0.001; r = 0.908, p < 0.001) and controls (r = 0.992, p < 0.001; r = 0.985, p < 0.001) between the two examiners. Conclusions: LEFS and LEHRQoL were well accepted among filarial LE patients and the patients with low literacy were able to respond without any difficulty to both assessment tools. LEFS was found suitable for the assessment of lower extremity functions of the LE patients as in other diseases affecting the lower limb and it also indirectly brought out the impact on the QoL.
Collapse
Affiliation(s)
- De Britto Lourduraj
- Unit of Clinical Epidemiology and Chemotherapy, Vector Control Research Centre, Indian Council of Medical Research (ICMR), Pondicherry, India
| | | | - Kamaraj Pattabi
- Division of Epidemiology & Biostatistics, National Institute of Epidemiology-ICMR, Chennai, India
| | - Vijayalakshmi Gnanasekaran
- Unit of Clinical Epidemiology and Chemotherapy, Vector Control Research Centre, Indian Council of Medical Research (ICMR), Pondicherry, India
| | - Anbusivam Sadhasivam
- Unit of Clinical Epidemiology and Chemotherapy, Vector Control Research Centre, Indian Council of Medical Research (ICMR), Pondicherry, India
| | - K Supriya Vinod
- College of Physiotherapy, Mother Theresa Post Graduate and Research Institute of Health Sciences, Pondicherry, India
| | - Deep Sharma
- Department of Orthopaedics, JIPMER, Pondicherry, India
| | - Yuvaraj Jayaram
- Division of Epidemiology & Biostatistics, National Institute of Epidemiology-ICMR, Chennai, India
| |
Collapse
|
6
|
Huang JS, Hong ZN, Sun KP, Cao H, Chen Q. Effect of the Different Mechanical Mitral Valve Sounds on the Patients' Quality of Life. Thorac Cardiovasc Surg 2019; 68:492-497. [PMID: 31491792 DOI: 10.1055/s-0039-1695788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The purpose of this study was to compare the opening and closing sounds of three different mechanical mitral valves and to analyze their effects on the quality of life of patients. METHODS Ninety patients who underwent mechanical mitral valve replacement (MVR) were divided into three groups: those who received Advancing the Standard (ATS), St. Jude Medical (SJM), or Carbomedics (CM) mechanical valves. The sound pressure of the different valves was measured with a microphone. A detailed, self-designed questionnaire with a 1 to 10 analog scale and the 36-item Short Form Health Survey (SF-36) score was used to assess the quality of life of the patients. RESULT The sound pressure measured by ATS was 64.4 ± 3.1 dB, while that measured by SJM, and CM was 64.5 ± 4.7 and 67.2 ± 5.3 dB, respectively. The overall subjective interference score in the ATS group was the lowest compared with that in the SJM and CM groups (ATS: 1.3 ± 0.9 dB, SJM: 3.9 ± 1.6 dB, CM: 4.1 ± 1.5 dB). Relatives and nonfamily members of the ATS group also had the lowest analog scale scores. Specific questions showed that the ATS valve had the least impact on sleep and daily life (impact on sleep: ATS: 4/30, SJM: 9/30, CM: 11/30, impact on daily life: ATS: 2/30, SJM: 8/30, CM: 8/30). The SF-36 score showed that there were significant differences in social functioning, role-emotional, mental health, and vitality. CONCLUSION Patients receiving ATS mechanical MVR may be less disturbed by valve noise than those receiving SJM or CM mechanical MVR in a single Chinese cardiac center.
Collapse
Affiliation(s)
- Jiang-Shan Huang
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Zhi-Nuan Hong
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Kai-Peng Sun
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Qiang Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| |
Collapse
|
7
|
Çankaya M, Karakaya İÇ, Karakaya MG. Reliability and validity of the Turkish version of the Lower Extremity Functional Scale in patients with different lower limb musculoskeletal dysfunctions. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2018.0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Lower extremity functional scales in Turkish are limited in number and generalisability. The aims of this study were to translate the Lower Extremity Functional Scale into Turkish, and to investigate its reliability and validity in patients with different musculoskeletal conditions in their lower extremities. Methods The Turkish Lower Extremity Functional Scale, Visual Analogue Scale and Timed Up and Go test were administered in 256 outpatients with a re-test after 24–48 hours. Internal consistency, test–retest reliability, construct validity, factor structure and floor-ceiling effects were investigated. Findings The Scale has good reliability and validity. The Spearman correlation coefficient was 0.91 and intraclass correlation coefficient was 0.923. The standard error of measurement value was 4.015 and internal consistency coefficient was 0.92. Item-total correlation values were 0.46–0.74. It had a 3-factor structure, explaining 58.51% of the total variance and the eigenvalues were 1.04–8.26. It had no floor and ceiling effects, and was negatively correlated with the Visual Analogue Scale and Timed Up and Go test (P=0.000). Conclusions The Turkish Lower Extremity Functional Scale is a reliable and valid tool to be used in participants with lower extremity musculoskeletal dysfunctions. Evaluation of its responsiveness and minimal clinically important difference in future studies would have a great value.
Collapse
Affiliation(s)
- Musa Çankaya
- Research Assistant, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - İlkim Çıtak Karakaya
- Professor, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mehmet Gürhan Karakaya
- Professor, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Turkey
| |
Collapse
|
8
|
Korakakis V, Saretsky M, Whiteley R, Azzopardi MC, Klauznicer J, Itani A, Al Sayrafi O, Giakas G, Malliaropoulos N. Translation into modern standard Arabic, cross-cultural adaptation and psychometric properties' evaluation of the Lower Extremity Functional Scale (LEFS) in Arabic-speaking athletes with Anterior Cruciate Ligament (ACL) injury. PLoS One 2019; 14:e0217791. [PMID: 31181087 PMCID: PMC6557503 DOI: 10.1371/journal.pone.0217791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Lower Extremity Functional Scale evaluates the functional status of patients that have lower extremity conditions of musculoskeletal origin. Regional Arabic dialects often create barriers to clear communication and comparative research. We aimed to cross-culturally adapt the Lower Extremity Functional Scale in modern standard Arabic that is widely used and understood in the Middle East and North Africa region, and assess its psychometric properties. METHODS Cross-cultural adaptation followed a combination of recommended guidelines. For psychometric evaluation 150 patients with anterior cruciate ligament injury and 65 asymptomatic individuals were recruited. All measurement properties as indicated by the Consensus-based Standards for the selection of health status Measurement Instruments recommendations were evaluated, including content-relevance analysis, structural validity, longitudinal reproducibility, anchor- and distribution-based methods of responsiveness, as well as the longitudinal pattern of change of Lower Extremity Functional Scale in anterior cruciate ligament injured patients' functional status. RESULTS The questionnaire presented excellent internal consistency (α = 0.96), reliability (0.80-0.98), and good convergent validity (ρ = 0.85). For reproducibility testing: minimal detectable change was 9.26 points; for responsiveness assessment: minimal clinically important difference was 9 points and presented moderate effect sizes (Glass'Δ = 0.71, Cohen's d = 0.81). Its unidimensionality was not confirmed and an exploratory factor analysis indicated a 2-factor solution explaining 78.1% of the variance. CONCLUSION The Arabic Lower Extremity Functional Scale presented acceptable psychometric properties comparable to the original version. The Arabic version of Lower Extremity Functional Scale can be used in research and clinical practice to assess the functional status of Arabic-patients suffering an anterior cruciate ligament injury.
Collapse
Affiliation(s)
- Vasileios Korakakis
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
- * E-mail:
| | | | - Rodney Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | | | - Abdallah Itani
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Omar Al Sayrafi
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Giannis Giakas
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Nikolaos Malliaropoulos
- Sports and Exercise Medicine Clinic, Thessaloniki, Greece
- National Track & Field Centre, Sports Medicine Clinic, Thessaloniki, Greece
- European Sports Care, London, United Kingdom
| |
Collapse
|
9
|
Horng YS, Hou WH, Liang HW. Responsiveness of the modified lower extremity functional scale in patients with low back pain and sciatica: A comparison with pain intensity and the modified Roland-Morris Disability Scale. Medicine (Baltimore) 2019; 98:e15105. [PMID: 30946376 PMCID: PMC6455991 DOI: 10.1097/md.0000000000015105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
We tested the responsiveness of the modified Lower Extremity Functional Scale (LEFS) for patients with low back pain (LBP) and sciatica and made a comparison with the modified Roland-Morris Disability Scale for sciatica (RMS-L) and self-reported pain intensity measured by visual analogue scale (VAS).One hundred and forty-eight participants were recruited from 2 university hospitals. The evaluation included demographic data, LBP history, and the modified LEFS, RMS-L, and VAS, with a follow-up one month later. Several responsiveness statistics were calculated.The study followed 132 participants, approximately 25% reported improvement. Guyatt responsiveness index (GRI) was 0.8 or higher for 3 measures, while standardized response means were 0.8 or higher for the RMS-L and VAS, but only 0.6 for the modified LEFS among improved group. According to ROC analysis, the modified LEFS had an area under curve (AUC) similar to that of the modified RMS-L, but significantly smaller than that of the VAS.The responsiveness of the modified LEFS was moderate but not superior to the VAS or RMS-L. Although, the modified LEFS could not replace the RMS-L or VAS, it could still be used as a complementary measure since these three measurements covered different body function, activity and participation domains.
Collapse
Affiliation(s)
- Yi-Shiung Horng
- Department of Rehabilitation Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, New Taipei City
- Department of Medicine, Tzu Chi University, Hualien
| | - Wen-Hsuan Hou
- School of Gerontology Health Management and Master Program in Long-Term Care, College of Nursing, Taipei Medical University
| | - Huey-Wen Liang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC
| |
Collapse
|
10
|
Hsu CY, Tsai YS, Yau CS, Shie HH, Wu CM. Differences in gait and trunk movement between patients after ankle fracture and healthy subjects. Biomed Eng Online 2019; 18:26. [PMID: 30890177 PMCID: PMC6425625 DOI: 10.1186/s12938-019-0644-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/11/2019] [Indexed: 12/15/2022] Open
Abstract
Background Studies have shown that gait asymmetry and activity limitation can persist several months or years after ankle fracture. However, evidence of gait and trunk movement patterns following ankle fracture during the early rehabilitation period is scarce. Thus, we compared gait patterns and trunk movement during the early phase of rehabilitation between patients with ankle fracture and matched controls. Methods Ten patients with ankle fractures, and ten age- and sex-matched healthy controls were prospectively enrolled. An automated infrared-assisted, trunk accelerometer-based gait analysis system was used to measure walking speed, step length, and cadence. The median time of the evaluation following ankle fracture was 4.0 months. Trunk movement intensity was evaluated as acceleration root mean square. Trunk movement symmetry and regularity were analysed using the autocorrelation method. Differences in gait characteristics between the patient and control groups were analysed using the Mann–Whitney U test. Follow-up assessment of falls was performed 24 months after the fracture. The correlations between Lower Extremity Functional Scale (LEFS) scores/falls and gait parameters were evaluated using Spearman’s rank correlation coefficient. Results Walking speed (p = 0.019), step length (p = 0.023), cadence (p = 0.003), and trunk movement intensity in anterior–posterior and vertical axis (p = 0.001, p = 0.003, respectively) were all significantly lower in the ankle fracture group than in the control group. Trunk movement symmetry in vertical direction (p = 0.019) decreased significantly in patients with ankle fractures, whereas between-strides regularity did not differ between groups. LEFS scores were moderately correlated with walking speed (r = 0.60, p = 0.044) and step length (r = 0.68, p = 0.021). During the 24 months after the fracture, 3 falls were reported by 3 patients. Trunk acceleration root mean square ratio in mediolateral axis (r = 0.72, p = 0.018) was highly correlated with future falls. Conclusion During early rehabilitation, patients with ankle fracture may develop trunk movement asymmetry in the vertical direction accompanied with slower walking speed and cadence, and smaller step lengths, which can contribute to muscular imbalances and potential injury. Thus, proper rehabilitation strategies should be employed for these patients.
Collapse
Affiliation(s)
- Chia-Yu Hsu
- Department of Rehabilitation Medicine, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan.,Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC)
| | - Yuh-Show Tsai
- Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC).
| | - Cheng-Shiang Yau
- Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC)
| | - Hung-Hai Shie
- Department of Physiotherapy, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan
| | - Chu-Ming Wu
- Department of Rehabilitation Medicine, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan
| |
Collapse
|
11
|
Morris R, Pallister I, Trickett RW. Measuring outcomes following tibial fracture. Injury 2019; 50:521-533. [PMID: 30482409 DOI: 10.1016/j.injury.2018.11.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/31/2018] [Accepted: 11/08/2018] [Indexed: 02/02/2023]
Abstract
AIM The aim of this study was to determine how outcome is measured following adult tibial fracture in the modern era of functional outcome measurement and patient reported outcomes. METHODS A systematic review of publications since 2009 was performed, looking specifically at acute, adult tibial shaft fractures. Ovid Medline, Embase, PubMed and PsycINFO databases were searched for relevant titles which were then screened by two authors with adjudication where necessary by a third. Relevant articles were reviewed in full and data was extracted concerning the study participants, study design and any measures that were used to quantify the results following fracture. The results were collated and patient reported outcome measures were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) standards. RESULTS A total of 943 titles and articles were reviewed, with 117 included for full analysis. A wide range of clinical and radiological "outcomes" were described, along with named clinician- and patient-reported outcome measures. There was considerable heterogeneity and lack of detail in the description of the simplest outcomes, such as union, infection or reoperation. Reported clinician and patient reported outcome measures are variably used. None of the identified patient reported outcome measures have been validated for use following tibial fracture. CONCLUSION We recommend definition of a core outcome set for use following tibial fracture. This will standardise outcome reporting following these injuries. Furthermore, there is need for a validated patient reported outcome measure to better assess patient important outcomes in this patient group.
Collapse
Affiliation(s)
- R Morris
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK
| | - I Pallister
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK
| | - R W Trickett
- Department of Trauma & Orthopaedics, Abertawe Bro Morgannwg University Health Board, Morriston Hospital, Swansea, SA6 6NL, UK.
| |
Collapse
|
12
|
Repo JP, Tukiainen EJ, Roine RP, Sampo M, Sandelin H, Häkkinen AH. Rasch analysis of the Lower Extremity Functional Scale for foot and ankle patients. Disabil Rehabil 2018; 41:2965-2971. [DOI: 10.1080/09638288.2018.1483435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Jussi P. Repo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Erkki J. Tukiainen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Risto P. Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, HUS, Finland
- Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland
| | - Mika Sampo
- Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Henrik Sandelin
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, HUS, Finland
| | - Arja H. Häkkinen
- Department of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
| |
Collapse
|
13
|
Peng WC, Chang YP, Chao YH, Fu SN, Rolf C, Shih TT, Su SC, Wang HK. Morphomechanical alterations in the medial gastrocnemius muscle in patients with a repaired Achilles tendon: Associations with outcome measures. Clin Biomech (Bristol, Avon) 2017; 43:50-57. [PMID: 28208087 DOI: 10.1016/j.clinbiomech.2017.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/21/2016] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Functional deficits are found in ankles that have sustained an Achilles rupture. This study sought to evaluate and compare the morphomechanical characteristics of the medial gastrocnemius muscle in the legs of participants within six months of a unilateral Achilles repair to determine any correlations between those characteristics and objective outcomes and self-reported functional levels. METHODS Fifteen participants were assessed via measurements of muscle morphologies (fascicle length, pennation angle, and muscle thickness) in a resting state, the mechanical properties of the proximal aponeurosis of the medial gastrocnemius muscle, the pennation angle during ramping maximal voluntary isometric contractions (MVIC), the heel raise test, and the Taiwan Chinese version of the Lower Extremity Functional Scale (LEFS-TC) questionnaire. Findings Compared with the non-injured legs, the repaired legs showed a lower muscle fascicle length (mean 4.4 vs. 5.0cm) and thickness (1.7 vs. 1.9cm), lower stiffness of the GM tendon and aponeurosis (174.1 vs. 375.6N/mm), and a greater GM pennation angle (31.2 vs. 28.9°) during 90% MVIC (all p≤0.05). Correlations were found between the morphomechanical results and maximal heel raise heights or the LEFS-TC score, and between the symmetry ratios of the fascicle lengths and the LEFS-TC score. Interpretation There are decreases in fascicle length, muscle thickness and mechanical properties in the medial gastrocnemius muscles of the participants within the first six months after an Achilles repair. These morphomechanical alterations demonstrate associations with functional levels in the lower extremities and indicated the need for early mobilization of the calf muscles after the repair.
Collapse
Affiliation(s)
- Wei-Chen Peng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ping Chang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Yuan-Hung Chao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - S N Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Christer Rolf
- Department of Orthopaedics, Clintec, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tiffany Tf Shih
- Department of Medical Image, National Taiwan University Hospital, Department of Surgery, College of Medicine, National Taiwan University, Taiwan
| | - Sheng-Chu Su
- Department of Business Administration, Hwa Hsia Institute of Technology, Taipei, Taiwan
| | - Hsing-Kuo Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
14
|
Alnahdi AH. Rasch validation of the Arabic version of the lower extremity functional scale. Disabil Rehabil 2016; 40:353-359. [DOI: 10.1080/09638288.2016.1254285] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ali H. Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
15
|
Bravini E, Giordano A, Sartorio F, Ferriero G, Vercelli S. Rasch analysis of the Italian Lower Extremity Functional Scale: insights on dimensionality and suggestions for an improved 15-item version. Clin Rehabil 2016; 31:532-543. [DOI: 10.1177/0269215516647180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Elisabetta Bravini
- School in Advanced Sciences and Technology in Rehabilitation Medicine and Sport, Tor Vergata University, Rome, Italy
| | - Andrea Giordano
- Bioengineering, Salvatore Maugeri Foundation – IRCCS, Veruno (NO), Italy
| | - Francesco Sartorio
- Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation – IRCCS, Veruno (NO), Italy
| | - Giorgio Ferriero
- Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation – IRCCS, Veruno (NO), Italy
| | - Stefano Vercelli
- Unit of Occupational Rehabilitation and Ergonomics, Salvatore Maugeri Foundation – IRCCS, Veruno (NO), Italy
| |
Collapse
|
16
|
Repo JP, Tukiainen EJ, Roine RP, Ilves O, Järvenpää S, Häkkinen A. Reliability and validity of the Finnish version of the Lower Extremity Functional Scale (LEFS). Disabil Rehabil 2016; 39:1228-1234. [DOI: 10.1080/09638288.2016.1193230] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jussi P. Repo
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Erkki J. Tukiainen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto P. Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland
| | - Outi Ilves
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Salme Järvenpää
- Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Arja Häkkinen
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
| |
Collapse
|
17
|
Abstract
STUDY DESIGN Systematic review of measurement properties. BACKGROUND Many primary studies have examined the measurement properties, such as reliability, validity, and sensitivity to change, of the Lower Extremity Functional Scale (LEFS) in different clinical populations. A systematic review summarizing these properties for the LEFS may provide an important resource. OBJECTIVE To locate and synthesize evidence on the measurement properties of the LEFS and to discuss the clinical implications of the evidence. METHODS A literature search was conducted in 4 databases (PubMed, MEDLINE, Embase, and CINAHL), using predefined search terms. Two reviewers performed a critical appraisal of the included studies using a standardized assessment form. RESULTS A total of 27 studies were included in the review, of which 18 achieved a very good to excellent methodological quality level. The LEFS scores demonstrated excellent test-retest reliability (intraclass correlation coefficients ranging between 0.85 and 0.99) and demonstrated the expected relationships with measures assessing similar constructs (Pearson correlation coefficient values of greater than 0.7). The responsiveness of the LEFS scores was excellent, as suggested by consistently high effect sizes (greater than 0.8) in patients with different lower extremity conditions. Minimal detectable change at the 90% confidence level (MDC90) for the LEFS scores varied between 8.1 and 15.3 across different reassessment intervals in a wide range of patient populations. The pooled estimate of the MDC90 was 6 points and the minimal clinically important difference was 9 points in patients with lower extremity musculoskeletal conditions, which are indicative of true change and clinically meaningful change, respectively. CONCLUSION The results of this review support the reliability, validity, and responsiveness of the LEFS scores for assessing functional impairment in a wide array of patient groups with lower extremity musculoskeletal conditions.
Collapse
|
18
|
Confirmatory factor analysis of the Arabic version of the Lower Extremity Functional Scale. Int J Rehabil Res 2016; 39:36-41. [DOI: 10.1097/mrr.0000000000000141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Alnahdi AH, Alrashid GI, Alkhaldi HA, Aldali AZ. Cross-cultural adaptation, validity and reliability of the Arabic version of the Lower Extremity Functional Scale. Disabil Rehabil 2015; 38:897-904. [PMID: 26186622 DOI: 10.3109/09638288.2015.1066452] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The aim was to translate and cross-culturally adapt the Lower Extremity Functional Scale (LEFS) into Arabic language and to examine its measurement properties in patients with musculoskeletal disorders of the lower extremity. METHODS Standard forward and backward translation followed by expert committee review, then preliminary testing was carried out to produce the final Arabic version of LEFS (LEFS-Ar). The test-retest reliability, measurement error, internal consistency and construct validity of the LEFS-Ar were examined in patients with musculoskeletal disorders of the lower extremity (N = 116). RESULTS The LEFS-Ar had excellent test-retest reliability (ICC2,1 = 0.96). LEFS-Ar standard error of measurement was 3.5 points while the minimal detectable change MDC95 was 9.8 points. LEFS-Ar showed excellent internal consistency with Cronbach's alpha of 0.95. Parallel analysis and factor analysis showed that LEFS-Ar measures one underlying factor with all items loading heavily on this single factor. LEFS-Ar showed significant positive correlation with patient's global assessment of function (r = 0.59) and that patients recovering from surgery reported lower LEFS-Ar score compared to patients with no surgery further supporting the construct validity of the LEFS-Ar. CONCLUSION LEFS-Ar has excellent internal consistency, test-retest reliability with relatively small measurement error and is a valid measure of activity limitation due to lower extremity musculoskeletal disorders. All these measurement properties of the LEFS-Ar suggest the clinical usefulness of this measure. IMPLICATIONS FOR REHABILITATION The Arabic Lower Extremity Functional Scale (LEFS-Ar) is a reliable and valid measure of activity limitation due to lower extremity musculoskeletal disorders with relatively small measurement error. LEFS-Ar can be used in daily clinical practice and for research purposes to quantify activity limitation in Arabic-speaking individuals with lower extremity musculoskeletal disorders.
Collapse
Affiliation(s)
- Ali H Alnahdi
- a Department of Rehabilitation Sciences , College of Applied Medical Sciences, King Saud University , Riyadh , Saudi Arabia and
| | - Ghada I Alrashid
- b Department of Rehabilitation , King Khalid University Hospital, King Saud University , Riyadh , Saudi Arabia
| | - Hatem A Alkhaldi
- b Department of Rehabilitation , King Khalid University Hospital, King Saud University , Riyadh , Saudi Arabia
| | - Ali Z Aldali
- a Department of Rehabilitation Sciences , College of Applied Medical Sciences, King Saud University , Riyadh , Saudi Arabia and
| |
Collapse
|
20
|
Wu HC, Hsu CC, Huang BH, Wen SH. Update of the normative data for the Chinese Child Development Inventory for children over 3 years old. Tzu Chi Med J 2015. [DOI: 10.1016/j.tcmj.2015.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
21
|
Stasi S, Papathanasiou G, Korres N, Marinakis G, Chronopoulos E, Baltopoulos P, Papaioannou N. Validation of the Lower Extremity Functional Scale in community-dwelling elderly people (LEFS-Greek); determination of functional status cut-off points using TUG test. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|